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PRE 2010 DOCSDate: Owner: Address MARCH 15. 1967 City Of Fridley, BUILDING PERMIT N9 .9isi Builder RODNEY BILLMAN, INC. Address — 3000 - 36TH AVENUE N. E. MINNEAPOLIS, MINNESOTA 55418 LOCATION OF BUILDING No. 1524 _ Street _ WINDEMERE DRIVE N. E. Part of Lot Lot _ 12 __ Block 3 Addition or Sub -Division . INNSBRUCK, 5TH ADDITION Corner Lot — B Inside Lot Setback 35___ Sideyard ._ 5 Sewer Elevation ___ 984.5 Elevation 987.5 TOP OF FOOTING DESCRIPTION OF BUILDING To be Used as: DWELLING Front 54 Depth 28 & 26'fkeight 20 Sq. Ft. 1,484_ Cu. Ft 29,680 GARAGE Front 22 Depth 22 Leight 10 Sq. Ft. 484 Cu, Ft, _ 4.480 Type of Construction FRAME Est. Cost ` 25 000 __ To be Completed — SEWER LOCATION - 11.3 to the South MIXERM for Sanitary Sewer WATER LOCATION - Water location directly in line with extended center line of Windermere Circ&e East 30' to the curb stop. In consideration of the issuance to me of a permit to construct the building described above I agree to the proposed work In accordance with the description above set forth A/ � in compliance with provisions ordinances of the city of Fridley. I-- i $100.00 SEWER CONNECtION CWARGE In consideration of the payment of a fee of $ 35.00 , permit is hereby granted t , RODNEY BILLMAN 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 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. CLARENCE BELISLE Building Inspector NOTICE: fide penbit does not cover the construction, installation for wiring, plumbing, gas heating, Sewer or water. Be erre to we the Building Inspector for separate permits for these hems. D C - APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER e ADDRESS ADDRESS 3tP-e"-e' —3 �0 �l LOCATION OF BUILDING NO, STREET t _� � l PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT '�-' INSIDE LOT SETBACK. �� SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION, 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; Front—Depth-4 -- 7-`-e-Height SI Cu. Ft. ° q. Ft. Front Depth Height Sq. Ft. �� Cu. Ftp Type of Construction Estimated Cost o To be completed 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., DATE7 ��� -- � '� ' SIGNATURE (Schedule of Fee Costs can be found on t Reverse Side),. U y Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 a each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 ............ 2.50 $ STEAM apt Im WJL"M SYNTM s Furnace &heli & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR, Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ Dept. of Bldgs. Phone SU 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 rrect. MA Y /J �Slley, Minn 19 — Owner Kind of Used as To be completed about JUL 1 -1961 d� Estimated Cost, $ �3122 —� QYL uilding Permit No. o Permit No. �" L DESCRIPTION OF. WORK OIL BURNER—to 3 gal. per hour ....................... 5.00 $ over 3 gal. per hour --See Fee Schedule- HEATING RONNE Warm Air—No- GAS BURNER (up to 400,000 BTU) ....................... �' ®� 5.00 $ Trade Name Size No,��� � ® Capacity. Sq. Ft. BTU H.P. GAS FITTING FEES: NO RATE T ®SAL 1st 3 Fixtures ...................... x $1.50 $ Total Connected Loa Rind of Fue Additional Fixtures ................. x .50 $ BURNER —Trade Nam �/-���-�-� Size No Gas Range to 200,000 BTU ........... x 2.00 $ Capacity Sq. Ft. E.D R/' ' TU H.P. AIR CONDITIONING 'VnCING MATING & WIR COND. CM FAN HEATING SYSTEM See Fee Schedule 6409 GOODRICH AVE. S. VENTILATING SYSTEM $ MIYINVA-POLIS 26, UMN. ALTERATIONS & REPAIRS TOTAL FEE$�L Signe 929-Ss38 ROUGH 42 2M Business Phone No FINAL (REMARKS—OVER) 136 2 S VK f 7 1 x a HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINK. n co uic � au i�rs Windows Doors Yes—No I Yes—No Windows and Doors—Crackage and Area is yy�� l Width Height No. of Lineal ft. Area No. of panne of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 6 Coef. Btu Infiltration Btu 31 � Glass yo 1p Exp. wall + g K"D Net exp. wall D® Int. wall Net exp. wall Ceiling 9 Floor Iz Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 &Jd Room l Length A Width i Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane Height llghte of crack SQ. ft. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Windows and Doors—Crackage and Area Width Helght No. of Lineal ft. No. of Dane of. lights of crack ei Infiltration qV0 Glass Exp. wal Net exp. wall Int. wall Ceiling Floor� Z== Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Width ] No. of pane Net exp. wall Fl.l LQ.r Room I Length 1("% Width Height Windows and Doors—Crackage and Area % �� Z / Width Height No. of Lineal ft. Area No. ofpane of pane lights of crack* sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 6 Coef. Btu Coef. Btu Infiltration Glass Exp. wall Z2 Glass ZQ K"D f Exp. wall - Ceiling . Net exp. wall Floor 9 Int. wall Ceiling ® 12,2Q Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area % �� Z / Width Height No. of Lineal ft. Area No. ofpane of pane lights of crack* sq. ft. f "7 ® Z- G— Coef. Btu Infiltration —Z7�Tc Glass Exp. wall Z� Net exp. wall Int. wall Ceiling . Floor Total Stu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D•36 2-40- 5 A . '` HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Rof Floor s—No Yes—No I Ye19_ o Fl.IAT (VZ k Room I Length 4� Width Height Z– F1.1 Rejj Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pahe lights of crack eq. ft. :3� Coef. Infiltration Glass Exp. wall �� K Net exp. wall (j Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Z- F1.1 e-0 Room I Length 1 Width Windows and Doors—Crackage and Area Width Height No. of No. of pane of pane lights Lineal ft. of crack Area sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. .o zo Coef. Btu Infiltration n 722- 2ZGlass Glass Exp. wall y 12_ S' 9 -70-0 Net exp. wall .92- 9` -Int. Int.wall ,0 1 Ceiling '12-1(- Floor l Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 2- Fl. Room I Length Width j t Height Windows and Doors—Crackage and Area °- Width I Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. T32- I t90 Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling j Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I MINNEAPOLIS, MINN. Insulation Kind How Applied R.. I Length / R Width I/ Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 791 Glass Exp. wall Net exp. wall ,0 1 Int. wall Ceiling l Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FIT 09-� Room I Length Width Windows and Doors—Crackage and Area Width Height No. of Lfneal ft. Area No. of Dane of pne lights of crack sq. ft. Infiltration Glass AD Z Exp. wall Net exp. wall Int. wall Ceiling 0 K 1!4 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Windows and Doors—Crackage and Area Width Helght No. oL Lineal ft Area No. oL Wane of Wane lights of crack eq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area SUBJECT City ®f Fridley 2198-22 AT THE TOP OF THE TWINS BUILDING PERMIT r ' , RECEI . COMMUNITY DEVELOPMENT DIV. •� r � � PROTECTIVE INSPECTION SEC. t NUMBER REV GATE PAGE Of APPROVED BY i � �1 � CITY HALL FRIDLEY 55432 IL'---11•e ,'� 612-571-3450 910-F15 7/19/93 JOB ADDRESS 1524 Windemere Drive NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 3 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wayne German 1524 Windemere Drive NE 783-9481 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 ❑ NEW ❑ ADDITION C�1 ALTERATION REPAIR ❑ MOVE ❑ REMOVE x❑ B DESCRIBE WORK Remodel Kitchen; Reroof Dwelling (25 Squares)- 2nd Layer 8 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd XMW layer but not the 3rd. Ice and water protection at eaves and valleys, Provide adequate attic ventilation. install smoke detectors per UBC 1210 adjacent to all sleeping areas and in basement. Bring plumbing and electrical up to Code. Firestop soffits. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 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 $5f350 $2.68 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- $81.00 Fire SC $5,35 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $89,03 SIGNATURE OF CONTRACTOR OR AUT T tDATEI WH PER ALIDATED THIS IS YOUR PERMIT pG t F1ATE SiGNAT F OWNER,iF OWNE UILDERi IDATEI NEW [ l ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Addres Legal Description: Effective 5126/93 Owner Name & Address: Tel. # �7-3- %V?l Contractor: e:-? MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF Ill LIVING AREA: Length Width GARAGE AREA: Length Width DECK AREA: Length Width OTHER: -'�� UCS t' C'A� 2SGGoNO z - Comer Lot )Q Inside Lot [ ) Type of Construction: Approx. Completion Date: Ft. Yd Setback Driveway Curb Cut Width Needed: Ft. + 6 Ft = - DATE: - / % — % APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on I .001 of Permit Va $.501$1,000 Valu; $750 per SAC Un $5.00 (State Licer Alt. "A" or Alt. " l�� Conservation Plan Fee Determined by Engineering Agreement Necessary [ ) Not Necessary [ ) TOTAL $ 6903 STIPULATIONS: _i � : :..;+ FRIULLY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Elfecuve Un Jan 1, 2002 PLUMBING FIXTURE RATES: 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** NO Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type_ _'rtvrlkr;;,,, r-'/— (Idfvb Reinspection Fee $47.00/Hr RATE $ 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 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL JOB ADDRESS /J`A 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. ?—AA g 1 G 2-- , 20_ Owner Building Used As 6V.�' I Estimated Cost PERMIT NO. PLUMBING COMPANY SIGNED Y .- TEL N0. 7G3 , �% j-/ cg FAX # Approved B� Rough -in Date Final Date .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 $ 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 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT VENT ONNFCTOR ANn n(WR RTION AIR VERIFICATION When replacing an existing ,ran _ , 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 plastiGPVC 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 cnmhu_stinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new nnmhuetinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When jp-qftlion a a new venting cyst _m, 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 #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 ftDiameter 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: - F1x(]pltty of Fridley _PWOR DRAMS OAS I'tt•11VI(# eWilding wA rnR PIPM irnspectialls _ agV&W ) _ 1+,1'rCM SINK 763-572-3604 - - . WATER S(WTWR (S)S) DATV w _ _ VAUNDRY TRAY Z17TADDKt.45 11115 APPLICANT 4� PROPElt7Y MAUR n TKNANT ADDRI PHONE CONT1tAMR ISE; SUSMn' A t.OP Y OF s fAY73 YOUR STATE ADORE LICENSE WITH �Pti(;A17UN PHONE pF.ttMIT 7'Y'F'� G' TVrE ©FWOM: j C3 W -W VET FAX NO. :7635711287 Dec. 28 0� P-2? )PLUMING Permit No.: RESIDENTIAL APPLICADON Rmcived� Hy: CITY OF FRIODLEY I Dwo R e'd; O OWNBR FAMLY YOUR VtAn. Ao nRFSS JAL-$ 42% EXPDA7E WIZ +dnj ,) Y rax QTWOPAMILY Toww mus8 iACf:MMEN1' '^- STATE_*,1 /T� PER. MS IbS.663 the -- petxait fit is a mtAi�tnum of $1&00 or 5% orthe notal coat up to 5500.40, whichever is greater, for the ilnprowm tent. inmWatian or Ycoacumcat of a raidtxttW fixture. excluding the &k,,t t (This shoW reDeet only he aoer of iatxw ) Lab" cost under $300 - Sl 5.00_ lAbm cost betwen $300 to UM -cost oflabor x.05 FUR MIM W>i HMM L42M IMCLEDS SSW xtnsS WI AR HAEMO UN 1:10.00 M FIK M. t�CCzd'7' C MUD- Yilt f11R1SSc {11�ICATR 7(rrAi. NUM BA OF F=ACR MV,.DW) DATH SR WR.AV v - RATtl�M _PWOR DRAMS OAS I'tt•11VI(# wA rnR PIPM _. CLOT= WASkMR. _ agV&W ) _ 1+,1'rCM SINK , S IMRn iD rp03. - - . WATER S(WTWR (S)S) .__. Dmr WAs1iL'R w _ _ VAUNDRY TRAY WAi1'�t C,r.Ustrr �WA7ER.10.0W.EAM S3. ( h _, ,-BACKFLOW PREY. (sIS) FOR IRRMXnOn _ wA770t.Mh'iU penak pie--$ 71 aurcme c 50 ^-�••••, ••• •+�•ww aay.w x51fl.00-$ TOTAL DUE 5U Numbs• +vf fextufcs 515.00 x 515.00 - $-._ Number of fiKtarin @ S35,po ` x $35.00-$ _ State Sumhmge x. Q TiliS IS AbrAPPLICATION FOR A PERMtf-NQt VA1dD iWM pR(X`.13SkPi7 C hereby apply for a building pttmit ,and T acicn0W1vdSc that the inform Wen above is t o,tlpictc and accumr'c; abet �, work will be in conformance witb the eaditlaltces and codes of the City of pridicy ad wirb the Mlnnese t COnsr Wden Codes; that I e work wil this is nut a pa mit but only ea ,Wticstiv" for A prtnlit and work is not tp .mors witboat a permit; that the oro$[ will si h accordance with the approved play in the case of worts which �� axpim review anti approval of p1m%. 11"A'CM,OFAMICAXTIO ` - NRIP1iNAME !< 2•d City of Ridley Building In& -pe ttjoajs BegartMant 6431 i, n vcrsity Avenue W Fridley, ]VIN 55432 - 763-S72-3604 FAX 763-502-4977 Cal/ 29LT T29 Zig Zutgwnid auel Rpues dg*:eo 90 8T Uer Jan 18 06 03:44p Randu Lane Plumbing 612 521 1765 .............................._..........._....................'::...'9..,.;���:.�................................---.........._..........._............_ ........_... ... ry, .......... ..............................................1111......... :..........�......._..........._ ,111..... . ........1-.....................1..._....1.11..........I.._....._.......I...... ....... ..._.:...::::..:::: .......... ... I ....... . ............ ..................... . f 11.1 ................... . .. ........................ ........... ............ �..,....:............:_ Y::::::�...........................................................................:::::....:::..::::....: 111:1.. ":::::::::...:: .................................. _....._......._._.................._..._................ _.. .................... .................................. .... _....... �............... ...... 11.. ::::_.N ..................-...........:.......-:.....' ........ :...... :U.M.::::::::::.......:..........................::::::::::::::.::.:...:::.:.:::::::: .A aenoa6VPf?PLff se6tdMoL uapeuunoq. w Av [I Ax MW asaw El POVAUM ecoid [) dVSv Aid*2j L] rm" 4\p% �.. 1.93HS N3AO3 Xd'.A +uoo•6urgwnidsuo;.puee(iolApiuo.i'MAAM :eaIS 4°M 9 L"079 -M 1X8-4 9 R-29-ZO :Ouold 4 GPAC Xw s!o<ietru AW dM►peor8.Jsa+M to94 aul `Bu1, PH 2 bulgwnld `su0S 2 au97 Apuey p.1 w CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE _5z�8(� Effective 4/1/2004 Fridley, MN 55432_ APPLICATION FOR _POWER PLANTS AND HEATING, COOLING, VENTILATION 763-572-3604 FAX 763-5711287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Fu U m`ce SheFtowDuct WorR,- BttrF ieLr & Cal RepIaceme 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 Commercial/Industrial/Institutional JOB ADDRESS / r Fie Total Owner "' �w � � KV� $35.00 $�' ` Building Used As " "' $10.00 $ ESTIMATED COS TPERMIT NO 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/Industrial/Institutional t State Surcharge $ TOTAL FEE $ REINSPECTION FEE $50.00/HOUR C *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City DESCRIPTION OF FURNACE AND BURNE # of Heating Units / Circle One (Steam) (Hot Water) fiR vTrade ame U Size No BTU Name! HP EDR � Fuel Total Connected Load Burner Trade Name BTU HP Size EDR The undersigned hereby makes application for a permitfor 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 statdcNQW% .%ALf Gec1~ c DBA:: GOLDEN VALLEY HEATING & AIR HEATIN 5182 WEST BROADWAY f CRYSTAL, MN 55429 Signed` . U 7Chi.5352000 Tel # Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date do FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacinsa an existinsa 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 () Nol� 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 t+ No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yesv No( ) When installinsa a new ventinsa 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 kv No( ) Is the common vent and vent connector's 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 1 q g Re t, BTU Input VQ,0 0 0 Fan A fisted orfat' Appliance #2 Type ����ry C;C � BTU Input d ®® Fan Assisted r Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances — Total Btu Input ® 0 0 Common Vent Type C- %f -5 S.17 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: Date Signed By: : E13 Permit No.-� 3uilding BUILDING Inspections RESIDENTIAL APPLICATION Received By:77 763-572-3604 CI'T`Y OF FRIDLEY Date Recd:�/�a >ATE ITE ADDRESS YOUR E-MAIL ADDRESS 'HIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION NAME: 4 ADDRESS: / -5 -1 kVit a% cl- a, :`e W CITY PHONE:, G. 3 u rS V' 77 M STATE LICENSE # 3 R -b7 EXP DATE ADDRESS: [' v-& 141 31-1 0, " tJ CITY C1 ®v A s— STATE% ZLP Sr Jr3 a PROPERTY TYPE I ❑ SINGLE FAN ❑ TWO FAMIL PERMIT TYPE ❑ ADDITIONu CiAKAUtVNk1rJJ U W 11 LV"a ❑ BASEMENT FINISH GOOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: 0 NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: -re«-4' e�' l— r 4- (-e i.- SIZE OF IMPROVEMENT NUMBER OF SQUARES_ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other ❑ HOUSE ONLY 044OUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia HEIGHT Sq. Ft. BASEMENT SEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: I . Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ QL -70 .001 times the total job valuation Surcharge $ I ?, 5— .0005 x Permit Valuation Minimum $.50 License Surcharge k $ t;' I on $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = R x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations 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 equires review and approval of plans. p-�-^ 1 SIGNATURE OF APPLICANT r���- �R.i e W Q PRINTNAME�DATE