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CITY OF FRIDLEY PE Q�2604-019�1- 6431 UNIVERSITY AVENUE NE FMLEY, MN 55432 DATE ISSUED: 10/19/2004 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1552 WOODSIDE CT NE PIN : T000070 LEGAL DESC : THEILMANN ESTATES : LOT 2 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : NEW CONSTRUCTION VALUATION : $ 163,529.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SOD IN FRONT AND SIDE YARDS. PROVIDE HARD SURFACE DRIVEWAY. PROVIDE CITY WITH VERIFYING SURVEY BEFORE CAPPING. SEWER AND WATER LOCATIONS AVAILABLE FROM CITY ENGINEERING DEPARTMENT. CONSTRUCT HOUSE & GARAGE LINEAR FOOT 22 STATE LICENSED CONTRACTOR 1 ENTER FEE AMOUNT 14937 PARK FEE 1500 SAC UNITS 1 APPLICANT BUILDING PERMIT FEE PLAN CHECK FEE 1,352.15 878.90 MEADOW VIEW HOMES INC 14621 ABERDEEN ST NE STATE SURCHARGE, VALUE 81.76 HAM LAKE, MN 55304 PARK FEE 1,500.00 FIRE SURCHARGE 163.53 DRIVEWAY CURB CUT 440.00 FEE SHORTAGE AMOUNT SAC CHARGE LICENSE SURCHARGE 14,936.58 1,350.00 5.00 OWNER MEADOW VIEW HOMES INC 14621 ABERDEEN ST NE TOTAL 20,707.92 HAM LAKE, MN 55304 PAID WITH CHECK # 18643 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 wort 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 regulatin tt!`On��the performance of constct}o_n./ Annlic , \ ` � �7 Date 41 fit V) SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW ADON ALTER II Construction Address: Legal Description: Owner Name & Addre Contractor. C17Y OF FRIDLEY 8431 Unkwslty Ave NE. Fes►. MN 55M SINGLE FAIWI-Y AND DUPLEXES R-1 AND R,Z ,1 BUILDING PERMIT APPUCATION 1) (763) MN LICENSE a, Tel. # Ltomw#20024837 Attach to this oppricstlon, a Certificate of Survey of the d _with the proposed construc tlon drawn on it to scale. •Jr;i i K;i U010AftgA: L Width_ Height--_.. Sq. Ft GARACM AREA: Length width Wit Sq. Ft. DECKAREA: Length VlAdth HgNftund _„_ Sq. Ft 0111M. 169- �31AO ► 01 493 % o��� fb Consfruction Type:., 1 rha d vi- Estimated Cost: $0 ®, 0 0 L� 3 j. I I Driveway Curb Cut Wit Needed: LS—Ft + e Ft ■� Ft x 3 a 6 DATE: - -� APPLICANT: / TeL a,IA-. L21� 0 Cal (763) 672.8804 for Permit Fs" B maWng in appiloWon or Fare to 7112.571-1287 N using rsalR card and we will sett you for card number. CRY Uig ONLY - Permit Fee Furs Surcharge State surcharge SAC ChoMe License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL N Fee Schedule on Romrse Side .001 of Pemnit Valuatlon (1/10th%) $.50/$1,000 Valuauon $1200 per SAC Unk 13,5-6 $5.00 (State Uoenl d Residential Contractors) A" Air " or AIL 'IS" Abcwe $450.00 Conservation Plan Review Fee Detemilned by'Engineering Agreement Necessary J ] Not Nsoesswy I 1 9 Ll �� NEW CfTY OF FRIDLEY ADON i j 6431 WNW. �y Ave NE. F,WSy, MN 88432 ALTER i i SINGLE FANfL.Y AND DUPLEXES R-1 AND R-2 5�0 BUILDING PERMIT APPUCATION Cori -strut n Address: lt4:$•- l Legal Description! e ` Owner Name & Address:IVJLCuuiuw .., Contractor: 1462i Abodwn Shed PiE ' MN LICENSE Address: —TO1. 0 Uomw 1f 20024837 D _ I I Attach to this application, a Certificate of Survey of the with the proposed construction drawn on It to scale, EfhKbve 1/1/2002 (763) 672.3 04 RLisLj el LIVING ARVA: Length Width _ Helgtg __ , , Sq. Ft GARAGE AREA: Length WidthHeWit _ Sq. Ft. DECK AREA: Length Width , HQUOround _ Sq. Ft OTHM. Construction Tym-4L 0 0111 14 - 6 Esti rated Cost: $ 0, Q 0 0 Driveway Curb Cut VVidth Needed LS -Ft + 8 Ft ■•L L Ft x $ :� A. s -� K J DATE: -qU� APPLICANT: 2�'„� Cali (763) $723604 for Permit fans N waWna In application or Fax to 7113-671-1287 If wing aMit Card and we will call you for owd number. Permit Fee $ ss� , is Fire Surcharge $ (o 2, . State Surcharge $_ !R1 SAC Charge $ 00 License Surcharge $ s a ®® Driveway Eamw $ I-LIL a oc) Erosion Control $ Park Fee $� Sewer Main Charge $ Cie )c. TOTAL $ �� dggo CITY USE ONLY - Fee Schedule on Roterse Side .001 of Pern* Valuation (1/10thQ/o) $.601$1,000 Valua6an $1200 per SAC Unit $5.00 (State Ucenered Residential Contractors) Aft "A" or Alt "Ba Above $460.00 Conservation Plan Review Fee Determined by'Engineering Agreement Necessartr [ ] Not Necessary J ah Sir , Addre;s: CATEGORY I" ALTERNATE FOR SNE & TWO FAMILY DWELLINGS �S'fRVCTIONS: This alternative may be used for one- and t%so-family dwellings built to meet the Category 1 requirements of linnesotu Mules, Chapter 7670. Complete Parts A. B. and C. Clearly mark plans with: insulation R -+aloes: ++tn,iov and sky h%. -ht t.'• Clues; size and type of equipment; equipment controls; and location o1' vapor retarder and wind++aA barriers. ',More w::ail:d formation can be found in the Albinesota EnI rgh-•C'or/I: summary sheets uvailable from the Minnesota Departm:nt of Contmcree 'art A. BUILDING ENVELOPE ie.k proposed envelope joint sealing option + (3 -Prescripiiwc (Caulking. gaskets. etc.) O l'erromiance twit per 7t/7u.W 70 suhp '7.C,) - peck therr•it en.: fly ca! elation option used 4 X "Cookbook" (complete worksheet below) l7 MnCheck method (attach report) ❑ Performartm (attach U•valuc calculations) (3 Systems Analysis mcthoJ (attach anal; sig) Cookbook" Worksheet INSTRUCTIONS :p I. Check itemis) that design meets un .tlinrunrrn list to the right dust meet all items to use" C'ookhaol." action •r 2. Indicate propascd ++all type on table 11CIM ,r 3. indicate Windov% U -value and source. :p 4. Verify total window (including area ofull foundation %in,lo++s) and door area is equal or leas than allu%ahic percentage. TABLE FOR DETERMINING -MAXIJIUM WINDOW AND DOOR AREA MINIMUM REQUIREMENTS (for "Cookbook" option only) ❑ Ceiling Insulation: Minimum K-33 %%ith 71.:' energy heel: or (Minimum It -44 with to%% truss heel. of Minimum R-38 with R-5 shcathin•: then na at1w ❑ Iron% Uours: \I:tx. U -value of0.3our I'.'solid wood %%i:h storm O ltun Joist Insulation: Alinimunt K -Iv O (doors o+er unconditioned spaces: Minimum K-24 O Foundation Insulution: Minimum K -lit O foundation windows: ::' insulated etas$. %uod Ise +ini I item. TABLE FOR DETERMINING -MAXIJIUM WINDOW AND DOOR AREA iximum Allowable Total Window and Door Area as ` 12�67-28% 'ercentage of Exposed Wall l2% 14% 16% t3% 20% 22% 24% tl: Ty (Standard Franting): Maximum Average Window U -value (axes t foundation windows): 2x4. R-13 insulation. 2 R-7 sheathing 0.55 0.47 0.41 0.36 0.33 0.30 0.'_7 0.25 0.23 2x4. R:13 insulation. ° 3 ,hcathine 0.52--0.45 0.39 0.33 0.31 0.23 0.26 0,24 0.22 20. R-19 insulation. < R-5 sheathing! 0.43 0.41 0.36 0.32 0.29 0.26 0.24 0.22 0.21 -0-2 2x6. R-19 insulation. z R-5 shcuthinto 0.43 0.42 0.37 0.34 0.31 0.23 0.36 .1 2.%6.1(-21 insulation.o! R-5 sheathing 0.51 0.43 0.33 0.]4 0.30 0.23 0.25 0.23 0.22 20. K -:I insulation. 2 R-5 sheathing 0.53 0.50 0.44 1 0.39 0.33 1 0.32 0.29 0.27 0.23 .11 Type (Advanced Framing): Maximum Average Window U -value (except foundation windows): 2x6. R-19 insulation. < R-5 sheathing 0.52 0.45 0.39 0.35 0.31 0.23 0.26 2x6.1(-19 insulation. a R-5 sheathing 0.53 0.50 0.44 0.39 0.35 0.32 0.39 N40.22 .25 2x6. R-3 I insulation. < K-5 sheathings 0.55 U.47 0.41 0.36 0.33. 0.30 0.37 .23 2.h. R-21 insulation, t 1(-5 sheathing 0.60 0.52 0.46 0.41 0.36 0.33 0.30 .26 Window U -value: l ,� J aourcc. I U N1.1m. u t%arimmr. 177.1 F1"11VVVVD 0�� X '2 ' '_ ',Z < o� +window & door area gross exli se ►wag! arca DE lQN ALLO«'ABLE (from table above) 11NNESOT4 .ENERGY CODE - WHICH RULES MAY/ USE? TYPE OF RESIDENTIAL BUILDI C I APPLICABLE RULES ietached R-3 occupancy 1- and 2 -family d++ellings Chapter 7672: or Examples: single family, twin homes. duplexes Cha, ter 7670 "Category I" with statutory depressurization and ventilation requirements .trached R-3 occupancy dwellings Chapur 7674; o?. Examples: triplex townhouses and row house: Char tar 7670 %%ith either "Cate -gory 1" or "Cutego ?" Fro. iSions 1 ................ L..:Ll:nnc of l crnrtrc nr to-;- ('), I^! •-,0.1.-or SEP -23-2004 09:02 FROM:AIR MECHANICAL INC 7634341699 TO:7637571517 P:7/9 Pert B.P LSSURIZATION PROTECTION Cheek option used: O Fuel burnirLit equipment. (complete Achedules below' O No foal burning equipment INSTRUCTIONS Step I. , Complete the Conab=ian Equ pnrent Schedule below. Only i inent `5CiPEDit;i:.ti• whit a Y (Yes) may be selected under the "Category 1" altemste p 6�ysi i3ei3t S Aver` ®0`'m Flow $►Ep Z. Complete 5xhauaL1Malz-up A1r Schedule on the right if direct or power cfrn venud or solid rue) UmOsPheric vent "ce heating rquipirmt is efts selected, cfzn S7ACC besting - nOttVpW fml i IR • Sealed enmhuntinn 1, ne=. i�-_ lc..r .{• .:. s. _ Direct or power vented .. aan,na comousuon `,� (� Lnr= or power ventedI y - nonsolid, fop] ❑ Sealed combustionhomes IIatrcall vent., Y ? =solid fpei O Almosphcricallg vented Dine( ar Power vented 177 — • .._ _ _ ... ..... _ ❑ Atmo�enhariratly vow...1 11�91X=CWY VenTPG SW d - • •-••� Yfl 1121 vcrncv I i+hpvtver vett,=d.n p fa;*„J- tg is iastadle t>9 flow is rest red:for BsylS ' d t j,at: d+ an via}Le�uP air to matci5 —...1..� �vV.1t'iGb oxceeds:3i�•''�• Part Ci. '6ENTTATION {i���'v7#t�latat� mu��.l�•prmriisl�,ger:tb_p _ � ' eaq - :►1?t}'-. Gu3sted•flelDwj or�io feet: X.' �.�; � `' ' ,: , . • .. .. ... .. ett> j}''af`grit.>.'voifl(f�ednooM)'l:dfri'- efpt Check modtod(s);nposed 4 ' D Exhaust only fie Balanced (heti r=overy vend lator, air Fan description or location + Yt 1._ R-i'1,I c _ _j a,r_ Statement of Cbmppllance: The proposed building design represented in these documents is consistent with the building pians, apceiAeatfona, and other calculaIms submitted with the perms application. 7ba proposed building has beers designed io meet tits requ anti orae Minnesota Energy Code. nt (print m) z —J&Y-_ 26 s- y13 Yf-77 4' 7 4ppliesrtt (print name) ^� Signature Dam Telephone number Part C2. VENTILATION ATIO (Subrrdt Part C2 upon Completion orsystem verificationt) x---------------------------------- +obSitcAddrtz;-------- -------------------------- Permit Number Fan t�c,C;npd on or:ltxat*M . • i �ML1 = errn. Cfm T Venriladon rete tnus{'bs m�.s�tued and v tifi�d v�hen~tte•perfotTriai,ce.,�pgo�,,;s'dsiai o lieu o� th. prescriptive optiao far the seal' of 'oitrts in.the bus? .c6ndidot;itd t6v4 •om •Pm t I§ ll CMOs= Statement; Installed ventilation system is in t:omplian= wit now, h Mid Sr=gy Cade and is sized tp provide the Bosign air Dcant tprini name) Signatum Dote Telephone number NEW i CITY OF FRtDLEY ADCN j j 6431 UnW.Mky Ave NE. FeArl. MN 88432 ALTER j j SINGLA PAtALY AND DUPLEXES R-1 AND R-2 SUB'CONTRA•C'FOR LIST - EtTo We 1/1/2002 (763) Gn-W04 Bldg Insp Address LInr�S ju Perrriit # General Contractor Meadow. View .8omea; . In' n'er• Jeffrey •L. Crim 'Plumbing Contractor Rdb 'Garin Pbugbirig; Inc•f • - 'Heatirig Contractor . Air mecY nical, Inc. 'Sewer/Septic Contractor' Asper s, bccavating;' .Inc. `Water Contractor ion Casper's Ekcavat3.ng, Irid /R•.A..-41acG1over 'Constriction and StOne' 'Fireplace Contractor Lawn Sprinkler Contractor. N/A, 'Swimming Pool'Contractor Excavating Contractor ' Casper•'s 16cp rating; Iric./fi: A;. MacGlover Coristniction Masonry Contractor J.Z.' Masonry, 1;rY d. , Insulation Contractor f6rd'ic Insulation; Inc: Blacktop Contractor ' ,�.ind-laXes Blacktop, � Inc. Stucco Contractor Roof Contractor M�teriors .by 'Mendel]. ' `Separate permits arb required, NOTE: ALL contractors must be,licensed'and Insured,' CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1Z5'/ ADDRESS : 1552 WOODSIDE CT NE PIN : T000070 LEGAL DESC : THEILMANN ESTATES LOT 2 BLOCK 2 PERMIT TYPE ELECTRICAL PROPERTY TYPE MULTI DWELL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT NO.: 2004-02150 DATE ISSUED: 11/22/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. 0;0 # INSPECTIONS # 0-100 AMP CIRCUITS 0 # 101+ AMP CIRCUITS APPLICANT SOLBERG ELECTRIC INC 19941 IGUANA ST. NW ELK RIVER, MN 55330 (763)753-0074 OWNER MEADOW VIEW HOMES INC 14621 ABERDEEN ST NE HAM LAKE, MN 55304 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 wort 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 (NON-RESI) ELEC AMP SERVICE FEE ELEC CIRCUIT FEE (0-100 AMPS) ELEC CIRCUIT FEE (101+ AMPS) STATE SURCHARGE, ELEC FLAT ELEC PERMIT FEE - MIN (RESI) TOTAL PAID WITH CHECK # 681526 SEPARATE PERMITS REQUIKED rUK wUKK U I Ilex I HAIN uG3k tuacu r%n%J V L�. 4 0 100.00 0.00 0.00 0.00 0.50 80.00 80.50 CITY OF FRIDLEY PERMIT NO.: - 2004-02156 � 6431 UNIVERSITY AVENUE NE • FRIDLEY, MN 55432 DATE ISSUED: 11/22/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1552 WOODSIDE CT NE PIN : T000070 LEGAL DESC : THEILMANN ESTATES : LOT 2 BLOCK 2 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. # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 9880 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 0.00 35.00 AIR MECHANICAL INC 16411 ABERDEEN ST NE GAS RANGE FEE 0.00 HAM LAKE, MN 55304 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT GAS PIPING FEE TOTAL 0.50 10.00 70.50 OWNER MEADOW VIEW HOMES INC 14621 ABERDEEN ST NE PAID WITH CHECK # 029318 HAM LAKE, MN 55304 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 other state or local law regulating construction or the performance of construction. Applicant Date Bldg Ins Dat/ZA224 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 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 Lf JOB ADDRESS f p RATE SCHEDULE Fie Total Residential Owner Id Furnace Shell and Duct Work, Burner & ® .-- a f ++ also Replacement Furnace $35.00 $ 3 6, Building Used As 1 � Gas Piping (New Furnace, Fireplace, Insert) - $10.00 $ ��� ESTIMATED COST 90tCo. PERMIT NO Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ (Wa # of Heating U is / Circle One (Steam) (Hot Wat rm A' Trade Name: 0 C (6 g bbl Jif ® g® - l Z Size No. *Air Conditioning- AllSizes $25.00 $Q�9,o BTU s7n rlro 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 TOTAL FEE $ MLD Signe�_l 1, 0 fArd LIW Tel #WciR 7. q-6-3 74� REINSPECTION FEE $50.00/HOUR FAX # �G:i� - ,[ Date 1 f *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 0- 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 replacina 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 anew 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 PERMIT NO.: 200402196 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/30/2004 ( 763) 57Z -36U4 YAX: (763) 571-11I37 ADDRESS : 1552 WOODSIDE CT NE Po 4 PIN : T000070 LEGAL DESC : THEILMANN ESTATES : LOT 2 BLOCK 2 PERMIT TYPE : PLUMBING PROPERTY TYPE COMMERCIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION $ 0.00 # BACK FLOW PREVENTERS 0 # CATCH BASINS 0 # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # OF NEW FIXTURES 15 # RAIN WATER LEADERS 0 VALUE (FOR MINIMUM CALL) 300 APPLICANT PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) 150.00 0.00 ROB GARING PLUMBING 2770 174TH LANE NORTHWEST CATCH BASIN 0.00 ANDOVER, MN 55304 RAIN WATER LEADER 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 BACK FLOW PREVENTER STATE SURCHARGE, PLBG FLAT PLBG PERMIT MINIMUM FEE 0.00 0.50 0.00 OWNER MEADOW VIEW HOMES INC 14621 ABERDEEN ST NE TOTAL 150.50 HAM LAKE, MN 55304 PAID WITH CHECK # 6469 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 other state, or local law regutatmg—c�nstrfiction or the performance of construction Bldg SEPARATE PERMITS REOVIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. 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 Stories : Urinal RATE TOTAL New Fixtures Wash Tray I>: Floor Drain :.:::::::: Au:>:< tosher :::::<::.:::..:::•: ..Ran Gas a <'> :.... Wa er Heate r t ........:.:.:: s Elect Ga Basement e $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric Floor 1 $35.00 >«. $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Floor 2 Type $15.00 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $10.00 1!5-0 Iva 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 TOTAL FEE JOB ADDRESS 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. DATE: //_ -3 0 0 Y 20 OWNER ®l Ce��u &,'/'cJ b64q el - BUILDING l' BUILDING USED AS /V,- <" I -101n �_ ESTIMATED COST PERMIT NO. PLUMBINGCOMPANY SIGNED BY (�/�� ��ri �' TEL N0.7e--J" -�3 _ //- Approved By $ .50 Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST $ OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE t 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( ) i The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and terminatidn. 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 Fum�ce V6nting Tables for fan assisted and natural draft appliances. Yes () NO( ) 16 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 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 N'AX: ADDRESS : 1552 WOODSIDE CT NE PIN : T000070 LEGAL DESC : THEILMANN ESTATES : LOT 2 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FEE SHORTAGE VALUATION NOTE: PERMIT# 2004-02150 ENTER FEE AMOUNT APPLICANT SOLBERG ELECTRIC INC 19941 IGUANA ST. NW ELK RIVER, MN 55330 (763)753-0074 OWNER MEADOW VIEW HOMES INC 14621 ABERDEEN ST NE HAM LAKE, MN 55304 25 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 wort 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. App / Date i 1 Bldg 571-12N7 PERMIT NO.: 2004-02324 DATE ISSUED: 12/23/2004 89632 FEE SHORTAGE AMOUNT TOTAL PAID WITH CHECK # 681668 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 25.00 25.00 ......., .. ,.. :.>... :�- ... s:yr �,� .... .. :� ?4},asH.�;.•.Rv,!.iKti�;i 3. }:a .-eti:: �¢wi ; ORDER FOR PAYMENT NO. a 2 cy, �—a1I.SD R Installer of Wiring _ .•SG/;E (2 -ea ,y Owner/Occupant_& •_A.,rv c'y V Z l /��-✓! '5 Job�-- Property Address _ %s� -2- " lejoc),45t zip �- Date /— -/` ^ G Y Permit No. 1--6 $!! 4 9 / � Date Filed CD Additional rough -in Inspection was required. O No access - scheduled Inspection. O Fee shortage - see computation. O Reinspection fee. Fee Computation: //-/ ?- r- Y d S c " 76 o - ti,' A- S y 3 a o' G Please return this order with your check In the amount of��• Dayable to the city/ township by (date) %/-Z-�0 d � Inspector (_ �� siva Telephone 65-1- 72 %- 7 45 RETURN THIS ORDER WITH PAYMENT TO THE CITY/TOWNSHIP WHERE THE JOB IS LOCATED. RC -02 DS- o©g 7? CITY OF FRIDLEY NEW. ° b [� ] ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763),6Q4!BicJg Iljp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) T1-T2t37 ax' BUILDING PERMIT APPLICATION(0 " Construction Address: 1.5SZ W rre" C'T Legal Description: Lr-t- JUt L<- Owner Name & Address: U u -j f 0 -'e _Tel. # 7(J -7S7 -73Z o Contractor: /V� 1-1. t.w Ike, -w MN LICENSE #. Address: 1gQ1 _&64erc, j=2!,• _�1 F, t-, 4J, M 1v/ Tel. #_ LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Surrey 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 f Z Width i y Hgt/Ground Sq. Ft /C8 �4 40 Construction Type: a Estimated Cost: $__4_9 00.00 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: `'/a c�S APPLICANT: 1Z Tel. # (o12 -f6 0 y3 Y 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 $ ' 1 - o� STIPULATIONS: l !Y�--------------- 2 X-Vt o I`"d.C. 3 1 zk ro8,x � 2xta k-6 a:�ee4v;cf �4�t i 1- 2x '�Q WU CS �x6xi2 �r Pte" 1 Building BUILDING Permit No..(O-0_13/ Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: g �� 763-50 2-4977 FAX EFFECTIVE 1-1-2010p g DATE f 24 r L'% YOUR E-MAIL ADDRESS t04 tA, /ff'7 '4A_fl SITE ADDRESS Z S Z �O0 C7 O Sly E G- G C' THIS APPLICANT IS: ❑ OWNER OCONTRACTOR PROPERTY OWNER/ /� NAME: 6A66 TENANT ADDRESS: /19S2— 6/ V-1,9_rra& C -c -l -a -f CITY �'--tZe,:: rSTATENZIP PHONE: CONTRACTOR NAME: E `b1- C-0 N r�yv�►—��,✓ SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # (1C�'7!8 Z— EXP DATE ��1_.e_Jt AND CERTIFICATE OF /1� ADDRESS: �f// I ®GG{"�is(/�-SF CITY STATEIK,wZIP O/% INSURANCE PHONE / Z/ FAX PROPERTY TYPE 0 SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR XREMODELING DESCRIBE WORK BEING DONE: �f S�O�Iti _��/� ✓l i /, Gd -, C / rJ r® N Fi W 6/ .46 6 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING O HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ¢USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ bd . C110 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 $ .0005 x Permit Valuation Minimum $.50 License Surcharge $$5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 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 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 on site; that the work will be in accordance with the approved plan in the case oP6�A4 1 wo t requires review and approval of plans. SIGNATURE OF APPLICANT TM PRINT NAME PRU`G' S'6 40 LADATE 1/7-1/to, is 2x+ Sc -5'6-t1lo ,, ��q k zll gxt�c�