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PRE 2010 DOCSGey ®f Fridley, Minn. 11742 6431 University Ave. N. E., Minneapolis, Minn. 55432 BURDING PERMIT owner: _Landvest De e1QP, MCorp r . Builder Same ,Address X28 -5y-enue SSouth Address Same LOCATION OF BUILDING No, 1548 Street South Timber Ridge N.E c Part of Lot Pali of Section Mock Addition or Sub -Division Corner Lot Inside Lot Setback Sideyard Sewer Elevation . Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Iownhous a Front 38' Depth -29f71,11 Height 201 Sq. Ft. 1854t CIL Ft 17288 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction -- Who d Frame rat. Cost — $21,187 To be Completed - 6 months Stipulations: See 1531 South Timber Ridge In consideration of the issuance to me of a permit to constrvo the building described above, I ft proposed work in accordance with the description aboveset rM and in compliance with all ; ordinances of the city of Fridley. a - — ns of In consideration of the payment of a fee of $ , permit is hereby granted to 1433 lVAct- DPU _ Corp. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings V.1thin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said i CE BELISL NOTICE: This permit does not cover the construction, installation for wg, plumbing, gas heating, sewer or water. Be sure we the Building Inspector for separate permits for these items. ! APPLICATION FOR RESIDENTIAL, ALTERATION, #- 1.t3 Y 7 OR ADDITION BUILDING PERMIT CITY Of FRIDLEYj MINKSOTA BUCK I ITION I 4ORM LOT: I IR LOT; SETBACK: SIMARD% ApltvAotst"ch to tbU f Certificates of Survey of Lot and proposed i,14location dra on A*ese Certificates, DESCRIPTION OF EUILOING )L Vaca Be gqugme Feet; LS Cubic e ; ��. �C�O Front; Depth: Height Square Xpaet; Cubic Feet s Ty#e of CoustructiomBstisaated Costt; $ 2/ /S% ,- // To Be "toted; . (� l'u =Lt� fte,pn4orpigned hereby makes application for, a pemit for the work haretA $ if#.ad, agreeing to du all work iu stiEict accordance with the !City of. ,dj. Or4$W=es and Tutftp pf the Department q£ Bu:L�dinga, amd hereby doclarev OWX all the facts apid representations stated 1A this appItcation axe true WA correct, t, ®, 1 =4; 49 /�. � 81GNATUU s �/e- ( Revue Me For AddWanal Infortqation.,. ) le-isj2e�2�� J. �u fi' o to T I Swroo AWvJ 4.W �r� aGdts =His gmvm ) 44 r 3.� 1 I 1 AM u' ei nay R i gg. s T I Swroo AWvJ 4.W �r� aGdts =His gmvm ) 44 I 1 • al-stY® BO 'TI d ® 0 LU 8 « • o w N • • m a t m m o . • m o .• o 0 a 6i 0 o • o o o • m . o � • � Edo .. o a a • • Q o (()� ¢97II1 D • O 0 O o � m O . � e • � • . • m m • ��{{ •Y 2 m m • roe • a 05®®D Application for Power Plants and H % Cooling. Ventilation. Ite enation and Air Conditioning Syten$s and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ................ $10.00 $ Replacement of Furnace .... . ..... 6.00 $ Repairs & Alterations—up to $500,00 6.00 Repairs & Alterations each add. $500.00 3.00 MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ........ .. $10.00 a each add. 60,000 BTU .................... .. 3.00 ; Replacement of Furnace .. &00 Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $M.00 .... &00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. Furnace Shell & Line --to 640 sq. ft. EDR Plot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam $,00 Each add. 320 sq. ft. EDR Hot Water 3,00 $ OIL BURNER—to 3 gal. per hour 6,00 $ over 3 gal, per hour—See Fee Schedule GASB (up to 299,0W BTU) over 195,000 BTU See Fee ule GAS FITTING 1st 3 Fixtures ..... _ Additional Fixtures _ Gas Range to 199, _ ROU`0if FIN11L /0 -I - —?Y 5.00 $_ -57 0 v NO RATE TOTAL —x$2.00 $�-C�o — x .75 $ - x$ 5.00 $ l UJ See Fa schedule 37 .Uo TOTAL PW a &11. S1_0 (SUPRUTARG� s_.5Q) Dept. of Hldge. Phone 660-3460 City of Fridley: The undersigned hereby makes application for a permit for the work hereir specified, agreeing to do all work in strict accordance with the City Ordigancei and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and erect. Fridley, Owner Kind of Building .� Used as To be completed about Estimated Cost,��— Permit No. Permit No. 1 58 "' HEATING or PO tram, Not Water arffi —No.� . Trade Name Sin No -9 Q- 6 I M Capacity ® Sq. Ft. E.D.R BTU H.P Total Connected Load Kind of Fue Q� BURNER — Trade Name Size ift Capaci Sq. FL Emit BTU (REMARKS -OVER) W I Y Ur FRIM -EY APPLICATION FOR PLUMBING AND GAS FITfING PERMIT PARTIAL RATE SCHEDULE m PLUMBING FIXTURE RATES: NO. T cz R=ber Fixtures •� $3.00 0 Future Fixture Opening x o $ hater A C! e A 0 ►"s+ N C + *s to °' c $ L I k W' O.9 w S 100,000 BTU to 199,000 BTU Heater tl -+ .1 u .r a E+ m c_ a New Ground kin Old Building i N v w N x c u $5.00 $ _ 14 4 a n .� O oc g m ro ro s „a. 0s a w w u w ,t 3 o ;as Tlec u a a ci w 1st 2n3 3rd (Fa o Future Connection Opening Connected with Sewer {*) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL R=ber Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ . 0 Catch Sasin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 S 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground kin Old Building x $5.00 $ Electric Water Heater x $5.00 $ _ GAS FITTING FEES: 1st 3 fixtures x •$3.00 $ Additional Fixtures X $1.00 $ Gas Range to 199,000 BTU x SY0.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 S each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) . Job Address Department of Buildings, City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the York 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 corre Fridley, Mn. / f OWNER ` L KIND 0- ILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company �- - Signed By Tel. No. 21 -- ROUGH INSP. Date , FINAL INSP. 1p Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.SO STATE SURGE ' t SUBJECT IIT City of Fridley 2 Z7! 0 9: AT THE TOP OF THE TWINS BUILDING -PERMIT REC O. �` COMMUNITY DEVELOPMENT DIV. _�����- EC r PROTECTIVE INSPECTION S. /O� , CITY HALL FRIDLEY 55432 NUMBER REv DATE PAGE OF APPROVED BY 612-571-3450 910-F15 12/3/98 JOB ADDRESS 1520, 1524, 1528, 1532,1536, 1540, 1544 1548 South Timber Ridge N.E. I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED OESCR. Part of Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO A-1 Roofing& Const. 3020 Sumter Ave - ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION R REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK .Reroof town homes (114 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment�,must comply with the State Building Code. YPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING,[NO VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTIONONING 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. 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 $4.88 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF AN OTHER.STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TH PERFORMANCE OF CONSTRUCTION 162.25 Fire SC $9.77 (^/ t� ` `� r1 ^ PLAN CHECK FEE TOTAL FEE 176.90 IGNATURE OF CON:RACTOROR AUTHORIZED AGENT IOATEI WHEN PROPERLY V IDATEO THIS IS YOUR PERMIT ., µgo BATE S,GNATURE OF OWNER, -F OWNER BUILDER, IDATEI ` NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 10% BUILDING PERMIT APPLICATION �' D ConstructionAddress: Legal Description: Owner Name & Address: Tel. # Contractor: 0 J0 Ain Al,MN LICENSE # Address: (° s�� / Tel. #`Z 6 •� 9 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width GARAGE AREA: Length Width DECK AREA: Length Width _ OTHER: l Pao 1 `4 Height Height Hgt/Ground r 6. Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: ii C�_ ( 66� _ Estimated Cost: $ T7 � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �Zr_ 3 ' �� APPLICANT: -.n L��/1 I Tel. # `Sq CITY USE ONLY Permit Fee $�. �S� Fee Schedule on Reverse Side Fire Surcharge $__ .001 of Permit Valuation (1/10th%) State Surcharge $ $:50/$1,000 Valuation SAC Charge $ $1000 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 $,—J-? . STIPULATIONS: CIS OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2000 64".1 University Ave NE a' FridleyMN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ,a RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work JOB ADDRESS 134 5• OWNER Rate TOTAL BUILDING USED AS $ 30.00 $ ESTIMATED COST�69 PERMIT NO. /-*/7gOf $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heatingnits Circle One (Steam) (Hot Water) 0DarmAir $ 10.00 $ Trade Name_ /n 6X Size No. BTU 9b, 660 HP EDR $ 25.00 $ Fuel f Total Connected Load Burner Trade Name Size No. $ BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE //�o�`� 00 Rough -In Date Final Date , COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION `When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( ) No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes( No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : f UNOE FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 June 22, 2001 Mr. Joe Quigley 1548 South Timber Ridge NE Fridley, MN 55432 Re: Final Reinspection at 1548 South Timber Ridge NE Contractor: Cronstrom's Heating & Air Cond Dear Mr. Quigley: A mechanical permit was issued on December 6, 2000 to install a furnace and air conditioner at your address. According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the mechanical work authorized by this permit. Corrections were noted on the inspection conducted on December 13, 2000. As of this date, no reinspection has been called for to inspect the corrections. The permit fee that was paid covers the inspections to make sure the work was completed according to the Mechanical Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permit and no further action will be taken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, DA NSEN Buil g Inspector SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMI TO.: 2004-01392 6431 UNIVERSITY AVENUE NES FRIDLEY, MN 55432 DATE ISSUED: 08/20/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1548 S TEWBER RIDGE NE PIN : 133024110131 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : TOWNHOUSES CONSTRUCTION TYPE : DECK VALUATION : $ 1,381.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 10'X T DECK/STEP. STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE 50.95 LICENSE SURCHARGE 5.00 GASSEN COMPANY INC 7275 BUSH LAKE RD FIRE SURCHARGE 1.38 EDINA, MN 55439- STATE SURCHARGE, VALUE 0.69 (952) 522-5575 TOTAL 58.02 PAID WITH CHECK # 24679 OWNER QUIGLEY JOSEPH S TRUSTEE 1548 S TINIBER RIDGE 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 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 ctio t ei or,Fbof cons c Applicant Date Bldg Insp ' Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Ins 0- ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION IO .�- Construction Address: Legal Description: bm %1v Owner Name & Add7715gtt : Tel. # Contractor. ' MN LICENSE # Address: °^7 i �j ; -&i Let- k -e a zom'- Tel. # cr-r . Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Width Hei ht /'2 Sq. Ft LIVING.AREA: Length 9 -- GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: I J tI�L 7 Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ L DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in a cation. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - F, Fee $ CK hitt Pan Review $ `,Fire Surcharge $ State Surcharge $ < SAC Charge $ License Surcharge _ $ 'nn Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $"''�° 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 [ ] STIPULATIONS: + CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 6431 University Ave NE Fridley, MN 55932 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS /5 W. i 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 — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ OWNER Z2) -LI Z2 Gas Range $10.00 $ / J .BUILDING USED AS Gas Dryer $ 10'Q0 ? NO. ESTIMATED COST, ice;' PERMIT .J *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercialilnddstrial BTU HP EDR �. 1.25% of Value of Appliance or Work $ Fuel ' Total Connected Load State Surcharge .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE= MINIMUM FEE FOR*ANYHEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr HEATING COMPANY Signed By TelNo. Approved By Rough—in Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE F�R STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURN E Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: I,J CHIMNEY AND STA K VERIFICATION 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 Dodged 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 7. Has a liner been provided for water heater Yes (} No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: I,J City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit ��iO Residential Application City of Fridley See Back Side For Required Information Date 3/2//4& Site Address: I The applicant is: (cirice one) ureter c:ontraci� Property Owner: 'Z -am <-ruor" Address: Llg 5 -Jt, 7, In6r'-- rl`4 city: T- I c State:,_ N''°' Zip: SS 7 a C' Phone: &S/- 2 -y2 -7s-_-_ Cell: - Fax Company Name Contact Person City: ► W : Zip: Phone: (2(?-- 3 - (-71 t- a I: Fax: cm„l• MN Bond# & Exp Date— of ate_ of Work (circle o Detailed Description of work: -SA-4 (+ 14eo54- —J - Equipment Installed: MFG: t�fti- a Model: i > r-ro "p- Size1BT): Sas am v MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: Fireplace (gas) $15.00 New Gas Grill $10.00 $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _A1C to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 _Air $35.00 _Gas Dryer $10.00 Ventilator $15.00 _Boiler _Chimney Liner $10.00 Gas Piping $10.00 niar4 Mirk -tin on Gas Ranae/Oven $10:00 Permit Fee $ 2 S'` • cpo (Total from above -Minimum fee $35.00) Surcharge 1 0.50 Total Due $ Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical 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 case of all work which requires review and approval of plans. - Signature of Approval Ins Sate, Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1997 NORBLOM PLUMBING CO. DBA VENTCO/APPLIANCE INSTALLERS (612) 827-4033 2905 GARFIELD AVE. SOUTH MINNEAPM IR UM SNAnA **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. QUIGLEY ,SPH 1548 SOUTH TIMBER RIDGE PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS FRIDLEY , 55431 - H 571-5392 W 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 , 1997 Sump/Receiving Tank* $ 7.00 Water Treating Appliance $10.00 -7 l Owner Water Heater —Electric $ 7.00 L Water Heater — Gas** $10.00 1010b Building Used As o< �® Gas Range** $10.00 �In Gas Dryer** $10.00 Estimated Cost 0 PERMIT NO. �e �� �z =Lucowz Back Flow Preventer Required ( )Yes () No 20C'>2 Type $15.00 PLUMBING COMP NY AL.U19/�,�r// -0j®� Reinspection Fee $42.00/Hr ®® 7 ,,jj a'Uj® SIGNED BY TEL N0.C7�/r i0 3 ®6--05 I ALL OTHERS AND/OR REPAIRS AND ALTERATIONS a]CCC99z 1.5% of Value of Fixture or Appliance Z 0 Approved By Rough—In Date Final Date State Surcharge $ .50 MINIMUM FEE F R ANY PLUMBING GAS PERMIT IS $20.00 TOTAL FEE $ 20-5-0 PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. NORBLOM PLUMBING CO. ®BA VENTCO/APPLIANCE INSTALLERS (612) 827-4033 2905 GARFIELD AVE. SOUTH MINNEAPOLIS, MN 55408 NORBLOM PLUMBING CO. ®BA VENTCO/APPLIANCE INSTALLERS (612) 827-4033 2905 GARFIELD AVE. SOUTH MINNEAPOLIS, MN 55408