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PRE 2010 DOCS53 -8L -s--915.51 *61-,)� City ®f Fridley iubrECT AT THI TOP Os THE TWlft$ T L . PLUMBING PERMIT T APPL I CAT I �i� r�-------; C0NUVNITY DEVEL0MENT DIV, PROUCTOV9 CT*M WK i ° ®--•� ; COTe HALL. P7100L%V POOR P"E OR A Ov o ®Y - 0 2 15 3 1 1 800 Job Address 1501 N. E. Windem&re Drive Owner Ad cess Phone William Dietz 339-7766 Contractor Address MINNEGASCO AVE 1e 733 MARQUETTE Kind of Building Use mpts., Frame Res. Completion Date stimateCost 11-19-73 --- _--- -- ... __20,.00 _ Plumbing Fixture Rates: NO. RATE TOTAL + 1 W I- -----I i (! Number Fixtures x $2.00 I! I Future Fixtures x $1.50 I; New Fixture -Old Open. x $1.50 i �. ,dar I i I ® ! Catch Basin x $3<25 era I j t Water Heater -99,000 BTU x $3.00 os)w Ground Run Old Bldg. x $3.25 •MNIral m w ( Elec. Water Heater x $2.00 + SNISY9 !W 10 Gas Fitting Fees: c BNwaaf I 3 Q tlO°'.I •� 1st 3 Fixtures x $2.00 ,® ulsaaMONS I Additional Fixtures x $ .75 iwno�l I I I I i NNINO Gas Range -199,000 BTU x $5.00 v Repairs & Alterations Install Gas Light See e91N18I I I I I Description: & Grill Code 9.00 eN)erel I I State Surcharge .50 fCfas "A --' Surcharge ...50¢ sumPref + I 3 TOTAL FEE $ 9.50 I I I !The undersigned hereby makes application for a permit e,rN)anl ! I I I for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling .�aeo-a aaarM I of the Department of Buildings, and hereby declare that all'the facts and representations stated in this • application are true and correct. Signature Date SUBJECT PERCity ofFridley THE TOP OF THE TWINS ��wlm_12AT I �I[ ®IA IG D IT r DV L IV r BUILDING -COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 4a 5- 1 NUMBER REV. DATE PAGE OF APPROVED BY = /•••1 CITY HALL FRIDLEY 55432 �' •"•- ,`J 612-560-3450 910—F15 6/6/73 JOB ADDRESS 1501 Windemere Drive N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 30 & 3 'of 1 Innsbruck 5 h Add_. ion SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr Will am Die Lz 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Rodney Billman, Irc 151 Silver Lake Road 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 IN NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK CONSTRUCT 71' x 40' Dwellmg and 28' x 26' GARAGE 9 CHANGE QF USE FROM TO STIPULATIONS PROVIDE A HARD SURFACE DRIVEWAY. PROVIDE A VERIFYING SURVEY BEFORE CAPPING. VARIANCE APPROVED BY COUNCIL 6/4/73 WATER LOCATION: 10 6' S.E. of SEWER SERVICE SEWER LOCATION: 15' S.E. of Marhole PERMITS REQUIRED FOR 'AIRING. SEPERATE HEATING, PLUMBING AND S!(INS- SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD . VENTILATING OR AIR CONDITIONING. Wood Frama 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 2175 43, 560 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. $40,569 20®28 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- $95o 00 $275-00 STRUCTIC94 OR THE PERFORMAN/E OF CONSTRUCTION.' /,/)w�-�+�-t bac-° v• PLAN CHECK FEE TOTAL FEE j %� $390028, SSIIGN�lRRE OF NTR CTOR OR AUTHORIZED A NT (DATE) WHEN PROPER ATEDJHIS IS YOUR PERMIT Lsti/ SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) BLDG INSP. DA E APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:�-,/, e�'�� BUILDER:.u-�%----��- i ADDRESS: ADDRESS: NO•. `' STREET: LOT: X10 4L�LOCK: / ADDITION:_-aG�z-c ,i CORNER LOT: INSIDE LOT:��SETBACK: -�a SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING G To Be Used As: ✓i)��v c l� -> " �� _e__ Front:_ �` hfd, Depth. J0 'Height: Square Feet: �� Cubic Feet: Front: r` Depth: J � Height: '. Square Feet; Cubic Feet: Type of Construction: Estimated Cost: To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE : ' l�-�� SIGNATURE: (See Reverse Side For Additional Information.) • 6 f „^ s �' 1 Nyb '� _- � 3• ,w#,i Cn .�` qM .W": Z. � � fr.ffi '�'# fit.. :., 3'�.y4'�,9� � @I`' �`� Yh' - �' _ - '�- Y�zu� ��-.•'' @. �.e;�Vi .rf+• _y �'4$ ,�'. "sfi s -.�-t , �p Sur ✓ a,� sr;, • µrya. F- Y /o \ �_ 40 Le -r COs S`@GK 1= ihimsbaucK 5TH- AooirwN aLrJaTEs - DIZA'SJAGE AN.0 ur•�, r �At1 AAEN�S r / UrNy, 1d Ako Isvow crud wrvd rrpmjmlotwn ,�rs 44,ja f z - �� '� w� �� afs , {`px�. }�, r armed �d � s�►-hey�d by �mr ....q.. ; . 5 16UR8" EN►# /NG, INC. t 4ifiVAl. y 1YBi 4 S 22 L. S. 1D-A- ey Billman s Inc. 3000 36th Ave. N.E. St. Anthony Village lo k 34, vc 4, EF11 NGfj INC. ENI G 1 HH7 YU!u- Suf t -TY Is WCC/ RIO n7 Odl ,1\ LaT ;,Tw Aocwria�-.i ANOK^ CcZQ7-4-CY Z "N ic 47 I Application for Power Plants and Heating. Cooling. Ventilation, R&Mgeraflon and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SM -3450 GRAVITY WARM AIR: RATE TOTAL Location Furnace Shell & Duct Work .......................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .................. Repairs & Alterations each add. $500.00 ............... MECH. WARM AIR q Furnace Shell & Duct Work to 120,000 BTU .QI.4i $s each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... Each add. 200 sq. ft. EDR Steam ..................... . Each add. 320 sq. ft. EDR Hot Water .................. OIL BURNER—to 3 gal. per hour ........................ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ......I .Aqjwj. GAS FITTING FEES: NO 1st 3 Fixtures ................ s $1 Additional Fixtures x Gas Range to 2000,0000 BTU AIR CONDITIONING /( /i/c FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL X See Fee Schedule TOTAL FEE CE TOTAL $-- J City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner 19011 Kind of Building Used as To be co Estimated Cost, $ i, Old New Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER steam, Hot Water, arm Air N Trade Nam CSize No �f � f.LjS'�is�P Capac! Sq. E.D.R_ �� g H.P. Total Connected Load 1• Kind of Fuel ®- BURNERde Na �r� Size No— , i Capacityj& P10 109111 Sq. Ft. E.D.R BTU H.P. (A,07# �� AWL She RAY It WELT ER °r EA Ci NG CQ 4,637., r_Himno E. By 4 z Business Phone No - (REMARKS -OVER) City of Fridley AT THE TOP Of THE TWIN$ rL-------COMMUNITY DEVELOPIAENT DIV, 1 PROTECTIVR 01ftCTom a", CITY HALL FRID69T `l*11 PLUMBING, PERMIT APPL I CAT I Oil Job Address - 0 12/15/73 1 1 1 1 800 e, 1 r for i L -Z Bt)pi ld ing omp 4AHSVIA sant "AVG Nlan v3j-V M I\ 11 1 v n I i i W 3 8I 88 Estimatea Cost G� �SCTt� { Plumbing Fixture Rates: NO. RATE TOTAL I! Number Fixtures /l x $2.00 Future Fixtures 4' x $1.50 New Fixture -Old Open. x $1.50 Catch Basin x $3.25 i Water Heater -99,000 BTU _�_ x $3.00 �i D Ground Run Old Bldg. x 3.25 E Elec. Water Heater x $2.00 Gas Fitting Fees: 3ONva 1st 3 Fixtures _�_ x $2.00 66 ' Additional Fixtures x $ .75 I Gas Range -199,000 BTU x $5.00 Repairs & Alterations See Description: Code '1ddY State Surcharge .50 TOTAL FEE $ !The undersigned hereby makes application for a permit for the work herein specified$ agreeing to do all eve in strict accordance with the City Ordinances and Tulin; of the Department of Buildings, and hereby declare that ! application re true and correct. i •781NI Gaal •MNival I I jl-- m I y SNIGYH aoo-1jtg II I!I 10 uIsaaMOHS o '1N HNINGaa _ v� 4AHSVIA sant "AVG Nlan v3j-V M I\ 11 1 v aaaress Phone - _Address -� -Phone i I� 3 8I 88 Estimatea Cost G� aaaress Phone - _Address -� -Phone Use Estimatea Cost G� �SCTt� { Plumbing Fixture Rates: NO. RATE TOTAL I! Number Fixtures /l x $2.00 Future Fixtures 4' x $1.50 New Fixture -Old Open. x $1.50 Catch Basin x $3.25 i Water Heater -99,000 BTU _�_ x $3.00 �i Ground Run Old Bldg. x 3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: 1st 3 Fixtures _�_ x $2.00 66 ' Additional Fixtures x $ .75 I Gas Range -199,000 BTU x $5.00 Repairs & Alterations See Description: Code State Surcharge .50 TOTAL FEE $ !The undersigned hereby makes application for a permit for the work herein specified$ agreeing to do all work in strict accordance with the City Ordinances and Tulin; of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application re true and correct. SUBJECT PERMIT City of Fridley 15 2 5 B AT THE TOP OF THE TWINS BUILDING PERMIT r � R CEIPT N COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC., CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE - OF APPROVED BY 612-571-3450 910-F15 6/12/79 JOB ADDRESS 1501 Windemere Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 29,30 1 lInnsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Dietz 1501 Windemere Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Leonard Goodroad 7906 Terrace Road N.E.- 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING d Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK t Addition t -n Rouge - 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRM, HEATING+ PLUMBING AND SIGN& WANING Before dkft'eW1 ' 1wd utilfties TEUMME - WORM • GAS Etc. REQUIRED BY LAW 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 l ISTALLS I 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 $9,880 $4.95 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- $60.00 NON' STRUCTION OR THE PERFORMANCE OF CON TRUCTION. PLAN CHECK FEE TOTALFEE L $15.00 $79.95 SIGNATURE OFCONiRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT C/\y�/Ci' i `- /o_ SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI BLDG INSP 4A E CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL. BUILDING PERMITS ((Yew, Alterations, Additions, or Repairs) OWNER: i A , a�'-"11:A' ADDRESS: TEL NO: I& BUILDER: :L,11,/'ILDd ADDRESS: tom- TEL NO: A�Q Construction Location STRE9T NO: STREET: LOT: �. C BLOCK: �� ADDITION: Corner Lot: •�„a�� Inside Lot: Setback:_1 5ideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square. Feet_Cubic Feet: �) 4 ` sl Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $?t1, To Be Completed:22-o z f 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. „ I DATE: Ll( SIGNATURE: J Stipulations: �Gn V X &-0& z �00.OV Mod 'tom 9.4?y e+. 9�' - THE -JOHN J. RYAN CO. " scAt.a: INCH rEEEPHONE. 64e.e8sn } EL 1595 SELBY AVENUE, ST. PAUL 55104 _! OF PROPERTY OF e2Izze,e LOCATION /✓r0/ %/��i�E'/cQ �i'��/ �, /_ /�/�e� iY�i.:��9 x 7 DEBCRIDW A& FOLLOWS Lo ,� 7 v ft i a'S - ZJ S � r- n -. .. E 4a �� 1� Qi° •mss _ . ' - , # - f N: 1� O, - 7:> CERTIFICATE OF LOCATION OF. BUILDING <. CERTIFICAM OF 3U8VEY at_� ihereby certifythat on 19 ".1 hereby certify.thaf'on -this survey- plan; r -'report' was prepared by me or under "this serve lan or report v+ras grepared'bp® mar or, Y,P ., my direct supervision and that ram- a duly- Registerec} land iny: 0iepcs supervision and that-Re�si eyor. under the laws the State,of 'Mtnnesota Surveyor under the taws of tha.Siorurun��,� - rs c'L r &•,c�a 'tit M� � :� . 4 +. - " • c > 4 _. _ .. , � - � ,t0►iN"'_1.` 6?va►�[ �arrtsrss�sr'o�n"anoV►rvnra�' u.ti'adaror - _"-x.�_ ..�_� �.Yra -------------- "g, SUBJECT PE City of Fridley 2 212 0 ` AT THE TOP OF THE TWINS BUILDING PERMIT Ir RECEIPT NO. I COMMUNITY DEVELOPMENT DIV. ` _ PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/20/93 JOB ADDRESS 1501 Windemere Drive NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 29, 30 1 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dietz 1501 Windemere Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Right Way Roofing 11304 Red Fox Drive Maple Grove 55369 557--8678 3999 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 ❑ N1EW ❑ ADDITION ❑ ALTERATION [R REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (Tear -off) 9 CHANGEQFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code! Provide adequate attic ventilation. Provide smoke detectors as per UHC 1210 adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 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 $5,r500 $2.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT , PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire $5.50, STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $81.00 PLAN CHECK FEE TOTALFEE License SC.$5,M $94,25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WH PER ALIDATED THIS IS YO R PERMIT BL G INS GATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 5/26/93 ADDN [ ] CITY OF FRIDLEY ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application D, Construction Address: I W ('� do vA �eA e Legal Description: Owner Ird7: 1 -;k �2� Tel. # Contractor: i Hca- v�-� rv,,, MN LICENSE # Address: I I /,)19 l,�U v 1 JJ'- Tel. # SSS - rd i $ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF I1"ROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ j Inside Lot [ j &�t. Yd Setback Type of Construction: . rC vv, Approx. Completion Date: _ Driveway Curb Cut Width Needed: DATE: APPLICA Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Side Yard Setbacks. Estimated Cost: $ S S (Cost on Back) $ Ii Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) _ $ 2 L °� $.50/$1,000 Valuation $ $750 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ Conservation Plan Review $450.00 $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ j STIPULATIONS: Tel. # -YS) -10 8 U I Y UF- F HIULLY IPVSF'tL� I IUN UIv. 6431 University Ave NE Fridley, MN 55432 572-3604 "ueuive �An Jdiiudry 1, 1yy0 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR {ttV. ' ' al o er a TraS Floor DrainSto ....Auto ........G s Range .`" aterHeate r 'es Gas EIe cWasher Basement Floor 1 Floor 2 00 FI r 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS /5� /1rv�u— ' 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 _'1993 Sump/Receiving'Tank $ 7.00 Water Treating Appliance $10.00 Owner I Water Heater –Electric $ 7.00 �1- Water Heater – Gas $10.00 Building Used As �rC('i7�ace Gas Range $10.00 Gas Dryer $10.00 Estimated Cost 4V PERMIT NO. Back Flow Prevente( Required ( )Yes O No Type •$5.00 PLUMBING COMPANY Reinspection Fee $30.00 SIGNED BY ,�J�� `f� TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance Approved Bs Rough–In Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $_425T) PLUS THE $.5o STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATIONAND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS ��®l �� Z RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Burner – Also Replacement Furnace $ 20.00 $ _— (Side Vent – Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ Gas Range $10.00 $_______ Gas Dryer $10.00 $ Ir Conditioning – All Sizes $10.00 $ j� �;U All Others/Repairs & Alterations (LIST.ON BACK) $ 1% of value of Appliance or Work - Commercial/industrial $ 1 % of value of Appliance or Work - State Surcharge $___.� TOTAL FEE PLUS THE $ 50 STATE SURCHARGE FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On January 1, 1995 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 ar rulings of the Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. ") 16) 1995__ BUILDING USED AS /� '` z. ® ``� G' or - ESTIMATED COST PERMIT NO. 1. pESCRI2TION 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 Nam® Size No. BTU HP _ EDR Sharp HEATING COMPANY eatin 4854 Central Ave. PIE Signed B Columbia Hoiohts,ing— MP rebNol 072 = 9459 Approved71 B / Rough–Ir; Date Final Date y FILL OUT BACKSIDE FOR STACK: VERIFICATION ON REPLACEMENiFURNACE NOTE: #1 through #8 required when using a side vent furnace. fl 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 . ( ) 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_ Tone: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RM9 SCHEDULE Residential APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning - All Sizes Rate TOTAL $ 30.00 $ $10.00 $ /o. $ 10.00 $ $10.00 $ $ 25.00 $ AI hers/Repairs & AlterationLIST ON BAC I% of alue of Appliance or Wort Commercial/1 ndustrial 1.25% of Value of Appliance or Work State Surcharge iY U4, OTAL FEE l Effective On August 1, 1995 JOB ADDRESS 119'0 1 W Lrd&ne-1 V -- OK 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 correct.,,- rrecct. t�� 1995 OWNER BI lI BUILDING USED AS 5 (4 1P- AA�n LJ °Y"CS I CZ- _ � ESTIMATED COST (0-75, PERMIT NO. i Il• M i►' L� :► No. of Heating Units I Circle, -One (Steam) (Hot Water) rm Air' Trade Name t� t+'1er% size No. HA � Al BTU ® HP EDR Fuel Total Connected Load $�150 Burner Trade Name Size No. MINI MUM FEE FOR ANY HEATING/COOLING1VENTI_LATION REFRICIERATION/AIR CONDITIONING_ PERMIT IS $25.00 PLUS THE .50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr BTU HP EDR BLAINE HTG. A/C & ELECT. nv, BLAINE HTG. A/C & ELECT. 13562 CENTRAL AVE. N.E. HEATING C0111M)OF.NTj3A„ AVE ANOKA-i_N_55304 ANDA, MN 55304 Signed By _ Tei No. Approved Rough-InDate Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CHIMNI Y AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration 3. Has- no_„foreign objects lodged within 4. 5: b 7. 8. Is securely supported Meets all current Code requirements for size and total BTU's connected Has total heating BTLI's of All other BTU's TOTAL BTU's Has a liner been provided for water heater Has combustion air been provided for water heater Remarks: Y A J HEATING CO: Signed By: Date: Yes ( ) No ( ) Yes (::) No .( ) Yes No Yes( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) 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 RATE SCHEDULE : The'undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) 19 Gas Piping (Needed with new furnace) $10.00 $ ,�� ZZ-- l OWNER -- Gas Range $10.00 $ BUIIb)'*NG USED AS $10.00 $ESTft�1ATED COST PERMIT NO. LConditfloning— All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER rs & Alterations (LIST ON BACK) "�� 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No, Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ 50 Burner Trade Name Size No. TOTAL FEE BTU HP EDR $ , SZ) 6bar� HEATING COMP Y H i" g and Air Conditionl MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION Ave, i�1 �A "�'b'a612@ishts, REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By �Nd5421 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By u Date' Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE 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: _i' CHEWNEY AND STACK VERIFICATION 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 ( ) 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: _i' CITY OF FRIDLEY PERMIT N .: 2004-01583 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/13/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1501 WINDEMERE DR NE PIN : 253024120076 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION 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. REPLACE TWO FURNACES (WARM AIR, CARRIER, 88,000 & 66,000 BTUS), DOWNSIZE CLASS B FLUES TO 5 INCH, REVENT WATER HEATER AND ADD HUMIDIFIERS ON BOTH FURNACES. # A/C UNITS 0 VALUE OF APPL OR WORK 1300 # FURNACES 2 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 0 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 0.00 70.00 SUPERIOR CONTRACTORS INC 612142 AVE N GAS RANGE FEE 0.00 CRYSTAL, MN 55422 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 13.00 STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 16783 0.50 83.50 OWNER DIETZ WILLIAM A & ETHEL M 1501 WINDEMERE DR NE FRIDLEY, MN 55421 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 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 provisions of any o er state or local law regulating construction or the perfo ce o construction. Applicant Z Date Bldg Insp Da1-4t SEPARATE PERMITS REQUMED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range - 4�q Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOBADDRESS Fee Total Owneril'T� $35.00 $ r7O'(-Building Used As $10.00 $ ESTIMATED COST PERMIT NO OCA ��'✓ $10.00 $ Gas Dryer .- . $10.00 $ *Air Conditioning - AllSizes $25.00 $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $13 Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Commercial/Industrial/Institutiona I 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/Industrial/Institutional / State Surcharge $ TOTAL FEE %-� REINSPECTION FEE $50.00/HOUR e'3 26 *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 i. DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle One (Steam) (Hot Water) (Warm Trade Name Size No.S?DkAoq BTU 9T600 HP EDR °!TFIDo',4 02 Fuel A� 4.7 <-' A -S- Total Connected Load Burner Trade Name BTU Ifs Size No. EDR 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 aN acT%o in�acre true and correct. SUPERIOR CO 612142ND AVENUE NO. HEATING CO CRYSTAL, MN 55422 FAX # Date Tel # Approved by Rough -in Date Final Date 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 () 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 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 F'DQAJ Appliance #2 Type "f_ Appliance #3 Type FO k�A-e Common Vent Type C.4Ss �. BTU Input EKC&3n Assiste or Nat BTU Input J67®0b Fan Assisted or at BTU -Input 66, ®C6 an Assiste r N Inputs �t Vent Height I y ` Diameter & " inches Appliance #1 Vent Connector Height 3 ft Length ft Diameterin Type Appliance #2 Vent Connector Height .5ft Length J ft Diameter in Type S e Appliance #3 Vent Connector Height =ft Length 3 ft Diameter min Type ALTERATIONS: (Describe) R15PIAeylue. r� HEATING CO: Signed By: Date:. L?_ ?`0y SUPERIOR CONTRACTORS W,,;C 612142ND AVEWUE No, CRYSTAL, WIN 55a2 06--- C6414 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: 0 tl Z /`, :1 de, lee _ =-/Z, Legal Description: 9� 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. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: Alp4w4w Estimated Cost: $ Za '0 ew-�q Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x $ _ DATE: APPLICANT: Tel. #'W 3',7�S5- Z 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. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge 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 $ 7 ®/ STIPULATIONS: 'r"RyIM TIE KITOEW-M CO FAX NO. 651-482-0533 Feb. 22 2005 04:47PM P2 Ti I �O u�ia Z c cmn �j Company Cttarta gafhm C-(W),�, M#F;AX M) 1"i Tenomwdmwpwo KITCHEIPLAN CO FAX NO. : 651-482-0533 Feb. 22 2005 04:48PM P4 Diana Berndt CKD, CBD - SI, TWVWWGud Drkv.SbWWAGW, W mgsmos28•(W)4 •IPAX(851)462 i Diana Berndt CKD, CBD. 817 TwWw**dDdwv8hoMv) , MkmeaM $8128•(881)482415WvFAX(M")4Me= CITY OF FRIDLEY INSPECTION DIV. b (0 Effective April 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas** $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge 0 JOB 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. OWNER DATE: / �� ( '200t) BUILDING USED AS , 4mI tq_ ESTIMATED COSTri PERMIT NO. PLUMBING COMPANY r/ SIGNED BY tfn I TEL N0. Approved By Rough -In Date Final Date (� MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ Ur D 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 replacing an existing furnace, the undersigned hereby verges 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 installing 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 : City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No.: (6 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da 'd• DATE YOUR E-MAIL ADDRESS fii &I .bI shad(cam, ",jJw5 ' camSITE ADDRESS 0U0 r (. THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: 1'1STATE PI 11v ZIP _ _ 3) TENANT PHONE: CONTRACTOR COMPANY NAME: �. SUBMIT A COPY OF CONTACT PERSON: IiClut 1 STATE LICENSE # EXP DATE YOUR STATE LICENSE WITH APPLICATION ADDRESS: I2-A 9ya11 CTIY { STATE ZIP f�-7 X51-22q- PHONE `l� FAX 651 ` Z28 - ci rn PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: �NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORKfa ngjZfj an Uko� PER MS 1613.665 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 FDCTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 GAS GRILL $10.00 _NEW BOILER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 10.00 POOL HEATER $35.00 __DUCT WORK $10.00 _ GAS PIPING $1000 $15.00 PI RMIT FEE PRQCTS FOR�JNU . R X00 _VENTILATOR ITU PR '_ eyTS:OYER $SQQ, Number of fixtures @ $10.00 x$10.00=$ V Permit Feb $ Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total= $ -_5b 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 all work whi re s d approval of plans. SIGNATURE OF APPLICA PRINT NAME `G/ �, �, ' /Y3 JADATE/-Q �ei ® -7 PUASENOTE.:,SEP TE,1')RMIT"�`AREn .Qll11C D ii Rt-ft F:n VrY6Tf�Ai kKlhAfL!L7AATf/ A7"itrentr City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No.:9 -615-91 Inspections RESIDENTIAL APPLICATION Received B A&40�6-- 763-572-3604 CITY OF FRIDLEY - �' 763-502-4977�rFAX Dat EFFECTIVE 1-1-08 g DATE YOUR E-MAIL ADDRESS 0 � SITE ADDRESS l T THIS APPLICANT IS: ❑ OWNER kONTRACTOR PROPERTY NAME: OWNER/ ® ADDRESS: 14vt ITY STA ZIP 71 TENANT PHONE: o� CONTRACTOR COMPANY NAME: NOTE: SEPARATE CITY CONTACT PERSON: P ®� LICENSES ARE REQUIRED FOR GAS STATE LICENSE # EXP DATE P l STAT)ZIP 1 J� AND HVAC. DRESS: Wl CITY iy SUBMIT COPY OF BOND ry PHONE FAX AND INSURANCE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT )kALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ft" Ala zPate 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) 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 WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _A/C _FIREPLACE NEW TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR $35.00 $35.00 UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS kDUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 :,. FEE PR T$'"Pi1R•UAILIRSi}4 =" FhRFl�i11TSYII Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 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 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 Minne onstructi 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 acco a pprov Ian in the case of all work which refires review and approval of plans. PRINT NAME !/If* SIGNATURE OF APPLICANT ,' —DATE Jrl APPROVED BY DATE _..�. � . , � SB�ARA'Tl�'1�Ef?�T'S City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977