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PRE 2010 DOCSBUILDING PERMIT N° 2217 Village of Fri. leY , Minn. , Date, .... ........ . Owner Builder ........................... Address .......... ..........Address.................. ddress.................. .. ...... ........... ... LOCATION OF i BUILDING No. ... I StreetOr .. .. .. Part of Lot Lot -. � .V�l lock .. _ l � ..... Addition •r S�b Division ... � ................... , —'eve... Corner Lot ..... Inside Lot ... Setback °` ' Sideyard , '``................ f DESCRIPTION O BUILDING To be Used as: .. Front . ,.. Depth Height _........ Sq. Fi........... Cu. Ft.. ....... .. f.­­ .. Front ......... Depth ........ Height . >........ Sq. Ft......... Cu. Ft, ........ Type of Censtructioa 41140YAVAVLEst Cost . 10ASO V . .... To be Completed it In consideratia I i i. n i of the issuance to me of a permit to construct the building ;,described above, I agree to do the proposed work . accordance with the description above set forth and in compliance with all provisions of ordinances of . the 'age of',Fridley. it....................... In ideration,'of the payment of a fee of $..140, permit is hereby granted to ....... "construct ;,-�,,� the express'eoriditia done in, around and to the building or addition as described above. This permit is granted upon that the person to wholn� t'f is granted and his agents, employees and workmen, in all work upon said building, or any pari thereof,"'shall. conform' in all respects to the ordinances of Fridley, Minnesota in the village limits garding location, construction, alteration, maintenance, repair and moving of buildings with- and this permit may be revolted at any time uon violation of any of the provisions of said ordinances. ". `ice o . Building Inspector Ur V­ NOTICE: l This permit oes not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. le sure to see the Building Inspector for separate permits for these Items. 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) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On August 1, 1995 JOB ADDRESS ( YID / cSy sJ State Surcharge TOTAL FEE s36? � MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION 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. Burner Trade Name BTU HP Size No. HEATING COMPANY &-d4l-j AZ EDR C Signed f2 G' W-4�.� Tel No. 4-/J�- C%PY.,3 Approved By Rough -In Date Final Date FILL OUT BACK SID OR STACK VERIFICATION ON REPLACEMENT FURNACE � ,� 6U The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and 30.00 rulings of the Building Division, and hereby declares that all the facts and $ $ -38 rue and correct. representations stated in this application aJ,-, ,199 $ 10.00 $ OWNER /aZcs 1 n est L� $ 10.00 $ BUILDING USED AS . [r $10.00 $ s ESTIMATED COST �'f u c� PERMIT NO. $ 25.00 $ QESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm A' Trade Name �A�Z&x .. Size No. LIC, 7A - BTU i1 HP EDR $ Fuel IU d4--ITotal Connected Load State Surcharge TOTAL FEE s36? � MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION 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. Burner Trade Name BTU HP Size No. HEATING COMPANY &-d4l-j AZ EDR C Signed f2 G' W-4�.� Tel No. 4-/J�- C%PY.,3 Approved By Rough -In Date Final Date FILL OUT BACK SID OR STACK VERIFICATION ON REPLACEMENT FURNACE � ,� 6U CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (°°15'No ( ) 2. Is free from rust or deterioration Yes (V No ( ) 3. Has no foreign objects lodged within Yes ("'I'No ( ) 4. Is securely supported Yes (P-,:f"No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (/-f 'No ( ) 6 Has total heating BTU's of , All other BTU's TOTAL BTU's -7 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: Listt ALTERATIONS Being Done: / �/`�-�✓�'.�r ��J' `7�i�,�r�-cam HEATING CO:,�� Signed By: Date: % —�� SUBJECT ' City of Fridley 2 9361 361 WI AT THE TOP OF THE TNS BUILDING P E R M I T r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. � PROTECTIVE INSPECTION SEC. r � 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 5/3/99 JOB ADDRESS 6401 Taylor Street 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. N 701 of 3 2 Sub. 88 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ray Breffle, 6401 Taylor Street, Fridley, MN 55432 571-4461 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Twin City Roofing, 8605 Dunkirk, Maple Grove, MN 55311 420-4601 201-321-6 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 [ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK REroof House & Garage (20 sq.) tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. CONSTRUCTION HOURS: 7:00 a.m, to 9:00 p.m. Monday through Friday; 9:00 a.m. to 9:00 p.m. on Saturday; no work on Sunday 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. 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 $1,714.00 $.86 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 PERFORM A CE OF CONSTRUCTION $56.75 $56.75IF Fore SC $1.71 PLAN CHECK FEE TOTAL F E e� License $5.00 121.07 URE OFC 'RACTOR OR AUTHOR AGENT ,DATE, EN AL OAT IS IS YOUR PERMIT 001,ROP BL ,NSP DATE S,GNATURE OF OWNERJF OWNER BUILDER, ,DATE, NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: Address:®� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: I Effective 1/1/99 ffAVU'Vlf' , yo � MN LICENSE# �-�� V, IUW Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Sq. Ft. 4-,-t orr- Construction Type: Estimated Cost: ${ (Fee Schedule on Back) .Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:. APPLICANT:LTel. # 1,70 -?L7 � STIPULATIONS: / C l r— CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ /, / .001 of Permit Valuation (1 / 10th %) State Surcharge $ (o $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ C) 0 $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 [ ] f o2C 6 TOTAL $ , 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 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $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 $15.50. 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 $23.25. 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. Building Ck Inspections 7.63-572-3604 DATE C OO o SITE ADDRESS t' THIS APPLICANT IS: PROPERTY OWNER/ TENANT r� MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS .11-4- ME ❑ OWNER 11CONTRACTOR I CONTRACTOR I COMPANY SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: CONTACT PERSON: ICENSE # STATE L EXP DATE ADDRESS: 13562 CENTRAL AVE NE CITY ANOKA STATE >�zrn 55304 PHONE 763-757-6202 FAX 763-757-6701 Permit No.: Received By: Date Rec'd: ATEYh�zIP, SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE ❑ NEW REPLACEMENT 0 ALTERAnON/REMODEL DETAILED DESCRIPTION OF WORK 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)lSIZE/BTUTU W1.9- �O'I Equipment Installed MFG: Q'_)MODEL: V 'C�3 ®TLI MFG: MODEL: SIZESIZEBBTU MFG: MODEL: GAS RANGE/OVEN $10.00 LAIC $25.00 _FIREPLACE (GAS) $15.00 �y GAS GRILL $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 GASUNIq HTR $10.00 _LIBOILER $35.00 _FURNACE $35.00 _CHIMNEY NER $10.00 —GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ —25 TOTAL DUE $ Number of fixtures @ $25.00 x$25.00 = $6 Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ S, <�O 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 APPLIC ° PRINT NAME R®GER 1T(iFF ETN DATE eA (0 1 2 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 '7ti1_r.'77_';6n4 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING 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 UNT Energy Code 7670 or 7672 6. Duct Design Per IMC 1346. 0603.2 .a. RCCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations