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PRE 2010 DOCSCity of Fridley SUBJECT PER ®431�08 AT THE TOP OF THE TWINS BUILDING PERMIT • r COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � i "t CITY HALL FRIDLEY 55432 ---- �'� 612-560-3450 RECEIPT NO. /� O'�j` NUMBER 910-1715 REV. DATE B-27_7 PAGE OF APPROVED BY JOB ADDRESS 6261 VAN 13UPEN 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 1 SHOREWOOD SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE WALTER T. JOHNSON 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 RESIDENCE 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [XX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 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. 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 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 $500.00 .50 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. $5.00 PLAN CHECK FEE TOTAL FEE SIGNATURE OF CONTRACTOR AUTHORIZEDAGENT (DATE) I S5.50 WHEN PROPERLY V LIDATED THI IS YOUR PERMIT SIGNATURE OF OWNER IIFO RBUILDERI (DATE) BLDG INSP DATE e . 1/- r ---T10 - s . , A !' L' ALTLii�T ION PLICATION FOR RhSIDLNTIA ., a OR ADDITION•BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAt1E BUILDER: ADDRESS:' ADDRESS: 140:_. STREET • -�✓ - 'r/ LOT: BLOCK: / ADDITION: .2k�� CORNER LOT: C INSIDE LOT: SETBACK: SIMARD: Applicant attach to this form. Two Certificates -if Survey -of Lot and.proposed building location c., awn on •these Certificates. DESCRIPTION OF BUILDING To Be Used As: • 7 Front: Depth: Height: Square Feet: Cubic.Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ D To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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: `� �� SIGNATURE ..(See Reverse Side For Additional Information.)' OU BUILDING V -ER IT FL'L SLIH' 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 fortis and in the manner herein provided to -wits UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic 'feet; or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for each one thousand cubic feet. 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 ($500.00) or fraction thereof in rate of $3.00 per each five hundred dollars. the cost of all proposed work. In no case shall the fee charged for any permit -as set forth in Section.2 be Jess than $5.00. 'VERIFICAT.ION 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 fox which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued.. CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR:(� RATn TOTAL � VIAJ .J BLF? G 6J i Job'Address I� 1E , Furnace Shell & Duct Work $12.00 $ *Replacement of Furnace 7.00 $ Department Repairs & Alterations -up to $500.00 of Buildings Repairs & Alterations each add. $500.00 4.00 $ dle City of Fridley Tel. #571=i450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the *Replacement of Furnace 7.00$ facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn. , 19_ STF_V-1 OR HOT WATER SYSTEM: OWNER \I%1!�, LTi C" -I __ �-10 I�i � 0 A) Boiler & Lines up to 100,000 BTU $12.00 $ �. KIND OF BUILDING �OC.�+m1 P — each addn. 50,000 BTU 4.00 $ F Boiler only up to 100,000 BTU 7.00 $ USED AS 0 each addn. 50,000 BTU 6.00 $ �q V A U6, j -i,7 q TO BE COMPLETED AB UT OIL BURNER- to 3 gal. per hour $10.00 $ - 7 //11 ev ®CJ. each add. 3 gal. per hour 10.00 $ ESTIMATED COST / GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ f ) OLD - NEW BUILDING PERMIT NO. PERMIT NO. lg l (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: lst 3 Fixtures x $ 3.OG ® $T �. /� DESCRIPTION OF FURNACE/BURNER Additional Fixtures x $ 1.00 $ O Gas Range to 199,000 BTU x $10.00 $ HEATING or P R PLANTS, Steam, Hot Water, Warm Air- No. �K_ AIR CONDITIONING $ Trade Name �k� [-�f Size No. FAN HEATING SYSTEms See Fee Schedule $ VENTILATING SYSTEMS $ Capacity S Ft. EDR BT� HP ALTERATIONS & REPAIRSS $ �' y q' State Surcharge $ .50 Total Connected Load Kind of Fuel TOTAL FEE $C1 BURNER - Trade Name Size No. ROUGE: INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date ($10.00) FT.T% INSP. I�^ I ^ � CompanyJAL Date /• A2PROVAL FOR PERMIT d&le Signed By W Tel. No. 5--7 /3 900 M.INII•U-M FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE *Attached stack verification form SUBJECT T City ®f Fridley � 2 6 0 33 AT THE TOP OF THE TWINS BUILDING PERMIT t T NO. 1 16______ COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. � 7p�� ((�� NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/22/98 JOB ADDRESS 6261 Van Buren Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 1 Shorewood SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Walter Johnson 6261 Van Buren Street NE 571-1398 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Steven Lee Contr. 9465 Irving Ave, Brooklyn Park, MN 55444 424-1198 5758 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 O ALTERATION j REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage 18 S) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 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 $1,501 $.75 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. $51.25 Fire SI,', $1.50 PLAN CHECK FEE TOTAL FEE License SC $5.00 $58.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY LI DATED THIS IS YOUR PERMIT //,/ 4'�!z 4 �, BL INSP -�� L '� GATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND BUILDING PERMIT PAPPIX,IECATIOAND R-2 ConstructionAddress: 6, 6 % V,, Legal Description: Owner Name & Address: a Irs _Tel. # Contractor: X. L MN LICENSE # Address: �l/c/ �/c Tel. # 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 S . Ft. r 1 Construction Type: T��.� �� r t mated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: —��— Permit Fee $ S), sire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ , C Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS: Tel. # �� %— )J 9� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] . . a 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 fust $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. Building Inspections 763-572-3604 763-502-4977 FAX DATE 7L% —,IU SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE MECHANICAL Permit No.:2,,o U " RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY Date WD�� EFFECTIVE7-1-2010 1 /� YOUR E-MAIL ADDRESS '�� 420&Dr 1 (1? (OAW& 57 JM' T ❑ OWNER )&ONTRACTOR ADDRESS: CITY Ier�l+1L3(�2J CITY %��G�� STATE&ZIP PHONE: COMPANY NAME: oagWC2.5 .5a ✓ UiG t CONTACT PERSON: _T A . STATE LICENSE # EXP DATE ADDRESS: cry CITY �" sL,STATI6v`ZIP.rS/! PHONE FAX FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE IITYPE OF WORK: I ❑ NEW PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 (GAS) $15.00 GAS RANGEIOVEN $10.00 TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _BOILER $35.00 _FIREPLACE FURNACE $35.00 _GAS UNIT HTR $10.00 LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 _GAS _GAS PIPING $10.00 VENTILATOR $15.00 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I a owledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and co of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only antcatio permit and wok is not to start without a permit; that the work will be in accordance with the approved plan in the a of all rew and approval of plans. AL DA City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS 0 EXISTING 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 MN Rule 1346 Sec. 501 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N1104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 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.