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PRE 2010 DOCSVMage of Frldley, MDR. fBUMBING PERMT Office of INSPECTOR OF BUILDINGS owner Architect h Fridley, Minn., Builder '""� 9 LOCATION OF BUILDING No. 2—ti. 1 Street V_Q a✓l I LJ� Part of Lotlul e, Lot Imo. I Block Addition or Sub -Division DESCRIPTION OF BUILDING Front _p �' Height _Stories_ Manner of Construction �' � w a De t To be used as �_ To be completed a � , Estimated Cost . a w1k ;61 .,A ¢' W Ili Permit is hereby g anted to.; the building a.. described in the above statement. This permit is granted upon the express co clition that the �,rson to whom it is granted, and his agents, employees and workmen, in all the work done in, round and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, '*nn., regarding the construction, alteration, maintenance, repair and moving of buildings within the city lim3s, and this permit may be revoked at any time upon violation of any of the provisions of said :.. ordinances. I•: 3 , of Buildings. In consider, the above perm above set forth sworn, I hereby true as therein Subscribed day AGREEMENT AND SWORN STATEMENT .on of the issue and delivery to me by the Inspector of Buildings of Fridley of I hereby agree to do the proposed work in accordance with the description id according to the provisions of the ordinances of Fridley, and, being first duly sate and say that the facts stated by me and contained in the above permit are Lted.TV , c sworn to before me at Fridley, Mftinesmta, Hlis I - 5 5 3ba NWO 879.01 City ®f Fridley Dept. of Bldgs. Phone 980-3480 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PL RING 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 ... . I ....... ........ .. x $3.25 $ �U' • • WATER HTR. $ Electric Water Heater = $2.00 $ CAB FITTING FEES: F 1st 3 Fixtures .......................... ,n $ Additional Fixtures . .......... �7i $ V a Repl & r e (I x $5.00 / N GAS ELEC. Base lot lac a 1 2nd 3rd -- 4th - -- ° 701=0 Connection Openings Connected with e ?few Fixtun. Old Openings sewer❑ l PARTIAL RATE SCHEDULE PL RING 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 ... . I ....... ........ .. x $3.25 $ Water Heater (Up to 99,000 BTU) x $3.00 $ New Ground Run Old Bldg. . .... .. x $3,25 $ Electric Water Heater = $2.00 $ CAB FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures . .......... I....... —X$.75 $ Gas Range to 199,000 BTU ....... Repl & r e (I x $5.00 REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $.? •d0 I.em1ltnzt 'x389 Ne. Van Buren. St. 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 -0-0t. 2, 1969 ..19_ w Owner Guy SAnAar Kind of Building f rame Used as r-Asi dAnnn To be completed about no+Hi 196.__ Estimated Cost, $ 10.00 Old-.XNew. Building Permit No. Pe 't 1140. By Business Phone No 44Ao� ROUGH FINAL 4 Air S ams and Doi a PARTIAL RATE SCHEDULE G RAVITT WAW4 AM: nATE Tony., P%nasce Shell & Duct Work $10.00 � Replacement of Furnace 6.00 $ Repairs & Alterations—up to $500.00 600 3 Repairs & Alterations each add. $500.00 300 � s em. WARVI AM Furnace Shell do Duct Work to 130,000 BTU each add. 60.000 S'1'iT .. ...... Replt anent of Furnace Repairs & Alterations—up to $500.00 Repairs & Alterations each add. $300.00 STEAM or HOT WATER 8 YETEN 3.U0 $ 6.00 6.W $ 3.00 $ Furnace Shell & Lines—to 400 sq. ft. FDR Steam elo.Qo $ Furnace Shell & Line—to 640 sq. ft. EDR Not Water 10.00 $. Each add 200 sq. ft. EDR Steam -4. CA $ Each add. 320 sq. ft. EDR Hot mater 3.00 $ OIL BURNER—to 3 gaL per hour over 3 gal, per hour—wee Fee Schedule GAS SUM Cup to M,000 BTU) 5M over 199400 EM Sae F�" schedule GAS FITTING FEES: no RATE TOTAL as1 3 Fixturesz� 200 g- ._.� Additional Fixtures x .76 $_— Gas Range to 1W..W0 x$ 5.00 $ AL State Surcharge .50 �p67� 1rG30 Dept. of Bld9z. phone s-3 City of Mdleyy: The undersigned hereby makes application for a permit for the work herds specified. agreeing to do all work in strict accordance with the City Ordinancer- and ruling of the Department of Buildings, and hereby declares that an the fad and representations stated in this application are true and correct. Ol Inidley, Mnn 3— SCJ lidr.y Kind of Building Used as To be completed about, - T" 3 Estimated Cost; g - (fin Old—New. Building Permit No. ___ Permit ado. �% 1 Name - size/ - - .; y Ft ED.R Total ConnecteidLawadted' M c; ,, of Fin � ,.- t0=aQa5—®veaA C row `' COA N=-thas COAR9, VC10- M, ads ass n amd rAh1wE g S7= a DQ . GRAVITY WARM PiM MTN TOTAL Furnace Shell & Duct Worts ... ... . $10.00 Replacement of Furnace 6.00 Repairs & Alterations—up to $500.00 600 $ Repairs & Alterations each add. 5500.00 300 bmf. WARM AM Furnace Shell & Duct Work to 130,000 BTU each add. 60.000 BTU .. ...... Replacement of Furnace Repairs & Alteration—up to $500.00 Repairs & Alterations each add. $500.00 ..$10.00 $L - 3.U1 s 6.00 6.00 $ 3.00 $ Furnace Shell & Lines—to 400 sq. Lt. EDR Steam $10.40 $ Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 10.00 $. Each add 200 sq. ft. EDR Steam g.tNl $ Each add. 320 sq. ft. EDR Hot Water 3.00 $-- OIL _,_,_- OIL SURNEiR—to 3 gal. per hour 6,00 over 3 gal. per hour—See Fee Schedule GAS BURNER (up tD 1M,000 BTU) 5.00 $ Deer 109,000 UM Tutee Fee Schedule GAS FI'T'TING NO IRATE TOTAL 1st 3 Fixtures xz Too $ Additional Fixtures a ,75 $__ Gas Range tv INAW 23 5.00 S State Surcharge .50 AYES M0MNG �_ x' FAN =AT= STS Fee schoduliVENTM&TMG ZTETEN ALTERATIONS & REPA11W TOTAL. Em $4 fit. of Bkdoz. Fhmw ro-34M City of Fridley: The undersigned hereby makes application for a permit for the work herd specified, agreeing to do all work in strict accordance with the City Ordinwices and ruling of the Department of Buildings, and hereby declares that an the fad and representations stated in this application are true and correct. Fridley, Asian 1! Owner Kind of Building 1 Used as . To be completed about, ��' 7 Estimated Cost1 $ 601;LNew. Building Permit No. _-- Permit No. Old OF WORK HRffRfG or team, Hot Water, Warm Air—No Trade Name Size No_ rL ///1j Capacity—_-- — Sq. Ft, E ID.R BTU 4— ILPI Total Connected Lomd Of I BURNER — Tri No Size No Capacity Sq. V. ED Ideal H is-aiing e. /air 3116 FREMONT AVE. N. MLS., N01NN. BUS. 522r,4369 IF NO ANSWER CALL RES. 53D -16« S1 , SUBJECT City ®f Fridley (12�07775' AT THE TOP OF THE TWINS BUILDING PERMIT •, RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. 1 �0 PROTECTIVE INSPECTION SEC. 7 q 7�� o � cJ / CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910415 4/22/91 JOB ADDRESS 7389 Van Buren Street NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 22 4 Shaffer's Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Kolodjski 7389 Van Buren Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. C 0 Field Co. 2940 Harriet Ave S, Mpls., MN 55408 824^2631 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Fire Repairs 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detector on both.levels, Replace three floor joists and double two others, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED$1� 40Q $9.70 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT F PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE CON- PROV IONS OF ANY THER STATE OR LOCAL LAW RE LATING CON- $207.00 Fire $C $19.40 T U ON OR THE PE 0OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE Z $236.10 SIGNA RE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)WHEN '( PR ERLY ALI�THI YOUR PER IT - L �__9 L — SP FATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI I NEW [ ] Effective 1/1/91 ADrN [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: Legal Description: L.®T �.--x -3a-cscA-- L4 Owner Name & Address: -7\ I e.Va6►C L Kz Lem OSS K\ Tel • # Cmitractor: C�, �t�7 Gam. 1�.�� Sa_�.�..�sc,-a� Tb1. # t^2131 Address: '7 q 4.o t�,cv e s cy I " \�L� �� s-�'k68 Attach to this application, a Certificate of Survey of the lot, with the proposed constn=ticn drawn on it to scale. LIYIIif3 AREA: Length Width Height Sq. Ft. QRMM AREA: length Width Heicht Sq. Ft. DECK AREA: Length Width Sq. Ft. 07MM: Corner Lot [ ] Inside Int [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: `qA_�$ ,.� ��-� Estimated Cost: $ / °! . ego Approx. Co®pletion Date: �5 1C, kiI Lw7 edn2-Ck idth If New Is Desired: Ft. $ $ Width + 6' See Back Page APPLICANT: L Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge Driveway Escrow Perk Fee Sewer Main charge CITY USEY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10Th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. 'B" Above Fee Determined by Eng; rAa-� Agreement Necessary [ ] Not Necessary [ ] 1�1, yon IY IGa,00_ Me 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: $1 to $500 $15 (Minimum Fee is $15 plus surcharge) $501 to $2,000 $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof DMEW DE MMICH ESCWW (Cmicrete Cnb Streets Only) Alternate "A": Removal and replacemexit 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. Permits for construction will be issued a minimum of 24 hairs 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. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS�� New Fixtures $7.00 0 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 _ Rain Water Leader $ 7.00 '1991 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas $10.00 Building Used As Gas Range Gas Dryer $10.00 $10.00 Estimated Cost %S� PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $5.00 PLUMBING COMPANY Reinspection Fee $30.00 SIGNED BY �� TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance 024d Approved By Rough -In Date Final Date State Surcharge .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $25150 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY Effective Date January 1, 1991 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 furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer RATE $ 20.00 $ 10.00 $ 10.00 $ 10.00 * Air ,Conditioning (all sizes) $ 10.00 All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL li of Value of Appliance or Work TOTAL Job Address2a2Lan y (A r � ed � $ Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 S $ 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 S S State Surcharge S .50 TOTAL FEE $ �: REINSPECTION FEE $30.00. $ Rough Insp. Date Final Insp.�2.2. Date Approval for Permit MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. e KIND OF BUILDING F`CCA USED AS QQJ� 4 � TO BE COMPLETED ABOUT y ESTIMATED COST \ 4 - OLD OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU NP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP C% n ` _ n Company T� flp iY/ Signed By 60RNA "IT Tel. No. N X11 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 requirements for size and total BTU'connected Yes ( ) No { ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date CITY OF FRIDLEY Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE QESIDEKTIAL RATE TOTAL Furnace Shell and Duct Work, a a Burner (Also replacement furnace) $ 20.00 $ Gas Piping $ 10.00 $ (Piping needed with new furnace) Gas Range $10.00 $ GG s Dryer $ 10.00 S Air -Conditioning (all sizes) S 10.00 $ ! d • D� All Others/Repairs and Alterations 1% of Value of Appliance or Work S COMMERCIAL/INDUSTRIAL li of Value of Appliance or Work State Surcharge REINSPECTION FEE $30.00. Rough Insp. Date / Final Insp. -- Date Approval for Permit S MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Job Address 7 / V a--� i Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 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 land correct. OWNER D KIND OF BUILDING F USED AS TO BE COMPLETED ABOUT / e� ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name LiL Size No. 63- d��I% lX 3 —7 Capacity Sq. Ft. EDA BTU % HP Total Connected Load Kind of Fuel — BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company IM-009109MR(INDMIN ameffm Signed By . vAmIM ee446 Tel. No. KM UWW SERVICE 921,D-4MI, i { Fill out back side for stack verification on replacement furnaces r. w CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; Rema rk s Company J�Z4::� 7—Affz,�ell-c Signed By Date —� 1. Has been carefully examined Yes (,o Z. Is free from rust or deterioration Yes VrNo ( ) . 3. Has no foreign objects lodged within Yes (@' No 4. Is securely supported Yes (P No ( ) 5. Meets all current Code requirements for size and total BTU' connected Yes No .6. v— Has Total heating BTU's of L All other BTU's TOTAL L5 Rema rk s Company J�Z4::� 7—Affz,�ell-c Signed By Date —� HOUSE HEATING TEST RECORD ADDRESS A�� \� �� APT. FLOOR CITY SUBURB OCCUPANT OWNER HEAT LOSS DATE HTG. INST. n SOLD BY INSTALLED BY rm i'-0" Electrical Work By Gas Line By TYPE OF HEAT GA FA Y__HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE MAKE OF BURNER Model — Q Model Serial S-gq ( to d Max. BTU Rating INPUT —7 5 MAKE OF FURNACE Model CONTROLS THERMOSTAT Heat Plug Vent Size bi Valve II�� F KIND OF LINER ALJUTA SIZE�NONE -�� Limit Draft Hood k LZr' ` 0 Regularor I Limit Setting �` Filters Size A oxas Number I _ Fan Setting jck:l so a Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure s4i to Percent CO ° Date Tested 2 Input CFH IS 00 0 Percent 02 SRR Company Testing r_ Stack Temp. Percent CO OName of Tester 'j& 1, I, Form 235 - SUBJECT City of Fridley 29947 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. -1171-16 1 . � NUMBEII REV GATE PAGE OF APPROVED 8r CITY HALL FRIDLEY. 55432 1 612-571-3450 910-F15 7/28/99 JOB ADDRESS 7389 Van Buren Street NE I LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED OESCR. 22 4 Shaffer's Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO M & A Siding 505 157th Ave NE Ham Lake MN 434-0049 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 X31: REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside house and izarage 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIRED 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 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 5200 2 .60 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE CCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TR CTI THE RFORMANC CON RUCTION125.25 PLAN CHECK FEE TOTAL E �2 3'-q H N P P iNSp I AT I$ UR ERMIT r�A7E S�GN4TURE OF CON'RACTOR OA AUTHORIZED AGENT iDATE, S-GNATURE OF OWNEROF OWNER BUILDERI iDATEi - NEV[' ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 8 VG 0 3/rc Legal Description: Owner Name & Address: Tel. # Contract, Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT 'ENSE # Tel. # el 341 - i LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: %^Pe, r-- '07-q X rd� i "0/4 :;E& & // � Construction Type: Driveway Curb Cut Width Needed: Estimated Cost: $ g:2!::20 ,W Ft. + 6 Ft = Ft x $ M DATE: - v2? -�APPLICANT: - k A !� �e- Tel. # 4 '6® `I F Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ L a3 . ®,!� 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. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] . Not Necessary [ ] r. BUILDING PER14✓IIT 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 DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. CITY OF FRIDLEY INSPLu i lUii bi v, Effective On Jan 1, 2002 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Was sh Flo :: Auto. or Gas Water Heater— ii�iii�ii Stories Urinal U shower Tray Drain Range Gas Elec Basement Floor I Floor 2 ........... .... . ...... .. ........ Floor 3 ............. jFIoor4 -- ----- ----------- PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $7.00 and representations stated in this application are true and correct. Catch Basin $7.00 Rain Water Leader $7.00 20® 2_ Sump/Receiving Tank $7.00 Water Treating Appliance $10.00 Owner Water Heater -Electric $7.00 Water Heater - Gas** $10.00 Building Used As Gas Range" Gas Dryer** $10.00 $10.00 Estimated Cost PERMIT NO. 6PI (0 Back Flow Preventer Required )Yes No Type $15.00 PLUMBING COMPANY V Reinspection Fee $47.00/Hr SIGNED BY; TEL NO. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX # 1.5% of Value of Fixture or Appliance - Approved By — Rough -in Date Final Date A State Surcharge $ .50 )1 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $0-5--L PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE Q-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When re liming an PxbstinI3 furance, 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 px�n—A _nmh nc+inn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to inctaii a new _nmh jsfinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When innfallona a now venting nystem, 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 #1 Type BTU Input Fan Assisted or Nat 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 _ HEATING CO: Signed By: Date: