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PRE 2010 DOCSSUBJECT PER O. City of Fridley 15209 AT THE TOP OF THE TWINS BUILDING PERM!T r RECEIPT NO. Ly ______ COMMUNITY DEVELOPMENT DIV.g r PROTECTIVE INSPECTION SEC. I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/23/79 JOB ADDRESS 5407 West Brenner Pass N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 9 Innsbruck North Townhouse Plat 5 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrel A. Farr Development Corp. 7286 - 72nd Lane N. 55428 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 7 CLASS OF WORK ❑ NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B 8 DESCRIBE WORK Construct an 18' x 28' Townhouse 9 CHANGE OF USE FROM TO STIPULATIONS. Party wall must be two separate 1 hour walls from bottom to roof. Firestop soffits. Provide combustion air for furnace from outside. �PFR�r� WARNNG �Arify �f'/?*TS , p Before digging call local utilities C Ual ejG TELEPHONE - ELECTRIC -GAS ate. ASD st% Fc REQUIRED BY LAS/ W/ 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 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 $26,300 $13.15 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS Y O ER TAT OR LOCAL LAW REGULATING CON- $52.99 $425.00 STRUCTIO OR E E OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ;F�01 .$1.3.25 $504.39 lov SIGNATU RE OFC NT C OR AU RIZEDAGENT (DATE) s WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP SATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) • W 1 i UI' 1-1001_L'.i ' APPLICATIUI! roR PUH -DI !G PERMITS (j'IEVI, AL't'ERAT)OII(S, nt)I)ITIOId,-, OR REPAIRS) . i%UXLDER: Street: IA/. LOT: � HLOCY.: �� .ADDITION: 5 COMER LOT: INSIDE LOT: swo cr.: SIDEYARDS: ,. Applicaft attach to this form R>>o Certificates of Survey of Lot' and proposed, . - builAing location drav-Pin on these Certificates. MESCRI PTI ON OF .BUI LDI RG, To Be Used As: . • /�L.... . Fxont= Depth o? = Height: �+� - Square Feet: 141 Vo 'cubic Feet: /.3; a 'Fronts . Depth.._, Height: Scxuare, Feet: Cubic- -Feet: :Type of Construction: Estimated Cost: $ aG 0,942 To Be Completed: ?���9 - i, Alt. A Alt- R .rroposed Driveway 1-idt:h if New Opening Is Desired $ $ (SEE rX. VERSE SIDE OF SHL -T) The u:idersigned hereby snakes application for a permit for the work herein .specified, agreeing to do all worl: in strict accordance with the City of Fridley Ordinances and rulings of the Dc-partnient. of Duildings, and hereby- declares erebydeclares that all the facts and represcnt:atioi stat d in this application are true Uld correct. See reverse s' e diti hal ornzation. DATE. SXGt`XVUI :1:: Stipulations: ,3 Sog,% W .o• •. CITY OF FRIDLEY . • APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Vwater Job Address �"� - o m H C m a s+ w w Heater .. a� a .i 03°' e tu m x o x d ou, Department of Buildings V x .. City of Fridley H v a a r o w sin w v M. a- c 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 ist ! t , and rulings of the Department of Buildings, and hereby declares that all 2n3 the facts and representations stated in this application are true and eorreat ^ Fridley, Mn. , 19' k 3 , 4th 0 NER f (R) a Future Connection Opening Co ectad with Sewer KIND OF BUILDING • { )s Nev Fixture, Old Opening Water USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST •OLD PLUMBING FIXTURE RATES: NO. RATE TOTAL _ PERMIT N0. PERMIT NO.. - C--W--B Number Fixtures Future Fixture Opening x x $3.00 $2.00 $ 1q $ ' Company �! New Fixture, Old Opening X • $2.00 ° $ Signed By Catch Basin x $5.00 $ Water Heater - to 99,000 BTU / X $5.00 $ 5,CR) Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water.Softener x $7.00 $ New Ground Run Old Building X $5.00 $ ROUGH INSP. Electric Water Heater x $5,00 Date ° e GAS FITTING FEES: FINAL INSP. /x-10 Z 7 ° 1st 3 fixtures d x •$3.00 $ Date Additional Fixtures X $1.00 $ Gas Range to 199,000 BTU X $10.00 $ APPROVAL FOR PERMIT , REPAIRS F, ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ �� MINIMUM FEE FOR ANY PLUMBING PERMIT ZS $7.80 pZCs $.So STATE SWCOM State Surcharge $ .50 _ TOTAL FEE $ REINSPECTION FEE OF FIR Li LE APPLICATION FOR POWER SLANTS ANII HE COOLING, VENTILATION, REFRIGE-ATION AND aIR CONDITIO $ D NINu. YSTEMS AND EVICES `PARTIAL RATE SCHEDULE Job Address���� Department of Buildings C}ty of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the :cork herein specified agreeing to do all -:k in strict accordance with the Cita Ccdes and rulings of the Departzient :f Buildings; and hereby declares that all t:.e facts and representations stated in this application are true and correct. Fridley, Minn. T 19,19 KIND PF BUILDING M to- PSBR AS F­STT?",�77PP POST 1 UND A�?1 NFA ppl�PTNG Ui�MT *». No. 40 n 4 DESCRTY.1''? pF FOR.\ACE/SURNER /� HEATING Ar PGptvR FLJ? NT$r Sten 1$Q': Y?dferq Warm AI r- No. l.46oC (_O ou) T+`ade NzTe Size No. —0) (no Capacfty 00Q Sq• Ft. £DR BTU Total Corr.ccted Load Don kind of Fuel 67(�y BURNER - Vada Na=e Size No. Capacit.° S F... ..:R BTU HP 09 Al- a. f U --- -- �5ned By ' -- - - - MIN-XICU; FEE FOR ANY HEATING PER!'.YT IS $7.50 FLS $_ 50 STATE SURC:iARGE *Attached stack verification fors GR44 :AVITY 11AR.N1 AIR: RATE TOTAL -a Furnace Shell & Duct Work 512.00 6 P.eplacer..ent of Furnace 7100 �^ Repairs &Alterations -up to 5500.00 7.00 $ -' Repairs & Alterations each add. $500,00 4.00 $ a MCHANICAL iiAR..N1 AIR: Furnace Shell & Duct York to 100,000 BTU $12.00 S to .6b each add. 50,000 BTU 4.00 $ *c_apla:e=e nt of Furnace 7.00 $ Re airs a .alterations -up to $500.00 7,00 $ Reairs & :operations each add. $500,00 4,00 $ STA.1.1 OR IDT 1•ATER SYSTEM: &oiler &:Lines up to 100;000 BCU $12.00 $ each.addn. 50,000 BTU 4.00 $ Boller oly up to 11)0,000 BTU each addnn. 50,000 BTU OIL BUR:\ER- to 3 gal. per hour- S1G.QQ $ each add. 3 gal. per hour 1Q•Aq $ GAS BURNER- froom 100,0o0 BTU to 199,ggq P�K vl0•RQ a if?•Db (over -199,999 BTU see Fee Sche ule $ GAS FITTING FE'S: 1st 3Fixtures r3Z'itiona1 Fixtures. x $ T•CA $ Gas Pange to 199,000 $T:7 at $: AIR CONDITIONING $ FAX HE: TING SYSTEMS See $ Fee Schedule VENTILATING SYSTEMS S ALTERATIONS REPAIRS g State surcharge _$ ,0 10TAL, FEE $ .N�ti>d IN-.rp. --REINSPECTTON FEE Job Address���� Department of Buildings C}ty of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the :cork herein specified agreeing to do all -:k in strict accordance with the Cita Ccdes and rulings of the Departzient :f Buildings; and hereby declares that all t:.e facts and representations stated in this application are true and correct. Fridley, Minn. T 19,19 KIND PF BUILDING M to- PSBR AS F­STT?",�77PP POST 1 UND A�?1 NFA ppl�PTNG Ui�MT *». No. 40 n 4 DESCRTY.1''? pF FOR.\ACE/SURNER /� HEATING Ar PGptvR FLJ? NT$r Sten 1$Q': Y?dferq Warm AI r- No. l.46oC (_O ou) T+`ade NzTe Size No. —0) (no Capacfty 00Q Sq• Ft. £DR BTU Total Corr.ccted Load Don kind of Fuel 67(�y BURNER - Vada Na=e Size No. Capacit.° S F... ..:R BTU HP 09 Al- a. f U --- -- �5ned By ' -- - - - MIN-XICU; FEE FOR ANY HEATING PER!'.YT IS $7.50 FLS $_ 50 STATE SURC:iARGE *Attached stack verification fors 8, 1980 7 6431 UNIVERSITY AVENUE N.E., PRIDLEY, P4INNE5OTA 56432 Darrel Farr Development Corp. 4600 Lake Road Minneapolis, MN 55422 Re: Final Inspections on Fountain Oaks Townhouses Dear Sirs: TELEPHONE ( 612)571-3450 Final inspections were made on April 4, 1980 of the following addresses and the items noted must be completed before the structures can be finaled out; 5401 West Brenner Pass 1. Regrade to provide proper drainage and lower grade to expose concrete slab. 2. Provide a ball check in the floor drain. 3. Obtain a final inspection on the heating work. 5403 West Brenner Pass 1. Complete the grading. 2. Repair and install the ball check in the floor drain. 3. Obtain a final inspection on the heating work. 5405 West Brenner Pass 1. Install a ball check in the floor drain. 2. Regrade front to provide proper drainage and lower grade at garage to expose concrete slab. J5407 West Brenner Pass 1. Provide a ball check in the floor drain. 2. Plug future water closet run in lower level. 3. Obtain a final inspection on the heating work. 5409 West Brenner Pass 1. Install a ball check in the floor drain. 2. Regrade and expose concrete garage slab. 3. Obtain a final inspection on the heating work. 5413 West Brenner Pass 1.Provide a ball check in the floor drain. 2.Complete grading properly. 3. Obtain a final inspection on the heating work. 5415 West Brenner Pass 1. Install a ball check in the floor drain. 2. The discharge hose from the sump pump must discharge to the outside and not into the sanitary sewer. 3. Obtain a final inspection on the heating work. W Darrel Farr Development Corp. Apxi l 81 19BG Re: Final Inspections on Fountain Oaks 5417 West Brenner Pass 1. Complete final grading. 2. Install a ball check in the floor drain. 3. Obtain a final inspection on the heating work. Page 2 5419 West Brenner Pass 1. Install a ball check in the floor drain. 2. The discharge hose from the•sump pump must discharge to the outside and not into the sanitary sewer. 3. Obtain a final inspection on the heating work. 5421 West Brenner Pass 1. Install a ball check in the floor drain. 2. The discharge from the sump pump must discharge to the outside and not into the sanitary sewer. 3. Obtain a final inspection on the heating work. 5423 West Brenner Pass 1. Install a ball check in the floor drain. 2. Obtain a final inspection on the heating work. 5425 West Brenner Pass 1. Nail treads on stair leading to the basement. 2. Install a ball check in the floor drain. 3. Obtain a final inspection on the heating work. 5427 West Brenner Pass 1. Install a ball check in the floor drain. 2. Obtain a final inspection on the heating work. 5431 West Brenner Pass 1. Install a ball check in the floor drain. 2. Sleeping is prohibited in the basement unless an escape window is installed and a fire alarm. .3. The discharge hose from the sump pump must discharge to the outside and not into the sanitary sewer. 4. Obtain a final inspection on the heating work. 5433 West Brenner Pass 1. Install a ball check in the floor drain. _ 2. Obtain a final inspection on the heating work. 5435 West Brenner Pass 1. Install a ball check in the floor drain. 2. Obtain a final inspection on the heating work. 1629 Brenner Pass 1. Install a ball check in the floor drain. 2. Provide an access panel for the upstairs bathroom. 1621 Brenner Pass 1. Support the basement stair at mid -point. 2. Install a ball check in the floor drain. P ✓Maa v.. a Ha. i 1../G V GiV2/11t4'11 V 1.V1�J. #• April 8, 1980 Re; Final Inspections on Fountain Oaks Page 3 1627 Brenner Pass 1. Install a ball check in the floor drain. 2. Obtain a final inspection on the heating work. t 1643 Brenner Pass 1. Install a ball check in the floor drain. 2. Obtain a final inspection on the heating work. 1633 Brenner Pass 1. Install a ball check in the floor drain. 2. Obtain a final inspection on the heating work. We will expect the above items to be completed by June 2, 1980 and reinspection called for. If• you have any questions on these items, please contact me at 571-3450. Sincerely, Q -W& -a -z DARREL G. CLARK Chief Building Official DGC/mh -•---,-ate,-....,,_,.,,...�..�. SUBJECT City of Fridley 2 9 2 1 AT THE TOP OF THE TWINS BUILDING PERMIT r - _ RECEIPT NO. • COMMUNITY DEVELOPMENT DIV PROTECTIVE INSPECTION SEC r � � CITY HALL FRIDLEY- 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/20/94 % JOB ADDRESS 5407 West Brenner Pass NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 g 1 Innsbruck North Townhouse Plat 5 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald Burchett 5407 West Brenner Pass NE 572-8776 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 Rebuild deck (16' x10) 9 CHANGE OF USE FROM TO STIPULATIONS Handrail/guardrail, including spacing, must meet building code. SEPARATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,304 $.65 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 $1.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $33.00 PLAN CHECK FEE TOTAL FEE $34.95 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY ALI DATED THIS IS YOUR PERMIT(",// BLD INSP s pA TE Y--- SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW (] Effective 1/ 1/94 ADDN [t�� CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: 5 g 0 7 W r/eA y e P -1 a Fr' d (e Al A) 6--x-? Legal Description: Owner Name & Address: a na I CL 13vr 'Ag& W areae 94 RW Tel. # 57Z -977(o Contractor: 0 W N EQ MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Le Width_ Hgt/Ground 6 l Sq. Ft. l� OTHER: � Corner Lot (] Inside Lot (] Ft. Yd Setback Side Yazd Setbacks Type of Construction: Repko DIC to sgw_ D;,nsr timated Cost: $ Approx. Completion Date: I' Z5 1,71 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ 33. 0 C? Fee Schedule on Reverse Side Fire Surcharge $ / -30 .001 of Permit Valuation (1/10th%Q) State Surcharge $ t �� $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "1I" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary ( ] Not Necessary [ .I TOTAL STIPULATIONS: F SUBJECT - PERMIT NO. City of Fridley 31201 AT THE TOP OF 'THE TWINS I BUILDING � I ILo ®I N r D E R AA I j ®<J V E ' • 1 ECEIPT NO. 16 i COMMUNITY DEVELOPMENT DIV. L _ L 'PROTECTIVE INSPECTION SEC. Le/Lc` 1 , , NUMBER REV DATE PAGE Of APP I CITY HALL FRIDLEY 55432 L 612-571-3450 910415 7/14/00 JOB ADDRESS 5401 - 11 W. Brenner Pass 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1-6 9 Innsbruck North Townhouse Plat 5 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Innsbruck Townhome Association 651-224-5482 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Garlock-French Roofing Corp., 2301 E 25th St., Mpls., MN 55406 612-722-7129 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 00001423 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Y@ REPAIR ❑ MOVE ❑ .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 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 6 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 $ZI, 194.75 $10.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL, LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT FEE $381.04 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN ROPE :VALIDATE THIS IS Y UR PERMI _ S-GNATURE OF OWNEROF OWNER BUILOERi IDATEI J CCC 'NSP ATf F Building Inspections 763-572-3604 DATE C+J- SITE ADDRESS _ C THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERNIIT TYPE TYPE OF WORK: MECEIANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY 7- YOUR E-MAIL ADDRESS � rennP/1 P�� 0 OWNER OCONTRACTOR COMPANY Permit Received 1 CITY STATE ZIP CONTACT PERSON: River City Sheet Metal J o STATE LICENSE # 8290 ,lain St. bji&,rsmte 39 ADDRESS: Fridley Ml�l �y�d`��CITY STATE zIP PHONE 179Q% 7="A-0) F _ O SINGLE FAMILY O TWO FAMILY 0 TOWNHOUSE 0 NEW )kREPLACEMENT 0 ALTERATIONIREMODEL DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% 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 labor ) 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 WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) SIZE/BTU[d Equipment Installed MFG: P- It MODEL: tr MFG: MODEL: l • ft I O .- .4 SIZE/BTU MFG: MODEL: SIZE/BTU /C $25.00 _FIREPLACE {GAS) $15.00 . GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL 00 _BOILER $35.00 LWACE $35.00 - _GAS UNIT HTR $100.0.0 0 � CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 nrau.a•^- .»s.. iwi�.�iassL+rm�.+1YYW[Mh'OY.�'+7X�7:Y�`P,L10 Permit Fee $ _moi . ® Number of fixtures @ $10:00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ & 0 .—So Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 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 allvj4ich re / es review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 1 i DATE 912--101!( City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel ]NIC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. 1MC Chapter 5 with MN Amendments 3. Venting a. Gas appliances ]FGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations CITY OF FRIDLEY COMMt)Nn7 DEVELOPMENT DEPARTMENT TOTAL P.01 per{�®® PLUBtl�iG P ritiV= OA bl RESIDENTIAL APPLICATION Rees a City of Ff 9dle f Date Roce;veo 'SEE 0 9 20d8 NOTE: IF PROPERTY IS NOT OWNERIOCCUPIED- Al LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE 9 - L4- O YOUR E-MAIL ADDRESS SITE ADDRESS �Li' d A� Eo- t_ A A � e- �Azz THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACT NAME ` A l PROPERTY OWNER! TENANT ADDRESS -SLI ib -7 W f-a e -2 .� ted" CITY lFKLr Q STATE ♦l -'I ta% ZIP rL e3r PHONE ii °� 3�j4 NAME at L,,- C UCENSE # CONTRACTOR ADDRESS 5?J-9 b ctTY_E�VN,STATE. &�- ZtP_°ro�NE #'1 S .�i - t' FAX# PERM TYPE 'X SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK M N61N --e REPLACEMENT gg DETAILED DESCRIPTION OF WORK :rn s�d4 Q FESS ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) l3ATi4 SINKMV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City License) SWMMG POOL WATT SOITENER (8351 CLOTHES WASHER KITCtIEN SINK WATER CLOSET BACKFLOW PREY. ($95) DISHWASHER LAUNDRY TRAY WA7ERfM (SW FOR IIMGA170N WATER METER OTHER Permit Few $ MINIMUM: $48.00 or 3% of cost of the improvement -whichever is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ 3 J O Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT - NOT VALID (UNTIL PROCESSED I hereby apply for a pfumb)ng permit and I acknowledge that the i nformatim above is complete and accurate: that the wont will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Constnution C ides: that I understand this i$ not a permit but only an application for a permit and worts is not to start without a permit; that the work will be in accortfanoe with the approved plan in the case of all work which requires review anti approval of plans. NAME OF APPLICANT f\Jd L k- C& -,-",2,V DATE Please type or print SIGNATURE OF APPLICANT L L- �_ l 'F , 1210, CITY OF FRIDLEY COMMt)Nn7 DEVELOPMENT DEPARTMENT TOTAL P.01