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PRE 2010 DOCSSUBJECT PER ' City of Fridleyblr'-6921 AT THE TOP OF THE TWINS BUILDING PERMIT r �Ilk CEIPT N COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. L>9 1P CITY HALL FRIDLEY 55432 NUMBER REV. DATE .PAGE OF APPROVED BY 612-571-3450 910-F15 2/14/83 JOB ADDRESS 5417 West Bavarian Pass N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 1 Innsbruck North Townhouse Fiat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrel A. Farr Development Corp. 4600 Ia.ke Rd., Robbinsdale, NILS 55422 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sams -536-9936 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK X El ALTERATION ❑ ADDITION ALTERATION ❑ REPAIR MOVE REMOVE ❑ X 8 DESCRIBE WORK Construct a 39'' x 52' Townhouse and a 201 x 24' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Change inside layers of gypsum from -'� to 5/8 inch on party wall. SEPEPATE PERMITS REQUIRED FOR IRIN aFTING, PLUNIM AND SIGNS, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 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 $23.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $47,500 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $425.00 TRU TION OR THFAPFRFORMANE OF CONSTRUCTION. $274.00 PLAN CHECK FEE TOTALFEE G $68.50 $791.25 SIG ATUREOFC RACTORORAUTHORIZEDAGENT (DATE) WHEN PROPER IDATED THIS IS YOUR PERMIT A s -i A BLDG INSP E SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS SO0_C? o (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS). OWNER: Darrel A. Farr Development Corp -BUILDER:. Same Address,: 4600 Lake Rd. Address: Same Robbinsdale, MN 55422 Tel. No.:.(612) 536-9936 No.: 5417 Street: West Bavarian Pass LOT: 14 BLOCK: 1 ADDITION: Innsbruck North Townhouse Plat 4 CORNER LOT: INSIDE IDT: X SETBACK: SIDEYARDS: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING SALZBURG II To Be Used As: RPairlPn('P Front: 39-0Depth: 52-0 Heights 17-0 \I 0101I.- �r Square Feet: Ja. - Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: t i p)(' ,2(® 4'L, 16,'714 4709 101 . z 4W4 0 4r) 14 qv Type of Construction: Wood Frame Estimated Cost: $ per/ • . Isbo To Be Completed: May 1. 1983 /Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. DATE: SIGNATURE: Stipulations: (Jqn_m'K- C"AOLY.,�� 4 pt �T.zv OrPO4-4- Ty �4 1, Q 7 �,2 CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT m NO. RATE TOTAL New Fixtures 9 1>. m q b $ 3.50 U k a $ 1.50 water Heater ani .ei $ 4.00 $ F b $ 5.00 $ m Ae�v W Wwi $ 5.00 g Rain Water Leader N O $ Hydraulic Valve S 5.00 "$ O aw O N $ tlUl tq $ 7.00 $ NM Hot Water Heater d Iq $ f�A Gas Range O W f�A $ U 3 gyp $ 10.00 $ ,C H ALL OTHERS AND/OR REPAIRS AND ALTERATIONS lec is of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge 1. R) 50 C7 ' TOTAL FEE $ 9 pp3 1st 2nd Le% 3rd 4th (R) a Future Connection Opening Connected with Sewer (4) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures 9 $ 5.00 $� Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve S 5.00 "$ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater d $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS is of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ 50 ($15.00) ' TOTAL FEE $ y � , (g( 1-0 EttectiVS Aug. 1, i9bl Job Address�r ��Of'i% / •ly,� 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 n Fridley, Nn. 3-3-13 -3-1 3 , 19 KIND OF BUILDING . P"'(�' 6 USED AS �W TO BE COMPLETED ABOUT -) ©/4 ESTIMATED COST .s�t OLD - NEW BUILDING PERMIT NO. —rPERMMIT NO. 96:11 Company rzl C J��N lq'6 C6 CA //V �-- Signed By Tel. No. ROUGH INSP. Date FINAL INSP. Co -(O - ® 3 Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIVISION % 01��� 6431 University Ave NE. Fridley, MN 55432 APPLICATION FOR POWER PLAINTS AND HEATING, COOLING, VENTILATION, 572-3604 ' REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DE'VICIE, _C�' JOB ADDRESS ` LA- 1-7 �i� RATE SCHEDULE Residential OWNER(�,i1 Rate TOTAL Effective On May 10, 1999 Furnace Shell and Duct Work, Burner - Also Replacement Furnace BUILDING USED AS (Side Vent - Fill Out Back) $ 30.00 $ , l 2 ESTIMATED COST ®� PERMIT NO. / �� Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ laaa $ No. of Heating Circle One (Steam) (Piot Water) a m Air) Gas Dryer y $ 10.00 $ _ gUUnits�_ Trade Name 6_ ns - Size No. BTU (,on. b --)C) HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 17o of Value of Appliance or Work $ BTU HP EDR Commercial/ Industria 1 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 representations stated in this application are'true and correct. TOTAL FEE $ MINIMUM FEE, FOR ANY HEATING/COOLINGIVENTILATION REFRIGERATION/AIR CONDITIONING PERMIT 1JJ2.5,00 PLUS THE 5.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr L'Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEAT IN Q.Q0 Signe DATE Approved By Rough -In Date Final Date Remarks: List ALTERATIONS BeingDone• HEATING CO: Signed By: ,Date: 1 LO CHIMNEY AND STACK..VERMCATION 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 ( ) S. 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 () No ( ) Remarks: List ALTERATIONS BeingDone• HEATING CO: Signed By: ,Date: 1 LO CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS��-57 New Fixtures $ 7.00' The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 3z I_q98-- Sump/Receiving Tank $ 7.00 Water Treating Appliance •®a Owners Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 Building Used As Gas Range** $10.00 Gas Dryer** $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMP NY Reinspection Fee $42.00/Hr SIGNED BY TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1�� 1.5% of Value of Fixture or Appliance �®<�� _ Approved ByRough—In Date Final Date I eabo : State Surcharge $ .50 MINIMUM FIFflANYPLUMBING/GAS PERMIT IS $20.00 TOTALFEE $ ` ®. PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. l SUBJECT PERMIT NO. City of Fridley 312 0'5 AT THE TOP OF THE TWINS BUILDING PERMIT r T , RECEIPT T T COMMUNITY DEVELOPMENT DIV. ,,/e /�� _ >r PROTECTIVE INSPECTION SEC. LT[ !—f NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIOLEY SS�32 612-571-3450 910-F15 7/14/00 JOB ADDRESS 5415 -'5417 W. Bavarian Pass 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 13;14 1 Innsbruck North Townhouse Plat 4 sHEEr, 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Innsbruck Townhome.Association 651-22.4-5482. 3 CONTRACTOR ' MAIL ADDRESS ZIP PHONE LICENSE NO Garlock-French Roofing Corp., 2301 E 25th St., Mpls., M 55406 612-722-7129 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 00001423 S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW O ADDITION O ALTERATION M REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Tear Off and Reroof Townhouse Building 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment.must comply with the State Building Code. Permit Inspection Cards will Be Mailed. To Homeowner To, Post TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT.. AUTHORIZED IS NOT COMMENCED WITHIN 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 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 $4.54 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $21,914.75 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $9.07 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $181.25 PLAN CHECK FEE I TOTAL EE 194.86 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N P OPERL L1DA E HIS IS 'SUR PERMIYF S,GNATUREOFOWNEROFOWNER BUILOERI _ _IDATEI WfIA Boqflsysp' ".- ... ,._ - E l SUBJECT ,PERMIT NO. City of Fridley 32443 P,AT THE TOP OF THE TWINS BUILDING PERMIT Ir REC COMMUNITY DEVELOPMENT DIV. j7 r PROTECTIVE INSPECTION SEC. �/1 CITY HALL FRIDLEY 55432 �a NuMBE11 REV GATE PAGE OF APPROVED By 612 — —3450 910-F15 3/5/02 JOB ADDRESS 5415 - 5417 West Bavarian Pass NE t LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 13 &141 1 Innsbruck North Townhouse Plat 4 SHEET 2 PROPERTY OWNER • MAIL ADORES$ ZIP PHONE Innsbruck Townhomes 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Columbus Exteriors, 2131 111th Lane NW, Coon Rapids, MN 55433 612-363-7770 3509 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwellings > CLASS of WORK JD NEW 0 ADDITION O ALTERATION X REPAIR O MOVE O REMOVE 8 DESCRIBE WORK town Reside houses & garages 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code requires that a weather - resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions to this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in the application guidelines. Call for inspection of wrap before covering. 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 12Q 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 VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $6.42 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT' $12,840.00 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $1 84 Fire SC STRUCTIONAR THE PERFORMANCE OF CONSTRUCTION $223.25 . PLAN CHECK FEE FEE $5. cen 72-47.51 SoG ATURE Of CONTRACTOR OR AUTHORiZEO AGENT iDATEi HEN R P VALIOAT THIS IS YOUR PERMIT r �vez� S,GNATURE Of OWNERQi OWNER BUILDER) IDATEi EL II pAtE NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Ai Contractor. LIVING AREA: Tr t s Q rc.--/< Tb" o S Tel. # e� MN LICENSE It 3 \3-0 IL f, A) -3 Tel.# 6/z_3G3 - 777O Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length U. Length Len DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft Width Height Sq. Ft Wdth Hgt/Ground Sq. Ft. !7 tD C/ 5 .4 1r-0 �fQ It 'C. _'�'" Estimated Cost: $ / Z, 0 `fi o • Q D Uib Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ Z --APPLICANT: Tel. # h - �� 3 PCall (763) 572-3604 for Permit Fees if mailing In application or Fax to 763=571-1287 if using credit card and we will "call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ c4C 3. Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ 02 $.50/$1,000 Valuation $ _ $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ �7 �� ftd I STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 F63) 572-3604 FAX: (763)571-1287 ADDRESS : 5417 W BAVARIAN PASS NE PIN : 243024440084 LEGAL DESC : INNSBRUCK NO T H PLAT 4 : LOT 14 BLOCK 1 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION s PERMIT NO.: 2004-00258 �' 81S DATE ISSUED: 02/24/2004 VALUATION 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 AIR CONDITIONER # A/C UNITS # FURNACES # GAS RANGES APPLICANT DAVES APPLIANCE HEATING & AIR INC 160137 AVE NE COLUMBIA HEIGHTS, MN 55421 (763)781-6901 OWNER HARSTAD DONALD W & THELEN W J 5417 W BAVARIAN PASS NE FRIDLEY, MN 55432 1 VALUE OF APPL OR WORK 0 0 # GAS DRYERS 0 0 ENTER VALUATION 0 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. A Dlicant /I Date HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 25.50 PAID WITH CHECK # 33870 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OFfRIDLEY INSPECTION DIVISION Ettective January 1, 2003 6431 University Ave NE Fridley' MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 RATE SCHEDULE 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 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIQNING PERMIT IS $25.00 PLUS THE $ 5Q STAFF SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE�� Rough -In Date Final Date JOB ADDRESS 0 1 1-) . b?N_W\-(JNQ OWNER:]�)�11"JN/ k VAnl &tQ Rate TOTAL s BUILDING USED AS $ 30.00 $ ESTIMATED COST ij PERMIT N0.i'�- $ 10.00 $ DESCRIPTION OF FURNACE AND OR B RNER $ 10.00 $ No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No._ BTU HP EDR $ 25.00 $ Fuel _ Total Connected Load Burner Trade Name Size No. $ BTU HP EDR. State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIQNING PERMIT IS $25.00 PLUS THE $ 5Q STAFF SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE�� Rough -In Date Final Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When nar�enlnTan eyigHnn fance, 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 Yes( No( } specifications including sizing, length, number of elbows and termination. 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 No( ) assisted and natural draft appliances. .....Yes( The javieffnasemhsi= is sized and installed to meet the current codes Yes () No ( ) and manufacturer's specifications. When required to ' wili be steed and instaiied Yes( No( } to meet the current codes and manufacturer's specifications. the undersigned hereby verifies that When inaftillina a now ymifing syWarn, 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 yes( )No( ) separately as per current codes. and Vent C TynP-andgqo7atCnmrnen Appliance #1 Type BTU Input Fan Assisted BTU Input_—. Fan Assisted or Nat or Nat,_________ Appliance #2 Type 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 _ Length ft Diameter ____�ln in Type . Type Appliance 02 #2 Vent Connector Height,,, ft Diameter Appliance #3 Vent Connector Height,_ ft Length _. — in Type, .� From: unknown Page: 2/2 Date: 10/24/2008 9:44:35 AM „ Building MECHANICAL Permit No.. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat r ® 763-502-4977 FAX `1.V�: EFFECTIVE 1-1-08 DATE 1, R E-MAIL ADDRESS aA���(X��� t�"tC�l C\Q & k3C� tf, i r , C ' SITE ADDRESS�� �CONTRA�CTOR THIS APPLICANT IS: 0 OWNER PROPERTY NAME OWNER/ TENANT Y� ADDRES 1x'16\ J STAIQ nZlp PHONE: CONTRACTOR COMPANY NAME: kkPA�W\Ck,\Y- C.. NOTE: SEPARATE CITY CONTACT PERSON. LICENSES ARE STATE LICENSE # RXP DATE REQUIRED FOR GAS�tt ADDRESS: �LOl�1 - 1nP CITY C STAI�ZIRJV'tZ� AND HVAC. SUBMIT COPY OF BOND 4.. PIiONEI���%�� FAXy-Z9– AND INSURANCE PERMIT TYPE �,� LwSINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: ❑ NEW IBJ REPLACEMENT 0 ALTERATION/R13MODE1. AILED ES PTI N OF WORKon, PER MS 16B.665 the permit fee is a minimum of $15.00 or 50/6 of the total cost up to $.500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of tabor) OR Labor cost under $300 - $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE., EXCEPT WHERENOTED. FIXTURES: (INDICATETOTAL NUMBER OF EACH BELOW) Equipment Installed MFQ: MODEL: SIZFJBTU MFG: MODEL: SIZEIBTU MFG: MODEL.: SIZE/BTUT IVC $25.00 -„-„FIREPLACE (OAS) $1$.00 GAS RANGWOVEN $10.00 AIR TO AIR EXCHANGEER $15 _.VREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 ✓FURNACE $35.00 ___.PAS UN1T'HTR $10.00 —CHIMNEY LINER$10.00 `GAS DRYER$10.00 POOL NEATER $35.00 '—VENTILATOR DUCT WORK $10.00 _GAS PIPINO $10.00 $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ L. Q_ Numbar of fixtures cr $10.00 _ x $10.00 = $ Surcharge $ 50 Number Of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $r�-�— OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50'rotal = $ THIS IS AN APPLICATION FORA PERMIT NOT VALID UNTIL PROCESSED I hereby apply for it mechanical permit and I acknowledge that the infonmtion above is complete and accurate; that the work will be in conformance with the ordinances and codcs of the City of Fridley and w' 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 lha work Il n accordant a with the ap ed Ian in the case of all work which squires review tut ppmval of Ions. SIGNATURE OF APPLICANAMEam—w Ei'! APPROVED BY DATE PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING ELECTRICAL AND MECHANICAL WURK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 I'