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PRE 2010 DOCS09m SUBJECT P.� City of Fridley - 16176'- AT THE TOP OF THE TWINS BUILDING PERMIT _ . ' RE � • COMMUNITY DEVELOPMENT DIV. <: -_ ---- `/ r � � PROTECTIVE INSPECTION SEC. G 1 � i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-1`15 5/12/81 JOB ADDRESS 5604 West Bavarian Pass-N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 ] Q Innsbruck Villages SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Darrel A. Farr Development 4600 Lake Road, Robbinsdale MN 55422 536-9936 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 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE x 8 DESCRIBE WORK Construct a 27' x 29' Townhouse 9 CHANGE QF USE FROM TO STIPULATIONS 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 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 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 $37,470 $18.74 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- $81.10 $425.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 20.27 $ 45.11 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHE PROPER V I T D SIS YOUR PERMIT .y INSP � 2 °- f1ATE SIGNATUREOFOWNERIIFOWNERBUILDERI (DATE) 09m CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS). • �. .1O -'r � No . 6--& LOT: s CORNER LOT: Street: BLOCK: BUILDER:• .554z?- INSIDE IAT: SETBACK: SIDEYARDS: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION SOF BUILDING To Be Used As: its Front: Depth: Height: Square Feet: Cubic Feet: 115656,7 < Front: Depth: Height: Square Feet: _ Cubic Feet:' -/�o� lJ d� Type of Construction: Estimated Cost: $�� -To Be Completed: /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 fQr additional infoxzmation. _ DATE: hglg SIGNATURE: (/�(� C Stipulations: I T- CITY OF FRIDLEY APPLICATION FOR PUJMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE m PLUMBING FIXTURE RATES: NO. N m TOTAL y� /0 o $3.00 X m Water r.i m m '03 x $2.00 H r. .14 M o $5.00 41 Hi 0, 14 tp $5.00 Heater 100,000 BTU to 199,000 BTU s4 a x H G m H x� row tJ 3+ G crd Q' a $5.00 4 $4 _ x N U c .0 ..4 ••. yr C G 3 p 8 U ••i o .0 o 0 0 O y »4 44 m .+ 0 O +� m 44 N m N m .e lec sn G a t v1 S a w rq w V m a 3 u c 0 as Fad 3rd i (R) - Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures /0 x $3.00 $36.0 Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Nater Heater - to 99,000 BTU x $5.00 $ 00 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ E'lectric Water Heater _ x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ 3.oc) 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 (510.00) Job Address - (� go 9 t,(-) ('o t gu) / 't-_.. 4-)P,!o Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for at 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 Fridley, Mn. 19 it KIND OF BUILDING,_ , USED AS TO BE CC ESTIMATED wsT OLD - NEW BUILDING PERMIT NO. ROUGH INSP. Date PERMIT NO.� Company Signed By� elf L Tel. No. APPROVAL FOR PERMIT {9r s MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURMMRGE SuBjECT PERMIT NO. City of Fridley ,� 5?_4 ��8AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. ' COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r I /'--1 CITY HALL FRIDLEY 55432 NUMBER REVDATE PAGE OF APPROVED By 612-571-3450 910-F15 5/7/96 108 ADDRESS See Below I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Variou t I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Various 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Columbus Exteriors - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Townhouses 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside 44 Units (11 Buildings) 9 CHANGEOFUSEFROM TO STIPULATIONS % A& 5600,5602,5604,5606 West Bav ian Pass; 5601,5603,5605,5607 West Bavarian Pass; 5610,5612,5614,5616 es*-Baverlan-Faaa ; 5620,5622,5624,5626 West Bavarian Pass; 5620,5622,5624,5626 North Innsbruck Ct; 1521,1523,1525,1527 Trapp Court-; 5650,5652,5654,5656 West Bavarian Pass; 5660,5662,5664,5666 West Bavarian Pass; 5661,5653,5655,5657 West Bavarian Pass; 5671,5673,5675,5677 West Bavarian Pass; and 5681,5683,5685,5687 West Bavarian Pass 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 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 44 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 $228,800 $114.40 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- $1,532.25 Fire SC $228.80 STRUCTION R THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $1,880.45 SiGyf EOFCONTRACTOR ORAUTHORIZEDAGENT tDATEi WHEN PROPERLY DATED THIS IS YOUR PERMIT BLDG SP 4ATE S.GNATURE.OF OWNEROF OWNER BUROERi iDATEi CITY OF r IDLEY INSPECTION DIV. 6431 University. Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE i January 1,1W7 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, ,. REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 $ (Side Vent — Fill Out Back) Gas Pim' g (Needed with new furnace) $10.00 $�� Gas Range $10,00 $ Gas Dryer $10.00 $ *Air Conditioning — All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK I % of Value of Appliance or Work $ CommercialAndustrial 1.25% of Value of.Appliance or Work $ State Surcharge .50 TOTAL FEE $ -5 MINIMUM FEE FOR ANY HEATING/COOUNGNENTILATION 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. JOB ADDRESS 67oo V jS r 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 and1co�ect, 1 1997 OWNER • p fl S c 1,�4- 5-7 BUILDING USED AS ESTIMATED COST PERMIT NO .t 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 Burner Trade Name Size No. TO HP HEATING COMPANY Signed By. Tel No. Approved By Rough—In Date Final Date FILL OUT BACKSIDE FO STACK VERIFICATION ON REPLACEMENT FURNA E 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: . t List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Uelftar FURNACE EXCHANGE INC. 408063 rd Avenue North Brooklyn Park, MN 55443 CHDd NEY AND STACK VERIFICATION The undersigned hereby verifies that the -existing chimney or stack: 1. Has been carefully examined -. Yes O No ( ) 2. Is free from rust or deterioration Yes O 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 ( ) No ( ) Remarks: . t List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Uelftar FURNACE EXCHANGE INC. 408063 rd Avenue North Brooklyn Park, MN 55443 • SUBJEti City of Fridley 3 2 0 9 4 AT THE TOP OF THE TWINS BUILDING PERMIT __ COMMUNITY DEVELOPMENT DIV.® R #C// V r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF rPROVIO BY CITY HALL FRIDLEY 55432 612-571-3450 910415 8/21/01 JOB ADDRESS 5604 West Bavarian Pass 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 10 Innsbruck Villages SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rod Bush, 5604 W. Bavarian Pass, Fridley, MN 55432 763-571-6741 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Murphy Bros Building & Remodeling, 1613 93rd Ln NE, Blaine, MN 55449 763-780-3262 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LI BCT4S NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK IX NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows 9 CHANGEOFUSEFROM 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. 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 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ $1.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,000.00 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 $3.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 PLAN CHECK FEETO AL FEE Licens .00 92.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGE N T IDATEI VALI ED THIS I UERMIT ® S,GNATURE OF OWNER,IF OWNER BUILDER, IDATEI r4VN4ROP (��) OAiE NW Effective 1/1/2000 ADEN H CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER ❑✓ SINGLE FAMILYAND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION Construction Address: 5604 W BAVARIAN PASS Legal Description: Owner Name: Rod Bush Address: 5604 west Bavarian Pass ,Minnesota Tel. # 7635716741 ST 55432 Contractor: Murphy Bros. Buidling & Remodeling MN LICENSE # BC -3416 Address: 1613 93rd Lane NE Blaine MN 55449 Tel. # 7637803262 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. GARAGEAREA: Length Width Height Sq. Ft. DECKAREA: Length Width Hgt(Ground Sq. Ft. OTHER: Replace 4 sliding windows with vinyl inserts Number of Squares: 0 Construction Type: replace windows Estimated Cost: $ 3000 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: 08/14/2001 CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT Tel. #.8883301777 Call (763) 572-3604 for Permit Fees If mailing in application Fee Schedule on Reverse Side $ 63 o o .001 of Permit Valuation (1/10th %) $ T® $.50/$1,000 Valuation $ $1100 per SAC Unit $ Ob $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement NecessaryO Not Necessary❑ R37&15 r To: Fridley Building 6431 University Ave NE Fridley MN 55432 Murphy Bros. Buidling & Remodeling 1613 93rd Lane NE Blaine MN 55449 Carrier. Western National Mut Number. WC17820-1 Exp.: 08/03/2002 Number. BC -3416 Classltype: ResidentialBuilder Exp.: 03/31/2002 NetClerk ID# 95593 7635723604 7635711287 Homeowner name: Rod Bush Project address: 5604W BAVARIAN PASS FRIDLEY MN 55432 Job Description: Replace 4 sliding windows with vinyl inserts Class/type: Exp.: 03/31/2002 �#er itcenses Number. Class/type: Exp,. Homeowner tel: 7635716741 Valuation: 3000 IPayment Type: Check Credit card number. Card holder name: Expiration date: l 9 i 720 Dubuque Ave., - South San Francisco, CA 94080 - Government Services: 888-330-1777 - Fax: 877-846-5888 -- SUBJECT P15k City of Fridley 32574 AT THE TOP OF THE TWINS BUILDING PERillIT -ReCOWN-0. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 11EV DATE PAGE Of APPROVED BY CITY HALL FRIDLEY 55432NUMBER 612-571-3450 910-F15 5/8/02 JOB ADDRESS 5604 West Bavarian Pass NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 3 10 Innsbruck Villages SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Heiderscheid Bros Construction 13025 Hwy 65 NE, Blaine, MN 55434 763-862-0616 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20060354 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION Q,�LTERATION l REPAIR O MOVE : O REMOVE B DESCRIBE WORK Partia oo (7.5 Sq) Flat Roof 9 CHANGE OF USE FROM T STIPULATIONS Install ma of cture 's ecifications. pe t d 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 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 $4.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,500 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW EG A G CON- $167.25 Fire SC $8.50 STRUCTION OR THE PERFO CE OF CO TRUCTI T PLAN CHECK FEE DTAL FEE , IAI A 4 License $5.00 $1 .00 GNAM OF R TO HORi iDAT N P PERLY ATED WS IS Y URMIT r ' G 1 ;NA RE OF OW :O 4DE i ATEA B OG 16SP rj&TE 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: 2 1 ' Legal Description: Owner Name & Address: Tel. # Contractor—Lidleff MN LICENSE # Address: i ! Tel. # Attach td 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: Com=— Estimated Cost: Driveway Curb Cut Width Needed: Ft + 6 Ft = t x $ = v DATE: k)4 APPLICANT: �,r � L " � , I Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-5714287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ �Sf Fee Schedule on Reverse Side . $ C' .001 of Permit Valuation (1/10th% $ ' $.50/$1,000 Valuation $ l� $1200 per SAC Unit $C'a a $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 [ ] $�J S �� STIPULATIONS: Heiderscheid Bros. Construction Inc. 13025 Hwy 65 NE Blaine, MN 55434 763-862-0616 fax 763-862-8253 Dear City of Fridley, We are requesting that the permit on the following, address be refunded to us. 5604 West Bavairian pass Permit number 32574 Total amount due is $185.00 You will find a- copy of the receipt included . 4 Mike Heiderscheid PURCHASE ORDER THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY F 74539 THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US 1:7_ ® SUPPLIER 4� � s ADDRESS Sy �p - CrffOF 1 IXEY PHONE NO.�� ol No/ le 6431 UNIV. AVE. N.E. 763-571-:;�/ FRIDLEY, 45 55432-4384 ®CONTACT 763-571-3450 PRINTED ON RECYCLED PAPER. PAYMENT VOUCHER $ BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW STATED ITEMS. C�^0 J D E ED PAYMENT AU ORIgIBY ACCOUNT OTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWING UNIT PRICE AMOUNT 9 'f holt,Sl�ozS / qq LtLU42 161-0660 r JW m/ now - 3-v/ - 0 4 AlK X A TOTAL I IMS00 THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD. CITY OF FRIDLEY PERMITo.: 2004-ooso7�� 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/01/2004 572-36U4 k'AX: (763) 571-1Z87 ADDRESS : 5604 W BAVARIAN PASS NE PIN : 243024410193 LEGAL DESC : INNSBRUCK VILLAGES : LOT 3 BLOCK 10 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 800.00 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) # GAS DRYERS # OF NEW FIXTURES APPLICANT OVERACKER TERRY PLUMBING 1630 CO RD 10 SPRING LAKE PARK, MN 55432- (763) 572-8880 OWNER BUSCH RODNEY L & DONNA R 5604 W BAVARIAN PASS NE FRIDLEY, MN 55432 0 # GAS WATER HEATERS 1 0 # GAS RANGES 0 0 # WATER TRMT APPLIANCES 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. Bldg Insp. PLBG PERMIT MIN MUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 7003 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY CSF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT /c`�zgg5 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS Sl tl-f LO ��°, `' j� ' '`�'� PAXS r New Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $10.00 and representations stated in this application are true and correct. Catch Basin $10.00 a ® V Rain Water Leader $10.00 DATE: , 20 Sump/Receiving Tank $10.00 o �`� M Water Treating Appliance $35.00 OWNER Water Heater -Electric $35.00 Water Heater - Gas** �_ $35.00 3 5iea BUILDING USED AS Won- & Gas Range** $10.00 03 �V�" w � Gas Dryer** $10.00 ESTIMATED COST �L1 PERMIT NO. l Back Flow Preventer Required ( )Yes () No $15.00 PLUMBING COMPANY s `/ 0Type Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE SIGNED BY ° i`'� TEL N0. Approved By Rough -In Date Final Date 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 replacina 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 installina 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: