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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: .------•--.._`_'...... Q ........ /... . ....---...------... Owner: Address. N? 4297 Builder 41, - --------- .......... . _... Address................. - .... .............. _......... .......... __------ ------------- ___ - - �f LO TION OF B IL�DING No........__°...7/Street ....._...... - ���r i....._ ._.. _.......y..... e'1� P rt of t ......................... - - - ..... ......... r/' e Lot ........ _0-- ... Block ..... ........ .....7 ............................. Addition or Sub -Division ... ................... . .... .... _ A.............. Corner Lot K................. �- c �► c `w ......... Inside Lot ....................................... Setback .�,F...._�..�C�........ Side ard................................ __ Sewer Elevation ........................•----............-----------....................------------..........---•-•... Foundation Elevation DESCRIPTION OF BUILDING To be Used as G� �o .............. ........._..................... Front -. Depth .........�..� Height7.-'® Sq. Ft. _9..®_! -Cu. Ft _.....� _.............................-.......-.............. Front ........................ Depth ...................... Height ........................ Sq. Ft. ..... _................. Cu. Ft. .................... ... Type of Construction........................................................... Est. Cost.........�)� be Completed ........------------••-------...._......._...-- -- In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $....J .., permit is hereby granted ...._... ............ ...... .-------........................_....--- 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT .CITY OF FRIDLEY., MINNESOTA Owners Name Builder - -- Address _. Address LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Sub.Div.� Cornski Loi nside ,Lot Set Baas �' Side -Yard SEWER ELEVATIOWL FOUNDATION SET iVATION Applica.nt.attach to this form Certificate of Survey of Lot and proposed building loca.ti6' .* t DESCRIPTION OF BUILDING To be used as: . - • ...Font • Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction E Estimated Cost < To be completed_ ; The undersigned hereby makes application for a permit.for the work herein:specified,, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of._Buildingsj- and,hereby declares that all the facts and representa- tions stated �in thisapplication are. true and correct. DATE SIGNATURE (A Schedule of Fee costs can be found on the ..evdrse Side.) R114PING -?ERM;T FEE SCHEWLE.. ' Section 2. The Inspector of Buildings shall; before issuing any -permit for the erection of any building or structure, or for any addition to any existing building or structure,,or for any alterations or repairs to lr -i��ln--'W!Idifig'-b.'t'-�;'tructure , up= application- therefor I requ , e any ex is` g - the payment by the applicant for such permit of fees to the amount -the manner- herein --provided--to-wit c.- 2.1 For any such permit for the *bkeb.t-i(in.�of: sing' -fireproof building., other than a garage, warehouse, factory or, grain elevator, or for the any.. fttbprodf: addition, for similar occupancy, to any -: existing building shall be at the rate of $1.40 for each one th6iiiirid -fra-.ation! thereof, in 6;u&.. cubical contentsi-,:n f.Qr. the. erection'.-af any. fireproof garage,, ware- ''' house factory or grain elevator, -or or the erection ofany fireproof '-`baT. _.addition, ....for- simil �6ccd�)&ncy , to : &hy,.qxisting building shall -at:th shall P rate of .25for each one thousand cubic feet, classified as 'ffireproof" by'­,sectibri.-:-'592::6f- thb Minn&pdl-is Building-G-6dei--: HOUSES 2.3 For any such permit for -the'erec ion of any non -fireproof building other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing builaihg.' Permit $1.00 for each one thoupand-cubic feet. GARAGES 2./+ For any such permit for the erectioTr-ef -any'non--;fireproof - garage..,• • po warehouse,:fAqtq,ry or grain elevator, or for the erection ' ' of any non- ........ . "addition -----for -.sintliLr occupancy -i- to-- any existing building --or for each such building or addition. Ninety Cents for each one thousand cubic feet or fraction thersof-i---i-n-the dubidal.-eontents-ther.eof. with a minimum of V.OQ..., For the purpose of computing fees for building permits the cubical — ------- 66fttetts' '6f any" -building or addition to. -a- uniform hei ht - throughout by - I lying_..the,ground area covered from a.,p .point six 6) indhes below multJ oi ,p the ave-rageheight, of - h& - base t'' cellar t6, pen., qr.. _,,j -per,. o, a pitched t the' 'Might roof surface .611 thd maih• pur ace or o , e average gable '-f r'o6 f 2.5 For repairs or alterations to an existing structure, the fee shall -each -Five Hundred Dollars 4500.00•)-, ..or.. fraction thereof �n the cost of all proposed work. 2.6 In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT ERMIT 12676 r COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 612-560-3450 ECEIPT NO. NUMBER 910-F15 REV. DATE PAGE OF APPROVED BY JOB ADDRESS 7471 Van Buren Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 30 1 Sha.ffers Sub. NO. 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Tri -CO Builders 7955 Van Buren Street 55432 633-4681 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQ.UiRO FOR i1YIRING, MEATI'ING;. ,PLU.MBING AND SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, aff:f(RN'T00tt Rj fUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. & end wall 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 1,000.00 .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 6.00 PLAN CHECK FEE TOTALFEE 6.50 Sj�NATUREO TRACT RAUT IZEDAGENT .(DATEI -'+ HEN PROPERLY V 1D � HIS IS YOUR PERMIT ✓'' IGNATU OFO E VWNE73bUILDE A 1 BLDG INSP. ME r' Ae r 4 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: BUILDER: - ADDRESS: ADDRESS: - NO:. ;� 7 STREET LOT: 3 0 BLOCK: CORNER LOT: _INSIDE LOT: SETBACK: t SIDEYARD:C�` Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As DESCRIPTION OF BUILDING Front Depth: Height:_ Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Flet: Type of Construction: a Estimated Cost: $ To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: � SIGNATURE : fl (See %Werse Side For Additional Information. If BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition.to any existing building or structure, or for any alteration or.repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of,fees to the amount herein below set forth and in the manner herein provided to -wit: 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 k -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 $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. ,CE.RTIFICATE 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. 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 J l/ JOB ADDRESS / 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 $� representations stated in this application are true and correct. (Side Vent – Fill Out Back) — _ 99 6 Gas Piping (Needed with new furnace) $10.00 $ OWNER&,(6df B ?� `� Y ' ®C 2 7 -0, Gas Range - $10.00 $ - BUILDING USED dwpo Gas Dryer $10.00 $ ESTIMATED COST � PERMIT N0. *Air Conditioning – AlUSizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alt6rations (LIST ON BACK) 11% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Y Size No. B0 1919 LOW Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $„_.50 Burner Trade Name Size No. TOTAL FEE BTU HP EDR �.�0 BLAINE HTG. A/C & ELECT. INC. HEATING OMPAN 13662 CENTRAL AVE. N.E. MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION A, MR 00JU4 REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed Tel No. /25�J�® PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr ApprovJBy�Rough–In DateFinal Date *Air Conditioners can not be placed in a side yard without FILLOUTBASTACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CEMWNEY AND STACK VERIFICATION The undersigned hereby ver'if'ies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of � ®® o All other BTU's grzI OL -10 TOTAL BTU's �Z Q 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: Yes No ( ) Yes N No ( ) Yes ( ) No Yes No ( ) Yes >eNo ( ) Yes ( ) No " 71� 7"' 4— Yes- Yes No ( ) List ALTERATIONS Being Done: 9 HEATING CO: Signed By: Date: BLAINE HiQ. A/C & ELECT. INC. 13562 CENTRAL AVE. N.E. ANOKA, MN 55304 SUBJECT City ®f Fridley 2660 2 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 7 COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC.17 P _ r 1 1 � � NUMBER REV DATE PAGE OF APPROVED 8Y CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7 i4 98 JOB ADDRESS 7471 Van Buren St. NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 30 1 4 Shaffer's Subdivision No. 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barbara Nieswaa 784-0627 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Stock Roofing, Inc. 289 Liberty St.780-3561 3112 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 ❑ NEIN ❑ ADDITION ❑ ALTERATION TJ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House and Garage 22 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 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 i I 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 $1,834.80 .92 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI IONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST T ON OR THE PERF MA CE OF CONSTRUCTION. rj9, rjQ ire SC 1.83 PLAN CHECK FEE TOTA EE A ' I CA"� Licens 5.00 .25 SIGNATURE OF CONT ACTOR OR AUTHORIZED AGENT (DATE) EN OP BLD I. _ ALIDAT D HIS IS YOUR PERMIT ..n i QATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY,.OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Z ConstructionAddress: Legal Description: Owner Name & Address: Tel. Contractor: c ®� ¢ Q%� r MN LICENSE # 4 4 Address• r �� �-® ��� �� - IFY__� lz� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: (.� �� /, V 3 % h 0 Construction Type: Estimated Cost: $ (Fee Schedule" on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: P I q -c APPLICANT: Tel. # (1 � CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ J, .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ o $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: 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 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 "fust $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. CITY OF FRIDLEY INSPECTION DIV. WT 3431 University Ave NE �� Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTl1RF19 TO RF INSTAI 1 Fr) ON FAr.14 FI OrIR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: New. Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** NO. RATE TOTAL JOB ADDRESS_ NNIF Jts -j-- Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 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. ANDERSON, CARESSE 2-7 , 20 ®1 7471 VAN BUREN STREET N.E. FRIDLEY, MN 55432 Owner _ (763) 783-3959 Building Used As '�S-61flA24 C 00 Estimated Cost PERMIT NO. PLUMBING COMPANYdo'=MPLO!✓����i Reinspection Fee $47.00/Hr SIGNED BY _ TEL N0. Z - O ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance • Approved By Rough -In Date Final Date � c�dSCd�• State Surcharge $ .50 - MINIMUM FEE R ANY PLUM13INGIGAS PERMIT IS $20.00 TOTAL FEE $20-50 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE <� Wash rfl:_ Floor ==�<� Auto. :: Gas �:<r:: Water Heater Stories �� :•: Show Urinal Shower Tray ::: Z: Drain Washer �';��=� =<i��' �:.:.:<::. Range �~ Gas Elec ...............:.. ............... ..:.......::::::. <.: :. ..:............:..::.:.. .i��€�:;�:. ..... en Basem t ii'rTiY:i� Floor 1 :i Floor 2 Floor 3 Floor ....'.4...v.... �.-1 PLUMBING FIXTURE RATES: New. Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** NO. RATE TOTAL JOB ADDRESS_ NNIF Jts -j-- Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 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. ANDERSON, CARESSE 2-7 , 20 ®1 7471 VAN BUREN STREET N.E. FRIDLEY, MN 55432 Owner _ (763) 783-3959 Building Used As '�S-61flA24 C 00 Estimated Cost PERMIT NO. PLUMBING COMPANYdo'=MPLO!✓����i Reinspection Fee $47.00/Hr SIGNED BY _ TEL N0. Z - O ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance • Approved By Rough -In Date Final Date � c�dSCd�• State Surcharge $ .50 - MINIMUM FEE R ANY PLUM13INGIGAS PERMIT IS $20.00 TOTAL FEE $20-50 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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 ventingsystem is plastic/PVC and meets all current codes and manufacturer specifications :including sizing, length, number of elbows and termination. Yes O 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 installed to meet the current codes and manufacturer's specifications. Yes () 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 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 ALTERATIONS: (Describe) O HEATING Cb: Signed By: Date; 1 U7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 January 11, 2002 Ms. Caresse Anderson 7471 Van Buren St NE Fridley, MN 55432 Re: Final Inspection at 7471 Van Buren St NE Contractor: Norblom Plumbing Dear Ms. Anderson: A plumbing permit was issued on July 12, 2001 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date, no final inspection has been called for. The permit fee that was paid covers the inspection to make sure the work was completed according to the Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, DJ/mh S, sue iEti PER City ®f Fridley 3211 AT THE TOP OF THE TWINS BUILDING PERMIT � . CEIPT N ' COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r : PROTECTIVE � e l ��' ,•� CITY HALL FRIDLEY 55432 L j\� NUMBER REV DATE 8/28/01 PAGE OF APPROVED BY .��- 612-571-3450 910-F15 JOB ADDRESS 7471 Van Buren Street 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 30 4 Shaffer's Subdivision N0. 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Caresse Anderson, 7471 Van Buren St, Fridley, NN 55432 763-783-3959 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Home Depot Installed Sales, 3200 Cobb Galleria Pkway, Atlanta, GA 30339 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-542-8826 20268257 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK jJ NEW O ADDITION 0 ALTERATION 0 REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK New windows (3) 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking & flashing for all exterior openings. SEPARATE PERMITS ARE REOUIRED 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 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 09 COMPLIED $2,292.00 $1.15 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE ice a $5 00 $91.69 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI W EN OPERLY VALIDATED THIS IS YOUR RMIT,. jjAll A /QAIE S-GNATURE OF OWNEAOF OWNER BUILDER, IDATEI :in 9L INSo S, NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FREDLEY ALTER [ ] SINGLE FAAfILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 1 \)c3.vice�C�.� Legal Description: Owner.Name & Address: Contractor:. r Address: A la Tel. #4 +13'9 H*e4 MN LICENSE # 3200 Cobb Galleria Pkwy., Ste. #200 Tel. # Atlanta, GA 30339 763-542-8826 ►urvey.of the BC -20268257 )n it to scale. DESC. ON OF IMPROVENWNT., LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA.: Length Width Hgt/CGround Sq. Ft. OTHER: Jke%vn t m r n ► , ;,v�, A nA , %o=- .: r, \ rveq., n e.. ;,,kAf..: ,R Construction Type: Estimated Cost: $ �,9a Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $®�5 Sewer Main Charge $ \�..� ..._r. �►','.i►,� Alf►, • • 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 I ] T®TAI., $ �I•(��� STRULATIONS: ��Vj07, 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 amoun..herein below set forth and in the manner herein provided -to -wit: ` TOTAL, VALUE FEES $1 to $500 $23.50 $501 to $2,000 $23.50_ for first $500 t plus $3.05 for each additional $100 or fraction thereof, to and•_including;.$2,000 $2,001 to $25,000 _... $:69,25 for first $2., plus. $14.00_fbr each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof,. to and: including $50,000 $50,001 to $100,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to -$500,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof 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. CATION 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.