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PRE 2010 DOCSidEW [ ] CITY OF FRIDLEY ADDN [ j 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: S. % G rt `r e IOoi.t tl Legal Description: t o f Owner Name & Addresj/ Com% 4��,�. �� Tel. # Contractor. 1r/ PG ACLJye e �� 44"Wi MN LICENSE # Address: /'&6 I S t - A) t Tel. # %C,l " 757- 7:3213 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Construction Type: %V Q��? S 1 MIC F� Ih; 12) Estimated Cost: $ C)e Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: i W APPLICANT: 42i Tel. # (12-46 o .. Y3 Y7 Call (763) 572-3604 for Permit Fees if mails gin 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 D 0_VeA0 pe-,- P,- $ / TOTAL $ 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 [ ] STIPULATIONS: City of Fridley 6431 University Ave. NE Fridley, MN 55432-4383 763-571-3450 06 -Jul -05 Special Assessment Search And Statement of Charges TO: On all that tract or parcel of land lying and being in Anoka County, Minnesota described as follows to wit: Parcel No: 13-30-24-44-0118 1551 WOODSIDE CT Lot: 4, Block: 1, THEILMANN EST LEVIED SPECIAL ASSESSMENTS This is to certify that I have examined the records in the office of the Clerk, City of Fridley, Anoka County, Minnesota, and for such search, certify that the following special assessments appear unpaid with respect to the above described tract or parcel of land: Term Certified Initial Interest Remaining Current Current Proiect Number Project Description Type (Yrs) Date Amount Rate Balance Principal Interest NONE PENDING SPECIAL ASSESSMENTS For the purposes of this document, the City of Fridley has determined that an assessment is considered pending after the City Council passes a resolution ordering the improvement, the approval of plans and the advertising for bids. This is prior to the City Council adopting the final assessment roll. If you seek further information, you should do so upon your own independent inquiry. Any amount given as to pending assessments is informational only and may or may not be the amount ultimately assessed. Term Initial Interest Estimated Proiect Number Proiect Description (Yrs) Year Rate Pending Amt. 5000-2004-01 00 Theilmann Estates Improvements 0 2004 0.000% $14,936.58 $14,936.58 MISCELLANEOUS FEES Description Status Date Fee Amt. Park Fees Unpaid 3/24/2003 $1,500.00 UTILITY CHARGES You shall be responsible to verify the status of any outstanding utility charges. To check utility charges ( water and sewer) contact Fridley Utility Billing Department at 763-572-3529. The records referred to above are public and may be inspected by anyone during regular business hours. The search of these records was made by the undersigned as a public service on request. The undersigned certifies that the above indicated searches were made and are believed to be accurate, however, the undersigned or the City of Fridley does not insure the accuracy of the above statements and does not assume liability for errors and/or omissions. The above figures are good through November 15, 20 Date Prepared: Wednesday, July 06, 2005 By Page 1 of 1 JUW'-21-2005 06:18 FROM:AIR MECHANICAL INC 7634341699 T0:7637571517 P:2/6 � i ' AfiZ^LJ.A AUP A I lAO HEATING,00bL1NG & RADIANT "Creating Custom Comfort AN 1 -ROM: BRIAN B1113OF t -f, GEeNtd L MIANAGRP, RC: I J s- Irv"t�L+eA 4 ; C-4, DATE: THE FOLLOWING IS TIIE INFORMATION YOU REQUE.TrED FOR Tl•IE H* VAC I~QUIFMENT ANIS VF.NTILATKYR RQUIpmr-I JT: FURNACE MFG: C firw- 0. MODEL. 57? AA• 1. u- a p MA COND. MFG. _ Garr r � �„� ..� MODEL. c*. L t Lf S> VE:N'nIATIOM AIR•TO-AIR. MFG. VC ,% MODRL: _ _� • U :.�.� SOURCE MNTS: P o (— rr%A (WIRED TO RUN ON LOW CONTINUOUS SPEED) BATH FANS -I) "% ca C]"M• MFG: LOCATION �''l ` r �•. Jti - - LOCATION S - 3} Ci CFM MFG /0".-. =a i LOCATION— OCATION AN AIR CYCLER FR WILL BE USED FOR VENTILATIQN DISTRIIIi,.ITION THROUGH OUT THE THE 10USS. THE AIR CYCLER WILL, BE WIRSD WITH THE ?IJRNACE AN AND BATH FANS (IF hPPi-ICABLE) TO RUN -20 MINUTES OUT OF EVIXY HOV& TOTAL CLJI3IC FEET' br I#CIiJSE: . � (o X -00$3 -CFM NEEDED ,. S'S C, rr' i '1 HCRE WILL BE A 6" FRESH AIR IN THE Lrril-ITY ROOM FOR THE WATER HEATER, ADDITIONAL NOTES: A WIRINQ *IAGRAM! FQR THE AIR CYCLER WELL BE INCLUI))rL! Norlh; 16411 A�%Oeen SL NE - Ham Lake, NII 55304. • (763) 434--774.7 - (763) 434-1689 lax- www.airmachanicalinc.com South: 2795 Highway 55 E • Eagan, MN 55121 • (551) 452.2025 - (651) 452.6&251"9 Www.radl2nLoWeLlpts corn JUN -21-2005 06:38AM From: 7634341699 ID:MEADOW VIEW HM Pa9e:002 R=95% JUN --21-2005 06:18 FROM:AIR MECHANICAL INC 7634341699 �I UM AirCycler Model ' FR The AUr Cyder Model RFjR-1v A low cost deuce attached to the. air handler cabinet and connected to the 1oVVf.V*ltage thermostat wiring' tiiotk inside the air ltaitdleG 9y peflodically op�eratiang the central heating and cmoiing system {an, AfrvCyder Improves the effecW of the tempemture control, humin and filtration system in a [muse. Doing so `averagmP the air temperature Ohdi#otm throughout the low helping to ellrtinate stagnant and ilncomforbtile air that a 'dtermostat can't detect. "t's "smart" about AKyder:11" is that it hems the house fan on Dflt anter a selected period of time during which the central system flan has not operated. TO:7637571517 P:3/6 irCyder Applications: 10* Ventilation systems F Enhanced Temperature Cantto>l 1► Enhanced Humidity Control [rr=t R Air Cleaning systems opwatb9 V0tugm 1 tet VA[ Cup to 3o V.as Inw} mate Fan Ckn/off ne Selection Ito>n Minute Adjustment down Bin The ,AirCycler Model "FR- cimtrol viii operate the air Handier unit fan for a sehwWbk Fan oN tirre if the fats has been inactive for a selectable Farr OFF time. FAN ON and OFF delay saMrugs ° FR" Madel: 110.199 rniniAas in 1 TWIRWe hkaernents, plus an Unlimited setting For both ON and OFF, Not= The A►rgdeR C?NI*ff itmction enaWes or disables the fan reyciinq fund'., but all tne;:msuat con"I signals OPerate W mally regardiea of the $witch Positign, All WtPub Protected by a 3A self -re g fuse_ Impossible to damage with wiring arju . .Figure i Allod, el• -, FR Wiring 0jagr;3rn.(R4$it Use) Thanw9tax Ar Kvtdier-unk AKYdw M* dW I'm. Eft? W W (heat} ' Wt {241e:0 R R (24 VAG} R � 6 Esau) C.j24 VACss«mgrpnj a_ s t Nates: R Wits nvtr�ectlort d Strew teniei A JUN -21-20005 06:38AM From: 7634341699 ID:MEADOaW VIEW HM Pase:0703 R=96% JUN=21-2005 06:18 FROM:AIR MECHANICAL INC 7634341699 70:763757151( N:4/b Date; 612112005 Revision Date: 6/2112005 New Construction Site Information Address 1: 1551 Woodside Ct. Project # Address 2: Lot; Block: City: Fridley County: Subdivision. lication Information Business Name: Air Mechanical Inc. MN Contractor License #: Contact Person: Brian Ebert Office Ph: 763-746-3753 Fax: 763-434-1699 Cell Ph: Address 1: 16411 Aberdeen St. N. E. City: Ham Lake State: Mn. Zip Code: 55304 House Details Square Feet: 5229 sq. fL Avg. Ceiling Ht: 8 ft. Number of Bedrooms: 4 Ventilation : Balanced Total Ventilation Capacity: 183 cfm. Minimum Continuous Ventilation :75cfm. Intermittent Ventilation: 108 cfm. Combustion Appliance Water Heater: Power Vent input BTUs; 50,000 Independently Vented Furnacall3oiler. Direct VenUSealed Combustion Input STUB: 120,000 Independently Vented Other Combustion Avoliances Gas Fired Direct Vent Fireplace(s). Yes Gas Fired Power Vent Fineplace(s): No Gas Fred Natural Draft Fireplace(s): No Solid Fuel Appliance(s); No Exhaust Eguipment Continuous Exhaust ventilation Capacity (cfm): NA Clothes Dryer (cfm): 135 Exhaust Fan Rating (cfm): 140 Make -Up Air No Make --Up Air Required by Code Combustion Air Round Rigid Required: 4 inches or Insulated Flex: 5 inches ,Applicant Name (print): Signature/Date: Code Official (print): SignatureiDate: a) 2004 CenterPoint Fnergy Minncgasca 2004 M,echanioaI Code Guidelirkes, Page 1 JUN -21-2005 06:38AM From: 7634341699 ID:MEADOW VIEW HM Pa9e:004 R=96% J•UI�H' I-i'Udtk ab: 18 FHUM: H1R MECHANICRL INC 7634341699 IU: f6i(5f151f H:5/b F z -CATEGORY 11" ALTERNATE FOR ONE & TWO FAMILY DWELLINGS NSTRL°CilONIM This ailernatiae wag he used for alna- and nvo-fan ilr divellipp built to niect VN C'91crorf 1 realuirchlaats of ,1111desom it,n6es, Cimpter 767& CompleW A, B, and C- Clewly tnaa.$: plans ssith- insulation it-+a�,:� v��ad+� W1,J A t'- .altics; siza and ty a of c+quipment; tquiplt m contrah. and location of Vapor rstar&-r mid Winllesaalp barri+:ts ':Llatra• sir.!it,a a:efer nadoo can b,.- found in the 1;pj tcvtstajkv. gr-C-OJO sttMMAry sh&-H 2V41 bbl,! feM ttta hl 1111' MOO DCO t-IMM_t of Cam-m[C'Mt Fart A. BUILDING ENVELOPE 1* --t prdpasc4 lapc joint sotiiasg option + .p .Ietcsaaipti;c le lllvinp. �. cic.} Q J3af%v m mgv 4 w 1Lr 7h7&LUd ,0 scbp ?.C.} -ice OWT12 a w.r�� t �`►1y1 ,:Wn O•p1= Wd'� [ - �t ►" (eGR1t1�71�'4C is '4H 114151 Q 17111 i�1lf 1 +� i'dtE O' rGjAlit) 13 Pcrl'ann.�oe (attm� il-valn.: eai+:nlatsan3} Q S}-stelus � sif r�dw.i 1 aril: gar 3Cookbookl$ Work beet l2%S B4 Tn0. 3 •:a }A 1. check i+tCoo ilxu *op mom nn 4fixtr UM k aptar vA.r.S list lfx&*W rwap.+sa4 ve:d1 to to an tabk bckm' •s, 3. talla w OL imJsm U- aluc Wd sumo. :, c{► Verily t0jA ae,i aa- (Wtkdit wca of all 6tutedaAin aia lams), and diner ark% is orm of L." 9:m1 alto abla ps a- s 201 it Window and UmtsAn a as I y �169G _ 2it°f� wan 12% H% Q21 li ?efr. It -l9 sl�elat6xp. � R 3 sh,�b+� lylA3'il,'�t�! tfiEQiglliE+4l -� (for &Cookboa agtion only) C} CClleran Irmlatiam= Mamunl It -3s with 75s CHWO Incl: ar Afiae111ura R44 unit hin v4MIUMA M Mi111mm ♦t.-33 tvbh R•5 Sbe hin: -hen 1W OM - p t~ ni lluum itIMC, UA2[a* of t0l) pr j".- *.did M"0+l s mb 560M 0 Bawl 101.+4 tnmuwa: bliq MUM k-IY t3 ¢ yp� 4r6111alCelahtiiiaSanE . 1SM11ggM R-== � i d�eet.4�baa Irtsulatlou: titiagtlnn: �►-1++ �] Faend al eam i�ittdas+ 3= inad3wd Lt mw nal l it Window and UmtsAn a as I y �169G _ 2it°f� wan 12% H% Q21 li ?efr. It -l9 sl�elat6xp. � R 3 sh,�b+� �, ,••'"• `",�••• t ?aab. R•19 ia�►t1.�liaan. IL-5 :*b�'athanle f1. Qd8 0.43 1 2L6, tc,.21 kc.6uLniml. R $ Amathing 8 3I 0-0 y 9 [;.ZI tul�tmtp.6 R*� At+Cthixl�. p�� Y -+o Vr 44 all (Adv=W 1't311n1m aCOF 14IaatUntlln �RTJ �a" 1i stidtry 2w6. R- 19 in Ukdi*IL c PO$111001i.440-v 11-39 ia.6. R-19 iatsvl:ua>A. � R 3 3hhcatPlurlr 03S om $44 imint n.<R-55hC=hitle O.W 0,474 1 asap. R-Zt 101%ptatiu k 2 9-5 Abdalom 060 3 0_46 ik''jsla a U_% Som 100 x S-7 Ze 40 7Q n�ndtr� &. daoraaca. � � cxp�d �rs11 • 1 ,AI -L WABt.E f'Iaw esbk 'c) v1I NESOTa Ei►'1 ER-GY CODE — WHItH RULES MAY Q USE? PE t7F REST �F -M, kL BUIEDIXG �+,PI}l.li'AI3l. RULES i7WOWR Fuantpi c f3tmi4 , tw;r1 IAottla� C 7612: gar �+1,r 161v -Cg_ got% l" +s itl I sntQtaly d_pramli--Asan ana' re Attaa:ll O RX -3 accupancy dwatliMP C.a,�plcs: tripj,_% to snihaaws and NW a1anic-1 L31.grt:r 7'670: oar g ti to iih c+dnx a: aory l" or ^C� *" C:.as:aic 767 " a.,-.�p.P,-...r wf a: eIoM 1+e< t$.= -tom ro t4, -or JUN -21-2005 06:38AM From: 7634341699 ID:MEADDW VIEW HM Pa9e:005 R=95% 'JUN -21-2005 06:18 FROM:AIR MECHANICAL INC 7634341699 TO:7637571517 P:6/6 Pak)% DEPRESSURIZATION PROTECTION •'!reek option eked:.. r1*10,bumin'; aequipm tel (cti111pl4•1e sehtdaks balow) Q No W burnaw; a intro tett 1!v5i2t11LTls�:•� 99HAU5TlMAKE-UP AM SFREDUL.E" ti:cp !. C'a+mplttt the t'uarl+uara:ar ayfri��urnt '%•.frd,• t 1v oniti etlit)pnwrnr rheum devices over 308 creel Flow With a Y (yesi rrta4• be sctc4•tw under dae "Cat ,:a y 1"alrtrnatw. can :ri*Mll 2. Cfompletr n* the right if direct or pthwr j efm vcntad qtr solid Cuet atmospheric cent spat: h�sirt� at}atiprtHttrt is. s,•�.ti real, i _ Am CCONMUS M-NEQUIPs1 EINTSCHEDIME, - - S �'' '1'' (chook all 4im proposed) bgt;ng-tlottsolid fuel Sealed cvmbWi0n Hearth - seonsolitl 1'rtcl l i Seakt# f ttbustiVO Y ❑ (?itect or pmtvr %,MU .1 1 Y' W Direct or pmtirer vented Y -notts;lid fuel ❑ StaleJ combustioh#wwl YSpace heating- solid fuel (3 Alm4uphorkall verned Y Dire�t or pauvr YWater heating •- solid fuel 0 Aunasphericall;► trnkd Y „ Almosphariedily lid fuel 117Atmimpherically i eate~i I Y I F 11MV4kherically vented solid fat or direct dr pmw voted noiiRWtial space terming Is innal led. then make-up .air to, march. flow is mquired for Tach havidiml ah= devift urhich exec!& 300 cubic feet per minute. �Iart Ct. VENTILATION lLAT1CiN - (iNocltanical Mdlzion must be provided per the tafpr gttatiay•calculued belo% cubic fact x 0.09a'IL3 fmlaute - S5' crm ( x is crMAX400111) + 19 crm crM flume of habitable roo ns auniber of bcdraam -G1 V+.. Kw- V YENTZAMON FAR SCHEi�1its wdk methodCS) proposed 4 L 13 Exhaust;nig 0 I3alanecd (hew recovezy ventilator, air eehanger. etc.] a descr' rion or lacttuoa 3 � ,� 8� �',t. � TOTALS l�fl"ILATION Int*e 0 char &0 chn Coca crnt rfm ct'rn DESIGNED , E.shaust � cl'nt `i S` eLttn efm It'Ifm Itetttent Of Corntrliance: The proposed buililing design rcprC OMM in these documents is consi*Mt with the building plans. •cificalk. or.I rxha:.` elation$ submimed Wilt the permit application. 'ghe proposed buildike has bean dt:;�Md to tstret the uircments orthe Alinneffsota Energy Code. .7ticant (print name) si gatute Date _ Telephone number art 02. VE 'MATION (Submit Part er upon completion ol•srstent jerificationt' ) M----------- -------------------------- ----------------- ------------ 5ity rtd�lnr°s3: . ^J— --. !'anti Nurnbe ddmription or location i TOTALS 51J intake cfin etrtt c ctr•-t ! ctM .F'ORMANCEf E%b;k49ff cfm cfrn elm c . l t:ftn t' etuilatir t$tc is be Measwed and terifled , w1ft the perfarmance option. is used in lieu of rite pcesctip zivc opfk n for the sealing of j,oiM in the baiidirtu c mditb-w eavelopc ((rent Pan A). IPIismce NV.ttrr.rvnt: :•:;svclin l,:hon a%%LI0l is in c-"- PH;irity tva It NM 1:83orm. ctwft and iS Siz:.! lis pr•+ _r, a::'r1:..1 JUN -21-2005 O6:39AM From: 7634341699 IQ=MEADOW VIEW HM Pa9e:OO6 R=95% *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 Approved by Rough -in Date Final Date off�< CITY OF FRIDLEY BUILDING INSPECTION �� Effective 4/1/2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 763-572-3604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 8I S/ CaPZ7— RATESCHEDULE Fee Total n Residential Owner —M _0 i C-u_p ` Furnace Shell and Duct Work, Burner & ®® t — Ston also Replacement Furnace $35.00 $ Building Used As tSJC'3 Gas Piping (New Furnace, Fireplace, Insert) $10.00 $ s ESTIMATED COSTALACCn5EiPERMIT NO Gas Range 9"i f c-- +0 $10.00 $� DESCRIPTION OF FURNACE AND BURNER Gas Dryer ��l j Iry ef `f J $10.00 $ # of Heating Units_ Circle One (Steam) (Hot Wat (Warm Air} Trade Name a -cc Size No. *Air Conditioning - AllSizes $25.00 $ BTU HP EDR Fuel Total Connected Load All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Burner Trade Name Size No. Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein 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/Industrial/Institutional and representations stated in this application are true and correct State Surcharge $ HEATING CO f 9 e TOTAL FEE $ ®° Signe& Tel #70 1& __342:7- REINSPECTION FEE $50.00/HOUR G1 FAX # o Date Wns *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 Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT..VENT CONNECTORAND 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 O, No { ) When installing a new venting system, the undersigned hereby verifies that it is alisted assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Ventingjables for fan assisted and natural draft appliances. Yes O 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 O 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 Tota( 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 : o,r- PLUMBING RESIDENTIAL APPLICATION City of Fridley 01771 Pe I umber _w!!&__w!!&_c9bad By Date Received NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. 9 .� O DATE /' YOUR E-MAIL ADDRESS SITE ADDRESS -5-1 jJoo,61_T, ` e C--/- �THE THEAPPLICANT IS: (CIRCLE ONE) OWNERS "ONTRACTOR_% NAME O�/��u Vt�lea / ley PROPERTY OWNER/ ADDRESS TENANT CITY STATE ZIP PHONE # .��' NAME c7DAS LICENSE # ADDRESS A'770 CONTRACTOR CITY � j�c�•�uPr /�n STATE A- ZIP 1r-3 Y PHONE # 76.3' 753-x/3 FAX# 210 7.rI - 9-5-/6 PERMIT TYPE _—SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) ( BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK V WATER CLOSET BACKFLOW PREY. ($15) / DISHWASHER LAUNDRY TRAY _[_WATER HTR ($35) FOR IRRIGATION WATER METER OTHER jz' d® Permit Fee $ MINIMUM: $15.00 or 5% of cost of the improvement -whichever is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ C�r;Z5_1 0 Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT — NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 which requires review and approval 0lans. v �+ �r��7 Y_3 /_O- NAME OF APPLICANT 7 G / r �n �f�L DATE dor print SIGNATURE OF APPLICANT CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT 6431 UNIVESITY AVENUE NE, FRIDLEY, MN 55432 (763)572-3604 City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 Water and Sewer Permit Application ❑ New Connection ❑ Existing Date: /h, r Job Address: YName of Applicant Name of Property Owner: Existing Structure Permit #®"��, Permit Type: Sewer Fee:d�� Water Fee: Meter Fee: Repair Fee: Relocation: State Surcharge: SAC Charge: Special Assessment Fee: Total: $ 5-8-9 Applicant Signature: Inspector approval: ❑Utility Line Repair/Relocation ❑Water and Sewer Connection /pv&( z—_- VCG0eI6✓ Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 hispection Fee for Water/Sewer Line Repair $40 Special Assessments See En ' eerin Cost of Water Meter See Utility Billing SAC Charge $1450 State Surcharge $ .50 Water Tap See En ' eerin 04/04/05 NEW [) CITY OF FRIDLEY ADDN [) 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Addre Legal Description: (763) 572-3604 Bldg Insp (763) 571-1287 Fax Owner Name & Address: M ec,6c-L� ji e Lj Tel. # Sq. Ft Contractor 14ec, cu) e &L, MN LICENSE # �� , ®�Oc�y J 7 Address: / ` (.) i rJy E Tel. 79 7_ `73�? o 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 _. _ _Sc- -Ft - -- OTHER: Construction Type: Ir J�) Estimat —_� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: y -,O APPLICANT: � -� Tel. # (l2 --X 0 .. `�3 � 7 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. CRY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewgr Main Charge TOTAL 08.16- 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. T" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: FROM :City of Fridley Building Inspections 763572-3604 FAX NO. :76357112E37 RESIQUI q1A-L';,h", .4-; DKIS M6 YOUR VrMAIL ADMiMS SITEADPiFUSS THIS AePLICAN"T IS: 0 OWNER 'WONTRACTOR PROPERTY OWNER/ TENANT 63- 101 San. 20 2M6 02:18PM P4 /fip CATION Received By, 11f pay Date Rec'd: �&A( �u fir at di STATFZIP— CONMCTOR COMPANYNAME SUBMI!l'A COPY OF CONTACT PERSON: YO( JR STATE STATE LICENSit# -2005-0661� IAChXSE WITH ADDRESS: !Io V1t.4hPj=(�41S:E1 CITY STAT zll�� APPIACA110N FAX 4!�J- 14,(, 3-17 PERMIT TYPE 1INQJ,fi FAMILY !11-TOWNI-IOUSP TYPE OF WORK. 13 NEW 13 REKACMM�'.T DETAILED DESCRIPTION OF WORK Al AD jer7,lr /7?� lf-41111 k 3 -lu-taAA5 PER MS 1613.665 the pomit fee is a minimum of $1$.Q0 or 50A.Ofthe.tetal WA up to S500,00, whichever is greater, for the improvement, installation or replacement of -a rc9idffA4fq", e*aaft the fixttires, (This should reflect only the cost of labor) Labor cost under $300 = 915.00. X.05 FOR PROJECTS WT -MRF, LABOR KXCEEIM $500, PUS ARBRAM Oi4SlO.WPUjtpVbl)RV, 'P-XCSPTWMENoTRi), FiXTLW-S: ([NDICATTV10PAL NLUBEROF FACH BELOW) . !– . EquipmontInsWled MFQ MODEL: MFG:MODEL: S1ZEfflTU-.-- MFG: 'MODEL.S17,H/Wru. , -- A/CW.00 $1$.00 — OAS RAN MIOVEN $10.00 -- AIR *'1'0 A I k EXCI TANGE E R $15 — FUOMAGE (WOOD) $35.00 -- NMF0AS1jR11,T,S!0-0A BOILER SX -00 FUMAC9,M5.00 ciAsUNIT HTR sio.Do CITUNEYLINER $10,00 _jK)OL HENI-lik".5.00 XDu(--r WORK 511100 A 0,V=TOQR $150 PA .PA T!�t $10�00 _ I I I Permit Fee $ lb _CD_ r fs. ',%ftbeioffbcWres@S'10.00 x $I 0X* = Surcharge S .50 Number of fixtures @ $15.00 x $15.00 = TOTAL DUE Number of floddrts @ $25.00 x $25.00 - - Number of fixtures @ $35-00 X $15.00 = $ State Surcharge $ .50 Total = $ TH[SISAIV APPI.Ir—ATIJI;POA ,ArMWI-WYr%rALMUNMPROCESSED I hereby apply for a building permit and Lacknowl'' thal;,010 wom*11.4ove Is complete and accurate; that the work will be in conformance with the ordinances and co -Of FiWloy and wfth;thb Hmmota Construction Codes; that I understand this is dot �r: 4 not a permit but only an application for a permit and v6i is-'.4ito owf"wAuLd a permit; that the work will be in accordance with the approved plan in the C -430I' 11 work which requires m*1ow and *royal otpl"- SIGNAYURF Or APPLICANTD, Z) 1"Iz. 'Id, PRIPOINAME City ofFridley Building'-Inopectioiw.peoartment 6431 Pniversw, -Avii:Ia NFA ViJ41py, MN 55432 7&'-V2-36b4j FAX" 763r!502A071 FROM' :City of Fridley FAX M0. :7635711287 Jan. 20 2006 02:18PM P5 REQUIRED INFORMA11ON NEEDED TO PROCESS PERMIT RESIDENTIAL -PERM �'I' ArryQ,►ATION HVAC ❑ NEW HOMESIADDITIONS EXISTIN (;*1iOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTIN.G FIM ,R r .f;'r.idny r 1. Combustion Air (See note below) a. tail or solid fuel IMC Chapter 7.with MN; Amendm6nts b. Natwral Gas or Propane/1F'GC Chapter 3with MN Amendments 2. Make-up Air (See nate below) a, DMC Oiaptor 5 with'MN Ana o► nt ,, Y 3. Venting a. Gas appliances ]FGC ChapW'5.wM Mei Amendments b. Fuel other than gas ]MC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES • ie a 6. 4. Pleat loss & cooling load per room a. Required on new construction 1MC l 346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 • 6. Duet Design Per IMC 1346,0603.2 a. ACOA Manual D NOTE: Centerpoint energy ,Mechanfcxl Code guidelines software may be used for combustion and make up air calicuclations • i Building BUILDING Inspections RESIDENTIAL APPLICATION 763-572-3604 y CITY OF FRIDLEY DATE7 Ca ¢ �%� YOUR E-MAIL ADDRESS SITE ADDRESS 15-5'/ (,7Oocl5e THIS APPLICANT IS: OWNER OCONTRACTOR Permit No.: Received By: Date Rec'd: 7 4-3 2- PROPERTY OWNER/ NAME: "4AoAA A15 Cc- i � �� ^F �= �-� TENANT ADDRESS: 1:5 Y 1 t�OC A S a J 157 &+ ^ CITY `T' r STATEMI,3 PHONE: ja 12 —fie — l q 3 CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE NAME: STATE LICENSE # EXP DATE ADDRESS: CITY STATE_ZIP 17 TWO PERMIT TYPE O ADDITION u uPMAU 'BASEMENT FINISH O ROOF O DECK O SIDING O DRAIN TILE O OTHER TYPE OF WORK: I ANEW " """" ""• D MAINTENANCE/REPAIR O REMODELING I)FSCIB RE WORK BEING DONE: T7/ r� itis A ID 19.5 e m� �t SIZE OF IMPROVEMENT OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDIN O Vinyl O Aluminum O Other O HOUSE & GARAGE O ATTACHED GARAGE O DETACHED GARAGE OSoffit O Trim O Fascia WINDOWS IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & WIDTH HEIGHT _BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing strucuu and proposed project. 2. Two sets of construction plans 3. Energy Calculations TYPE OF WINDOW TO BE INSTALLED NUMBER OF WuNijuWa ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING -THE 1997 U.C FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ •�— 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 9 , lead .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ V� Make checks payable to: City of Fridley Attach Stipulations .� 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is no 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 approv plan in the case of all work which requires review a val of plans. g_ �, SIGNATURE OF APPLICANT � U S PRINT NAME E Fk�a ° 5�� (DATE �"� �-OC _ J L J t !_ SJ — - - Ul in � f r- y I I u � ,51 37htd�' J five Q3 ��} g I r + & rW ffSnij $L r �! ra -&at No Socl °Tx°� olx- n L - - - - �I, �- 6V7S a' has ,8 x hol. I l Imo✓ 8� „ j 1�•H�3 il' '�,+U��a-1?J tea%►- n's r `(i vy I 'y -W NdW OJ J W1S /�f I ,� - Jr. — '5%1A 4 3-15 H5n74 Ij of x 9£ X6£ Cl- T-7`ZA - ?1x773 '�NvJ - I �NdJ Bx oZ IL Y, X „�S'l- NO1JJd3?1� h,, -'sanLs 9xzL W II I I --7itA Vr Pvnln=l Ot'- I I N I I I I I S71VM '%1� �N � IN ,� I Woo214�$ �vnln fi _ N I Qr1LS -77n� aIX p�X o�G UI I�ZI — Z�1d +—1-vrJ�1W ,41507j ° d o� 65Szy�t -bS6},dd�t b55z{�1 _ Pill 1/ A. li 09' h /' Building PLUMBING Permit No.: Inspections RESIDENTIAL, APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY g7c__� Date Recd: DATE Seek -5 1 2.00 (® YOUR E-MAIL ADDRESS SITE ADDRESS 15-5-1 THIS APPLICANT IS: 1 OWNER ❑CONTRACTOR PROPERTY NAME: 7 Rz S A S Sc -q T 5C-04 FFOWNER/ ADDRESS: 15-51 W &6d $(de_ CITY Fr e C( lCy _STAT /1�ZIP'554 3 2 - TENANT PHONE: % l 2- - `i CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE-ZIP- TATEZIPLICENSE LICENSEWITH PHONE FAX APPLICATION PERMIT TYPE GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: F&W ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK � ` p i's A 5e— k - 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 = =.F0FPROJECTS WHERE LABOR EXCEEDS�300; EES ARE BASED ON $10.00 PER FIXTURE; IXCEP3 WIiERE AOTED S «(InTDICATE TOTAL OF EACH BELOW) TER THSINK/LAV '7r5 DRAINS _•SHOWER _ WATER PIPING _FLOOR THTUB 3,56 GAS PIPING mw cmucEm) SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK 35 � WATER CLOSET fo5 _ BACKFLOW PREV. ($15) _ „L DISHWASHER 15o _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER °s y E '.. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ 00 Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ state -surcharge = $ .50 Total = $ `90 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 which requires revie and approval of plans. SIGNATURE OF APPLICANT J PRINT NAME _f40 0-, A 5 5 • SC' A FFDATE_�e4 f_ 5i '7'006 L� s� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 �n v 763-572-3604 v�/ �, FAX: 763-502-4977 Building Inspections 763-572-3604 V TRIS APPLICANT IS:V55 I PROPERTY OWNER/ TENANT MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY -?- O U Co YOUR E-MAIL ADDRESS °OWNER OCONTRACTOR ADDRESS: X00115 i d� �'� CITY PHONE. to 12 - q ( P 14 S CONTRACTOR I COMPANY SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: CONTACT PERSON: STATE LICENSE # EXP DATE Permit No.. Received By: --(- Date Recd: ai` 5432 - ATEMWZIP 5 L S Z ADDRESS: CITY STATE ZIP PHONE 15SINGLE FAMILY ❑ TWO FAMILY �LNEW 0 REPLACEMENT DETAILED DESCRIPTION OF WORK . P FAX 0 TOWNHOUSE 0 ALTERATIONIREMODEL 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 fixtures. (This should reflect only the cost of labor ) improvement, installation or replacement of a residential fixture, excluding the 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: (NDICATE TOTAL NUMBER OF EACH BELOW) MODEL: MFG: SIZEIBTU Equipment Installed MFG: MODEL: �— SIZEIBTU MFG: MODEL: SIZEIBTU I GAS RANGE/OVEN $10.00 FIREPLACE (GAS) $15 -DO $35 A/C $25.00 —FIREPLACE FF R E)S35.00 ) $35.00 TO AIR EXCHANGEER $15 '7-FURNACE NEW GAS GRILL $10.00 GAS �T HTR $10.00 _AIR _BOILER $35.00 — NA CHIMNEY LINER $10.00GAS DRYER $10.00 _POOL HEATER $35.00 $15.00 DUG? WORK $10.00 —GAS PIPING $10.00 _VEIJTTLATOR „ ry 111 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ 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 = $ 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 ��rk which requir�rev'w dapproval of plans. SIGNATURE OF APPLICANT ' PRINT NAME1 Flo wt S S . � DATE 5eP 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 HOMESAADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC 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 1