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PRE 2010 DOCSOwner/ : ' f++'1'+ ... ............ .... h Address .��='' 7 . .0 09,0 ........ Address .. ... .. ............ LOCATION OF BUILDING` �r No.. 46a, 1,4. � F Street +% . ............... Part of Lot ...................... Lot ..../go. ...... Block ... ........ . , Addition or Sub -Division � i� . ... ... , Corner Lot Inside Lot. ... Setback . v. . Sidey4rd. to.p o .................. DESCRIPTION OF BUILDING To be Used as: a 6 46a. Front Depth ... Height /.r F.... Sq. Ft. .. 'Cu. Ft. ........ l Front Depth .... .I► ... ..Height .. Sq. Ft. �.. Cu. Ft. ........ Type of Constructio Est Cos ,' %� ... .......... To be Completed , .... In consideration the proposed work in i ,I I' f the issuance to me of a permit to construct the building described above, I agree to do accordance with the description above set forth and incompliance with ordinances of the all provisions of ge of Fridley„ - .. ..... ................ .......... Ing ipn the express ocindition f the payment�of a fee oftenS.. ,� ... , permit is hereby granted to . . to construct the building g r addition as described above. This pe t is anted upon that the person to whom' it is granted and his agents, ernplo�ees 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 ro in the village limits arding location construction, alteration, maintenance, repair and moving of buildings with- d this permit lmay be revoked at any time upon- violation of !!any of the provisions of said ordinances. ' Building Inspector NOTICB:. This .permit d es not cover the construction, installation or alteration for wlring, plumbing, gas heating, sewer. or Water. B sure to see the Building Inspector for separate permits for these items,. City of Fridley, Mian.. BURDING PERMIT Date: June 1, 1965 Owner: 937.7 eW Washington N. E. Address 6332 Washington N. E. Builder Lawrence :Const. CO. LOCATION OF BUILDING No. 633.1 street Wash3.nbon Street N. E. Part of Lot Lot 3.2 Block - Addition or Sub -Division CEUSTIE ADDITION Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING 19 N® '7601 �27,4/7 7 To be Used as: Re -roof job Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost 9O-00 To be Completed Storm Damage Repair 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 a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of5� ,00 , permit is hereby granted to Iewrence Const. Compaw to construct the building or addition as described above. This permit is grantedupon the express condition that the person to whom it is granted and his agents, employees an 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 permit may be revoked at any time upon violation of any of the provisions of said Anon Jensen NOTICE: fhb pormb doss net cover the canstruation, infaga kn for whieg, plumbing, gas heating, sewer or water. Be an to see the Building hwpeater for separate permits for these hams. APPLICATION F& 'BUILDING PERMIT CITY OF FRIDLEY, mnmsOTA OWNERS NAME t & BUILDER ADDRESS ADDRESS, L`S LOCATION OF' BUILDING No. Street Part of Lot COTe- BLOCIt ADDITION OR SUBDIVISION Corner Lot 1fiside dT_ Setback Side -Yard SEWER ELEVATION. FOMATIOI$ ELEVATION Applicant attach to this form Two Certificates of Survey of Lot.and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING .-To be used as: Front Dept Height . Sq. Ft. Cu. Ft, Front Depth Height Sq. Ft. "Cu. Ft. Type of Construction Estimated Mllr,�L,4 s To b6 -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'gdildingii-And hereby declares that all the facts and representations stated��in this application are true -and correct, DAT � SIGNATURE V mo (Schedule of Fee Costs can be found on the Reverse Side). BUILDING PERMIT FEE SCHEDULE 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 build- ing or structure, or for any alterations 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 t6 -wit; 2.1. For any such permit for the erection of any fire -proof building, other than.a. garage, warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for 'similar occupancy, to any existing building, shall be.at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 22..2.. For any such permit for the erection of any fire -proof garage, Warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 50� of -the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof building, other thania garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet.. GARAGES 2,4. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non -fireproof addition, Ifor similar occupancy, to any existing building or for'each such " building oh addition - ninety cents ($0.90) for each one thousand cubic feet 'or fraction thereof, in the cubical contents thereof with the minimum of $4.00. For the purpose of computing fees for building permits, the cubical contents of any building or addition to.a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of 'the roof surface of the main gable of a pitched roof. 2.5. 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 i the cost of all proposed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2be less than $4.00. 0111 SUBJECT PER City of Fridley 2599 6 AT THE TOP OF THE TWINS BUILDING P IT r 'RFCVrT NO. COMMUNITY DEVELOPMENT DIV. X11 r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J\ 612-571-3450 910415 4/28/98 JOB ADDRESS 6311 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 4 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Corrine Hawkinson 6311 Washington Street NE 574-1408 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. B & B Roofing 6760 Madison Street NE, Fridley, MN 55432 571-0248 9048 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 Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Repair 4 Squares of Roofing 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 I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $500 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOESOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PR ISI NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON - TON OR THE PERF RMANCE CONS RUCTION. PLAN CHECK FEE TOTAL FEE / �/ „ 4/ " '/ License SC $ $22.00 SIGNATU OF CONTRACTOR OR AUTHORIZED AGENT MATE) WHEN PROPE Y VALI ATED THIS IS YOUR PERMIT 9�r O►INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI 0111 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Tel. Contractor: MN LICENSE Address: 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: Construction Type: r Estimated Cost: $ '-5Dd • ego EC/Gid F SC�u s (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 0&,� /L % APPLICANT:��' Tel. # S�/'Oaf YO CITY USE ONLY Permit Fee $ ,?/. D D Fee Schedule on Reverse Side Fire Surcharge $ , ,S"a .001 of Permit Valuation (1/10th%) State Surcharge $ , "U $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ " DD STIPULATIONS: SUBJE& PER City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 3 i 4 6 e ` I LV _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. !0 9�`Y�0 f I 0 t , NUMBER REV DATE PAGE OF APPROVED By = t ---'i CITY HALL FRIDLEY 55432 �'' 612-571-3450 910415 10 J 10 J 00 JOB ADDRESS 6311 Washington Street NE 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 4 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Benefield/Hawkinson 6311 Washington Street NE 763-574-1408 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Rusco Inc 5558 Smetana Dr, Minnetonka, MN 55343 952-935-9669 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 B DESCRIBE WORK Replace 8 windows within existing openings 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. Permit Inspection Cards Will Be Malled To Homeowner To Post SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $5,788 $2.89 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEESA CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $125.25 ire SC $5.79 EE PLAN CHMeS OTAL FEE Lice C $ /0 J,; $138.93 SIGNATURE OF CON' RACTOR OR AUTHORIZED AGENT IOATEI H NPR tY Y ID ED THIS IS YOUR MIT 00f!// -/ _40%A B DG IN - gaf f S-GNATURE OF OWNER,IF OWNER BUILDERI IDATEI NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: '3// f 1 Q v' ��• Legal Description: Effective 1/1/2000 612-572-3604 Bldg Insp Owner Name & Address: a . Tel. # AL2741 Contractor: &INNESOTA RUSCO, INC. MN LICENSE # 41'70 Address:_ .�a....�..._r._ .nu ee��7 Tel. # g4V'7/0ff-q !_ nn , - 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 Construction Type• _ _ Estimated Cost: $�,`�i% Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: 1/6 APPLICANT: Tel. # �64 9 Y6 6 /G` CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing in application Permit Fee $1,�,� , ,;,?$'" Fee Schedule on Reverse Side Fire Surcharge $:5—. 2"? 2"? .001 of Permit Valuation (1/10th%) State Surcharge $ oZ841 $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS-/��ve/e'�;7 ./ir�lr� �� �� /.,es LL •�/ <'_ 31D. T. / Z CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential APPLICATION FOR POWER PLANTS AND HEATING, COOUNG, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK ofvalp of Appliance or Work i=ly� _"'W Commercial/I dustrial r 1.25% of Value of Appliance or Work Effective On January 1, 1997 State Surcharge TOTAL FEE $ .50 $ S -D MINIMUM FEE FOR ANY HEATINGICOOLINGNENTILATION 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. Burner Trade Name Size No, BTU HP EDR HEATING COMPANY Signed ByVuAAC)S�' /% _ Tel No. _�Pef -sem l Approved By Rough—In Date FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNA E Final Date JOB ADDRESS (D WC s 1 cir The undersigned hereby makes application for a permit for the work herein Rate TOTAL 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 $ 30.00 $ representations stated in this application are true and correct. $10.00 $ o \ '" 4c/t)—� ) ' 1997 OWNER. c l e u:V'\'Scm �V $10.00 $ bcL.,ezv�,. BUILDING USED AS j $10.00 $ ' ESTIMATED COST p U U PERMIT NO. A2/ $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No, BTU HP EDR $ Fuel Total Connected Load State Surcharge TOTAL FEE $ .50 $ S -D MINIMUM FEE FOR ANY HEATINGICOOLINGNENTILATION 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. Burner Trade Name Size No, BTU HP EDR HEATING COMPANY Signed ByVuAAC)S�' /% _ Tel No. _�Pef -sem l Approved By Rough—In Date FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNA E Final Date Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CfEWNEY 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's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes O No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 6W-M171L' N ;r 10. 0 VILIM111%W QFA;M PERMIT NO.: 2004-01759 DATE ISSUED: 10/05/2004 ADDRESS : 6311 WASHINGTON ST NE PIN : 143024420058 LEGAL DESC : CHRISTIE ADDITION : LOT 12 BLOCK 4 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER HAWKINSON C A & BENEFIELD S M 6311 WASHINGTON ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAIDWITH CHECK # 118132 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. :,ITY OF FRIDLEY INSPECTION DIV. .x431 University Ave NE Fridley, MN 55432 572-3604 �SAPPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO RF INSTAI I Fn ON FAr,H FI nnR Effective On Jan 1, 2000 • -� c ®%. 8 R • ® New Fixtures � � � R• .. � p .•say . � � �ti � �R W�ii[ ii T M_ ® � R ��� $ 7.00 .and representations stated in this application are true and correct Catch Basin $ 7.00 Rain Water Leader $ 7.00 HAWKINSON, CORRINE ® 6311 WASHINGTON STREET NORTHEA .20 Sump/Receiving Tank $ 7.00 FRIDLEY, MN 55432 Water Treating Appliance $10.00 Owner (763) 574-1408 Water Heater -Electric $ 7.00 Water Heater- Gas** _� $10.00 Building Used AsSt:©� Com. Gas Range'* $10.00 °°1�Gas Dryer** $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING�) ANA o,=m 119u /wi PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS _54NC P'S 6W&i i✓ 1'2. 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 P,uilding 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 HAWKINSON, CORRINE ® 6311 WASHINGTON STREET NORTHEA .20 Sump/Receiving Tank $ 7.00 FRIDLEY, MN 55432 Water Treating Appliance $10.00 Owner (763) 574-1408 Water Heater -Electric $ 7.00 Water Heater- Gas** _� $10.00 Building Used AsSt:©� Com. Gas Range'* $10.00 °°1�Gas Dryer** $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING�) ANA o,=m 119u /wi Reinspection Fee $47.00/Hr SIGNED B ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approv By State Surcharge $ .50 MINIMUM I TOTAL FEE $M• PLUS THE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. TEL N0. 0-00 _ Rough -In Date Final Date `0 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 venting;,system is, plastic/PVC and meets all current codes and manufacturer specifications .including sizing, length, number of elbows and termination. Yes () No (_ ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and 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) -- HEATING CO: Signed By: Date: 1 Cf1YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 28, 2003 Ms. Corrine Hawkinson 6311 Washington Street NE Fridley, MN 55432 Re: Final Inspection at 6311 Washington Street NE Contractor: Norblom Plumbing Co Dear Ms. Hawkinson: A plumbing permit was issued on December 27, 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 the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. 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 by homeowner after notification" 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. DJ/mh CITY OF FRIDLEY PERMIT NO.: 2004-00978 6431 UNIVERSITY AVENUE NE T FRIDLEY MN 55432 DATE ISSUED: 06/23/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 6311 WASHINGTON ST NE PIN 143024420058 LEGAL DESC CHRISTIE ADDITION LOT 12 BLOCK 4 PERMIT TYPE PLUMBING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 170.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER HEATER. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS I # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE 0.00 CHAMPION WATER SERVICES INC PLBG FIXTURES (NEW OPENINGS) 0.00 16740 IREDALE PATH PLBG FIXTURES (EXIST OPENINGS) 0.00 LAKEVILLE, MN 55044 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 HAWKINSON C A & BENEFIELD S M PLBG REPAIR/ALTERATIONS 0.00 6311 WASHINGTON ST NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 35.50 PAID WITH CHECK # 5249 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulatinPOstraction or the performance of construction. Applican Date Bldg Insp ,]LvoDatetJ)-�11 EPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. g 14 -3 CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR #I✓i::::::: lip<:>:::<: Wash :<:::::: FI :Di1r#fs :::::...... oor al:::>::> Auto. =Gas Water Heater : >:.,:.::;:.:Urinal ::::>::::: Shower :S : :I::>::>�>�#I�::::i�#�.Tra I~:�it��>> Drain :::>::> Washer �t#<Range :1=t::::::::::: Gas Elec Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin NO. RATE TOTAL JOB ADDRESS Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance T Water Heater -Electric Water Heater - Gas** Gas Range" Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $10.00 The undersigned hereby makes application for a permit for the work herein $10.00 specified agreeing to do all work in strict accordance with the city codes $10.00 and rulings of the Building Division, and hereby declares that all the facts $10.00 and representations stated in this application are true and correct. $10.00 $10.00 DATE: ` 217 7 , 20 ®7° $10.00 $35.00 j�ro OWNER (�� ZA� e, 2�Alfjj &__6a A� $35.00 $35.00 BUILDING USED AS $10.00 $10.00 ESTIMATED COST (� PERMITNO. $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge $ b-0 TOTAL FEE $` o PLUMBING COMPANY SIGNED B TEL NO. ?Sa- FT f— R Approved By Rough -In Date Final Date r7 e� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A."PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and instailed 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) HEATING CO: Signed By: Date Building J 5 -OD. Y-- BUILDING Permit Fee Permit No.: I qo Inspections Plan Review RESIDENTIAL APPLICATION Received By: 763-572-3604 $ qQ CITY OF FRIDLEY Surcharge tMcNOV MO 763-502-4977 FAX License Surcharge $ 50 $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 8-19-09 Curb Cut Escrow $ DATE ' I YOUR E-MAIL ADDRESS �^1'Ct/1GifG(%� ca — '561 6iciceivie C�y1n SITE ADDRESS (p?a 1 t L.)c.sln%M (z,,.. Si. • $ THIS APPLICANT IS: ❑ OWNER .CONTRACTOR $ PROPERTY OWNER/ NAME: $ 39160 ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR NAME: Cta!b6v\ C1na. e e T: v.e STATE LICENSE #_ 3 2.�1 tc3 EXP DATE 3-34-10 �s SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF _ ADDRESS: Zt.% l 01 iniMl2 f C C� s Y liJ CITY Prtak-eL4 STATE IIP. 5Y/3Z INSURANCE PHONE FAX PROPERTY TYPE WSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED RrWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING 210THER _ �tAX ❑ SWIMMING POOLS 1 TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ;2'REMODELING pp DESCRIBE WORK BEING DONE: & ACIC e J wj e f?Su� Qet k,ie C Cact�> sc, �� i. X 1 tal/InUA' U" oI--PI:A SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES 11 HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING 4Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum Trim 1. Site Plan/Survey showing the existing structures ❑ Other Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS J;Kes []No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF _ _ /Lt J MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED i!O NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ J 5 -OD. Y-- OCCUPANCY TYPE Permit Fee $ 2 51 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ qQ .001 times the total job valuation Surcharge $ 1475- .0005 x Permit Valuation Minimum $.50 License Surcharge $ 50 $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 39160 Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for aylpmeand work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all wo _requires review and approval of plans. / SIGNATURE OF APPLICANT 6 , .. PRINT NAME G/�lCwr� 6" Cz/ DATE Af