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PRE 2010 DOCSSUBJECT PERMIT NO. City of Fridley ®122'72 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. i INSPECTION 1 i PROTECTIVE SEC. /� 1 � L4/ � r'"1 CITY HALL FRIDLEY 55432 IL NUMBER 'REV. DATE PAGE OF APPROVED BY 1"" , 612-560-3450 910-F15 819/73 JOB ADDRESS 5575 West Danube 1 k0A-6 1 LEGAL LOT NO. 12 BLOCK 2 TRACT OR ADDITION SEE ATTACHED Innsbruck North 2nd Addition DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Payne 6375 Zane Avenue North 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Essex Construction Corp. 7035 Wayzata Boulevard, Mpls. 546-9445 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 8 DESCRIBEWORK Construct 26' x 40' Dwelling and 34' x 24' Garage 9 CHANGE OF USE FROM- TO STIPULATIONS Provide a verifying survey before framing. Provide a hard surface drivewa SEWER LOCATION: 176' South of Manhole (INV. 953.47) Wye. Elev. 954.14 Top of Footing: 957.14 (Minimum) WATER LOCATION: 6' South of Sewer Service SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING 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 R-1 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 $27,505 13.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 57.00 275.00 STRUCTION 09 THE PERFORMAPjCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE LZLZ-4�0 345.75 SIGNATURE OF CONTRACTOR OA AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDA D TI11SI YOUR 'PERMIT •� BLDG INSP DATE SIGNATURE OF OWNERdIF OWNER BUILDER) (DATE) 9 5� SrSr APPLICATION FOR RESIDENTIAL, ALTERATION, a OR ADDITION BUILDING PERMIT s S CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: © r SBC BUILDER: 1-1 ADDRESS: 7 �� ti e iiia ADDRESS: '2035- NO:. 0.5 NO:. STREET W c �tio LOT: /,A BLOCK:- 02 ADDITION: CORNER LOT: INSIDE LOT: x --SETBACK:-2:S&- SIDEYARD:_IL5-_— Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As; D Fronts ,� 6e_ ®°< Depth: ��- ®�Height; Square Feet: Cubic Feet: _ Front:- -3 y'- 0 °• Depth: a y �- 0 e Height: /®sA " Square Feet; Cubic Feet: Type of Construction: 1.o"d Estimated Cost:_$ 0®,®® To Be Completed: 1L)6V• IS;._/� 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. r • r o DATE: 7j /9 7 SIGNATURE :-L�—) _ (See Reverse Side For Additional Information.) °'- ; a. q CJ .1 Y: Y i a' a Y .1 At Ddb®PSP✓add o HEAT LOSS CALCULATIONS DEP TMENT OF INSPECTION MM4FAPOLIS, MINK. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19T T—T / FI -1 Room I Lenath 1-7 _ Width /ij Heisrht .P 11 / Fl o, VP jrmaoom I Length Width2l- Height d r Windows ancT Doors—Crackage and Area Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3-o V 38 d v /9 Zd aOPCoef. Infiltration Coef. Btu Infiltration Infiltration r / Glass q# ro L 00 C3 Exp. wall 2-2,xP Net exp. wall e°?k / 3 /a 13/P Int. wall go Net exp. wall Ceiling / Z aC /O Floor /LP/ /2-0 / 2- % 7Z;0 6 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length /sem' Width Windows and Doors—Crackage and Area Width HeightNo. of Lineal ft.. Area No. of pane of pane lights of crack sq: ft. Glass Exp. wall 2,f- 8' Net exp. wallLip /0 Int. wall Ceiling /C—JC Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area j Fl. Room JLength P- Width Windows and Doors—Crackage and Area Width Height No. oL Lineal ft. Area No. a of Dane of pane 1lghts of crack sq. ft. Windows and Doors—Crackage an Area Btu Width Height No. of Lineal ft. Area No. off pane of panne lights of sq. fftt. 9crpack P� ^O .0 O1 1O v /9 Zd aOPCoef. Infiltration Coef. Btu Infiltration Infiltration Glass lye Z Glass 9 Glass .SSD Exp. wall ..$—v X 00 D4 Net exp. wall go Net exp. wall Int. wall 6 Int. wall /moi/ / Z 2,160 Floor Ceiling /tl,/�Z�i /- 6 jell /d 7tl/2, 'raf Floor / !i 7a6/ Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area isfhtfl m I V_ Rnnrn I i.enath I eo,"- Width /7-Ieiaht 4- 0 Btu 221 Infiltration Glass Exp. wall P'X Net exp. wall 6 D40 Int. wall Ceiling /g, /Z.dI /Z-1 JWO Floor ® �' Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2d L/ / Coef. Btu Infiltration Infiltration lye Z Glass � Glass Exp. wall s -o 00 Exp. wall Net exp. wall go Int. wall 6 O Ceiling /3—Y ® z /moi/ / Z 2,160 Floor _Ceiling /d Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area M I ./i . j Rt ftm I t pnoth �_ Width /r/ Height P"° Windows and Doors—Crackage and Area Width Height No. of Lineal ft: Area No. of pane of pane lights of crack sq. fQ Z Zo 36 / ZZ- / Coef. Btu Infiltration Zy e � Glass /V s -o 00 Exp. wall go Net exp. wall 6 O 1p Int. wall _Ceiling /d Floor / !i ft/ 0 Total Btu. sq. ft. E.D.R. or sq. ins.. W.A. Leader area 1 WATER NTR. a ! C S v 6 l� (�9 O S N GAS ELEC. 9 Base F F F 1st f 1 _I lei PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL x $200 $J�� 16Number Fixtures ................ $--q- Future Fixture Opening .... • • . • • • • . x $1.50 New Fixture Old Opening .......... . x $1.50 $ Catch Basin .................... x $3.25 $ d9 Water Heater 'Up to 99,000 BTU) .. • • x $3•00 a1 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water Heater .............. x $2.00 s GAS FLTTINC,, F S: a/ NO. RATE TOTAL ri �l Fixtur . • • . • • • x$2.00 $ Additional Fixtures ..... ......... x $ .75 $ Gas Range to 199,000 BTU ............... x $5.00 $` REPAIRS & ALTERATIONS—Refer to Code Description ................................. , ............. C TOTAL I City of Fridley: The .undersigned hereby makes application for a permit for the' work herei specified, agreeing to do all work in strict accordance with the City CTrdinance and ruling of the Department of Buildings. and hereby declares that all the fact and representations stated in this application are true and correct Z9 Fridley, Minn !2 9 o I Owner Kind of Used as To be completed about � Estimated Cost, $�T-.-� OldNew Building Permit No. Permit No. Signed By Business Phone No a y ROUGH FINAL, 3 ` j % - 2,5— 560-3450 City ® 5'dl'y 6431 UNIVERSITY AVENUE NE Superior Contractors 6121 - 42nd Avenue North Minneapolis, Minn. 55422 Dear Sirs: ANOKA COUNTY August 1, 1974 FRIDLEY, MINNESOTA 55421 Re: Electrical Permit Shortage The following is due for the electrical work.done at 5575 West Danube: Permit Amount $35.75 Amount Paid 22.00 AMOUNT DUE ,$13.75 Please remit the above within ten days of receipt of this letter. Sincerely, LEONARD EICHMILLER Electrical Inspector LE/mh 01 SUBJECT City of Fridley r 1629 AT THE TOP OF THE TWINS BUILDING PERMIT _ i � 1 `v ______ COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION t � � NUMBER REV. DATE PAGE OF APPROVED BY 1 ` CITY HALL FRIDLEY 55432 It---"1l� �1; `J 612-571-3450 910-F15 7/17/81 F / 10B ADDRESS 5575 W. Danube Rd. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12 2 Innsburck North 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roaer H Payne 5575 W. Danube Rd. Fridley 55432 574-1038 3 CONTRACTOR MATL'ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW p ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK r X 3ral 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. kTogd 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 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 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 TOTAL FEE AT OFC NTRACTORORAUTHORIZEDAGENT (DATE1 WHEN R P RL V LI A THIS IS YOUR PERMIT i/7 4 ,- BLDG WSP DATE SIGNATURE OF OWN IIFOWNERBUILDERI I ATEI '� 01 .. .. ._ .. ... _... .... .. .., J ._ . ..._1✓ • _ .. ._moi CITY OF FRIDLEY APPLICATIal FOR RESIDENTIAL BUILDING PEPuf ITS • (New, Alterations, Additions„ or Repairs) • OWNER: ® ci � PGS V AJ e- BUILDER: SA (=— ADDRESS: X29, PA'U6QF JQD. ADDRESS: TEL NO: TEL 140: 'TC Construction Location ` STRIMT NO: �� ') STREET: LOT: BLOCK: ADDITION: d AJS'130-0 eti)+ Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Oil (--f 00 Front: Depth: I Height: `ron _ Square.l'eet: 440 Cubic Feet: Front: Depth: Heiglit: Square -Feet: Cubic Feet: _ yt c" 4uto Type of Construction: IAJ.0'- � Estimated Cost: $ lb $e Oorpleted: Q . .If Alt. A Alt. B Proposed Driveway Width New Opening Is Desired: SEE REVERSE SIDE OF SHEET . Mie undersigned hereby makes application for a permit for the ti ork• herein specified, Agreeing to do ,all work in strict accordance with the .City of Fridley Ordinances and rulings of the De-1xi tment of Buildings, and hereby declares that all the facts and representations stated in this application are true an•orrect. DATE:, SIGNATURE: w �® Stipulations: W 4ES 7— t� 4? 0,4" P ' 40 �Y � 0�4ino9e Gose��� � pra►�G` f17 l': 4Z/46 o@ SL SL. , r4 q �Y � 0�4ino9e Gose��� SUBJECT P NO. City of Fridley 1 : 56 j-:) AT THE TOP OF THE TWINS BUILDING PERMIT r T N0. • COMMUNITY DEVELOPMENT DIV r PROTECTIVE INSPECTION SEC NUMBER REV DATE PAGE OF APPROVED BY /---1 CITY HALL FRIDLEY 55432 �', ' 612-571-3450 910-F15 7/5/95 JOB ADDRESS 5575 West Danube Road NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 2 1 Innsbruck North 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Peifer 5575 West Danube Road NE 572-8798 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO KKM Rite Way Waterproofing 448 Lilac St, Lino Lakes 55014 786-0550 EXEMPT 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 Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install interior drain the 9 CHANGE OF USE FROM TO STIPULATIONS Electrical extension cords can not be used as part of the power source to the pump. Drain tile can not be connected to the City Sanitary Sewer; it also can not drain onto a neighbor's property. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,636 @ $.82 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION F ANY OTHER STATE O LOML LAW REGULATING CON- STRUCT R E PERFORM CEO CONST ION 39.00 Fire SC $1.64 PLAN CHECK FEE TOTAL FEE License SC $N/A 141.46 SIGNA URE OF CONTR TOR OR AUTHORIZED AGENT (DATE) WHEN PROPE VALIDATED THIS IS YOUR PERMIT BL G INSP r)A E SIGNATURE OF OWNER OF OWNER BUILDER) (DATEI NEW ( ] ADDN [] ALTER Construction Address: Legal Description: Owner Name & Address: Contractor: l� Address: 9 4( LA � LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 1/ 1/95 i Li; 4�0w el. # MN LICENSE # Tel. # 7TL Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length C.. L'4 Comer Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: _ (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 t = Ft x DATE: APPLICANT: Tel. Ft. Yd Setback Side Yard Setbacks Estimated Cost.: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ ` STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $3��jj50 per SAC Unit .00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Determined by Engineering A ment Necessary[ ] Not Necessary ( ] E IL 4, -V-s CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE 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 Piping (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) 1 % of Value of Appliance or Work $ CommercialA ndustrial 1.25% of Value of Appliance or Work $ Effective On January 1, 1997 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. CIZ�Z 1997 OWNER. P � �, X��, _ /19— . A,, S 72 - S'151 BUILDING USED AS ESTIMATED COST � PERMIT NO. DESCRIPT10N OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) Trade Name Size No.�t BTU HP EDR Fuel Total Connected Load . State Surcharge 50 Burner Trade Name TOTAL FEE $ q BTU HP MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION 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. Size No. EDR . HEATING COMPANYe.4e Signed ByA, Tel No. (� Approved By Rough—In Date Final Date FILL OUT BACK SIDE FO STACK VERIFICATION ON REPLACEMENT FURNA E CEnAE EY AND STACK VERIFICATION The undersigned hereby verifies that the.existing chimney or stack: 1. Has been carefully examined Yes O No ( ) 2. Is fine from rust or deterioration Yes O No 3. Has no foreign objects lodged within Yes O 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: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 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-SSI /1 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work iri strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — Furnace rulings of the Building Division, and hereby declares that all the facts and Also Replacement representations stated in this application are true and corr . (Side Vent — Fill Out Back) _�aA 7 ,1990 Gas Piping (Needed with new furnace) $10.00 $ OWNER. � � C I—I t), Gas Range $10.00 $ BUILDING USED AS _...QJAL�J Gas Dryer $10.00 $ . ESTIMATED COST 0_0 PERMIT NO. L: *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No, of Heating Units % Circle One (Steam) (Hot Water) rm Trade Name Size No. 3 1 Commercial/Industrial BTUHP EDR 1.25% of Value of Appliance or Work $ .D Fue LV S Total Connected Load State Surcharge .50 Burner Trade Name Size No. TOTAL FEE$ d •� BTU HP EDR . BLAINE FiT(a. A/C ELECT:, INC. 13562 CENTRAL AVE. N.E. HEATINGOPANOVA, MN X5304MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATIONREFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed BLMILD','Pel No. 2 Lj-7 7(� PLUS THE $.50 STATE SURCHARGE 6Rough—In REINSPECTION FEE $42.00/Hr Approved By Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE F TACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE List ALTERATIONS Being_Done: HEATING CO: Signed By: Date: BLAINE HTQ. A/C ELECT., INC. CHIIVINEY AND STACK VERIFICATION i The undersigned hereby verifies that the. existing chimney or static 1. Has been carefully examined . Yes (Y1 No O . •. B. Is free from rust or deterioration Yes ( No ( ) 3. Has no foreign objects lodged within Yes ( No ( } 4. Is securely supported Yes No ( } 5. Meets all current Code requirements for size r and total BTU's connected Yes No ( } 6 Has total heating BTU's of l� a All other BTU's TOTAL BTU's I U 7. Has a liner been provided, for water heater Yes (�} No (}. 8. Has combustion air been provided for water heater Yes .kk) No ( } List ALTERATIONS Being_Done: HEATING CO: Signed By: Date: BLAINE HTQ. A/C ELECT., INC. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 PE NO.:2004-01902 ,, DATE ISSUE /2004 ADDRESS 5575 W DANUBE RD NE PIN 243024420086 LEGAL DESC INNSBRUCK NORTH 2ND ADD LOT 12 BLOCK 2 PERMIT TYPE HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE A FURNACE. # A/C UNITS 0 VALUE OF APPL OR WORK # FURNACES 0 # GAS DRYERS # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304 - OWNER OLSON CHARLES N & CHRISTINE F 5575 W DANUBE RD 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. A ulican , , Date . 1 Bldg HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 6133 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 2400 25.00 0.00 0.00 0.00 0.00 0.00 0.50 25.50 ;ITY OF FRIDLEY BUILDING INSPECTION Effective 4/1,/2004 9 3431 University Ave NE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 9 :Adley, MN 55432 L 763-5723604 FAX 763-5711287 REFRIGERATION AND AIR CONDITIONING SYSTSAND DEVICES 9 JOB ADDRESS rJ 75 - D RATE SCHEDULE Fee Tota Residenkial Owner��(i1 Furnace Shell and Duct Work, Burner & ��-S�c�Q�l� � also Replacement Furnace $35.00 $ Building Used As r �� ESTIMATED COST �� NO 4h Gas Piping (New Furnace, Fireplace, Insert) $10.00 $ _PERMIT Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. nditioning-AIL Sizes $25.00 $ a!g'ob *AC00-1 BTU HP EDR v O � Z � (f`rl C 3 Fuel Total Connected Load All Other Repairs or Alterations (List on Back) Size No. a- :I% of Value of Appliance or Work $ Burner Trade Name nHP a Minimum Fee $15.00 for Residential or 596 of cosi of BTU EDR whichever is eater on work less than $300.00 Improvement gr p Y � . The undersigned hereby makes application for a permit for the work herein 5 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/industriaVinstitufional and. repre—Rentations stated in this application are true and correct. CENTERPOINT ENERGY MINNEGASCO Y State Surcharge .50 HEATING CO 13562 CENTRAL AVE NE BLAINE, MN 55304 1 TOTAL FEE $ S � SU m 763-757-6202 Signed Tel # �r REINSPECTION FEE $50.00/HOUR FAX #1h3-757-6701 Date I 'may m *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 FURNACE EL cc Approved by Rough -in Date Final Date E0,d 1d101 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 ()o 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 _ stem, 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 r Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) CENTERPOINT ENERGY MINNEGASCO HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed By: Date :b "/z ©c( M1 m FRIF- H [GIJA1 SL Dl )GIG 1 NA AO AM 0 WON -I q?: t'[ b00Z—LZ—Nc H CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 ADDRESS : 5575 W DANUBE RD NE PIN : 243024420086 LEGAL DESC : INNSBRUCK NORTH 2ND ADD : LOT 12 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT NO.: 2004-01903 �d Id - DATE ISSUED: 10/18/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL AN AIR CONDITIONER. # INSPECTIONS 1 APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- C�1:•/�I D OLSON CHARLES N & CHRISTINE F 5575 W DANUBE RD 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 PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 6133 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. - - - - - - - - - - - - - - - - - - - - ;atc.h Basirw :ate Leader Nl� T DATE: Lu ,-j ;ump/Receiving Tank $lo.00 .20 Z2 Vater Treating Pff 1 F-i-oor 2 ;rTY OF'FRIDLEY INSPECTION DN. $35-00 Effective Apra 1., 200UniversityAve 431 UnNE 431 Vater Heater - GW- $m-00, Tddley. x+155432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT $io.00 763) 572-3604. FAX (763) 571-1287 3as D"r" $10.00 ESTIMATED COST PERMIT NO MARK NUMBER OF FIXTURES TO 13E INSTALLED ON EACH FLOOR PreveWtt-r Pc�qtired )Yes No Wa'sh J -Floor A u t o. 090M lGas Aff w w Floor I ;atc.h Basirw :ate Leader $10.00 DATE: Lu ,-j ;ump/Receiving Tank $lo.00 .20 Z2 Vater Treating Pff 1 F-i-oor 2 OWNER -�Z Vater Heater -Electric $35-00 Flol 3 'A ' State Surcharge ;atc.h Basirw :ate Leader $10.00 DATE: Lu ,-j ;ump/Receiving Tank $lo.00 .20 Z2 Vater Treating Pff 1 $36-00 OWNER -�Z Vater Heater -Electric $35-00 Vater Heater - GW- $m-00, BUILDING USED AS �as Range�� $io.00 IA.4 gli�4 3as D"r" $10.00 ESTIMATED COST PERMIT NO Fl-x, PreveWtt-r Pc�qtired )Yes No ®R" Aff State Surcharge