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PRE 2010 DOCSCity of Fridley, Aline. BUILDING PERMIT Date: February 16- 1971 7K 7 L 7 Owner: Mr & Mrs Nyenbuis Builder Richard Miller Homes (633-7464) Address Address 1700 Silver Lake Road No. iFm Street LOCATION OF BUILDING Stinson Boulevard part of Lot Lot _ _ ___1__ _ _ _ Block 2 Addition or sub -Division .____. C.irh_ra ' s Ash iii ition Corner Lot _ Inside Lot x Setback 35 Sideyard ._ . 10' & 5' g*X& Mevation 917.83 roumb 11 URRtiM 920.83 Wye Ton of Footing DESCRIPTION OF BUILDING To be Used as: _Dwelling Front 42 Depth 22 height 20' Sq. yL 924 C:a. Ft 19,008 Garages - Front _ 11_ Depth __221 Freight .__10' Sq. Ft. 419 Cu. Ft. 23,18$ Total Type of Construction Frame Fat. Cost A 272 000 ____ To be Completed May 31, 1971 1. Submit survey verifying basement location before framing. 2. Top course block design to be approved. 3. Hard surface driveway. 14� 4. Minimum 18 inches elevation over center line of street. SEWER LOCATION: 160' South of Manhole So. Imv. of Manhole 916.52 WATER LOCATION: 170' South 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 forth d in pliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of - 43. 00 ., permit is hereby granted to Richard Miller Homes to construct the building or addition as described above. This permit is granted upon the eFy ess condition that the person to whom it is granted and his agents, employees and workmen, in all work doneFridlMinnesota regardinug location, construction, alteration, maintenance, repair and. moving of buildings within the dty ]units and this permit may be revoked at any tune upon violation of any of the provisions of said ordinances. / !CGLd�fv� Building Inspector HANK MUHICH NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer, or water. Be sure to we the Building inspector for separate permits for these items. y APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME . a �/�,� �;� {� „? c BUILDER • eA., 1411., 11awas - ADDRESS: ADDRESS: 1700 :5/_ Aer 4 ga ke- X®z;� lVew /3�®5�,6 *q NO:. 4�1 j D STREET:_ _jsetsoj /u LOT: 1 BLOCK: ADDITION: CORNER LOT: INSIDE LOT: _SETBACK : -3Y" SIDEYARD :.%S' 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: _,I�4y� f�lo7 Front • Depth: : Height: ;2- ®fflwslfl�v� l Square Feet `pubic Feet: 910 g�__.._,..e- Front : [Depth : Z2 Height: % + oTR_ / �v 6 P �°r ®0 Square Feet;_ Cubic Feet: .. __ Type of Construction: f r -arn Estimated Cost: $ 7� a 0 0 To Be Completed: _Ila 44 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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 : , . Zq 71 SIGNATURE: (See Risverse Side For Additional Information.) 4 A -- P �2 4 A -- BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average.{ height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. U VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot,.showing the location of the foundation, once it has been constructed, will be required before proc® eedine with the framing. CERTIFICATE.OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. C-cf .0 C A -9 if, / -1 0 IZZ) CJ" -21 1 '4i C ity of b` Y k ey Dept. .& Phone ;1 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Future Connection Openings I � .a wua * Now Fixture, Old OpeningsBower � 0MP001 n PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixturesx $200 $ /�. DO Future Fixture Opening x $1.50 ac New Fixture Old Opening x $1.50 W z t t N WATER HTR, GAS ELEC. Base New Ground 'Run Old Bldg. x $3.25 $ Electric Water Heater : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... .. . .... ......... / x $2.00 $ 4.06 Additional Fixtures ..... .............. —x$.75 lot Gas Range to 199,000 BTU ............... x $5.00 $ -- — 2nd 3rd 4th _ -- Future Connection Openings I � .a wua * Now Fixture, Old OpeningsBower � 0MP001 n PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixturesx $200 $ /�. DO 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 : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... .. . .... ......... / x $2.00 $ 4.06 Additional Fixtures ..... .............. —x$.75 $ Gas Range to 199,000 BTU ............... x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description .................................. .............$ TOTAL FEE $ a 0 0 City of Fridley: The undersigned hereby makes application for a permit for the work herei specked, 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 ,rue and correct. Owner Kind of Building 5 Used as: _ P To be completed aboutrV `r4 A. rt p Estimated Cost, $ l % y —New. Building Permit No.-- _ _Permit 4 Signed _ - , »- ROUGH FINAL � '// `'�_ Business Phone No. 19 P Application for peer plants and Heating. Cooling, Ventilation. ReMgeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. 8.00 $§39LF/V_00 2.00 $ 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & 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 $ OIL BURNER—to 3 gal. per hour 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 5®00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures 1 x $1.50 $ -2•0 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINN..�' t4y F See Fee Schedule TOTAL FEE $�-�g� L/1®�n) HEAT IHSS ATTACHED. Location 6216 Stinson Blvd. N.E. 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. Owner Fridley, Minn March 109 1971 19 Richard Miller Homes Kind of Building Frame Used as Residential To be completed about 4/15/71 Estimated Cost, $40.00 Old—New. Building Permit No. Permit No. 1/49�� DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No 1 Trade Name Westinghouse Size No FLUB -110 Capacity, 88 ® 000 Sq. Ft. E.D.R. BTU H.P Total Connected Load_ 409125 Kind of Fuel Gas BURNER — Trade Name Westinghouse Size No FGUB®110 Capacity 88000 Sq. Ft. EMM BTU H.P (REMARKS -OVER) Signed FRED V®S& C HEMI`ING & AIR CONDITIONING By 8260Ave a Y29-6767 42 Business P&c*4 Park, M nnesoto 55426 r Engineering Sewer Water Parks Streets Maintenance MEMORANDUM 1 .' TO: William W. Bums, City Manager PW93-070 FROM: John G. Floral Works Director DATE: February 25, 1993 SUBJECT: Sanitary Sewer Backup At the Council meeting of February 22, - Councilmember Schneider requested information regarding sewer backups on Rice Creek Road. The only recent record we have on sewer backups on Rice Creek Road was on Saturday, January 30, 1993, which involved properties at 1461 and 1491 Rice Creek Road. This backup was caused by a large root mass that was undoubtedly cleared from someones service line and became stuck in the drop to the manhole in front of these properties. On February 18, 1993, we received a call regarding slow drainage at 6216 Stinson Boulevard. A small mass of roots were found in the downstream manhole but there was no backup damage to any properties. The Stinson Boulevard line connects to the Rice Creek Road line, but these are two separate events involving two different locations. The City has not been informed of any other problems in the sanitary sewer system in this area. Periodic notices in the City Newsletter advises any resident clearing their service line of roots to contact the City so that the roots can be obtained at a manhole and removed from the system. No notices were received on either of these occurrences. JGF:cz M CrTYOF FRIDLU SEWER-STOPPAGE ADDRESS C,;? f 6 CALL RECEIVED BY.&, DATE CREW LOCATION WHEN NOTIFIED 99CL+1� TIME % of EQUIPMENT TAKEN TO SITE L CAUSE OF STOPPAGE , TIME STOPPAGE RELIEVED % 'T.� �Nl s —/040/— DESCRIBE DESCRIBE DAMAGE lzo-Zldled4 NOTE ANY STATEMENTS MADE REGARDING DAMAGE OR POSSIBLE CLAIM CREW AND HOURS CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS �,� l f l N J v.� i� L ✓U 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 Fumace Shell and Duct Work, Bumer - 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) V - O / - 52, ,1998 Gas Piping (Needed with new furnace) $10.00 $ OWNER Gas Range $10.00 $ BUILDING USED AS %� i S Gas Dryer $10.00 $ ESTIMATED COST D G'fI - PERMIT N0. *Air Conditioning - All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) -�;U'Sfx l 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name `D; s c-,,✓ Size No. DO, �Uu Commercial/Industrial a BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $$:50 Burner Trade Name Size No. s BTU HP EDA TOTAL FEE HEATING COMPANY `2 ,S ftt S MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed ByQe,,,.,,��, Tel No. _7_70419/ PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved Byl441-_ Rough -In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CHDMY AND STACK 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 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 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: - SUBJECT City of Fridley 2 9 6 5 A7 THE TOP OF THE TWINS BUILDING PERMIT iaEaiwivo- `L COMMUNITY DEVELOPMENT DIY. ------ PROTECTIVE INSPECTION SEC. ' O� e� y �`j r 1 . � NUMBEIN DATE PAGE OF APPROVED BY ""'I CITY HALL FRIDLEY 55432 1 612-571-3450 91 0 -Fl! 7/13/99 JOB ADDRESS 6516 Stinson Blvd'. 1 LEGAL LOT NO. TRACTOR ADDITION SEE ATTACHED DESCR. 6 18LOCK 3 1 Moore Lake Park First Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John & Jane Gannon 521-5-065 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen 350 73502-4777 4 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 ❑ NEW ❑ ADDITION ❑ ALTERATION xrt REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 14 windows in home 9 CHANGEOFUSEFROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each leveT)f the house. Permit Inspection Cards Will Be "hailed To H®m®®Wner To Post, SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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. NO. 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 $13,000 $6.50 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 OR THE PERFORMANCE OF CONSTRUCTION $223.25 Fire SC $13.00 PLAN CHECK FEE TOTAL FEE Lic 5.00 $N7.75 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IOATEI EN P90PEfkVAXIDATED S IS Y y PER�AR BL So rIATE S1GNATU RE OF OWNER, if OWNER BUILDERI IDATEI 01 Prepaid- Plan Check $ Estimated Cost $ Receipt # k�j CITY OF FRIDLEY COADIERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION Construction .Address -6 V Ck • Zoning Legal _ Owner & Addresses C gIPACMR & ADDRESS Architect Effective 1/1/99 60 Uo v\r\G-r\ ( C-In,t1�-k � O bo C &4 Tel# & I D .S31 • SW5 A a PwN& i Szru �t=f" m ssc3 ai Tel# Lla•56a•If 7 77 Reg.# Engineer Reg.# BUILDING CONSTRUCTION TYPE OF WORK [] New [l Addition Alteration -Describe koSo 14 (� iC3cJj OFC. AREA: Length Width Height Sq. Ft. WHSE AREA: Length Width Height Sq. Ft. OTHER AREA: Length Width Height Sq. Ft. APPLICANT S Tel.)Date ' .9-9'1 VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) po Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOM VALUE Building Use Construction Type Occupancy Group Air Conditioning []Yes []No Fire Protection Provided O Yes O No Performance Bond Amount $ See Reverse for Schedule Received O Yes, O No Permit Fee Plan Check Fire Surcharge $ aa3a� $ Jaw $ /i- or) State Surcharge $ (st . �J U SAC Charge $ LA slon control $ S'00 Park Fee„ $ Spec. Assessments.$ Driveway Escrow $ TOTAL $ See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1050 per SAC Unit (Plans to MKCC for determination) $450.00 Conservation Plan Review Fee Determined. By Engineering Agreement Necessary [] Not Necessary O feet x $13.50/foot ATTACH STIPULATIONS BUILDING PERMIT FEE SCHEDULE $1 to 500 $21 (Minimum Fee is $21 plus surcharge) 1' 501 to 2,000 $21 for 1st $500 plus $2.75 for each addn'l $100 or fraction, to and including $2,000 2,001 to 25,000 $62.25 for 1st $2,000 plus $12.50 for each addn'l $1,000 or fraction, to and including $25,000 25,001 to 50,000 $349.75 for 1st $25,000 plus $9.00 for each addn'l $1,000 or fraction, to and including $50,000 50,001 to 100,000 $574.75 for 1st $50,000 plus $6.25 for each addn'l $1,000 or fraction, to and including $100,000 100,001 to 500,000 $887.25 for 1st $100,000 plus $5.00 for each addn'l $1,000 or fraction, to and including $500,000 500,001 to 1,000,000 $2887.25 for the 1st $500,000 plus $4.25 for each addn'1 $1,000 or fraction, to and including $1,000,000 1,000,001 and up $5012.25 for the 1st $1,000,000 plus $2.75 for each addn'l $1,000 or fraction $1 to 2,000 $29.25 2,001 to 25,000 $29.25 for 1st $2,000 plus $5.85 for each WWI $1,000 or fraction, to and including $25,000 25,001 to 50,000 $163.80 for 1st $25,000 plus $4.225 for each addn'l $1,000 or fraction, to and including $50,000 50,001 to 100,000 $269.43 for 1st $50,000 plus $2.925 for each addn'l $1, 000 or fraction, to and including $100,000 100,001 to 356,000 $415.68 for 1st $100,000 plus $2.275 for each addn'l $1,000 or fraction, to and including $356,000 Over $356,000 $1,000 (Balance due with issuance of building permit) PERFORMANCE BOND POLICIES When a building permit is issued for a commercial, industrial or a multiple dwelling residential project which requires outside improvements,a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting, water & sanitary sewer services, and storm drainage systems. Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3 % of the building permit value up to a 2 million dollar project or a $60,000 bond. Actual amounts will be rounded to the nearest $100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects with no outside improvements, generally will not require a bond. Bonds must remain open until the project is fully completed. Reproducible "as -built" drawings of all exterior underground utilities must be submitted to the City Engineering Dept before the project is considered complete and the bond released. All bonds will be held over one winter and through the next growing season to insure the survival of all landscape installations. The City will then inspect these properties in August of the year following the initial planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed. 571 km Elder -Jones Building Permit Service, Inc. a= 3 1124 East 80th Street 4 . Bloomington, NII 55424 Prone: (612) 854.2854 Fax: (612)854-4909 To whom it may concern: we. at Elder -Jones BWLd—ing Permit Service, Inc. are acting as an agent for Renewal by Andersen. If there are any: questions, or if the'permit has to be piERR in person, please give us a call at the number above. If the permit can be mailed back to us, we have enclosed a self-addressed envelope for your convenience. Thank you, AaA.� Tim Schenk ext 140 Jolene Connors ext. 134 Holly Connolly ext 158 Kara Lewis ext. 147 Elder -Jones Building Permit Service, Inc. 1120 East 80th Street • Bloomington, Minnesota 56420-1498 812-854-2854 FAX, 612-854-4909 Building PLUMBING Permit No.: -- - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: YOUR E-MAIL ADDRESS a M }des -a a 19,1ge �/ ® Y I i' l k' DATE (C'/� SITE ADDRESS ��' �� d�l, �? i (� fd Vie.. ) c THIS APPLICANT IS: 0 OWNER ❑CONTRACTOR PROPERTY NAME: , `s- i L41,-5, ADDRESS: CITY s STATP� IP OWNER/ TENANT PHONE: ri 6,3 - S -�� CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK Yl1ii'� r� �T QrC e K 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. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS —SHOWER _ WATER PIPING _ _FLOOR GAS PIPING o&w cn7LicEw4 _ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER " 1 8 f , u Permit Fee $ 5 al Number of fixtures $10.00 x $10.00: Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ i ;_ 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 o a work which require review and approval of//plans. SIGNATURE OF APPLIC PRINT NAME(?)M ' C° DATE t. A41 0� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �IoS Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE1 r �_� / YOUR E-MAIL ADDRESS SITE ADDRESS 4P�(G 'J } I n SCP 16r/O/ THIS APPLICANT IS: OWNER JVCONTRACTOR PROPERTY h❑ NAME:I\C.s M jV K�hr1 U/ OWNER/ ADDRESS: &,2((. 5i i✓ son 0Sl✓o/ CITY_Q'/Glit(?y STATE�nV ZIP T5y3� TENANT PHONE: 16 3 q CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY CONTACT PERSON: JOANN ? INREN SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 9320 EVERGREEN BLVD STE EITY "COON' 'RAP.IDS sTATEMN ZIPS5433 APPLICATION PHONE 763 – 757 -- 6202 FAX 763--757--6701 PERMIT TYPE 9SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 13 NEW PREPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK or%jaill FU&V,,t - t ,L)d C ) r P llv —1 () vU 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) Equipment Installed MFG: P Lluo, MODEL: 0 (rPA/ lei SIZE/BTU 10c) ()o MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU _A/C $25.00 —FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR BOILER $35.00 FURNACE $35.00 —GAS UNIT HTR $10.00 LINER $10.00 _GAS DRYER $10.00 —POOL HEATER $35.00 —CHIMNEY DUCT. WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 i" , • , .,,. f � �i'' ,. ` �� ; '-,',. 1 � M1wE�`',Es'' � . 1, a u f�1 fiIV14 � .._�r� .. PE 41 � r n ,h + Fµ�� Permit Fee $ CM Number of fixtures @ $10.00 x$1 .00=$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ vo State Surcharge = $ .50 Total = $'-S 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. a SIGNATURE OF APPLICANT eA. NAME ROGER HOFFHEIN DATENA r� g City of Fridley Building Inspections1)epartment 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 I City of Fridley Residential Mechanical Application Page 2 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/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building MECHANICAL Permit No. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 �4�U Q 2 2010 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 1.1.2010 DATE ` "1 YO -MAIL ADDRESS SITE ADDRESS 6 p_# ri-c d � SISp� N 4— THIS APPLICANT IS: 6 ❑ OWNER ONTRACTOR PROPERTY NAME: .� ADDRESS: CITY STATE ZIP OWNER/ TENANT r� '10� PHONE: CONTRACTOR COMPANY NAME: 1� SUBMIT A COPY OF CONTACT PERSON: NqUwj STATE LICENSE�e# S 7 ; EXP DATE YOUR STATE LICENSE WITH A ADDRESS 1' VP v— K9 C �`B STATE 'SLIP APPLICATION PHONE v FAX PERMIT TYPE OINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW .REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: MODEL: SIZEBTU LI� MODEL: ��SIZE(BTU MFG: MFG: MODEL: SIZEBTU _ C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 "�• t i A /tee � t � ,� �� ' �s � 1'�y � 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 e f all wQrk w c requires r iew and approval of plans. c t SIGNATURE OF APPLICA PRINT NAME APPROVAL INSPECTORS SIGNATURE DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 4 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC 0 NEW HOMES/ADDITIONS 0 EXISTING HOME 0 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/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N 1104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.