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PRE 2010 DOCSPPP7P- 774 City of Fridley, Minn. BUILDING PERMIT N® 3454 Date .. /0..... �.......... f y Owner ....................................... Builder .. Address...................................... Address ............................................. LOCATION OF BUILDING No.®�.. Street..?�r�o�r�.�.'1................... Part of Lot . Lot ....4 ...... Block ..... .......... Addition or Sub -Division /�� . • ......... . P Corner Lot ............ Inside Lot A........ Setback Sideyard ... eV:710 ....... DESCRIPTION OF BUILDING To be Used as: F 4V . .... .... Front :P?-eDepth -P*.?Height Y7.: iP Sq. Ft. r. � Cu. Ft. ?!A-VJJ6 .................... Front ........ Depth ........ Height ........ Sq. Ft......... Cu. Ft. ........ Type of Construction ................... Not. Cost..................... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set foir and in compliance with all provisions of ordinances of the city of Fridley. 0. Q. .2 ® V In consideration of the payment of a fee o $. ..., 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, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Inspector 0 NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Item& P ' J AppRccftn fw Pea= M—= cad NmmNmg. Cecling. Veen aa. Redgomran end Air 6oacSti ring Sydem cad ®owicct q -1 PARTIAL BATE SCHEDULE Dept. of Bldgm. Phone M -um GFAWTY WARM AIR: PATTB 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 $ BMCH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ........ ..$10.00 $-- each add. 60,000 BTU ....................... 3.uu $ 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. IDR Steam 3.00 $_- Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 199,000 BTU) ..... ... .......... . over 169,000 BTU See Fc* Schedule GAS FITTING FEES: b 1st 3 Fixtures . . ....... Additional Fixtures I ...... Gas Range to 169,000 .......... AM CO1tMMONMG FAN HEATING STS VENTILATMG STSTM ALTERATIONS & REPAIRS ROUGH FINAL:3-o20 -- 1l 6.00 $ 5.00 $ 3 RATE TOTAL X$ 2.00 $ x .9b $ X0 &W $ ton - ft Sea Fes Schedub 19 City of Fridley: The undersigned hereby makes application for a permit for the work hereir. 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. Fridley, Minn A Owner _r J U r4 r%a . N-2 W f%„ Kind of Building — V� ®� Ae —_ Used as _ oz— To be completed about _ Estimated Cost, . Building Permit No. Permit No. � )6 HEATING or POWER PLANTS --.Stearn, Hot Water, Warm Air—No Trade Name �, � 'g f C 3 � Size No Ind Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load_ 14- a o- 0 - - - - Kind of Fuel 1 BURNER — Trade Name Sits 140 Capacity Sal. Fl. ED R BT'U MP. (MU"Rxs-OVER) &4499� ` ' CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT RATE SCHEDULE e PLUMBING FIXTURE RATES: NO. >, m New Fixtures ro $ o Future Fixtures x m 3.50 Water 01 W m •N M If Beer Dispenser W $ H E tr 14 +-1 ro e q m 4u N M pi W w tr Rain Water Leader Heater $ 5.00 Hydraulic Valve $ 5.00 Sump or Receiving Tank '� 4-1 3 5.00 Water Treating Appliance $ 7.00 Hot Water Heater $ 5.00 m 0 $ 10.00 Gas Dryer C $ 10.00 g v .ci 8' � � ro k o x m ro" rt ro �' ro � m ro .°a U D ro W �mro PD -4 U) 3 0 W v) 4 W U M � 3 C7 � C7 O as lec let 2nd 3rd 4th - (R) - Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE New Fixtures $ 5.00 Future Fixtures $ 3.50 Old Opening, New Fixture $ 1.50 Beer Dispenser _ $ 4.00 Blow Off Basin $ 5.00 Catch Basin $ 5.00 Rain Water Leader $ 5.00 Hydraulic Valve $ 5.00 Sump or Receiving Tank $ 5.00 Water Treating Appliance $ 7.00 Hot Water Heater $ 5.00 Gas Range $ 10.00 Gas Dryer $ 10.00 TOTAL Effective Date May 1, 1988 Job Address !a60'1 -° \ c n y-, '\ so,, Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. , 19 * OWNER Q� KIND OF BUILDINGS USED AS TO BE COMPLETED ABOUT N-- —L'�- C, ESTIMATED COST \ St'sn _L --I, OLD -(ice )BUILDING PERMIT NO. PERMIT NO. 16 , 222( Company Signed By Tel. No. e (� ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT XA/42 Alvltl- &4nJe, iiiIJ s 3 Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 $ ALL OTRJ:�?S AND/OR REPAIRS AND ALTERATIONS P4INIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 1% of Value of Fixture or Appliance $ PLUS THE $.50 STATE SURCHARGE Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $---y� 115� L-0 CITY OF FRIDLEY Effective Date May 1. 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement fu®ace) Gas Piping (piping eed�th new'�jk Gas Rangeea Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations li of Value of Appliance or Work COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work RATE TOTAL Job Address $ 20.00 06i U $ 10.00 $ $ 10.00 $ $ 10.00 $ Cr � $ 10.00 State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit 116# 141� ¢ /0 -,?/ MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. $ .50 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. OWNER KIND OF USED AS Fridley, Minn. -.? , /,3 , 19 TO BE COMPLETED ABOUT �i ESTIMATED COST °j ell OLD NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water,rm Air- No. Trade Name ize No. �- r Capacity Sq. Ft. EDR�T r, BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HPp — Company Signed By Gil Tel. No. 5- l y Fill out back side for stack verification on replacement furnaces 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 requirei-ilents for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rks -7 A-7" L L 4 L,ll 1 � Company Signed By Date _ /,3 , SUBJECT PERMIT NO. City of Fridley 32321 AT THE TOP OF THE TWINS BUILDING PERMIT s° � - RECEIPT NO. • _____ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 r"'1 CITY HALL FRIDLEY 55432 �'""'A" NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 11 / 14/01 JOB ADDRESS 5809 Tennison Drive NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 6 2 Parkview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Karen & Tom Gahr, 5809 Tennison Drive, Fridley, MN 55432 763-572-8430 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen, 350 73rd Ave NE, Fridley, MN 55432 763-502-4777 MN20130983 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwelling 7 CLASS OF WORK CX NEW O ADDITION O ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace 8 windows within existing openings. 9 CHANGEOFUSEFROM 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. Caulking and flashing for all exterior openings. [hermit Inspecrion Cards Will Be Mailed To Homeowner 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 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 1 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 $8,265.00 $4.13 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $167.25 $8.27 FireAp STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK F TOTA F E Licens $ .00 $ '.65 SIGNATURE OF CON TRACTOR OR AUTHORIZER AGENT IDATEi C�ffHEN ROP Y ALJDA ED is 1$ Y0ER S-GNATUAE OF OWNER OF OWNER BUILD.E R, iDATE, WL-Dor iNSP pAtE NEW[ I Effective 5/10/99 ADDN CITY OF FRIDLEY ALTER SINGLE FAMELY AND DUPLEXES R-1 AND R-2 BUILDING :1'PERMIT APPLICATION Construction Address: - S1309 a Legal Description: Owner. Name & Address: 'fix 1, 'Ton-, C < Tel. # 46$ -512-W4 3® Contractor: Renewal By Andersen N LICENSE # - 350 -73rd Ave. NE Address: Fridley, MN 55432 Tel. # 763-502-4777 Attach to. this #MN20130983 lot, with th&p._,.,.,_ . ---- DESC- ON OF UWY90VWMF.NT . LIMING AREA: Length Width Leight Sq. Ft. GARAGE AREA.: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: \aC.� �i t�.ic � rx'�-Y�e�, Construction T °-o* YPe' Estimated Cost: $ $, a�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ®?•iso.®` APPLICANT: Tel. #clsd,3NS (aON Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 1616 �e�a,J $ $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%®) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "E" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ l STIPULATIONS: C. &ize4 kk 4� C, i..... k ��3 i•4 Permit Service, Inc- x • • a 1120 East 80th Street Bloomington, NIN 55420 Phone: (952) 345-6047 Fax: (952) 854-4909 To whom it may concern: We at Elder -Jones Building Permit Service, Inc. are acting as an agent for Renewal By Anderson. If there are any questions, or if the permit has to be picked up 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, Kara Benson ext. 147 Elder -Jones Building Permit Service, Inc. 1120 East 80th Street ' Bloomington, Minnesota 55420-1498 952-854-2854 1 FAX: 952-854-4909 ` X SUBJECT City of Fridley 33634 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. 1 L PROTECTIVE INSPECTION SEC. J r 1 � 1 NUMBER 1 REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 J 763-571-3450 910-F15 6/23/03 10B ADDRESS 5809 Tennison Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 2 1 Parkview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Karen & Thomas Gahr 5809 Tennison Drive NE 763-572-8430 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Cornerstone Construction 1596 Middleton Ave, St Paul MN 55116 651-699-0032 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5257 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW. ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 1X� 8 DESCRIBE WORK Construct a 191611 x 17 T V Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARmomr, SEPARATE PERWS Before digging call f®f REQUIRE® FOR. - all utility location WIRING HE`�� 4 O02 � LUIN6 AN®8I66 E0 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,222 $2.11 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 $111.25 Fire SC $4.22 PLAN CH CK FEE TOTAL FEE i j--CHICK ic se SC $5.00 122.58 �IGNaTU RE OF -RAC TOR OR AUT.IORIZED AGENT I ID TE EN PROPERLY VALIDATED THIS IS YOIgR PERMIT :�&GINS MATE S-GNATURE OF OWNEROF OWNER BUILDER, IDATEI X NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 PIdg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1sn2"A BUILDING PERMIT APPLICATION Construction Address: �� ! �� n o 5�a 1 Legal Description: /%e c /( Owner Name & Address: Aiare a 5 5 Tel. # - 713- 3 7z - FV.70 fl Contractor: ee.,, yl/e r�®n MN LICENSE # 57 S 7 Address: /S i6 //✓1 s cfcl/r� 7`�®� A� e S� d�a�vl �1 i _Tel. # -oaf Z 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 WidthHeight / Sq. Ft. GARAGE AREA: Length ' Width ' Height "Sq. Ft. ro DECK AREA: Length / % �� BP Width r� �� `Hgt/GroundSq. Ft. OTHER: m Construction Type: �t� ��r�t�:�� eegla _9timated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: l APPLICANT: Tel. # grS'1-201-/rSZ Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge /.1�' - 11 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 [ ] 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 $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 $500,001 to $1,000,000 $1,000,001 and up 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 $50,000 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 $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 the annually determined rate. 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 r ADDRESS: J roI %,g-na14 z� LOT WIDTH SIDEWALK �U Q Q Lo z►~u O N A.. . HOUSE SQ. FT. a SIDE YARD SIDE! YARD SETBACK SETBACK �G ffe VV �. Oe -,k �J JJ a O T O • J C) rr x yZ U 1 � cC }-• d lu 11-1 N 1- U _ � CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 t AX: ( 763) t-)71-11.57 ADDRESS : 5809 TENNISON DR NE PIN : 243024240037 LEGAL DESC : PARKVIEW HGHTS ADD : LOT 6 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL PERM NO.: 2004-00403(2 DATE ISSUED: 03/30/2004 J VALUATION $ 4,150.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE 5 WINDOWS WITHIN EXISTING OPENINGS STATE LICENSED CONTRACTOR 1 APPLICANT RENEWAL BY ANDERSEN (20130983) 1920 W CO RD C ROSEVILLE, MN 55113- (763) 502-4777 OWNER GAHR THOMAS C & DHEIN KAREN J 5809 TENNISON DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construAon or the performance of construction. Bldg BUILDING PERMIT FEE 111.25 FIRE SURCHARGE 4.15 STATE SURCHARGE, VALUE 2.08 LICENSE SURCHARGE 5.00 TOTAL 122.48 PAID WITH CHECK # 034288 QUDAD ATT; D1;DTkATTQ D1r7nTTTU Vn rnD 1I7nDY 11TLTRD TT-TAAT nVQ!`DT'nPn AnnVR NEW[ ] Effective 5/109; 7e ADDN [ ] CITY OF FRIDLEY Lf 03 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� f BUILDING PERMIT APPLICATIO Construction Address: S W l C71� C Legal Description: Owner Name & Address: Tel. Contractor:; ,W�` '`, An�,c,�,� MN LICENSE # oi01309 ?, Address: 19 aood C W�S�,',nstu� l , m� SS 11� Tel. # (c5l • alo4 �[- Attach. to- this application, a- Certificate- of Survey of -the lot, with the proposed construction drawn bn it to scale. DES.C]R i0N'OF ROVEMENT'_ LIVING AREA: GARAGE AREA: DECK AREA: L •1 Construction Type: Length Length Length Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + b Ft = _ Ft k $ _ $ CITY USE ONLY Permit Fee$ , -- Fee Schedule on Reverse Side Fire Surcharge $ 1 .001 of Permit Valuation (1/10th%) State Surcharge $ 7 ®� $.50/$1,000 Valuation SAC Charge $ $1050 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 [ ] U TOTAL $ � STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 PERMIT NO.: 2004-02203 DATE ISSUED: 12/01/2004 ADDRESS : 5809 TENNISON DR NE PIN : 243024240037 LEGAL DESC : PARKVIEW HGHTS ADD : LOT 6 BLOCK 2 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES I # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 3000 APPLICANT RESIDENTIAL HEATING & AIR, INC 1815 EAST 41 ST STREET SUITE A MINNEAPOLIS, MN 55415 (612)724-1899 [IT"TWO-41111_ GAHR THOMAS C & DHEIN KAREN J 5809 TENNISON DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulatin cons}ction or the performance of construction. An cant / l Date e 1 HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 16617 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 o 2-2-0 -a> 6 Effective 4/1/,2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Fee Total Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes JOB ADDRESS 5.60 C( _-3b lz�%l e Owner -TT'� .6- C -:p C' ik 2 $35.00 $ '35.430 Building Used As 14-a''` C-- $10.00 $10.00 $ $10.00 $ $10.00 $ $25.00 $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater. on work less than $500.00 Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR -0D ESTIMATED COST !Soon PERMIT NO t DESCRIPTION OF FURNACE AND BURNER # of Heating Units t Circle One (Steam) (Hot Water) (Warm Ai Trade Name L C-ki aycs c Size No. BTU 199 !'00 HP EDR Fuel N fe°r C2r-v S Total Connected Load Burner Trade Name BTU HP Size No. EDR 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. $ .50 HEATING CO NEEDED= HEAiINQ A ®1® fC --0 $� Signed 1515 East 41St Street, -Suit® A. Tel # s MN 554071-M FAX # f 6123 724"1 fate *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existina furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes 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 instaiied to meet the current codes and manufacturer's specifications. Yes (W' 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 9'6, o v c)Fan Assisted or Nat N � 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) HEATING CO: -Signed By: Date : Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Ree'd: ,�- DATE d' �" — �(6;' YOUR-F.-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER De6NTRACTOR PROPERTY NAME: C04L42OWNE_ ADDRESS: - SL)a) 2 CITY Pc STA ZIPy tl�Z TENANT PHONE: -0 CONTRACTOR NAME: , � STATE LICENSE # t41) L EXP DATE ��//jj �l J l Ili CITY„ 2�STATE �"�� Z� SUBMIT A COPY OF ; YOUR STATE ADDRESS: LICENSE WITH r7 PHONE FAX APPLICATION PERMIT TYPE ,,, "''il" GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑=REPLACEMENT DETAILED DESCRIPTION OF WORK �6tjW 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 = 'POR3'ROJECTS WHERE LABOR EXCEEDS1500 -FEES ARE BASED ON $10.00 PER FIXTURE; EXCEP7V&MRENGGTED-' FI MfS,,,(INDIC-ATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS _ SHOWER _ WATER PIPING _ _FLOOR PIPING no cnTucEmE) _ SWIMMING POOL L WATER SOFTNER ($35) —BATHTUB —GAS CLOTHES WASHER KITCHEN SINK —WATER CLOSET 1 BACKFLOW PREV. ($15) _ _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Number of fixtures @ $10.00 x $10.00= $ Permit Fee $_. Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ 5P 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 workwhich e s review and approval of plans. SIGNATURE OF APPLICANT PRIM NAME / DATE .r � City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977