PRE 2010 DOCS01
SUBJECT
PER
City of Fridley
r®13.969
AT THE TOP OF THE TWINS
BUILDING
P E R h I T
RE-
COMMUNITY DEVELOPMENT DIV.
r i � PROTECTIVE INSPECTION SEC.
1 . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
".J 612-560-3450
910-F15
3/29/77
JOB ADDRESS 1545 West Bavarian Court N. E%
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
25
1
Innsbruck North Townhouses Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Darrel A. Farr Development Corp. 7286 - 72nd Lane North 560-8110
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential (Kavalier Design)
7 CLASS OF WORK
Cj NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 37' x 40' Townhouse and a 21' x 22' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Provide truss design. Provide specifications of siding material.
Provide combustion air to furnace.
V4� NG
t%cft FOR :
.rRM1TS REQU�R€
Before d19909 call teat V1440
HEATING, PLUMBING AND SIG :
'iRMONE - ELECTRIC -NS Etc.
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Frame
VENTILATING OR AIR CONDITIONING.
Wood
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
R-1
1252 f 462
29,660 Total
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
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
$37,350
$18.88
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$ 118.64
$375.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$29-66
$541.98
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
W� N PR
ER AL=ED IS YOUR PERMIT
BLDG. INSP
DA
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
01
A111'],IC;"TIO,N 1:01: IZ1.iSl1)1;!�"1'IP,l,, AL'1E'lZATION2
OR ADDJ TI0.\ BU 11J)Ii\*G I11:1Z14IT
CITY OF FRJDL1 Y, %J11"NINESOTA
OTI-T E'll' S NE�1f1; :��f+s�t� � i�- ��tJ �� 4 L"JILDFP.:_ �Qdo, L� ry
ADDT.•'.T.� SS :]9 8&, 72 bate. AIOw+h ADDiRESS :_ /J. N. %5"r4 -AS
s;o :
STREET: -/Z&1 Alw-of
-25—
LOT: f BLOCK : / ADDITION:
CORTNER LOT: INSIDE LOT: P00011 SETBACK: " SI DEYARD :
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: 04t
'omhdMSf- Front: 37 Depth: "ilk Height:
Square Feet: Cubic Feet: c�P
�L2taae.. Front: o?% Depth:
MM
Height
Square Feet; �� Cubic Feet:_ �/' 1 4- 0
Type of Construction: 060 Eb`W"e, Estimated Cost: $ a3 >0
To Be Completed: ♦//!Qy� 19,�
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: J1,, &207 SIGNATURE:
01 AF
(See Reverse Side For Additional Information.)
OWL
18,69
54c 3
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Jr®C- 74"6 OEc5/ j; J
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Orc/
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
Future Fixture Opening
g x
$2.00
I
New Fixture, Old Opening
Water
m
$
Catch Basin
x
$5.00
$
E
a ro
$5.00
m
fd w
a
�"
Water Softener
x
Heater
$
New Ground Run Old Building
x
$5.00
$
,fie
cul
�
a�
p
x
q
d
N
a
let 3 fixtures
x
►+
O
$
Additional Fixtures
x
$1.00
O
rov
Gas Range to 199,000 BTU
x
N
R
REPAIRS $ ALTERATIONS
O
0
y�
$5.00
N
N
o
$2.00
lec
to
State Surcharge
N
M
vii
3
aw°
bci
w
ciM
a3
($10.00)
as
1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
Future Fixture Opening
g x
$2.00
$
New Fixture, Old Opening
x
$2,00 e
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x'
$5.00
$
GAS FITTING FEES:
let 3 fixtures
x
43.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$
REINSPECTION FEE
($10.00)
Job Address /5 --Vs— W 2 i
Department of Buildings
City of Fridley
Tel. #571-3450
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 .4
T
RIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO.
Fridley, Mn. , 19
PERMIT NO.
Company t /✓%u . i+� r .
Signed By
Tel. No. '�rxS' - L/ (
ROUGE INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT /
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
CITY OF FRIDLEY INSPECTION DIVISION
Effective On January 1, 2000
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 REFRIGERATION
AND AIR CONDITIONING
SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
OWNER
Residential Rate
TOTAL
Furnace Shell and Duct Work, Burner -
BUILDING USED AS
Also Replacement Furnace $ 30.00
$
(Side Vent - Fill Out Back)
ESTIMATED COST -�-S0,� oo PERMIT NO.
Gas Piping (Needed with new furnace, $ 10.00
$
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range $ 10.00
$
No. of Heatin Units Circle One (Steam) (Hot Water) (Warm Air)
Gas Dryer $ 10.00
$
Trade Name .c1 T Size No.
BTU_ sa9,,�>a- HP EDR
*14ir Conditioning -All Sizes $ 25.00
$
Fuel -6–As Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name Size No.
1%Q of Value of Appliance or Work
$ �2s
BTU HP EDR
Commercial/Industrial
1.25% of Value of Appliance or Work
$
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 an
State Surcharge
$ .50
rulings of the Building Division, and hereby declares that all the facts and
TOTAL FEE
_
$�0
representations stated in this application are true and correct.
dba fifes dei Corm
DATE
License #20090911
2700 N. Fail AM
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
HEATING CORnse , MN S, 113
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
651/633-2561
PLUS THE $.50 STATE SURCHARGE
Signed - R ��—__ TEL #
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
Approved BYARough-in Date Final Date 3 -3o -o/
written permission from adjoining property owner.
W
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 -LAMA 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 manufacturers 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'o[, Mat;
Total Appliances
Total Btu Inputa
a+L
43° 4 �P
dA
y
Common Vent Type
Vent Height
n � i
Diameter -',"fiches
Appliance #1 Vent Connector Height
ft Length
ft Diameter mar% ape
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
CITY OF FRIDLEY INSPECTION DIViSION �� Effective On January 1, 2001
6431 University Ave NE �m �%l��J�� LIST
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763-572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS ZS41)4)FC.< �
RATE SCHEDULE
OWNER 60,5 VV/� (5
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.00 $ L; o' 60
$ 10.00 $ 16,60
$ 10.00 $
$ 10.00 $
$ 25.00 $
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard.without
written permission from adjoining property owner.
$ .50
BUILDING USED AS
ESTIMATED COST PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units_L_ Circle One (Steam) (Hot Water) arm Air
Trade Name Y l A-)4- Size No.
BTU 601,000 HP EDR
Fuel ATZa�S Total Connected Load
Burner Trade Name
BTU HP
Size No
EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE
A{rC01100nin9 81400"1 Ma.
HEATING CO _... f6511 633-0125
Signe
New Brighton. MN 55112
Approved B)f Rough -In Date Final Da
CK SIDE -MUqr BE FILLED IN ON VENT SIZE, VENT CONNECTORS
D COMBUSTION AIR VERIFICATION
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,
Yes No ( )
and is securely supported and firestopped where required.
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
Yes AIN No ( )
assisted and natural draft appliances.
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
Yes No( )
Venting Tables for fan assisted and natural draft appliances.
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
AM
Appliance #2 Type �z i BTU Input Fan Assisted or Nat
1-147
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances �_ Total Btu Input 9di 006
r
Common Vent Type Vent Height at®Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in- Type
Appliance #2 Vent Connector Height ft Length ft Diameter h, Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO: O'A
Date
Signed By: : ��`
CITY OF FRIDLEY INSPEC'1 ION DIV.
6431 University Ave NE
Fridley, _MN 55432
763-572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2001
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
Gas Range** -
Gas Dryer**
Back Flow Preventer Required ( )Yes O 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
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL JOB ADDRESS 1C07
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.
9 -11 , 20
Owner
L) ® Building Used As ri
Estimated Cost PERMIT NO. 13,�D
PLUMBING COMPANY bC1A,) PC omb>/-)
SIGNED BY 6 o TEL N0. /G7? "0`Z15/
Approved By Rough -In Date Final Dat'<;01-9_a"
TOTAL FEE $�% PLUS
COMBUSTION AIR SHALL BE PROVIDED PER UMC SE ION 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
BTU Input
venting has been examined and is free from rust, deterioration, obstructions,
Appliance #2 Type
and is securely supported and firestopped where required.
No
Yes () ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
Yes O No ( )
specifications including sizing, length, number of elbows and termination.
Total Appliances _
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
Vent Height
include AGA-GAMA Category I Central Furnace Venting Tables for fan
Appliance #1 Vent Connector Height
assisted and natural draft appliances.
Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
ft Length
and manufacturer's specifications.
Yes () No ( )
When required to install a new combustion air, it will be sized and installed
ft Diameter in Type
to meet the current codes and manufacturer's specifications.
Yes ( ) No )
When installing a new ventina 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
Yes () No ( )
Venting Tables for fan assisted and natural draft appliances.
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
GNOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
January 11, 2002
Mr. Bob Yurecko
1545 West Bavarian Court NE
Fridley, MN 55432
Re: Final Inspection at 1545 West Bavarian Court NE
Contractor: Care Air Conditioning & Delson Plumbing Inc.
Dear Mr. Yurecko:
Permits were issued on September 14, 2001 to install a water softener and a furnace
at your address. According to Section 4715.2800 of the State Plumbing Code and
the 1991 Mechanical Code, final inspections shall be conducted on the work
authorized by these permits. Corrections were noted on the final inspection for the
furnace on September 26, 2001 which need to be seen to final out the work.
The permit fees that were paid cover the inspections to make sure the work was
completed according to the Code. We will keep your permits 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 permits "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
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
S7L-JbU4 YAA:
ADDRESS : 1545 W BAVARIAN CT NE
PIN : 243024440095
LEGAL DESC : INNSBRUCK NO T H PLAT 4
: LOT 25 BLOCK 1
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : TOWNHOUSES
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-00768 3
DATE ISSUED: 05/24/2004
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE AIR CONDITIONER.
# 101+ AMP CIRCUITS 0
APPLICANT
YURECKO ROBERT A & LYNN P
1545 W BAVARIAN CT NE
FRIDLEY, MN 55432
OWNER
YURECKO ROBERT A & LYNN P
1545 W BAVARIAN CT 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 worl
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 AMP SERVICE FEE 20.00
ELEC CIRCUIT FEE (101+ AMPS) 0.00
STATE SURCHARGE, ELEC FLAT 0.50
ELEC PERMIT FEE - MAX (RESI) 0.00
TOTAL 20.50
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY PERMIT N .�20000773
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 05/25/2004
EMP -M11112 N W.V:RrL11]11.7�- ►M:yh
ADDRESS : 1545 W BAVARIAN CT NE
PIN : 243024440095
LEGAL DESC : INNSBRUCK NO T H PLAT 4
LOT 25 BLOCK 1
PERMIT TYPE HEATING
PROPERTY TYPE TOWNHOUSES
CONSTRUCTION TYPE ADDITION/ALTERATION
VALUATION : $ 1,500.00
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL AN AIR CONDITIONER.
# A/C UNITS 1 # FURNACES 0
# GAS DRYERS 0 # GAS RANGES 0
APPLICANT
KEVIN'S HEATING & COOLING INC
6474 20 AVE S
HUGO, MN 55038
OWNER
YURECKO ROBERT A & LYNN P
1545 W BAVARIAN, CT 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 worl
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 1aA
regulating construction or the performance of constructio .
Bldg
FURNACE SHELL/DUCT WORK
0.00
GAS RANGE FEE
0.00
GAS DRYER FEE
0.00
AIR CONDITIONING FEE
25.00
STATE SURCHARGE, MECH FLAT
0.50
TOTAL
25.50
PAID WITH CHECK # 2465
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY BUILDING INSPECTIONesq08 Effective 4/1/2004
6431 University Ave NE
Fridley, MN 55432
763-572-3604 FAX 763-571-1287
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS Ar,
Fee Total
Owner 56b Lt4re c6
$35.00 $ Building Used As VAC 1�
$10.00 $ ESTIMATED COST l�yd° PERMIT NO
$10.00 $
DESCRIPTION OF FURNACE AND BURNER
Gas Dryer $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
��-dc) Trade Name Size No.
*Air Conditioning - All Sizes $25.00 $ V16 BTU HP EDR
Fuel Total Connected Load
All Other Repairs or Alterations (List on Back)
1% of Value of Appliance or Work $ Burner Trade Name Size No.
Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR
Improvement whichever is greater
The undersigned hereby makes application for a permit for the work herein
Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes
1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts
Minimum Fee $35.00 for Commercial/Industrial/Institutional and representations stated in this application are true and correct.
State Surcharge $ ` �� HEATING CO lr 'h)` /` Pd�t 4 -2 raa"ate j-V'C- .
TOTAL FEE $ Signed 'L . Tel # Ur^,�®~c'Y
REINSPECTION FEE $50.00/HOUR FAX # Date
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACEl
Approved by Rough -in Date Final Date � / I 014
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 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 :
CITY OF FRIDLEY PERMIT NO.: 2004-01829
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 10/05/2004
572-3604 t'AX: (763) 571-1287
ADDRESS
: 1545 W BAVARIAN CT NE
PIN
: 243024440095
LEGAL DESC
: INNSBRUCK NO T H PLAT 4
: LOT 25 BLOCK 1
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
YURECKO ROBERT A & LYNN P
1545 W BAVARIAN CT NE
FRIDLEY, MN 55432
ELEC PERMIT FEE - MIN (REST) 20.00
STATE SURCHARGE, ELEC. FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 118132
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
regulating construction or the performance of construction.
Applicant Date
Bldg Insp
Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
3uilding BUILDING Permit NO.: o
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY D dJ
)ATE ®� YOUR E-MAIL ADDRESS �� MIN III- 'xV fN
,ITE ADDRESS IN ` 0,44 G9 o. DA
'HIS APPLICANT IS: O OWNER O(CONTRACTOR
PROPERTY OWNER/
NAME: 10 r
TENANT
1 U
�,,g
CITY i STATBVOZIP�
ADDRESS: 15 �' ,
�60�1��h�` m a
PHONE: (J 11 -
1CONTRACTOR
CONTRACTOR
NAME:
STATE LICENSE.
EXP DATE -3
CITY ®e'5 tQ STATEWIPS53 I'
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: %calog
WITH APPLICATION
PHONE 'X2 - 3 11_ 51
Ax
3 ^ 391- 5!ZJ1 g xok
PROPERTY TYPE
JA SINGLE FAMILY/NEW CONSTRUCTION
SIZE
0 TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
O ADDITION
0 GARAGE/SHED
0 WINDOWS
0 BASEMENT FINISH
0 ROOF
0 DRAIN TILE
0 OTHER
0 DECK
SIDING
0 SWIMMING POOL
TYPE OF WORK:
0 NEW
0 ADDITION
0 MAINTENANCEIREPAIR
REMODELING
DESCRIBE WORK BEING DONE: 1K W "� ' 5 10� Z.'4, V%.5>G' 0, C'�
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft.
ROOFING 0 HOUSE ONLY
NUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
❑ ATTACHED GARAGE 1. Existing Floor Plan
GARAGES 2. Proposed floor plan
PROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
I1X Vinyl noSoffit ADDITIONS & PORCHES SUBMIT:
0 Aluminum Trim 1. Site Plan/Survey showing the existing structures
❑Other Fascia and proposed project
2. Two sets of construction plans
V4'INDOWS 3. Energy Calculations
IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED 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 $ 9� OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ %2 . j' .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $20 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ %(L 5Z. 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 a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work whic egnire view and approval of plans. #
SIGNATURE OF APPLICANT PRINT NAME J li DATE �� Z��T_
BuildingBUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
DaAMOCT 0 2 2009
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS:
❑ OWNER YkCONTRACTOR
PROPERTY OWNER/
NAME: �•�- k'GCk-�
TENANT
ADDRESS—L5-40-5 VJ 2Q1%i' CITY:may
STATFRkIP�
PHONE: " i(f & 50 - 26U.14
CONTRACTOR
NAME:
SUBMIT A COPY OF
STATE LICENSE # EXP DATE 2000
YOUR STATE LICENSE
ADDRESS: CITY
MA
STATWIP � i
WITH APPLICATION
PHONE FAX -% - ZC'4
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
Q TWO FAMILY NEW CONSTRUCTION STORIES
PIERMJT TYPE
ADDITION Q GAILIGE/STiE,D VvTNDOWS
O BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK 0 SIDING 0 OTHER
❑ SWIMMING POOL
TYPE OF WORK:
0 NEW ❑ ADDITIQN
O MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:_ ic )S
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
UIQ OFING
0 HOUSE ONLY
NUMBER OF SQUARES
0 HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
0 ATTACHED GARAGE
I.
Existing Floor Plan
PROPOSED SIZE:
0 DETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIDING
0 Vinyl
❑Soffit
FOR NEW CONSTRUCTION INCLUDING DECKS,
rn um
❑Trim
ADDITIONS
&PORCHES SUBMIT
❑ Other .
❑ Fascia
I .
Site Plan/Survey showing the existing structures
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS OYes []No LOCATION OF WINDOWS
3•
Enemy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
A If .1. PV.VC A 12F VIA
VEM f%XY V AT TT A TTr�i.7 rntr.r
TOTAL JOB V
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
SAN Tc%LAU.MAaa.11N,I M UUb*l* OF LABOR AND MATERIALS:
(USING THE 1997 U -B -C FEE SCHEDULE)
.TION $ i a fnj OCCUPANCY TYPE
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Pians to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridlev Attach
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 a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requiresTaWL view and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME Ch2ry 1 �� DATE•�� 1�