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PRE 2010 DOCS�] Community Development Department PLANNING DIVISION City of Fridley TO: Files of Harstad Townhomes FROM: -Michele McPherson, Planning Assistant DATE: August 19, 1994 SUBJECT: Building'Permit Issuance The Fridley .City Council approved the attached site plan at its August 15, 1994 meeting. In order for the development to proceed, a rezoning was approved for the east half of the project site: At the writing of this memo, 'the second reading of - the rezoning ordinance has not been conducted. The second reading and subsequent publication will notoccur until building permits have - been issued for the building adjacent to Fillmore Street.. Building permits are'to,-be issued for building plans as*ndicated on the enclosed'site plan. An increase in the number of units will require .review and approval by -the Fridley City`Council. Any decrease in density will be permitted, without review, by the City Council. Stipulated as a condition of the plat is that the petitioner is to petition for construction of a cul-de-sac at the end `of --Polk Street when building permits are applied for for 5531 and 5533 Polk Street. MM: ch M-94-484 I • at nN.u.wK ` p�c1n9 �O A v P O E ---y}� NOTE N "Um. a Ab poj d Rhoa EXCEPT "1 u. sba .wcay ...s w .eddy a e.we.E Planning Division Official Copy v� 6f � . A. r. «may � las) ra.am MATTKE ENGINEERING. INC. 7671 Cwttrd Avmwe NE. .ac Hillwind Townhome� Friday. MN 35432 IELE UtilityPlan (612) 783-0300 ERn a ^• scw 1 -gyp 4 6 ANT Y74 m Sam ON TOS PLAN 1 •..., -�, «. a1 � ..N.a. . n..n .n ww.. y � l.Ir . Aouaa. . mivoe . _ ARE ONLY APPRONN E % 0", 'm LOCATON AND NtRT 6E VFNFE'D OY B M7 l 1 nalA..A Pniw+wA w nl 11A1 11Y 4iln a 1 ►.C.w OM OOffR UTOIIIEi Eal. M IP+rwl. fhOAr, Aetlur 3'ar.@ 7 . S.6— 11Y 11M 11A1 RW : pl EI MAYCONTRACTOR. Aur ETaiT. AND rt SNALL eE TIE a auu . 3 Tw tw IYN ..+»..Paw E� RESPON9®U" OF :NE CONTRACTOR 7.71 K JTw s eMN. •tw twl T.Y a Ew.t TO ODTADI INE Law= OF smL _. T'w � PZ P O E ---y}� NOTE N "Um. a Ab poj d Rhoa EXCEPT "1 u. sba .wcay ...s w .eddy a e.we.E Planning Division Official Copy v� 6f � . A. r. «may � las) ra.am MATTKE ENGINEERING. INC. 7671 Cwttrd Avmwe NE. .ac Hillwind Townhome� Friday. MN 35432 IELE UtilityPlan (612) 783-0300 ERn a ^• scw 1 -gyp 4 6 SUBJECT PS. City of Fridley 2731-30 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. COMMUNITY DEVELOPMENT DIV tr I PROTECTIVE INSPECTION SEC. 1 , / NUMBER GATE PAGE OF APPROVED BY CITY HALL FRIDLEv 55432 612-571-3450 910-F15 T 11/30/94 JOB ADDRESS 1041 South Fill-more Cirrlp NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 Hillwind Townhomes SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Twin City Townhomes, Inc. 1250 E Moore Lake Dr, Fridley 55432 572-8872 8269 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 Cil NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Foundation for Townhouse and Garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Paid Park Fee of $750.00. Variances approved on 8/15/94 to reduce the front yard setback from 35' to 30'; reduce setback from 25' to 18.9' for front patios; and to increase the width of the driveways from 32' to 36'. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 I 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 $18,201.78 $9.10 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE Fire SC PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $198.00 $800.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $1,030.30 + PF SiG URE OFCONTRACTO A IZEDAG iDATEj 11 WHEN PROP LY VALIDATED THIS IS YOUR PERMIT � /2 j Si A U F OWNE i iDA E� - ,.y LOG NSP BATE NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: /CIC., 'Legal Descrrptron: .x;0`7 Owner Name & Address: Contractor: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 1/1/94 4--&0 Was, Tel. # S7Z-g8972- MN LICENSE Tel. # 57 Z -$S 7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Width Height Length Width Height Length Width Hgt/Ground l"" -o r ".. '1�. , .11, I/.# i 7 -7 /Sc '2,2 Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Sq. Ft. Sq. Ft. Sq. Ft. 3- /7 'G K1� �4kAQ 31 -1 t Side Yard cks Estimated Cost: $ 1&2P I ® ? (Cost on. Back) Driveway Cut Yidp Needed: Ft. +A Ft = F — $ DATE: / APPLICANT: Tel. #?2 -� CITY USE ONLY Permit Fee $ m Fee -Schedule on Reverse Side Fire Surcharge $ s ..001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ 00 $840 per SAC Unit License Surcharge $ 5,00$5.00 (State Licensed Residential Contractors) Driveway. Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ 5 0 00 Fee Determined by Engineering Sewer Main Charge $� Agreement Necessary [ ] Not Necessary t�'�� `� TOTAL`� STIPULATIONS: SUBJECT PE City of Fridley 732 Q I AT THE TOP OF THE TWINS BUILDING PERMIT Ir� RECEIPT NO. COMMUNITY DEVELOPMENT DIV. I L PROTECTIVE INSPECTION SEC. ! 64 `o r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/2/95 JOB ADDRESS 1041 South Fillmore Circle NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Hillwind Townhomes SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Twin City Townhomes Inc. 1250 East Moore Lake Dr, Fridley MN 55432 572-8872 8269 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 Townhouse & Garage FULL Permit 7 CLASS OF WORK �1 NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Full permit for 27' x 32' Townhouse and a 17'6" x 18' Garage. Foundation permit issued 11/30/94. 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Paid Park Fee of $750.00. Variances approved on 8/15/94 to reduce the front yard setback from 35' to 30' and to reduce setback from 25' to 18.9' for front patios and to increase the width of the driveways from 32' to 36'. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $72$799 $36.40 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE Fire SC DOESN PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVI O S OF ANY O ^ ER STATE Og LOCAL LAW REGUL TING CON- $401.00 AID $72.80 STRU NOR THE P FO ANC CONSTRUC N. PLAN CHECK FEE TOTAL FEE 5 License SC $5.00 $515.20 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI °- NEW ADDN ALTER {] [l Construction Address: Legal Description:' `�� Owner Name & Address: Contractor: �[ AiA' Address: /Z,00 Z ..2, Effective 1/ 1/94 CITY OF FRIDLEY�y b SINGLE FAMILY AND DUPLEXES R-1 AND R-22 .*f Building Permit Application`^ 11 1 — ---A/1 . LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # 5 7 Z° `- 9Z 12 MN LICENSE # S,. 6;, 9 Tel. # 57Z-107 Z. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length 7 Width 3� ' _ Height Length /% < ,, Width Height Length Width Hgt/Ground Sq. Ft. '� 9' ` Sq. Ft. ,3/< Sq. Ft. Corner Lot [ ] inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ y3 Approx. Completion Date: /0-Aj W1. 7Y (C t on Back) 7�1 7 123 Driveway Curb Cut Width Needed: Ft. 6 Ft t $ _ $ nATR- APPLIrANT. �Tel. # -d Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: /Ci V $ IVY $ Aa. 91 $ �ilS2-y Fee Schedule on Reverse Side ..001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $800 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 [ ] 5431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR <}8 � �.0Show .�•r: Wash . Tray Floor Drain Auto. Washer Gas an e Water Heater srieElec Basement Floor 1 Floor 2 . ' Floor.3' 3 Floor 4 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 q 17, 0 $ 4.00 $ 5.00 $ 7.00 .$7.00 $.7.00 $ 7.00 $10.00 $ 7.00 $i 0.00 14),06 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge $ .50 JOB ADDRESS l� 5 i T Jird✓ J� 6—Y C- /� The undersigned hereby makesapplication 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. Owner 1 Vy Building Used As Estimated Cost PERMIT NO, 14222 PLUMBING COMPANY ,\ •V m V SIGNED BY l!N L 11 &1 TEL N`0. �} _ I Approved Rough—In Date Final Date _ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ �.5�� PLUS THE $.50 STATE SURCHARGE i 01 3161 SUBJECT P - City of Fridley ? 3 3 ,2 5 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. I �� r NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/1/95 JOB ADDRESS 1041 Fillmore Circle AE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 1 Hillwind Townhouse SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Twin City Townhomes Inc 755-397.6 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Neisen Construction Inc 418 Hollyhock In, Hopkins MN 55343 933-6818 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 p REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace party wall; seal for smoke 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2, GOO $1.00 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 PERFORMANCE CO T C, TION $45.00 Fire SC $2.00 OVHE PLAN CHECK FEE TOTAL FEE License SC $5.00 $53.00 SIGNATURE OF CONTRACTOR CW-AUTHORIZED AGENT tDATEI WHEN ALIIDATED THIS IS YOUR PERMIT �P,yR�OPERL BLD "INSP 2Mir r'TE SIGNATURE OF OWNER pF OWNER BUILDERI IDATEI i 01 3161 NEW [ .] •ADDN [ :1 ALTER [] eonstructionAddress: Legal Description: _ Owner -Name 8i Addr Contractor: Address:. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 1/1/95 .--CITY: OF'FRIDLEY SINGLE FAMILY AND DUPLEXES. R-1 AND R-2 Building Permit -Application .475 ss:P MN LICENSE # Tel. # Attach to this. application, a Certificate of Survey of the. lot, . with. the proposed construction drawn on it. to scale. L DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width - ' Hgt/Ground ..- Sq. -Ft. Comer Lot [ ] Inside Lot [ j Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ 0 0 of Approx. Completion Date: /6 �7� (cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ,,;P,7 APPLICANT: �,��,�. —� �, Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ no .001 of Permit Valuation (1 / 10th %) State Surcharge $ /,(-)0 $.50/$1,000 Valuation SAC Charge $ $850 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 STIPULATIONS: $ '53. oo FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 August 31, 1995 Twin City Townhouses Inc 1250 E Moore Lake Dr NE Fridley, MN 55432 Re: Final Inspection at 1041 South Fillmore Circle NE, Fridley Dear Sirs: A final reinspection was conducted on August 31, 1995 of the above noted address. We found that the construction of the building unit complies to the best of our knowledge and belief, with all the requirements of the building codes of the City and the State of Minnesota relating thereto, and permission is hereby given for the occupancy of said unit. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, XW44 Z41, 1( BARRY W. RIESCH Building Inspector CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 512-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS L�)� ' 11 1- LL1I ` RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — r rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ ,o representations stated in this application are true and correct. ,1893 Gas Piping (Needed with new furnace) $10.00 $ /'0 OWNER_ J (�✓/ � i., / �/ % Oc,e>a�t�otti5'-� Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repalm & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commerciallindustrial 1% of Value of Appliance or Work $10.00 $ $10.00 $ State Surcharge TOTAL FEE $ .50 J , 47 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATIONIAIR CONDITIONING PERMIT IS $15.00 PLUS THE 1.60 -STATE SURCHARGE REINSPECTION FEE $30.00 * Conditioners can not be laced in a side rd without . Jr Con kio p Ya written permission from adjoining property owner. C/ j BUILDING USED ASS! �C ESTIMATED COST 2,200 PERMIT NO. No, of Heating Units l Circle One (Steam) (Hot Water) Pt arm AW Trade Name( a ►� Size No. BTU �' HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING Signed By Approved Rough—.In Date FILL OUT SIDE FOR STACK VERII REPLACEMENT FURNACE Final Date TION ON The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined ` Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4 Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Beina Done: y HEATING COMPANY Signed By Date 2' CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 ADDRESS : 1041 S FILLMORE CIR NE PIN : 243024320112 LEGAL DESC : UNAVAILABLE : LOT 0 BLOCK 0 PERMIT TYPE : HEATING PROPERTY TYPE : TOWNHOUSES CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT �20_ DATE ISSUED: 05/19/2004 VALUATION : $ 373.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL RANGE WITH APPROVED FLEX LINE, SHUT-OFF VALVE & ANTI -TIP BRACKET. # A/C UNITS 0 VALUE OF APPL OR WORK # GAS DRYERS APPLICANT CENTERPOINT ENERGY/1VIINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304 - OWNER RICHARD JOHNSON 1041 S FILLMORE CIR NE FRIDLEY, MN 55432 0 # GAS RANGES 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 regulating construcon or the performance of construction. i6 can A P Date it 1 Bldg GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT HEATING PERMIT MINIMUM FEE TOTAL PAID WITH CHECK # 1009041 CF.PARATF PF.RMTTC RF.nTTTRF.n FOR WORK OTHER THAN nF.SC:RIBF,D ABOVE 0 1 0.00 0.00 0.00 0.00 0.50 15.00 15.50 CITY OF FRIDLEY BUILDING INSPECTION r 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & 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) 10/6 of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES �/p JOB ADDRESS J O /, 1 � ,Fee Total Owner $35.00 $ Building Used As ?z9'6f& $10.00 $ ESTIMATED COST :573 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/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR 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. $ P4/L) HEATING CO �� f/1i1� �Z& $ I ro"5() *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 Tel # 1203 FAX # 60-3 1- 502'11 Date 511 LI hold Approved byi�A 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 existina 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 () 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 installina 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 : CITY OF FRIDLEY INSPEG I IUN DIV. 6431 University Ave NE Fridley,,MN 55432 (763) 572-3604, FAX (763) 571-1287 PLUMBING FIXTURE RATES: APPLICATION FOR PLUMBING AND GAS FITTING PERMIT . r MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 The undersigned hereby makes application for a permit 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 facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 9 ZI 71 200? Sump/Receiving Tank $ 7.00 $10.00 Owner Water Treating Appliance Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 ��/�_ Building Used As 1 �L� Gas Range** $10.00 Gas Dryer** $10.00 Estimated Cos PERMIT NO. Back Flow Preventer Required ( )Yes () No QD Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Hr SIGNED BY TEL N0. `t ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Date Final Date Approved By Rough -In State Surcharge $ .50 MINIMUM FEE R ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE OD5�__ 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 THEBELOWMUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED r'QMMQN VENT, VENT r.DNNFCT()R AND CQMR1 ISTIM AIR VFRIFICATION When !,placing 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 suAchnn enmh jctinn air is sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When required to ins all a new nnmhustinn air. it will be sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When installing a new venting nystem, the undersigned hereby verifies that it 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 ( ) 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: G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER -6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 June 22, 2004 Mr. Richard Johnson 1041 South Fillmore St NE Fridley, MN 55421 Re: Final Inspection at 1041 South Fillmore Street NE, Fridley Contractor: Shiloah Water Co. Dear Mr. Johnson: A plumbing permit was issued on September 18, 2003 to install a water softener 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 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 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 From: 763 497 8085 Page: 111 Date: 11/21/2008 4:01:57 PM Building MECHANICAL Permit NO.:G/U+0 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY 9001 763-502-4977 FA�/X EFFECTIVE 1-1-08 DATE t� YOUR E-MAILADDRESS SITE ADDRESS JCi�- I 4 ' d j,,e �� G' - THIS APPLICANT IS: ❑ OWNER VONTRACTOR PROPERTY NAME: TENANT WNER/ADDRESS: J O E-41 ; I �rn�r•G ��t1 10 - CrI'Y fit ; L' L1/ STATEM4 1�iZIP � PHONE: Co ►1..-4 ,' 4ii-�— CONTRACTOR COMPANYNAb'IE:�g�a� 2./5 F% •ncv ,� �.?c�'r�, �.�ic NOTE:— SEPARATECITY CONTACTPERSON: LICENSES ARE STATE LICENSE d EXP DATE 4q G� REQUIRED FOR GAS AND HVAC. ADDRESS:_ n a;. i�ZsK tj, <jS CITY STATE%�Z[P��l SUBMIT COPY OF BOND PHONES&_'S-Lter.laj`� FAX �l(�3.1{ly'`IGr(� AND INSURANCE PERMIT- TYPE 9ONGLE FAMILY ❑ TWO FAMELY ❑ TOWNHOUSE TYPE OF WORK: 13NEV El REPLACEMENTALT-RATIONMEMODEL DETAILED DESCRIPTION OF WORK _�r, fr'� �,,• �'K�� ,/ PER VIS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE. TOTAL NUMBER OF EACH BELOW) Equipment lnstalled MFG: /'i/F►ac.y MODEL. %19rrs7 ?(a S1ZE.BTU "7CD[C' MFG: MODEL: SIZEMMI MFG! MODEL: SIZEBTU _a/C.$25.00 iFIRULACE (GAS) $15.00 RANGE/OVEN $10.00 _GAS AIR TO AIR EXCHANGEER$15 _FIREPLACE (WOOD) $35.00 —NEW GAS GRILL $10.00 —BOILER $35.00 FURNACE $35.00 UNIT HTR $10.00 _GAS _CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 _DUCT WORK $:0.00 _GAS PIPING $10.00 VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee S Q_;2!• Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $ I5.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x S25.00 = $ Number of fixtures @ $35.00_ x $35.00 = State Surcharge = $ 50 MINIMUM $15.50 MINIMUM $15.50 Total = $ 35 „ THIS 1S AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and 1 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 Mitmescia Consducuon 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 Aill be in_aVArdance '' the approved plan in the case of all work which requires review and approval of plates. SIGNATURE OF APPLIC T PRINTNAME4o �` DATE `I & 1�-tr Cw�u APPROVED BY DATE PLEASE NOTE: SEPARATE PERMITS ARE RE 1MD FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, NIN 55432 763-572-3604 FAX: 763-502-4977