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PRE 2010 DOCSni CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE • �� Ge,) e 5� + My r e G, a �e A GRAVITY WARM A I fi: RATE TOTAL Job Address _.._.-ace S :ell & Duct Work $12.00 $ Ret,ace.Te :t of Furnace 7.00 7.00 $ $ Deparcmc:nt of Buildings Ravairs & lteraticrs-up to $500.00 4.00 $ City of Fridley Racairs & Alterations each add. $500.00 Tel. #571-3450 MECHANICAL W ARNI AIR: The undersigned hereby makes application for a permit for the work herein $12.00 $ specified agreeing to do all work in strict accordance with the City Codes Furnace She! & Duct Work to 100,000 BTL` -each 4.00 $ and rulingsofthe Department of Buildings, and hereby declares that all the adi. 50,600 BTU 7.00 $ facts and representations stated in this application are true and correct. Replacement of Furnace Repairs & Alterations -up to $500.0000 / 1 79/ Fridley, Minn. �© �ii� �� r 9 Re, airs & Alterations each add. $500.00 4.00 $ is ke Y -A A STZa?I OR HOT 1, AaTI , SYST01: OWNER Bailer E, Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING rc p'd 14!/( _e each adds. 50,OGO BTU 4.00 7.00 $ $ USED AS r{tf,_ t I Ivi q Boiler only up to 100,000 BTU each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT �� r1 OIL BURNER- to 3 gal. per hour $10.00 10.00 $ $ Ee ESTIMATED COST each add. 3.gal. per hour PEP4IT NO. 1 22 GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $NEW OL� BUILDING PERMIT NO. (over 199,999 BTU see Fee Schedule) $ _- GAS FITTING FEES: ist 3 Fixtures x $ 3.00 Additional Fixtures x $ 1.00 Gas Rana to 199,000 BTU x $10.00 AIR CONDITIONING FAN HEATING SYSTEMS See Fee Schedule VENTILATING SYSTEMS - ALTERATIONS & REPAIRS State Surcharge TOTAL FEE ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PMN1IT REINSPECTION FEE ($10.00) MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 $ 3, c`'6 DESCRIPTION OF FURNACE/BUR14ER HEATING or POWER PLANTS, Steam, Hot Wate , Warm Air- No. Trade Name Co f&vi'1 0-,,141 Size No. '3& 3 / o Capacity /� C ®D C) Sq. Ft. EDR BTU CHP Total Connected Load ,l 7 Kind of Fuel Q a S BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company —Iil ice/ iA Signed By • Tel.' -No. G IY � fa �a�P,� IIN ✓d oafl� - "d - Y u e e W .. isadsa;9 is aaa E 0^1 vlaII InE VlciIRe '19d114G�or.Jm rM9 e y9?a€.i v ie e 6 Fs Caf<�,"a WINDcAvi,, e, j D 00 is ; C, Gia C "J v✓ a t9ci�ir9 Yds. uc LY As � "'— � --._ — El. SP. + " _ 3 , m�� i e r�s.�. u d ,,, l g r 1►a�r8deufi�ara Y�,<.:m av a-- ---- - -=-' 1."�ifiP�,�1an b'tcd v .�. �e�c,rs E.P. v ,11 E � _ nto VIA i - � _.C-Pllrag PJP r €:. U. R. or q ars. 'VI. A 1 3a^ ()RS — 'P wall _. Imc6 � silm"i U;' 11 All 1dYa;;V. a..9 Y coca, I Bia. G cra i laes -- -- — — — fel � a A. loarl P amn VI 11 t!4 A-. Vtf Il 1^aP L "A — �K'c,ulas� CtP FI�r,P � � I @Q0.GP l�uld, i $iu i P. R. 4N 0fai Liu. .b 6 u a £B.:a —_ Civ ..J I i.- .,; ud __._ tnil"J{�Y i➢ ♦y 161'V I��Vv"cel �Il 1- ll ��4.i �.. P_�J �.�Ya '-.. _ t: (i ..1 t I'u'4'Yy V® of Y ,i," c i - � _.C-Pllrag PJP r €:. U. R. or q ars. 'VI. A 1 3a^ ()RS — 'P wall _. Imc6 � silm"i U;' 11 All 1dYa;;V. a..9 Y coca, I Bia. G cra i laes -- -- — — — fel � a A. loarl P amn VI 11 t!4 A-. Vtf Il 1^aP L "A — �K'c,ulas� CtP FI�r,P � � I @Q0.GP l�uld, i $iu i P. R. 4N 01 SUBJECT C;yri of Fdley �®E TWINS BUILDING PERM 2 19 3 -, `v ______ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC, I CITY HALL FRIDLEY 55432 t'' 612-571-3450 ECE NUMBER 910-F15 REV DATE 10/13/98 PAGE Of APPROVED BY JOB ADDRESS 861 West Moore Lake Drive 1 LEGAL DESCR. LOT NO. 10 BLOCK 3 JShorewood TRACT OR ADDITION SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Diane Bissonette 572-2384 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house 17 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OFCONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION ZONING SO. FT CU FT 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 'VALUATION $1456 SURTAX $.73 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PERMIT FEE $48.50 SAC CHARGE Fire SC $1.46 PLAN CHECK FEE TOTAL FEE 50.69 SI NATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE� 0®-�3 9F WHEN PgOPERL 8�D NSP 'e ALID TED THIS IS YOUR PERMIT r /9--13 T1AtE NATURE OF OWNER"0."ERt jDATE� 01 NEW [ ] Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION L �ConstructionAddress: �E (0 ( mcore—(�, j] r-rye U Legal Description: X Owner Name & Address: Tel. # S )D • Q 3 9 ,� XContractor: MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # 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 Width Hgt/Ground Sq. Ft. Ye rcy°) F "(f) to 5P _ . 1%S9 , l � 4 / D t�;� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ /YY( (Fee Schedule on Back) Ft x $ = $ �S DATE: ��- C 3- R APPLICANT: k0.ne � ,, Tel. # 57Q- U � CITY USE ONLY Permit Fee $ ° . S—O Fee Schedule on Reverse Side Fire Surcharge $ /. -/�o .001 of Permit Valuation (1/10th%) State Surcharge $ 73 1 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ -5d' STIPULATIONS: NEW [ ] CITY OF FRIDLEY�� ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 9 769 kl, /11 000o L j �b- Legal Description: Owner Name & Address: sc� rna :'f Tel. #�71,o Contractor: Sd�p MN LICENSE #(S 530 `7( G -Q ?- 9-6-/ Address: 2 `,6Z, Malay �i�, i Tel. # aGLbU 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 GARAGE AREA: Length Width DECK AREA: Length . Width OTHER: Height Sq. Ft. Height Sq. Ft. Hgt(Ground Sq. Ft. h 4-6w 'k ► k Construction Type: iD 1) 'n Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ DATE: 3r IF L045—APPLICANT: S' Tel. #6-21 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] TOTAL $ STIPULATIONS: ev iO4 )C �i w :pis- loop p� loop o fogrg 3 yam_ ON T) J (A e �i w :pis- loop p� loop o fogrg 3 yam_ ON T)