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PRE 2010 DOCSI: �l �l I, Village of Fridley, Mann. BUILDING PERK" NO 88 Office of INSPEOTOR OF BUIIMINGS Fridley, Minn•, , 19 L f LOCATION OF BUILDING No. t !Street_ `*, r t ` tiA ^ Part of Lot -L" LotBlock Addition or Sub -Division 1i DESCRIPTION OF BUILDING Front 6 Depth IS, Height Stories Manner of Construction_ To be used as t r'" To be completed — Estimated Cost Wa Permit is hereby granted to the building described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, 'employees and workmen, in all the work done in, aound and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. II , �2 Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the' issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein sated. Subscribed and sworn to before me at FridleY, Minnesota, this day of-,' �j' ` A.D. 19" f 9 II Original. 0 PERMIT for PowerRants and Heating, Cool- ing, ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of_ �Heating Plants Ja1i=Afj2 a A to be 4taped feted—repaired Make ,Size Oil fired ; Coal fired—L Gas fired—Z; Gas Authorization No. Approved by Final Inspection 19_ Inspector Perrmit N° 4811 Fee $ B� Office of the Inspector of Buildings City of Fridley City of Fridley, Min J 0 , 19_ Owner Location Kind of Building-:., How Occupied A!)YZb",0, Work to be Commenced—, 19— To be Completed ,19_ Estimated Cost, $ 1:pd,2-06 (gVew, Building Permit No Permission is hereby granted to -aO, %1-l0Jt� U 4jU p f) � _.�� to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this permit on file in the office of the Inspector of Buildings.t p; \ ts( /I�i�l , Inspector of Buildings .01�42 2M11 -VV City of Fridley 5915.51 Application for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone SU 4.7470 DESCRIPTION OF WORK 6424 Taylor Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ NO. RATE TOTAL — x $1.50 $ — x 1.20 $ — x 1.00 $ — x 3.25 $ — x 2.00 $ — x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ li Gas Range to 200,000 BTU .............. x 2.00 $—T.—O— REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 2.00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 16 Sep 66 19_ Owner L K Peterm n Kind of Building fr Used as Pe To be completed about 21. Se Estimated Cost, $ • 00 Old—New. Building Permit N ° e fit No. /% if Signed V, ROUGH FINAL d2 '2M Business Phone No 8� �U'd 0 �U' 6 z t F • N WATER HTR. GAS ELEC. +' 3 ��F vi� c� S <3 Sn C�ry0 Base 1st connyd Rkll 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ NO. RATE TOTAL — x $1.50 $ — x 1.20 $ — x 1.00 $ — x 3.25 $ — x 2.00 $ — x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ li Gas Range to 200,000 BTU .............. x 2.00 $—T.—O— REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 2.00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 16 Sep 66 19_ Owner L K Peterm n Kind of Building fr Used as Pe To be completed about 21. Se Estimated Cost, $ • 00 Old—New. Building Permit N ° e fit No. /% if Signed V, ROUGH FINAL d2 '2M Business Phone No Application for Power Plants and Hearing. Cooling. Ventilation. Refrigeration and 01, Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $� Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water ............ . .. . . . 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $� over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $--�— Additional Fixtures x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule $ TOTAL FEE $ Dept. of Bldgs. Phone 560-3450 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 Kind of Building za�� L Used as � To be completed about �/ Estimated Cost, $ ,t'r'y 0 Old—New. Building Permit No. Permit No.rl DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm —No Trade Name ti Size No os ` ® aid Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade NameSize No- Capacity Sq. Ft. EM R BTU H.P. (REMARKS -OVER) NA Signed_r:�'' - L By 4E Business Phone No- �7e SUBJECT NO. CitY of Fridley ®136KNIT �� AT THE TOP OF THE TWINS PERMIT r BUILDING RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r i PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-5650-3450 910-F15 7_28_76 JOB ADDRESS 6424 Tavlor Street 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS Lloyd Peterson 6424 Taylor Street ZIP PHONE N -F- 3 CONTRACTOR MAIL ADDRESS R;;rklpy ConStri-ICtion 1311 24th ZIP PHONE LICENSE NO. Avenue N.E. 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 Il 8 DESCRIBE WORK Install aluminum trim & gutters 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. aluminum 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 I HAVE READ AND EXAMINED THIS APPLICATION 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 $1 OO .5O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEIE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.50 PLAN CHECK FEE TOTALFEE _29-2 8.00 SIGN�RACTOR OR AUTHORIZED NT (DATE) / HEN PROPERLYyV IDATED THIS IS YqW R IT BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAMEBUILDER: ADDRESS: / ADDRESS: NO•.'� STREET: LOT: BLOCK: ADDITION: ��Z0A,1� 1A CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: y Type of Construction: 41&, Cost: $ To Be Completed:zz The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE:/4SIGNATURE. (See Reverse Side For Additional Information.) R BUILDING PERMIT FhI: SCHE'DULL 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: NEW CONSTRUCTIO.W: Single Family Homes and Garages: $/4.00/1000 cubic feet PLAN CHECK: 25 percent of building permit fee. 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 -f $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 $7.50. 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 proceeding 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. 9 0 • STATE OF MINNESOTA CITY OF FRIDLEY CITY COUNCIL PROCEEDINGS 5-, 6 In the Matter of Amendment to SP #84-15 to allow boatyard and be displayed outside at 6319 Highway 65 N.E. (Lift Ski and Bik itio furniture to . Do ument-668 Scott Holmer - The Lift Ski & Bike, Owner The above entitled matter came before the City Council of the City of Fridley and was heard on the 15th day of October 1 1984 , on a petition for a special use permit pursuant to the City -6—f Fridley.s Zoning Ordi,nance, for the following described property. Lots 9, 10, 11, Block 1, Moore Lake Highlands, IT IS ORDERED that a special use permit be granted as upon the following conditions or reasons: Special Use Permit was erroneously filed against the above referenced—pjW-erU. The City of Fridley hereby directs the Anoka County Recorder to i-e—move record STATE OF MINNESOTA ) COUNTY OF ANOKA ) ss. CITY OF FRIDLEY OFFICE OF THE CITY CLERK I, Richard Pribyl, Acting City Clerk for the City of Fridley with and in for said City of Fridley, do hereby certify that this Amendment to SP #84-15 is correct and true. IN WITNESS WHEREOF, I have hereunto set my hands this 25th day of October 1985 t;TATr c) -F kAQ1,;F-f-e,-FAJ 6c,utjT-q oF AtJrKA Richard Priby-T. Acting City Clerk On this 25th day of October , 1985 , before me, a notary public, within and for said County, personally appeared Richard Pribyl to be know to be the person described in and who executed the foregoing instrument, and acknowledged that he executed the same as his free act and deed. .5-1 DRAFTED BY: The City of Fridley 6431 University Avenue N.E. Fridley, MN 55432 Notaley Public SHip!.r-�, A. HAAPALA NOTARY ;.;:L.IC - ANOv' COUNT( MYCOM 1iSSisnExpjmsMay2"1.19S6 (SEAL) L§ OFFICE OF COUNTY RECORDER STATE OF MINNESOTA, COUNTY OF AMOKA 1 EO00 56 . mens was filed in this office for record on the_ 2 b 1985 _q,p1 19_,_,,, 0 o'clock AM,� and was duly recorded a �ume� Grantor cou y Recorder mrantc+a oe>»,ty Reooaua Che�lrad MWgin Tr. Incl= n a M 0 inn as szq L§ OFFICE OF COUNTY RECORDER STATE OF MINNESOTA, COUNTY OF AMOKA I hereby certify that the within irobw . mens was filed in this office for record on the_ 2 b 1985 _q,p1 19_,_,,, 0 o'clock AM,� and was duly recorded a in book__ • cou y Recorder oe>»,ty �� c•.r✓� �Il �r 5 S � 3 � 'k /9 0"k0 of County Recorder County of Anoka, Minn. I hereby certify that I have compared the WM4 Instrument with the original Instruramd �Q�now on flte Inmy office, end * at It Is a true and correct copy of the same. end Of the whole thereof, and that the above is 0 tf" COPY of the riling tirerooe, Daed��- a s-- 19ZL— n Recorder sueJEcr PE IT NO. City of Fridley (-� 3360BUILDING AT THE TOP OF THE TWINS PERMIT ` RECEIPT NO. `- _____ COMMUNITY DEVELOPMENT DIV. � INSPECTION SEC. r � PROTECTIVE -U-BE- REV DATE PAGE OF APPROVED BY It �; ,'� CITY HALL FRIDLEY 55432 1 •___763-571-3450 910-F15 6/13/03 10B ADDRESS 6424 Taylor Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fred Brandt 6424 Taylor Street NE 763-571-5377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sela Roofing & Remodeling Inc 4100 Excelsior Blvd St Louis Park MN 55416 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 612-823-8046 0001050 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE X 8 DESCRIBE WORK Replace 13 windows within existing openings 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. Caulk and flash all exterior openings. TYPE OF CONST OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $9,828 @ $4.91 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 OT ER STATE OR LOCAL LAW REGULATING CON. $181.25 Fire SC $9.83 STRUCT N OR THE PERF MANCE CONSTRUCTION PLAN CHECK FEE TOTAL FEE is :se SC $5.00 1 $200.99 SIGN ATU EOF O TRACTORO THORIZEO AGENT iOATE, ��1 HEN PROPERLY VALIDATED THIS IS YOQR PER IT _ S,GNATURE Of OWNER�-F OWNER BU4DE A. iDATE, 1t5UUU INS pAT NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 6 L 2 I L--' )i:4r Legal Description: Owner Name & Address: Tel. # Contractor. '100FIN w REMODELING, INC. MN LICENSE # 4100 OR Bff� Address:_— ix- I Q1 ��UN 55416 Tel. # G I Z - 3 �,� v%6 ID 00001050 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: Construction Type: C' C l n 3 n cQwS Estimated Cost: $ 92-1 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: d APPLICANT: Tel. # 61z 91�'°9'1 �a Call (763) 572-3604 for PerMlt Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $_ l "2&_ $. $� TOTAL $ o2oo - D CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUII.DING 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 $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,00 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet times $17.00. 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. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY , DATE�7 YOUR E-MAIL ADDRESS SITE ADDRESS �v� (/_CIYI THIS APPLICANT IS: V ❑ OWNER CONTRACTOR PROPERTY NAME: A4"wr OWNER/ TENANT ADDRESS: Jew 66d�k17"— 6r' CITY STATE ZIP PHONE: CONTRACTOR nn NAME: ^ (w_ STATE LICENS EXP DATE 1&14 i SUBMIT A COPY OF YOUR STATE ADDRESS4 2 2 / %;Lg4f ✓ t / CITY�� STATE,'%.kLIP d.� LICENSE WITH PHONE W o((ra— 4 FAX ® b APPLICATION PERMIT TYPE gSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW t9fUPLACEMENT 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) BATH SINK/LAV _FLOOR DRAINS t SHOWER _ WATER PIPING —BATHTUB —GAS PIPING rNa:r, rnruruNsi:)_ SWIMMING POOL _ WATER SOFTNER ($35) —CLOTHES WASHER _ KITCHEN SINK -1 WATER CLOSET BACKFLOW PREY. ($15) _ _ DISHWASHER _ LAUNDRY TRAY t WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ Number of fixtures @ $10.00 3 x $10.00 = $ 3 p Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $2h',5� TOTAL DUE $ State Surcharge = $ .50 Total THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. �j SIGNATURE OF APPLICANT L ✓x/ PRINT NAME�j� �i/lf�L r' 1/_40YY� DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building �� 7'CHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Emcm 763-502-4977 FAX EFFECTIVE 2-19-09 1 i DATEa YOUR E-MAIL ADDRESS �bct to n � Z i rl l�� vt lam+ �K1rr jY�T ejV �r & U00 % �.'� SITE ADDRESS L4 )(4 N THIS APPLICANT IS: ❑ OWNEW KICONTRACTOR PROPERTY NAME: 'f'r OWNER/ ADDRESS: -[o��[ 'S CITY t1�t�� d STATE MZIP �`S7� TENANT - 1103 -S l PHONE: i ' CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN ZINKEN YOUR STATE STATE LICENSE # BOND 22013346 EXP DATE 08/1912009 LICENSE WITH ADDRESs:9320 EVERGREEN BLVD NW SUITE B CITY COON RAPIDS STATE MN ZIP 55433 APPLICATION PHONE 763-757-6202 FAX 7631757-6701 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW ,REPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �ansl+aall �{emra�+i keit iyV1�/'" FEES ARE BASED ON $10.00 PER FIXTURE CEPT WHERE NOTED. FIXTURES: (INDICATE TQTAL UMBER OF EACH BELOW Equipment Installed MFG: MODEL: �j�L�y"oi SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU _�_A/C $25.00 _FIREPLACE (GAS) $15.00 RANGE/OVEN $10.00 _GAS AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEWGAS GRILL $10.00 _NEW _BOILER $35.00 _FURNACE $35.00 UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 PIPING $10.00 VENTILATOR $15.00 _GAS i. . �£+ �� �.��V �h� S �� „i �,�:S�z.YSiYY4J��,i1-�"' "`tiS ixs.,N� _ �C'YQ"������5-`3y�'''�-.�-, Yx s.. f.Y•�S� ?_.S,�z��.4' .d'�r* {. .�,:.'�4���"�FS S�C..'J<' kA�^<�� J-'304 E hS t."' .y'3'l � Y�?' i�i�:"% �' ;:'ae � �a'� $ vim., ''�i 1r�'m%3"-'�`i CkS-.,t.: y. i? ih:Yx � - t �"''.�. ''�� -<. "ai"�i +�. t--�' s. `1�Tr � ✓i:. {�• '" i P 4.s ioAXt �,<F� �..-' ... �'..'+"��tYt�h `b i-£ T'ih 3-hY vr� F' � .�' `3. � 4 ({�; ._ r� s� o��N-Cii F `� .4. Yy�-�'R4� '' ;�^ stY hL <•!. ',S °s.,a 6hr '-�<. `i��i��c� -, ?` a' v^c. ,yk�t�2��.R�u,� k � a.::b 2z` C +h "''.;:' 'N'..2x''r�<, ''kiaCn E zi".... k i ,� Y�^„...�r "T?K. 'i _NyhYv /.a 's£" ,� .b'i �,, ,�'.y`a"+'r <Y,.'^ ..# 3 ?v3-xa.' �{ S"' g s:E: �£s.-' S S , i`av� ,yi. i� n. i"rs'ry �4E ::_ ss *rt *'d.: 1 Yry( 'it St.L rw$ k .,Ft» n''uM h4^,a s".cQ .. "'i ..,.. Tl 'k 3s. �a^' PR 3 - i�'.'�d. .^..:tea p, d 3 sa'8 r'"'�' +�iS 3 3 iRA�chi? ZSF$+! ,=... <F� £Y. -.y r .:i' �= Ar'G.y <yyrx3 "R�`: E�3si- j��"t.S`<t �' Y 5if4.Kv FLU'...t :�e A`•iF ._3'{�� :4"�dtif nS Ila .6� d "F h 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 caseall work which r uire review and approval of plans. o ROGER HOFFHEIN SIGNATURE OF APPLICANT" A'1 PRINTNAME DATE / D City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 rK City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ZEXISTING 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.