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PRE 2010 DOCSCity ®f Fridley, BUHDING PERMIT N® 7041. Date: 4/1 Owner: 6ABuilder Address Address Y LOCf�TI OF BUILDING No. Street .-+Part t Lot _ __ Block ,-1 Addition or Sub -Division _ Corner Lot s� Inside Lot _ _ Setback -- Sideyard Sewer Elevation _ _ - Elevation S DESCRIPTION OF BUILDING be U as: .r �, Front Depth �� Height �� Sq. Ft. Cu. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction ' _Fant. ------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 f rth and in compliance with all provisions of ordinances of the city of Fridley. 6 In consideration of the payment of a fee of $, permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance . and moving of buildings within the city limits and this permit may be revoked at any time upon A tion o any of the provisions of said ordinances. / A 0 NOTICE: Thb permit dose not sorer the construction, instaWon for whing, phinhing, gas heating, sewer or water. Be sure to as the Building hqm for for repartee permits for these hems. To be used .a :...-. Front. Death_ • _� %� Cu.. Ft: Front Depth Height . Z `...•4r .Cat .. .. f ,• . "bra• Ft b. t of 1C1*6"At iCtion Est.$mated .Cost To -be'Complaed .. The uhAditsigned hereby makes application 99; a,permit for the, work.hereiia specified, agreeing to Ab,all..work in strict accordaace with the City of Fridley Ordinances and rulings."of the Department of Buildings, and,•hereby declares that.el�. the facts and represeatatious stated'in this application are true and,correcC:. (Schedule of Fee Costs can be found on the Reverse Side. 4 BUILDING PERMIT FEE SCHEDULE Section 2. The'lispector"of Buildings shall, before issuing any permit for the erection of any building or structure., or for any addition to any exist- ing building or structure, or for'any alterations or repairs to any existing building or structure, upon application therefor, 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: 2.1. For any such permit for the erection of any fire -proof building, other than_a.garages warehouse, factory or grain elevator, or for the-erection'of Any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents". 2.2.'`For any such permit for the.erection of any fire -proof garage, warehouse,_ factory or grain elevator, or for the erection of any fire. -proof addition, for .similar occupancy, to any existingbuilding shall be at' the rate of -$1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building. Code. HOUSES 2.3. For`any'such"permit for the erection of'any non -fireproof building other than a garage, warehouse, factory or'gran"elevator, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.09 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, fac.tory..or grain eievator, or for the erection of any non -fireproof' addition, -for --similar occupancy,to any existing building or for each such _w_. building or.addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.00., - For the purpose of computing fees for building .permits, the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of ithe .basement or cellar to the average height of the upper surface or to the average height of the roof surface of the maim gable of a pitched roof. 2.5. 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. 2.6. In no case shall the fee .charged. for,: aisy- permd t -as set forth in. Section 2 be less.ihan $4.00. City of Fridley Application for Plumbing and Gas Ruing Permit Dept. of Bldgs. Phone SU 4-7 DESCRIPTION OF WORK Number, Kind and Location of Fixtures 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. %") "g, Minn IP-- 19-4 Y Owner (� Kind of Building Used as To be completed about PARTIAL RATE SCHEDULE Estimated Cost, $ PLUMBING FIXTURE RATES: NO. RATE TOTAL Old New. . ding Permit Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin .... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... Z x 2.00 $-1- ) L,�j New Ground Run Old Bldg. ...... . x 3.25 $ ROUGH 9 1 J GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .........................._�_ x $1.50 $--/Se Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE e 7! d FINAL d2 I 3� i Z7�Zi gz ojg,i� 0 z z e v WATER HTR. <�a? 0 o' F N GAS ELEG rn Base 1st ` I 2nd 3rd 4th ° Future Connection Openings _ Connected with New Fixture, Old Openings Sewer Cesspool 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. %") "g, Minn IP-- 19-4 Y Owner (� Kind of Building Used as To be completed about PARTIAL RATE SCHEDULE Estimated Cost, $ PLUMBING FIXTURE RATES: NO. RATE TOTAL Old New. . ding Permit Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin .... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... Z x 2.00 $-1- ) L,�j New Ground Run Old Bldg. ...... . x 3.25 $ ROUGH 9 1 J GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .........................._�_ x $1.50 $--/Se Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE e 7! d FINAL d2 I SUBJECT PER City of Fridley 6 AT THE TOP OF THE TWINS BUILDING P E R M I T Ir? i l6. COMMUNITY DEVELOPMENT DIV -335 1 r PROTECTIVE INSPECTION SEC i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/31/95 � JOB ADDRESS 7490 Stinson Boulevard NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Dalberg Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John/Phyllis Hildreth 7490 Stinson Blvd NE 784-5421 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Custom Remodelers Inc 8729 Central Avenue, Blaine 55434 784-2646 1748 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION [ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling; Soffit & Fascia 9 CHANGE OF USE FROM TO STIPULATIONS Ventilation must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $9,800 $4.90 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- Fire SC $9.80 S UCTION OR THE PERFORMANCE OF CONSTRUCTION $162.25 PLAN CHECK FEE TOTAL FEE 3//� License SC 5.00 $181.95 siGNaruREOFcoNTRa TOR OR AUTHORIZE GE DarEi WHEN PROPER VALIDATED THIS IS YOUR PERMIT 0 iNSP ')AT SIGNATURE OF OWNER iiF OWNER BUILDERi iDATEt •. air.:. .:2 .. ,nuc,ti l.lr. .... 1 .. e. c .r.. ., ......vv,; ., .%-'-'-'— oc ...... aa, .,. ac..., ,as : ;hri:. :.:.. ... .. ...... ......... .. . ..... . ...... . ...... . . .. .. ..... ,.,•, ,. ... , , . .,...., 0 1'1.11.11ual. s, , ..,. , .. I NEW [ ] Effective 8/1/95 ADDN [) CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application*3531 ConstructionAddress:.. Legal Description: , y,� �, � vim, a 1 � w sv r/ 101, Owner Name & Address:. e „) Tel. # gy - .s y / Contractor: u S Adm a,&/ e e2 x.✓ _ MN LICENSE # y Address: T? ;2-!? °, ✓tel s-.�,1' . Tel. #�- Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: ' '3 o % S— (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ' / ,APPLICANT: P . CITY, USE ONLY Permit Fee $ �c �. S� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ �/. %'� $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [) Not Necessary [ ] TOTAL c- �J STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official 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 repair 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: TOTAL. VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000. $25,01 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,00 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000. $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION 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 Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. V . - 1% CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ 2_0 -DO State Surcharge TOTAL FEE $ .50 MINIMUM FEE FOR ANY HEATING/COOLIN_LVENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On March 1, 1996 JOB ADDRESS ?q ICS 5hnson f31yd 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. NOV V I t ,1996 OWNER �Ihn 4'1d_rr_th' 7?Li " s -V 2 l BUILDING USED AS MStd_ff ESTIMATED COST PERMIT N0. 17 SCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) arm A' Trade Name 6 I Size No. V BTU I OM HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No. EDR HEATING COMPANY 11 NIL �11�0n-,No- - - Signed By-OWJM, Approved ByRough—In Date Final Date FILL OUT BACK SIDE R STACK VERIFICATION ON REPLACEMENT FURNACE 6 Has total heating BTU's of 2-50,0400 .07 e7 All other BTU's 01-4000 TOTAL BTU's /m, b 0 z) 7. Has a liner been provided for water heater Yesyl) No ( ) 8. Has combustion air been provided for water heater Yes*� No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHIMNEY 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 2-50,0400 .07 e7 All other BTU's 01-4000 TOTAL BTU's /m, b 0 z) 7. Has a liner been provided for water heater Yesyl) No ( ) 8. Has combustion air been provided for water heater Yes*� No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: 01 SUBJECT 4fE RM1IT NO. city of Fridley 29588 AT THE TOP OF THE TWINS BUILDING P C DR' A I T � G Y,� RECEIPT NO. COMMUNITY DEVELOPMENT O r � � PROTECTIVE INSPECTION SEC.. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 1 910-F15 6/1/99 JOB ADDRESS 7490 Stinson Blvd. 1 LEGAL LOT N0. TRACT OR ADDITION SEE ATTACHED DESCR. 3 JBLOCK 2 1 Dalberg Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Hildreth78()-5421 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118721-6628 2179 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION XX REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (26 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with thEState Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2272$1.14 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 $83.25 + $83.05 IF Fire SC $2.27 PLAN CHECK FEE TOTAL FEE License SC $5.00 1$174.71 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT ,DATE, WHEN PROPEA4Y VALIDATED THIS I YOUR PERMIT BL G INS- OATf SIGNATURE OF OWNER,IF OWNER BUILDER, IDATEI 01 NEW [ J Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER j' SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �4 BUILDING PERMIT APPLICATION,! D ConstructionAddress: � Legal Description: e �� Owner Name &Address: � "�\(�„ ,— �,)fi'11,sri j1j�UQ�, Tel. # Contractor: m MN LICENSE # Address: 3 -ASC S OQS\� Ilcs -Pi L nu"'A-�'�'/ ? Tel. # _7,f,21--(oQaR Attach% this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. ' GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: p U V °� Construction Type: Estimated Cost: $ l �� . 6 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: b �q APPLICANT I ap"k!la) _Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL P5- ,{ CITY USE ONLY $"r Fee Schedule on Reverse Side $ -71.001 of Permit Valuation (1/10th%) $ 1 ' i /- $.50/$1,000 Valuation $ $1000 per SAC Unit / $ $5.00 (State Licensed Residential Contractors) ,�� /- ✓I $ Alt. "A" or Alt. "B" Above q,4 C $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: I 17` �' I CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000 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�� RATE SCHEDULE OWNER Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS �a Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) ESTIMATED COST 00..E PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units C'rcle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name ®X 4911 Size No. BTU _ ?,� HP EDR *Air Conditioning -ASI Sizes $ 25.00 $ Fuel A Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed TEL # REINSPECTION FEE $47.00/Hr 4�(f *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date /100 UU written permission from adjoining property o ne `0 FILL OUT BACK SIDE FOI1 STACK VERIFICATION ON REPLACEMENT FURNACE 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) Signed By: Date : SUBJE6T PERMIT NO: City ®f Fridley 3 16 0 0 \ AT THE TOP OF THE TWINS BUILDING P E R M I T � � RECEIP COMMUNITY DEVELOPMENT DIV. d PROTECTIVE INSPECTION SEC. 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 �.j 612-571-3450 910415 12 / 18 / 00 / / JOB ADDRESS 7490 Stinson Boulevard NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Dalberg Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John/Phyllis Hildreth 7490 Stinson Blvd NE, 763-784-5421 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Budget Exteriors Inc 8017 Nicollet Ave S, Bloomington, MN 952-887-1613 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 6564 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Window Replacement 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. permit hispection Cards Will Be Mailed To Ham'eawnor TO Pne' TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAO SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 @@ $4.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT `x9,000 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- $167.25 Firer $9.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK F TOTAL F E Lice e C $5 - YO/ 85.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDAtE, EN ROPER ALIDATED T SIS YOUR MIT 'P S-GNATURE OF OWNER ',F OWNER BUILDER, (DATE, JUN -21-220W 15:Z7 FROM C I Tr' OF FR I DLE i' TO NEW (] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAM LY AND DUPLEXES R-1 AND R.2 BUILDING PERMITAPPLICATION Construction Address: '1 C'® ��C=�� ; C� 95280'72659 P.02/03 Effect" 1/1)2000 (763) 672-3$04 Bldg k" Legal Description: Owner Name &Address �- �1. '�� TOL # '1 �'1�q c Contractor. MN UCEN #_L; L5 Address: �' C;` TeL �! �� S Attach to this appli adw, a Certificate of Survey of the lot, with the proposed c onstrucion drawn on 9 to scale. LNM AREA' Length WkIth Hight Sq. Ft GARAGE AREA; Length � 1Mdth He1ght�. gy Ft DECK AREA; Length ® Vit Hgt/Grwnd Sq, Ft OTHER: , f- Constmctton Type: L�(�� Estimated cost $ q n 0 Dnve"Y Crab Cut V*M Needed Ft + 6 Ft Ft x $ S DAM LZ 9 � CSC APPLICANT: (k_vj C) C , Tei, AW USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Call (763) 5124604 for Penni Fees if maWnq in appffcaftm $ 1(O • a Fee Schedule on Reverse Side $ (VOC), OC) .041 of Permit Valuation (1/10th*/o) $ $.50/$9,000 Valuation % $1100 per SAC Unit $ 8E()_$5-00 (State Lioensed Reskntia! Com) $ Alt. "A" or AIL "B" Above $----.$450.00 Conservation Plan Review $ Fee Deierr *wd by Engineering $ Agreenxmt Necessmy [l Not Necesary [ TOTAL STiP �l�� /'rte �—!i"" uLAT�olvs ��<�— SuBjECT NO. City of Fridley 34022 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. • ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER DATE PAGE O: APPROVED By j �•"i CITY HALL FRIDLEY 55432 763-571-3450 910-F1511/12/03 r JOB ADDRESS 7490 STINSON BLVD NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Dalberg Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Hildreth 7490 Stinson Blvd NE 651-784-5421 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Tacheny Roofing & Siding Inc 2980 Rice St, Little Canada, MN 55113 651-484-1466 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 7596 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑x REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Roofing repair 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,500 $1.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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 PLAN CHECK FEE TOTAL FEE ice se SC $5.00 1 $92.00 SIGN TURE OF CON 7 PAC TOR OR AUTHORIZED AGENT IDATEI ,WHEN PROPERLY VALIDATED THIS IS YOU PER IT G INSP �3 fIAIE S-GNATURE OF OWNER,IF OWNER BUILDERI IDATEI NEW I ] CITY OF FRIDLEY Effective 1/1!2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Constructic Address: Legal Description: YPxa l Y Owner Nar ,,ta & Address: Contractor: Address:_z LIVING ARE I.: GARAGE Al l -=A: DECK ARES OTHER: Tel. #_ 1cF,-.,t -11�,H f�l:1 ;NSE * Tel, # LOU LW9 LC.L(& Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft, Length Width HgVGround Sq. Ft. Constructior 'rype-.-ffrf 1Yp �m Estimated Cost: $ f� , Driveway Cr •b Cut Width Needed: Ft, + 6 Ft:i Ft x $ = S DATE:A'; U--') APPLICANT: _+E �:� ! V� 1( j _ Tel. #1Ca:i L- U I r1n Y Call (763) 572 .:1604 for Permit Fees if mailing In application or Fax to 763-571-1237 if using credit card and we will call you for c, i rd number. s� CrTY USE ONLY - Permit Fee $ Fee Schedule on Reverse Side Fire Surch� !•ge $ _ ® .001 of Permit Valuation (1110th%) � State Surct arge $_ $,50/$1,000 Valuation SAC Charg;:, $ $9200 per SAC Unit License Su • harge $ •60 $5.00 (State Licensed Residential Contractors) Driveway E.crow $ Alt, "A" or Alt. "B" Above Erosion Co -trot $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Mair Charge $ Agreement Necessary [ j Not Necessary [ J TOTAL $ - STIPULATIONS 01/0 �x D9/ol_