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PRE 2010 DOCSCity of Fridley, Afinn. 16 3. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BURDENG PERMT Date: - September 1- 1972 owner: ___. Richard Miller Homes Builder Ramp Address _.._...kQQ_Rie Greek Road N E _— Address Same No. 1624 ____, Street -Woodside Court X.E. , Part of Lot Lot .._._._...1_ Block _-2_ _ _ _._..___. Addition or Sub -Division it i ea Corner Lot Inside Lot X Setback 35 Sideyard 5 ' 4"Vr Elevation __9 07.59 � bA"dWck/iY4jt(dn/ 91 O -5.9---M in i nu im ye Top of Footing DESCRIPTION OF BUILDING To be Used as: 20' 24' Dwelling Front _ 22' Depth 261 iieight 2 O t Sq. Ft. Cu. Ft. Garagg _.._._ _ r _ Front 19'.8 Depth - 22' height _10' Sq. Ft. Cu. Ft. Type of Construction Wood Frame Est. Cost _. 29 982 To be Completed 2 months _ Stipulations: Provide a hard surface driveway. Provide a verifying survey before capping. 2 x 6 joists overspan. Submit redesign before rough in. $270.29 due for storm sewer escrow. WATER LOCATION: 10' E. of Sewer, 28.4' SW of Manhole, 14.6' W. of Hydrant SEWER LOCATION: 261 W. of Manhole (Inv. 907.75) In consideration of the issuance to me of a permit to construct the building described above I agree tq do the proposed work in accordance with the description above se"rth and in compliance with atll provisions of ordinances of the city of Fridley. 4-.,' -.--, 14.99 9ta In consideration of the payment of a fee of $4ZQQ _ _, permit is hereby granted to, RJab a rd Mi 11,er..Homes to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiriggBB m6thin the city limits and this permit may be revoked at any time upon violation of any of the provisions of Said ordinances. CLARENCE BELISLE NOTICE: This - pormit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sura to see the Building Inspector for separate permits for these items. S APPLICATION FOR RESIDENTIAL, ALTERATION, l OR ADDITION BUILDING PEP41T CITY OF FRIDLEY, MINNESOTA /;//OWNER'S NAME:. � A® hoMeB ILDER: fG40 ADDRESS • ADDRESS: / �T NO • STREET • W a� `� G Q t% LOT; % BLOCK: ADDITION: f2RI AP A( -F CORNER LOT: INSIDE LOT:SETBACK: SIDEYARDs Applicant attach to this form Two Certificates of Su_ rvgj of Lot and proposed building location drawn on these Certificates. DFep&RSL ON OF BUILDING To Be Used As: dsx&_ If C.()eLi.w-4 Front • Depth • Height: Square Feet: Cubic Feet: Front: Depth • 'Z �t, Height • �® Square Feet; Cubic Feet: Type of Construction: Estimated Cost: 9 .wlee To Be Completed: The undersigned hereby makes application for a permit for the work hexeiU specified, agreeing to do all work in sttict accordance with the City Qf Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and represel tions stated in this applicatton are true and correct. DATE: SIGNATURE: (See Reverse Side For Additional Information.) Lund Planning sr`�r�$ Q��'? 6875 Highway No.65 N.[. Land Surveying • • Minneapolis, Soils Testing ' P ,��• Minn. 35431 Civil Engineering 01Telephone 786-6066 Municipal Engineering Engineers & Surveyors Area Code 611 of Survey for ieW Certificate 14tGP W0.4f4"s rtificate Y NORT N WOOS/Di- COURT _ ..—L. 1 75.05 w f'Ro Sep_ ' fYi N VILCA G �- 5=0" L! Zo' Zo• I O N I h- - - - - - - -Js 7507 I W -T I BLOCK 2 BRIARDALE 0 moles iron monuman� ,40 Coun'b. ------- Uande; Dromwk4E U�iii4y„LatiQmanT 1 hereby certify that this iiC a +rae and correct representation of a survey of the boundaries of the above described land, and of the location of all buildin sr therocln, and all visible encroachments, If any, from or on said land. As surveyed by me this day of rc t, r- A.®. 1972_ lL SU`UR®AN ENGINEERING, INC. �n �QQ engineers Swrveyors 001, A /may �� 1 r� ✓ ` ® 7. 7S) 3 i 2� Z --------------- City of Widley Applicafl" Dept. of Bldgs. Phone 560-3450 � DESCRIPTION OF WORN • Number, Kind and Locatioa of Fixturesf.+r/ �/ s Iii V II ISI d I 1 I iI�I Igol� aI<I�I Iv. 1 l ®I :IG WATERR. M. MIFAMN 2nd 3rd PARTIAL RATE SCHEDULE PLUMBINTG FIXTURE RATES: NO. IRATE 'TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $ New Fixture Old Opening .......... . x $1.50 $ Catch Basin .................... x $3.25 $ �J Water Heater ;Up to 99,000 BTU) .... x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water Heater .............. s $2.00 $ :;AS FITTING FEES: NiO. RATE 'TOTAL 1st 3 Fixtures . • • .. • ...... • . • . x $2.00 ; c "� - Additional Fixtures ................. x $ .75 $ Gas Range to 199,000 BTU.. . ,.. , .. , , ... x MOD $ , REPAIRS & ALTERATIONS --Refer to Code lo'410 Description ....................................... .. -$ TOTAL FEE City of Fridley: The .undersigned hereby makes application for a permit for the- worts herei specified, agreeing to do an work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn- &®c/ IV 29�� Owner t A&0— M;1-ccnm Kind of Building>��' Used as To be completed about Sr,#0V' Estimated Cost, $ l(t/' a®+►s Aiair—New. Building Permit No. Permit No. Signed ffiffigAw`G • By. Business Phone ROUGH FINAL Applicafto for Poweir PkM OW H 1 , Ye n, Re ge n = Air Corelitioning Systemes -and Devices PARTIAL RATE SCHEDULE GRAY?TY WARM AM- RATE TOTAL Furnace Shell & Duct Work ...... .:................. $10.00 $ Replacement of Furnace ........................... 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 ' $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............$10.00 $ 10-.00 each add. 80,000 BTU ....................... &00 # Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 8.00 $ Repairs & Alterations each add. $500.00 .............. 8.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .. .$10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ...............:...... &00 ' $ Each add. 320 sq. ft. IDR Hot Water ..... 3.00 $ OIL BURNER to 3 gal. per hour ....... ... . .... ..... 8.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTI) ....... I ............ 8.00 $ 5.00 over 199,000 BTU See. Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ................. —4100 $ 2.00 Additional Fixtures ................... - ' 'x .78 $ Gas Range to 199.000 ........... it 800 $ AIR CONDITIONING WEST. ' S LO 361 61(30 ton j $ lR_nn FAN HEATING SYSTEM See Fee Schedois VENTILATING SYSTEM Surcharge $ . 50 ALTERATIONS do REPAIRS TOTAL FEE $ 35.50 � FINA 6 -,,g C/ - % Z_ Dept. of 1014[7. Phone 880-3480 ` T,,....a,... 1600 Rice Creek Terrace t, 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. Fridley, Minn Nov. 2 0 . is 42 Owner RICHARD MILLER HOMES Diad of Building Frame Used as Residence To be completed about 12-227,72. Estimated Cost, $ $1430.00 Old—New. Building Permit No. Permit No._,��L�J DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No— Trade ir—No Trade Name Westinghouse size No FGUB-110 P Capacity R A n nr 0 Sq, Ft. E.D.R BTU H.P. Total Connected Load Sind of F%ml Gas BURNER. — Trade Name Westinghouse size NSFGUB-120 P Capacity. 88,000 Sq. Ft. E:D.R BTU H.P. Heat loss attached. SALT SMAI� john Aorry h BucinessIREAFED N0 VOGT &COi ING 8 AIR CONWI(INING iRMwRKs-ovOi 3260 C"A m &ay 2 9201-6767, SL go* 1 "M 53-84—S-915.51 �:a6l y PARTIAL RATE SCHEDULE MUNNING nxrmc RATES: M06 RATE 707" N=bey FixtuTes . . . . a . . a . a a a . . . m tune msture f"'penIng .mom Z—. . a $ $l•50 S_ New FIxtiare Old Opening ...... m m o m It OI $ Catch Bassa ............. Water Heater 'Up to 99.= 3M. x 33.00 t New Ground Run Old Bldg. . ®. a .. m . x. S- EkwbkWater % q�.......os..o.. s �` o d0 GAS VTMXG FEES: NO. RATE TOTAL lot 3 Fixtum ...... • ....... • . • • x $.00 $ IIInxtum . a ............. x 6.75 _— 5 On to o BTUs e •. o s a•• ..• RMP x $5.00 -*00 I • State surcharge $®.50_. AnM & ALTERATI® to CO& _DftaipUm.•o••ss•oss.ae.00.c...as oao...00 aa aoeo ea-oo4 TOTA16 j 5.50 001 'r.mmowga Va rDm 53 -81,E -s-915.51 City of Fridley Appii aba fw FIzzMag cmd G= =� .ung Pondt Dept. of Bldom. Phone 5W-3450 DESCRIPTION OF WORK 1624 N: E. Woodside Court Numbar, Kind and LocaLflon of Fixtures Loeaffan ap p I; Q S F to ►°t. O X71 n. O V 6 i (�Y ¢ �U' o� N (�y P N1 WATER MIR. GAS ELEC. Base 1st In to Ll Gas Gr 11 2nd 3rd 4th • Future Coae®eYfios O Wnings l `'v"'aW` AM W"" Bawer p • New Fixture. Old Ops Ce=pool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... , ........ x $2.00 $ Future Fixture Opening ............ x $1.50 $ _. New Fixture Old Opening .....:.... . x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 99,000 BTU) . • .. x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater........... : $2.00 $ -VAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... • • • • • • x $2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU.. . x $5.00 $ City of Fridley: The .undersigned hereby makes application for a permit for the- work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct' Fridley, Adiinn 8-13-74 Owner Larry A. Seavant - Kind of Building Frame Res. Used as To be completed about 8-20-74 Estimated Cost, $ 10.00 Old-- Building Permit No. Permit leo. Signed Business Phu No�±��• �II�EG®S�0 ROUGH REPAIRS A ALTERATIONS --Rotor to Code .50 State Surcharge Description ...... Install Gas. ;Grill ........... 5.00 TOTAL. F= $ 5.50 or S.ur_r harge, .509 ' City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING - PERMIT PE ® 20207 r COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC: CITY HALL FRIDLEY 55432 L 612-571-3450 R NO. NUMBER 910-F15 REV, DATEPAGE 11/27/89 OF APPROVED BY JOB ADDRESS 1624 Woodside Court N.E. 1 LEGALLOT DESCR. NO. 1 BLOCK 2 TRACT OR ADDITION Briardale Addition SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg Nelson 1624 Woodside Court N.E. 572--8014 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Panelcraft 3118 Snellin Avenue South. M ls. MN 721--6628 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW X❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 121 x 10," Three Season Porch Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $2 550. SURTAX $1.28 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- S` TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $54.00 X PLAN CHECK FEE TOTALFEE $55.28 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) - WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT /l a SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI BLDG INSP PATE NEW { Effective 5/1/88 ADDN [ R-1 AND R-2 ALTER [ ] Building Permit ApplicAtion Construction Address: ,'Y z— V wj-'p SI PE c-77 Legal Description: Owner Name & Address: 61%'E67 �yeZ5aA /6,?- ed,51ol= i ,W t/26L� Tel. # 3- 71.- �Y0/ Contractor: 11�4,Z3Z-C,',Tel. # i d�K-z'Y Address: jf` S� L L L j� �/ %Z C - 5c, r'� > Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVMG AREA: length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK pp(�AREA: L!�e�+�n�gth idd/�® a� tshi 0 Hg�gt/Gro49 lund / Sq. Ft. 120 } Corner Lot [ ] Inside Iat t\ -T Ft. Yd Setback 3 � J Side Yard Setbacks Type, of Construction: c cp"0; Estimated Cost: $ Approx. Completion Date: iZ XT/ `z ISSO Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: /Z/4- A' ` APPLICANT: Tel. # 721 /�2-9 CITY USE CINLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ►STIPUTA IONS : � ON Permit Fee $ State Surcharge SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ OT r TOTAL lvilyL $ s CITY USE CINLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ►STIPUTA IONS : � SUBJECT P City of Fridley 24756 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir COMMUNITY DEVELOPMENT DIV. 1 v PROTECTIVE INSPECTION SEC. 36� r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 11/5/96 JOB ADDRESS 1624 Woodside Court NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Briardale Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg Nelson 1624 Woodside Court NE 572-8014 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sela Roofing 4100 Excelsior Blvd, St Louis Park, MN 55416 823-8046 1050 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (24 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS 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 $.99 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,980 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- $62.25 Fire SC $1.98 STRUCTION OR THE PERFORMANCE OF CONSTRU PLAN CHECKTOTAL FEE LicensFE SC J.00 IT $70.22 SI ATUREOFCONTRACTO ORAUTHORI DAGENT IDATEI FIR LY VALII A�TED THIS IS YOUR PERMI B iNSP r�A TE S,GNATURE OF OWNER OF OWNER BUILDER) IDATEi " NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: J ° 0 Legal Description: Owner Name & Address: &V -CC -1 iv -e I S n tAJ Effective 3/1/96 Tel. # S^7 Z- - 9- 01y Contractor: MN LICENSE # SELA ROOFING & REMODELING, INC, Address: 41QQ EXrFLSIQR BLVD- Tel. # _ ST LOUIS P� I ,on, a Certificate of Survey of the ot, wi proposed construction drawn on it to scale. P P DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: . (A it- Corner Lot j ] Inside Lot [ ] Ft. Yd Setback ~ Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost ' "on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft Ft x $ _ $ DATE: / % APPLICANT: Tel. # CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: ® v 4 $ l�'�5~ Fee Schedule on Reverse Side $ /. .001 of Permit Valuation (1/10th%) $ $.501$1,000 Valuation $ $900 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 f ] CITY OF FRIDLEY INSPECTION DIV. 3431 University Ave NE Fridley, MN 55432 572-3604 Effective On Jan 1, 2000 &/�S /6/ APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON FACH FI MR 160?-`? Z( -)JO SA � (7;— PLUMBING FIXTURE RATES: NO. RATE New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas**_ Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 TOTAL JOB ADDRESS 540E- dtS &.40i✓ 12— The 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 reF and correct. NELSON, GREGORY 1624 WOODSIDE COURT NE FRIDLEY, MN 55432 Owner (763) 572-8014 Building Used Asi��Jlp Estimated Cost PERMIT NO. PLUMBING COMPANY L15rk=M /PLO AJ(, Reinspection Fee $47.00/Hr SIGNED BY TEL NO.��"S�I ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date . 2"/3 . o State Surcharge $ .50 MINIMUM FEE OR ANY PLUMBINGIGAS PERMIT IS $20.00 TOTAL FEE $- PLUS THE 5.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A COMMON VENT INFO ON BACK SIDE Film PLUMBING FIXTURE RATES: NO. RATE New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas**_ Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 TOTAL JOB ADDRESS 540E- dtS &.40i✓ 12— The 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 reF and correct. NELSON, GREGORY 1624 WOODSIDE COURT NE FRIDLEY, MN 55432 Owner (763) 572-8014 Building Used Asi��Jlp Estimated Cost PERMIT NO. PLUMBING COMPANY L15rk=M /PLO AJ(, Reinspection Fee $47.00/Hr SIGNED BY TEL NO.��"S�I ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date . 2"/3 . o State Surcharge $ .50 MINIMUM FEE OR ANY PLUMBINGIGAS PERMIT IS $20.00 TOTAL FEE $- PLUS THE 5.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When reaiacina an existing furance, 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 specifcatiorns :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 appliancehas 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 INSPECTION DIVISION Effective On May 10, 1999 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 /4-7hlolra S/q& RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 $ -30,.09 (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, $ 10.00 but not replacement) Gas Range $ 10.00 Gas Dryer $ 10.00 $ *Air Conditioning - All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge $ 50 TOTAL FEE $ 5.x,50 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IU225.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. OWNER_ Greg 4 Pam BUILDING USED AS Kesamlmee ESTIMATED COST PERMIT NO—MCC2 (0 DESCRIPTION OF FURNACE AND OR BURNER. No. of Heating Units Circle One (Steam) (Hot Water) arm Air Trade Name Pt M-6i;n4 Size No. BTU rz00 HP EDR Fuel_ &P/ r _ Total Connected Load Burner Trade Name Size No. BTU HP 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 an rulings of the Building Division, and hereby declares that all the facts'and representations stated in this application are*true and correct. HEATING CO ShPei 97el�-( J,/, c Signed _ _ DATE - /3 Approved By Rough -In Date Final Date CHINi ENEY AND STACK VERMCATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Ye (Y,) No ) 2. Is free from rust or. deterioration Yes o 3. Has no foreign objects lodged within Yes ( No ( ) 4. Is securely supported Ye (%A) No ( ) 5. Meets all current„Code requirements for size and total BTU's connected es ('X) jai () 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ()Q o ( ) 8. Has combustion air been provided for water heater/res (jt) o ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: &17'e �/ Thr f2 -i3 .Vi” CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763-572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Effective On January 1, 2001 �� JOB ADDRESS RATE SCHEDULE � (° ( 1 � l./ _- \��r C�'" pC )'1 � ��/1� Residential � �/ Rate OTAL OWNER yv Furnace Shell and Duct Wor, Burner - BUILDING USED AS Also Replacement Furnace $ �r7 '� (Side Vent - Fill Out Back)' ESTIMATED COST PERMIT NO. Gas Piping (Needed with new furna e, $ 1 0 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work $ 10.00 $ $ 10.00 $ $ 25.00 $ 9S, n State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. No. of Heating U it's l Circle One (Steam) (Hot Water) ( arm Air) Trade N me �y�LC1'`�r� 1'?S't Size No.G' l fJ$Ut BTU cm HP EDR Fuel Total Connected Load h i'rr,,:tYrN1(j, a/a_ i7,, k� I r1 c� . Burner Trade Name Size No. BTU HP 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 7 I HEATING CO S� �U'R� �1 �� ry) PW !e Signed �� ( TEL # (6 3 —� l Approved By &A_ Rough -In Date Final Date BACK SIDE MUST'BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 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 : Building $ BUILDING Permit No.: - - Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date Recd: Fire Surcharge $ 0)(yes ` cc�'1 DATE YOUR E-MAIL ADDRESS i° . 1 SITE ADDRESS yy SAC Charge THIS APPLICANT IS: ❑ OWNER ONTRACTOR $1450 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: ADDRESS: �• CITY STATE ZIP TENANT PHONE: Park Fee CONTRACTOR NAME: PELLA WINDOWS & DOORS Fee Determined by Engineering Sewer Main Charge STATE LICE 15300 -25TH AVE. N. STE. #100 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:— PLYMOUTH, MN 55447 CITY STATE ZIP WITH APPLICATION PHONE 763-745-1400 ❑ SINGLE F LICENSE # 20165884 PROPERTY TYPE ❑ TWO FAM. ....... _ _ TRIES PERMIT TYPE ❑ ADDITION . ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAIN TENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: L Le1%r n o SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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 OR FOR NEW OPENINGS -DESCRIBE SIZE OF 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) rAL JOB VALUATION Permit Fee $ 5' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ , CSI (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ , DD .001 x Permit Valuation (1/10%) License Surcharge $ 5. Cyo $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ �l(. �.� 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 applic ' for a permit 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 is equires a andapproval o Tans.��,/�, ,,- 1105 SIGNATURE OF APPLIC NAME I `�w �l _I/1 Wyl DATF��