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PRE 2010 DOCSOriginal Permit for PLUMBING AND GAS FMING k 11 al N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for I Permit inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., g'ee DESCRIPTION OF WORK Number, Kind and Location of Fixtures to City of Fridley W W J .. 0 N Y Z w K Z 2 Z � O WATER HTR. Stories i- G Q 'Y U 2 ae 7 T N a m I- Z 6 f0 Y Z N m r Q 6' i F Z O X O O LL 3 S N O LL O U Q 4 U D7 Z w a( O C J V m X E LL J Q d tl Q ��pp < 6 tl C GAS ELEC. Basement ist x 2nd 3rd 4th Connected with Cas Piping for ®penings Permission is hereby granted to do the plumbing and gas fitting in the building described in the statement heEoo attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date nspector. Final Inspection Inspector. -OND-2 1rA_s-s5-v RIM Location Kind of Buildi 2&V2g=e Used as To be Completed , I9_ Estimated Cost $ /W/97 O -r) Old -New. Building Permit No. Inspector of Buildings. City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ 12 x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 Z • • WATER HTR. Water Heater (Up to 99,000 BTL) ...... x $3.00 $ 3i� x $3.25 �� Electric Water Heater s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 0°d 0U' aS �O R N GAS ELEG Base 1st 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings I Sewer � Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ 4 Water Heater (Up to 99,000 BTL) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS --Refer to Code Description ................................................$ TOTAL FEE 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 ap c tion are true and correct. Fridlev. Minn_ �— — Kind of Building Used as To be completed about ` Estimated Cost, $T rr Old—New. Building Permit No cj Permit No.®� ROUGH FINAL By Business Phone City of Fridley SUBJECT P NO. 15 4 7 2 AT THE TOP OF THE TWINS BUILDING PER I T i 1-------- COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ` i CITY HALL FRIDLEY 55432 612-571-3450 NUMBER 910-F15 TpEv DATE 9/20/79 PAGE OF APPROVED BY JOB ADDRESS 5855 Tennison Dr. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 ] Parkview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harold Andrews 5855 Tennison Dr. Fridley 55432 571-0713 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Riteway Waterproofing 7337 Lake Dr. Lino Lakes 786-0550 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 Cjj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Waterproof basement 9 CHANGE OF USE FROM TO STIPULATIONS Electrical extension cords can not be used as part of the.power source to the pump. SEPE.RATE PERMIT'S REQUIRED FOR WIRIN IDEATING, PLUM13ING AND SIGNS. C4 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TYPE OF CONST. Drain Tile OCCUPANCY GROUP OCCUPANCY LOAD THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R--1 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $2,768.00 SURTAX $1.39 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OT STATE OR LOCA) LAW REGULATING CON- STRUC N 0J3 THE R ORM NCE OF CONS RUCTION. -7f l/ $18.00 PLAN CHECK FEE TOTAL FEE $19.39 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ATE) WHEN PROPERLY YALIDATE THIS IS YOUR yyPEERMIT I+ ' En INSP DAit SIGNATURE OF OWNER IIF OWNER BUILDER) MATE)BLDG CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PER14ITS (New, Alterations, Additions, or Repairs) OWNER ZA B U I L RE R /.P/ 7e ADDRESS: 50,-J ADDRESS: 3-3 Zfkeif f o e / *,/ /'Jo -j-x e-5- TEL NO: 0 7 Z:3 TEL NO: Construction Location STREET NO: STREET: Dip, • 1 IDT: BLOCK: ADDITION: Corner Lot.- Inside Lot: Setback: Sideyards: Applicant attach to this form two certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Squane. Feet: Cubic Feet: Front: Depth: Height: Square-Feet: Cubic Feet: Type of Construction `WIC Estimated Cost: To Be Completed: '9 Z/,- 7 Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: SEE REVERSE SIDE OF SHEET 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 fact and _ representations stated in this application are true and corn DATE: SIGNATURE:. Stipulations: lei )JUIL01146 PLIMIT PCE SCHEDULE' SECTION 2. The Inspector of )3uildings ,.hall, 'before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, ar 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_ thb amount herein below set forth and in the manner herein provided to -wit: NEW CONSTRUCTION: Single family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete, Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x Y1S.75 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width •flus 6 feet x $17.85 ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof, ° For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars -($500.00) or fraction thereof in the cost of. all proposed work. .In -no case shall the fee charged for any permit as set forth in Section 2 be less. than $7.50 plus $.50 state surcharge. _..... _ ..- VERIFICATION OF FOUNDATIOtd - •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 Certificate of 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. SUBJECT P City of Fridley ® 19072 AT THE TOP OF THE TWINS BUILDING PERMIT i � • COMMUNITY DEVELOPMENT DIV. 1 �y-------�' � INSPECTION s 731 r � PROTECTIVE SEC. C 1 � � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF. APPROVED BY ----� j, 612-571-3450 910-F15 7/16/87 JOB ADDRESS 5855 Tennison Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Parkview Manor SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE David Fuhrmann same 574-9860 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Same 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 Repair of Roof. 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 $700.00 $.so 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. $15.00 PLAN CHECK FEE TOTALFEE $15.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPE LY TED IS IS YOUR PER I i .6 �'11f �SIGNOF OWN IIF OWNER BUILDER) ID E) BLDG )NSP DATE NEW [ ] ADDN. [ ] ALTER. [ ] Construction Addre Legal Description: City of Fridley Effective 14/1/86 �R-1 AND R-2 Building Permit Application Owner Name '& Address: _24 of Z2 .6 L �- —Tel. . # 2 7 q�6 Contractor: 'r /g n I Tel. Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Hgt/Ground Sq. Ft. 9F e SJR (11"' �QDF Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: f t7 A r PP /I? G 711� Estimated Cost: $ � Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See. Back Page for Explanation DATE: APPLICANT. Tel. 5774 �",6 D Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge V&W-Up STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit 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 Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $509000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $10.0,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 been constructed will be required before proceeding with the framing. CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 $ (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $ 10.00 $ Gas Range $10.00 $ Gas Dryer $ 10.00 $ *Air Conditioning — All Sizes $ 25.00 $ Atz-0� All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work $ Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge .50 TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGIVENTILATION 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. JOB ADDRESS7l�' Y%%�C�%j �Y A15 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 qnd correct. 1996 BUILDING USED AS p ESTIMATED COST _ PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units, Trade Name BTU Fuel Burner Trade Name BTU TING (COMPANY _ Circle One (Steam) (Hot Water) (Warm Air) Size No. HP EDR Total Connected Load Size No. HP EDR A/C & ELECT. INC. ANOKA, M 55304 -6 Tel No. �. Approved By AJ2 Rough—In Date FILL OUT BACK SIDEMFOR STACK VERIFICATION ON REPLACEMENT FURNACE Final 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; .ffom rust or deterioration Yes ( ) No ( ) 3. Has no ,foreign objects. lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets.;ali current Code requirements for size A. ahl"16ta1 BTU's connected Yes () No ( ) ,f 6 Has total heating BTU's of A11 other BTU's TO TU's 7. Hos a liner been provided for water heater Yes ( ) No ( ) 8. Has `cofnbustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: SUBJECT City ®f Fridley ?6760 AT THE TOP OF THE TWINS BUILDING PERMIT P , ' o 1 _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r e NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 5855 Tennison Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Parkview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Fuhrman 5855 Tennison Drive NE 574-9860 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ace Construction 6230 218 Ave NE, Elk River, MN 55303 323-3019 20001884 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 Ck7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (17 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 ] 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 $1,417 $•71 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 $1.42 TRUCTION OR THE PERFORMANCE OF C $48.50 .SC �Ft PLAN CHECK FEE License $5.00 TOTA EE $55.63 SIGNATURE OF CO RACTOR OR AU RIZED AGEN ID I N P OPE Y IDA AL NSP R HIS IS YOUR P M 6- v � GATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) x NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Q BUILDING PERMIT APPLICATION (DODO ConstructionAddress: Legal Description: a Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: tl Tel. # 57 /— =6 MN LICENSE # c;ZOQ0 Tel. # 3� C� 1:i G —r— 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 Hgt/Ground Sq. Ft. Construction Type: �� Estimated Cost: $ a-2 CS® A (Fee Schedul e ' on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ / /-/ DATE: APPLICANT: ��" ` Tel. # -Ls STIPULATIONS: r CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Eire Surcharge $ 1 .001 of Permit Valuation (1 / 10th %) State Surcharge $ l/ $.50/$1,000 Valuation 3AC Charge $ $1000 per SAC Unit License Surcharge $ (Acl) $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 $ STIPULATIONS: r 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 buildingor 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 $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. ,JNEHEATING AND ELECfRIGIINC. AIR HOUSE HEATING TEST RECORD 9lf-W ADDRESS__ '�tP�plyln a,0� OCCUPANT HEAT LOSS DATE HTG. INST. SOLD BY Electrical Work By�} TYPE OF HEAT GA FA -,L HV' STEAM® SPACE HTR.® GAS DESIGN MAKEC, —,Se Model fs fb�t��b�cfii Serial APT. FLOOR CITY SUBURB OWNER INSTALLED BY j"o 0— -_ Gas Una By A Igl 7 a UNIT HTR.® OTHER MAKE OF BURNER Model Max BTU Rating INPUT ((acc ata. MAKE OF FURNACE CONTROLS THERMOSTAT ,w Xj Heat Plug valva Limit Limit Setting Fan Setting Pilot Type._ � %°sa Pilot Make Pilot Model Pilot Timing L. W. Cut Off Pressure +° 04' Percent CO, Input CFH Percent Oa StackTemp. Percent CO 'VPV—% Form 235 Model Vent Size V, KIND OF LINER OcIss SIZE ° ° NONE Draft Hood 1.44 ie ®ri_ Regulator Fliters Size f o Number Chimney Location Inside iz Outside Chimney Construction F Smoke Bomb Wiring Draft Teat Tag Door Pressure Lighting Inst. y� Data Tested e Company Testing , 0 Name ofTester. CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 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 �J`a S S T' l l) V) RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work In strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $.30.00 $ !?�D'� representations stated in this application are true a d correct. (Side Vent — Fill Out Back)— (a — ,1997 Gas Piping (Needed with new furnace) $10.00 $ OWNER. rVl'�1 . y7 . Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ . ESTIMATED COST.®a PERMIT NQ.' *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR SURNI . All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No, of Heating Units r Circle One (Steam) (Hot Water) Trade Name ill -ya, Size No._33C A. _ h, 53i"O&O Commercial/Industrial BTU b b 0 0'c:� HP EDA 1.25% of Value of Appliance or Work $ Fuel Lja- a03 Total Connected Load State Surcharge .50 Burner Trade Name Size No. TOTAL FEE $ BTU HP EDR . BLAME WO. A/C ELECT„ INC. 13562 CENTRALAVE. N.E. ANOKA, M 55304 HEATING CO Y MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION • REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By o. �7 �C� PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—in Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE I=0 STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNAC U CEnA NEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or shack: 1. . Has been carefully examined Yes ( No* ( ) 2. Is fires from rust or deterioration Yes ( No ( ) 3. Has no foreign objects lodged widiin 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 © / 0 t31D All other BTU's ' 7 y i 0 0 TOTAL BTU's 0 0 7. Has a liner been provided. for water heater Yes No (). S. Has combustion air been provided for water heater Yes .6 No ( ) Remarks: . List ALTERATIONS Being Done: `' bass 13 Flue a "NE NE HTG- C ELECT., ING AVE.9;gnN.E. A HEATING CO: t a _w��n�_ Signed By: 'W^ N fl%Or4-VW-vv— Date: — ( (® -C7 1