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PRE 2010 DOCSX57 City ®f Fridley, Minn. 9278 BUILDING PERMIT Date; May 26, 1967 owner; Jerry Kuny Builder Rodney Billman Address Address 3000 26th Avenue N. E. ESM LOCATION OF BUILDING 1509 Street Windemere Dr. 10art0 f Lot . Block Lot ?§ Ll Addition or Sub -Division Innsbruck 5th Addn . Corner Lot --- Inside Lot x Setback _ _ Sideyard Sewer Elevation 986.78 989.78 To of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 763" Depth 67 ' Height .._..20 Sq. Ft. 3726 Cu. Ft Garage Front 25 Depth 46 ' Height 10' Sq. Ft. 115 0 Cu. Ft.11, 5 00 Type of Construction Frame Est. Cost u $50, 000 __ To be Completed 12/3%67 SEWER LOCATION - 98` West of Manhole WATER LOCATION - 881 West of Manhole In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set and in com ce with all provisi p s of ordinances of the city of Fridley. G $100.00 In consideration of the payment of a fee of $ 129.00 permit is hereby granted to Rodney Bi11umn. , Inc. 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the condruction, Installation for wiring, Plumbing, gas heating, sewer or water. Be eure to we the Building Inspector for separate permits for there hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILD��%'� ADDRESS ADDRESS ,=5'�-��,,- LOCATION OF BUILDING NO, I � f� vl STREET F� F �d - �� r,PART OF LOT LOT BLOCK , _) ADDITION OR SUBDIVISION �.-.,, /2c e, CORNER LOT INSIDE LOT �-' SETBACK SIDE -YARD SEWER ELEVATION OY6- FOUNDATION ELEVATION 99 q, 7�f Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. lo DESCRIPTION OF BUILDING To be used as; Front Depth height •z Sq. Ft. ,371' a, , r Cu. Ft. Front 'G. Depth Height/, Sq. Ft. Cu. Ft. / 1 Type of Construction Estimated Cost® To be completed o-3 The undersigned hereby makes.application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. d � DATE ' / 7- / SIGNATURE (Schedule of Fee Costs can be found n ZeReverse Side). OWNER'S APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ADDRESS ADDRESS����'� LOCATION OF BUILDING NO, / G STREET fjt 5 ,� i¢- a' ._ / , PART OF LOT LOTS BLOCK, ADDITION OR SUBDIVISION J ,��I,/z��e_-�S CORNER LOT INSIDE LOT &-' SETBACK SIDE -YARD SEWER ELEVATION �� (,.. % FOUNDATION ELEVATION q& V Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawnon these Certificates. lj 141- DESCRIPTION 42DESCRIPTION OF BUILDING �G To be used as; Front L/, ! Ac Depth_4Heightt Sq. Ft.��, ,,, r` Cu. Ft. Front Depth Height, Sq. Ft. r�F Cu. Ft.--, Type of Construction Estimated Cost A-6 To be completed_ � , % 5j 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. DATE -/ -��ZL1% Z SIGNATU (Schedule of Fee Costs can bei found ,r I* ?I t 7 Vt ap V ' City of Fridley Application for Plumbing and Cas F'ii#ing Permit � Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Locatiowe� y 6i NO. RATE yy ZY 12 Number Fixtures ...................... x $2.00 Z w x $1.50 w 0 Z z New Fixture Old Opening .............. ` WATER HTR. Catch Basin ...... ..................... x $3.25 $ ® Water Heater (Up to 99,000 BT I) ...... L— x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ �12 p F N GAS ELEG GAS FITTING FEES: NO. RATE TOTAL ) 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Base 1st 2nd 3rd 4th Future Connection Openings Connected with e New Fixture, Old Openings I Sewer Ej Cesspool 0 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... ..................... x $3.25 $ ® Water Heater (Up to 99,000 BT I) ...... L— x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $2.00 $. GAS FITTING FEES: NO. RATE TOTAL ) 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ TOTAL FEE City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true andeeorregt. Fridley, Owner Kind of Building — Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. si ty Business Phone No ROUGH � �/,/ 6 f FINAL 42 Application for Power Plants and H ' pp eating, Cooling, Ventilation. Refrigeration and � Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 560-3450 GRAVITY WARM AIR: RATE Furnace Shell & Duct Work ....... 4 .............. $10.00 Replacement of Furnace ............................. 6.00 Repairs & Alterations—up to $500.00 .................. 6.00 Repairs & Alterations each add. $500.00 ............... 3.00 MECIL -TARM AIR Furnace-!Y-Ihell & Duct Work to 120,000 BTU ....`Tr ...... $10.00 each au 30,000 BTU ....................... 3.00 Replacement of Furnace ............................. 6.00 Repairs & Alterations—up to $500.00 ................. 6.00 Repairs & Alterations each a, add. $500.00 .............. 3.00 STEAM or HOT WATER SYSTEM TOTAL $ $ $ Z ® si $ 30 $ $ Furnace Shell & Lines—to 400 sq. f£: , EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. E�DR Hot Water ... 10.00 $ Each add: 200 sq. ft. EDR Steam .... I ................. 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ f OIL BURNER—td 3 gal. per hour,.! ................ I .... 6.00 $ over.,•3 gal. per hKur—See Fee Schedule GAS BURNER (up a46,99,000 BTU) ....................... 5.00 $ /® over . 99,000 BTU See Fee Schedule GAS FITTING FF' S: NO RATE TOT�L 1.4i_..1 Fiy, tures ...................... x$ 2.00 $— 0-- Additional Fixtures ................ x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ 'Z AIR CONDITIONING $ FAN HEATING SYSTEM' See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL V City of Fridley: The undersigned hereby makes application for a permit for the work herein, specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn � I � 19 �6- Owner Kind of Building���:® Used as m io: To be completed about o� Estimated Cost, $�.�'� ®� Old—New. Building Permit No. Permit No. ��� ✓ DESCRIPTION OF WORN HEATING or POWER PLANTS -Steam, Hot WaterWarm No �4%-/ i=6-vzo® Trade Name /I Size Nott nW 170 Capacity. Sq. Ft. E D. M v BTU H.P. l-illTotal Connected Load ®� ® Kind of Fuel f BURNER — Trade Name --d4!1' ,0 Size No Capacity Sq. Ft. E.D.R BTU H.P. s 4 (REMARKS -OVER) MP'LS., MINN. 55429 PHONE 533-2160 City of Fridley, Mie. N0 9551 BUILDING PERMIT Date: Nov. 10, 1967 Owner. Jerry Rte_ Builder Siegler -Minnesota Address 1509 Windemere Dr. Address 106 East Lake St. LOCATION OF BUILDING No. 1509 Street Windemere Dr. ____ part of Lot Lot _.._.._28�__ Block I Addition or Sub -Division — n. ruck 5 th Comer Lot — Inside Lot _ _ Setback --- Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Chimney Front _ _ Depth Height — Sq. Ft Cu. Ft. Front Depth _ Height _ _ Sq. Ft. _ _ Cu. Ft. Type of Construction Class A Chimney Est. Cost _-175. OQ---.-- To be Completed — In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and In compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 5.00 pqt heyeby granted to Siegler - Minnesota 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 anypart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Offical Building NOTICE: This permit does not cover the construction, installation for wiring, plumbing, on heaNae, sewer or water. Be sure to ae the Building Inspector for separate permits for thea Homs. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEYY, MINNESOTA OWNER'S NAME �_ �2 R �,41.F .�1.K..� BUILDER r C- GL E R Al i kt Al '.w.wAr Iq/AI*uAlArl� :. uD�.wD..�o U�AODREs oi AiA�t.,..,. L; ,LOCATi0N' bF BUU-DYNG RT OF LOT �J BLOCK ADDITION OR SUBDIVISION f c�� �`. ,� i2 C s- iAT.... r COINER `LBT �,fOSIDE�' LOT � • ETBACR giDE'=YARD. SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates,of Survpy of Lot and proposed . bpildiAg' iocae�c�n drawa�on ttiesc •�e�tiiicatce'� .' ; • 'DESdaPTION Of -Bt i61NO To Be' Used ttih }_:.. ,.... . Frog( Depteight z Sq Ft Cu. Ft. ' .. Froat Depth 'Nei $ht Sq. Ft. Cu. lot; Type of Construction tith6te�d' Cook Z " � ��y q/y p a� IVY �YiI.Yrlr�rl�r.Alr1� d6 To Be Completed Wens J/) , l,9 7 (/ The undersigned hereby ((takes application for a permit for the work heroin specified, agreeing to do all work in strict accordance with thaw City of Fridley Ordinanees and rulings of the Department of Buildings, and hereby declares that All the facts and representations stated in this application are true and correct. DATE_%7oz�. /0 • �„ SIGNATURE ~-� (Schedule of Fee Costs can be found on the Reverse Side). yy 4 _ 52-84-5915.51 City of Fridley Application for Plumbing and Gas Fitting Perndt Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 1509 �indeii�re Tar Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ y Y ii z C Z Z a� 8C S O < U0' W 9 J O z (9 °d �p F N WATER HTR. GAS ELEC. Base Water Heater (Up to 99,000 BTU) ...... x $3.00 Ins aj 1 Cas IIF i n r'a. or $ e Electric Water Heater s $2.00 $ Ist GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ....................... .. x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. 2nd $ Gas-'neinerat or 1 5.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ 3rd TOTAL FEE $ 5.00 4th ° Future Connection Openings New Fixture, Old Openings Connected with Sewer I Cesspool PARTIAL RATE SCHEDULE PLUUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... .................. .. x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ....................... .. x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Gas-'neinerat or 1 5.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 5.00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, BE= 3-1-17-6719_ Owner Rodney Billman Kind of Building frame Used as res To be completed about 11-22 Estimated Cost, Old—New. Building Permit —Peir No. By Business Phone No ROUGH FINAL d2 I SUBJECTPERMIT NO. City ®f Fridley 2=0613 AT THE TOP OF THE TWINS BUILDING PERMIT i? RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �f 3Y® /3 r /"';.� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY IL --_- L A 612-571-3450 910-F15 10/3/90 JOB ADDRESS 1509 Windemere Drive N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 28 1 Tnnsb:ruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry Kuny 1509 Windemere Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings Co, 6331 Riverview Terrace N E F i 55432 `HONE 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PLICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof (.70 Squares] 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 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 $3,500 $1,75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $63,00 S RUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE e SC $3. $68.25 SIGNATURE OF CONTRACTOR OR A#THORIZED AGENT tDATEI WHEN PR PE L AT HIS IS YOURR�`PERMIT BLDG INSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI I NEW [ ] Effective 8/16/90 ADT [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: /.j � � &J, A1Vc- moi:=,ems' l� � Legal Description: L ol- ?--e i3 C o' -k t irm ws i3 P,4 cK 5'Tti A d o ,'tic -9- Owner Owner Name & Address: 'T t RP k'Ll ^1 V Tel. # Contractor: LZb'c-A,v g - p AW , ffc s Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVMG AREA: length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Grcxurl Sq. Ft. O'ER: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: %A p FF + R,=- - Re e F Estimated Cost: $ °S,7 Approx. Completion Date: 70 5 Proposed Driveway Width If New Opening Is Desired: Ft. $ $ �a Width + 6' See Back Page DATE: ®3 17 APP'rZCW: Tel. # 5-7 Y -7ye'g- Permit Fee $ . 00 Fire Surcharge $ 3, -!�-® State Surcharge SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ $ 69. x. STIPL1=CNS: CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Job Address-,./ % Furnace Shell & Duct work Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 Y=HANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacesent of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 STEM OR HOT 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 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 Additional Fixtures Gas Range to 199,000 BTU AIR CONDITIONING FAX HEATING SYSTEMS See Fee Schedule VENTILATING SYSTEMS .ALTERATIONS & REPAIRS S $12.00 $. 7.00 $ 7.00 $ 4.00 $ Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work heteJA /4.00 S /` 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 S facts and representations stated in this application are true and correct. $ S Fridley, sMinn. 19 OWNER�� / Iii// ✓l/✓ $12.00 $ KIND OF BUILDING 4.00 $ 7.00 $ USED AS 6.00 $ TO BE COMPLETED ABOUT ala $10.00 $ 10.00 $ COST$10.00 $ 011ATED NEW BUILDING PER14IT NO. x $ 3.00 $ X $ 1.00 $ X $10.00 • $ State Surcharge TOTAL FF—&, PERMIT NO. /0&Ll Q 7 DESCRIPTION OF FURNACE URNER HEATING or POWER PLANTS, Steam, Hot Water, Warm A - No. Trade Name Size No. GZpQ 5� Capacity _�Sr0j) Sq. Ft. EDR STU�;Z= = HP Total Connected Load Kind of Fuel BURNER - Trade llama Size No. MUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU Date. (,$10.00) Q Company IN FAL INSP. a'; z r.K3•, M „a° Date Signed By _ a� �.�s. APPROVAL FOR PERMIT Tel. No. NIMUK FEE FOR ANY TIIG PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE CITY OF FRIDLEY APPLICATION FOR HEATING REPLACEMENT CH114NEY AND. STACK VERIFICATION THIS FOR14 MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION .Q ,Q�j p , ,�, DATE NOV 2 9 1990 OWNER J-- ADDRESS The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration 3. Ho foreign objects are lodoed within 4. Ttat it is securely supported 5. That it meets all current Code requirements for size and total BTU connected 6. Total Heating BTU fZ), C?3'U All Other BTU �J TOTAL REMARKS HEATING PERMIT I SIGNED by censee Address R� lhpnd file Telephone Fridley City License l or CITY OF FRIDLEY INSPECTION DIV. Effective On January 1.1997 6431 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 Water Bath Stories Closet Urinal Tub Shower Sink Wash Drink. Floor Catch Auto. Gas Gas IMisc.. Water Heater Tray iFount I Drain Basin Washer Appl. Range F1xL.. Elec Basement Floor 1 Floor 2 Floor 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 $ 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 $1.50 JOBADDRESS��� 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. 1/2- , 19W r •i%�/'; Building Used As I en Estimated Cost �� PERMIT NO. PLUMBING COMPANY f/ / m SIGNED BY Approved By Rough -In Date Final Date1�0 Ov MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT 13 $20.00 s Building MECHANICAL Permit No.: c - � � Inspections RESIDEN'T'IAL APPLICATION Received By: 7.63-572-36Q4Date Recd: CITY OFF LEY DATE fl% DLA YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: 0 OWNER AGONTRACTOR PROPERTY NAME: L 4 OWNER/ ADDRESS: ,SC2 CITY STATZI �- TENANT PHONE. )Ig 40 CONTRACTOR COMPANY NAME i 611 [� �� �i+a � SUBMIT A COPY OF CONTACT PERS YOUR STATE STATE 1 ICENSE # Ridiey9MN EXP DATE LICENSE WITH ADDS: CITY STATE ZIP APPLICATION PHONE - F 9 PERMIT TYPE PKGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW EPaCEMENT 0 AUTERATION/REMODEL DETAILED DERIP ION OF OR®K a PER MS 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) 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. FATURES: (INDICATE TOTAL NUMBER OF EACH BELOW) MODEL,;Z �' � SIZE/BTU Equipment Installed MFG: SIZEIBTU ZAIC MFG: MODEL:MFG: MODEL: SIZEBTU 25.00_FIREPLACE (GAS) $15.00. _GAS RANGEIOVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00—VENTILATOR POOL HEATER $35.00 _DUCT WORK $1000 _GAS PIPING $10-00 p` O � ...?g ..'�.� q�lrvER. W�kn 3 .1�.. '7' P�4..tx' 7t .r. .. ,.°; •'M" �. 1R 0 , .... ...' Permit Fee $ �Z�®� Number of fixtures @ $10.00 x $10.Is 00 $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 — $ TOTAL DUE $ .� Number of f xtures@$25.00 x$25.00 = $ Number of ixtures @ $35.00 x $35.00 = $ State Surcharge = $ 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 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 which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME S DATE $SE 'ERNIl3' ' ® �AItE Mµ .. flRIDINL; CtTR. LIy , City Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY DATE -7-2-8-09 YOUR Ej MAIL ADDRESS SITE ADDRESS _ THIS APPLICANT IS: PROPERTY OWNER/ TENANT Fil E3 OWNER AcONTRACTOR Permit No.: ADDRESS: CITY STATE ZIP it PHONE: &70 — CONTRACTOR PERMIT COMPANY SUBMIT A COPY OF CONTACT YOUR STATE STATE LIC LICENSE WITH ADDRESS:. APPLICATION HONE_ PHONE- PERNIIT TYPE 0 SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW /NWLACEMENT 13 ALTERATIONIREMODEL DETAILED DESCRIPTION OF WORK ATE ZIP PER MS 1613.665 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 ) 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) MODEL: �O -1 '`a SIZE/BTU Equipment Installed MFG: MFG: MODEL: SIZEBTU MFG: MODESIZEBTU L- A/C 525.00 FIREPLACE (GAS) $15.00 . GAS RANGEIOVEN $10.00 IR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 A ACE $35.00 —GAS UNIT HTR $10.00 -BOILER S35.00 LINER $10.00 DRYER $10.00 POOL HEATER .00 00 DUCT WORK $10.00 GAS PIPING $10.00 VENTII,ATOR $1155.MW .�� :... : >;.•>.,,��, wry„._. �...:� ,.. ,...,..�,:� W .-:._,._ ........ ___ . Permit Fee $ _. O Number of fixtures @ $10.00 x $10.00 = Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ zas,,10 Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .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 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 YjWk which r ires review and approval of plansn ' ; DATE 747e-01?- SIGNATURE OF APPLICANT ""� PRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane. -UGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. TMC Chapter 5 with MIST Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas TMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction TMC 1346.0312 5. Ventilation a., Per MN Energy Code 7670 or 7672 6. Duct Design Per 1MC 1346:0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations NEW [) CM' Of: PtRID EY ADDN [ j 601 I Inivercily Aue ME, FrHl-„ MPI 5513? ALTER [ l ! SINGLE FAMILY Al'JD OUPLEXES R -t AND F;_ BUILDING PERMIT APPLICATION Construction Address: 1 150 CZ/ (,.,OJ l.,,4j ga15-- 03c�q (7r,l ) i t `rt)e1 r"IrI i (7631) ii' eC_ D r Legal Description: _ Owner Name & Address: '-Zs �-'.,, Tel Contractor: j MN 1-I0F_R1SE Address: F q0©EI�IRJ�,, ENG Tot. 41M EXCCLSIOP BLVD. �lt�el�t ;at ttlitr"r6i ? Cerfinrate or survey or the WLA ROOFING & REMODELF 4100 EXCELSIOR BLV ''0H*®sed construction drawn on it to scale. ST, LOUIS PARK, MN 5546 ID #0001050 DESCRIPTI[ON OF IMPROVEMENT LIVING AREA. Length GARAGE AREA: DECK AREA: OTHER: Construction Typ Width - Height S©. Ft, Length Width Height Sq. ri. Length` Width i-IpNrCr�l,thrl �.1 �1 i �aIvft_set Estimated Cosh s Driveway Curb Cut Width Ne�ded: Ft. + 6 Ft Ft x $ =$ /I r 'Ole, DATE: APPLICANT: r. �r Tel. f M.'0 7 Call (763) 572-3604 for Permit Fees if mailing in application, FaX to 763-571-1337 it using you for card humber. rrwrlit o,,2rrl and we.will call Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side. .001 of Permit valuation, (1110th%) $.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 E=ngineering Agreement Necessary [ ] Not Necessary STIPULATIONS: Z'ti'd 9ZS'ON S37US 5NIJ00d d73S WabZ:OZ SOOz'SZ'r1©N