PRE 2010 DOCS3.1
SUBJECT
PER
City of Fridley
12590
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
REC
�y------- COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r � �
t �
� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
�`•-'� � ,`� 612-560-3450
si 0-F15
16/14/74
JOB ADDRESS Woody Lane N.E.
1 LEGAL
LOT NO.
BLOCK
TRA CT OR ADDITION SEE ATTACHED
DESCR.
4
1
Meloland. Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Gordon Aspenson 17 Rice Creek Way N.E., Fridley
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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 0FWORK
$1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Construct a 40' x 26' Dwelling and a 20' x 24' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before
capping. Soil at rear house line to be checked after excavation,
SEWER LOCATION: 61' N.E. of Manhole (N. Inv. 895.60)
Wye Elev: 896 .47
Top of Footing:899.55 Minimum
WATER LOCATION: 10' N.E. of Sewer Service
SEPERATE PERMITS REQUIRES FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
1040
28,600 To
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I 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
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
12.08
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$24,173
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$53.00
X $300.00
PLAN CHECK FEE
TOTALFEE
$365.08
SIG . TUREOFCONTRACTORORAUTHORIZEDAGENT (DATE)
PRRAOPERLY V IDA ED THIS ($ YOUR PERM T
q
�IGNATUREWNER
/WHEN
BLDG. INSP DATE
EO ER BUILDERI (DATE)
3.1
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME A)
.�BUILDER:
ADDRESS: .17-111faE ADDRESS:
NO:. STREET: cr of
LOT: Z/ BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: t-- SETBACK: —SIDEYARD: 5--fV0
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
5 le Front: D - epth: 'T C Height:
l
Square Feet: A &-&� Cubic Feet: -j
Front: Depth: , 7�_
Height:
3,
Square Feet, Cubic Feet:
/-/ 4,
Type of Construction: Estimated Cost: $ S,67000
To Be Completed: AAV
—40
The undersigned he makes applk�a—t—in n for a permit for the work herein
specified, agreeing to do all work in st-kict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: SIGNATURE:
(See Rev/Se. S.4
de.For Additional Information.)?
"J
'-o
fP
'j d
H.C.
HEM
,.�.. ° ASS0,21ATES,
10130 CENTRAL AVE. N.E. (Hwy. 65) —BLAINE, MINNESOTA
712
SOUTH
MAIN C CAMBRIDGE. MINNESOTA
CERTIFtCATE OF SURVEY:
Lam-- A. R% rm-v I k
CIVIL ENGINEERS
K 1408'90 M
689-4798
P
Dr=N,, IROM
.
400s zoo
o Ash A f.,.
2S'
of
r
9 9 EL.®WINP40
L.,AKevis d9 AwoKA courqW,
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EPS.
CROACHMENTS, IF ANY, FROM OR ON SAID LAND.
AS SURVEYED BY GSE THIS... . .....DAY OF .....§§. prl ............ .........A.O�. p9.7 .........
N.C. HOIUM AND AS TATE C.
r � +
�..... .. ... ..C ` ✓
Minnesota Rogisteotion Ido.... .........................................
?S17
i+C1n9 qx':Y.a.�.•d`4KaatmAq,.ncuP-k-a zmb"GaN'+
4 :d w^Y-••m nd6'�m6arn.at. m �riBL: 4toCs1 cad ySa�^vetea r.
vP H 7vw-.'1
PARTIAL PATE SC:$—'aEDU;..E
GRATITT MAIM AIR:
l' A—AN:
TOTAL
F==<e Shell & Duct Work
310.00
�
Rey;a^rrnn:t of Fsrnare
6.00
$ &F -o"
P.cpat-c & A trrat.ons--up to $580.00
6;:3
S
Repairs & Alterations each add. $584.00
300
$
IMML WARM AM
Additional Fixtures
a .75
FVrrsace Shell & Duct Work to 220,000 BTU
.11000
X3 5.OtD
etch add. 60,D00 BTU
3.V)
S
Repiacer mt of Furnace
6.00
S
Repairs & Alterations --up to 8580.00
6.00
$
Repairs & Alterations each add. $588.Q4
3.00
$
STEAM az HOT WATER 6YSTL-M
Furnace Shell & Lanes— to 4;0 sq. ft F.DR Stea.^.i x10.00 $
Planate She:1 & Line --to 640 sq ft. EDR clot Water 1000 S.
Each add 200 sq. ft. EDR Steam -Ann
$
Each add. 320 sq. ft EDR Hot Wader 3.00 $
OIL SUPKEP.—to 3 gal. per hour
6.OSD
S
over 3 gal. per hour—See
Fee Schedule
GAS IitMN-11"R (up to IS9,000 BTU)
5.00
$ &F -o"
over I99.000 BTU Sme Fee Schedule
GAS FITTING r=.
NO RATE TOTAL
Ist 3 F.xtures
z$ 2,00
$
Additional Fixtures
a .75
S__.
Gas Range tb 199=0
X3 5.OtD
3
State Surcharge
.50
AIR Co"4iiaolTII;G1
$
FAN Fi .. iLTL G EYE=
Sze 7,00 �t ter. aI9
VI.a TII.� TM2 STSTIA"
$
ALTZRATTOPM & FuZPAln
TOTAL. 72.M.
2 17 -10
ZL
City of Fridley:
71
The undersigned hereby makes application for a permit for the work t
specified a&rL-eir.g to do ail work in strict accordance with the City Ord.'s
and ruling of the Depas trn(,nt of Buildings, and hereby drrlares that all the
and reUr,!,Pntatiuns stated in this application are true and correct.
m
10
Fridley. Yjnn / I
Owner
v
Kind of Building
Used as
To he completed about
Estimated Cast~ $
Old �Newuilding Permit No. Permit No.
2:a:� a iY01i
OF tr onx
Iik.ATTNG or P(?WrrER__i'S.c:s—uazn. Hot Fater. arm —No
Trade Name �'v�"a`t t� Size N AP d
Capacity_.._. � Sq. TL E.D.R_ oc�- 0 BTU Ej
Total Connected rand -9 7,1®® Kind of TVel
BURNER — Trs'de Name Size Pao-� ®®0
Ca3psacity Sq. FL E.D.R BTU Ili
Cityof Fridley
1i .
d do rLti"w�Q MurN s gand m uu .°.
Dept. of Bldga. Phone SM -3480
DESCRIPTION or WOTiI{ � �® `!!�_ 9Number, Kind and Location of Fi;ctuzes
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, Pilin ® °z i 7 , 192
. wsasacsc: qua
FuMu® Co�ocfdoa Opxninp S®er®P
e Now Fizftre, Old Openinp Ccsspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures .................
.._ x $2.00
Future Fixture Opening .............
x $1.50
2.
New Fixture Old Opening..........
x $1.50
Catch Basin ...........:..........
x $3.25
$
Water Heater (Up to 99,000 BTU) . • . •
�� x moo
$ ® �
New Ground Run Old Bldg.........
x $3.25
$
Electric Wator Heaver...........
x $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ............ • • • .
x $2.00
$ •
Additional Fixtures .................
�— x $ .75
$
Gas Range to 199,000 BTU..
x $5.00
$
. wsasacsc: qua
FuMu® Co�ocfdoa Opxninp S®er®P
e Now Fizftre, Old Openinp Ccsspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures .................
.._ x $2.00
Future Fixture Opening .............
x $1.50
$R ® Q
New Fixture Old Opening..........
x $1.50
Catch Basin ...........:..........
x $3.25
$
Water Heater (Up to 99,000 BTU) . • . •
�� x moo
$ ® �
New Ground Run Old Bldg.........
x $3.25
$
Electric Wator Heaver...........
x $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ............ • • • .
x $2.00
$ •
Additional Fixtures .................
�— x $ .75
$
Gas Range to 199,000 BTU..
x $5.00
$
�I
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Per=
Old --New. Building Permit No. PNo.
Signed
By
Business Phone No- - -
ROUGH .
REPAIRS ALTERATION91—Refer to Code .50 State Surcharge
Description............................................Ti
TOTAL rEE $.o`_' '
SUBJECT
City ®f Fridley
15.3 9
AT THE TOP OF THE TWINS
B U I L D I N G P E R M I T
r
RECEIPT N
• COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
`%
PROTECTIVE
63J' l
1 �
= CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/15/79
/
JOB ADDRESS 6014 woody Lane N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
1
Meloland Addition SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Ronald L. Beck. 6014 Woody Ln. N.E. Fridley 55432 571-8152
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW Xl ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Add on a ' X 10,1tensionto an existing redwood deck-
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Redwood
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
R-1
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED,
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
75
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
99-00
PLAN CHECK FEE
TOTALFEE
$9.75
ATUR4FON�TALTO R� ORIZED
PROPERLY ATED THIS IS YOUR ERM
vENT stDATE)
LDG INS TE
SIG TURE I OW R BUILDERI IDAT I
OWNER:
ADDRESS
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
BUILDER:
TEL NO: � 1 I _ ®1 � /-1--
ADDRESS:
TEL NO:
Construction Location
STREET NO: o I STREET:
LOT: BLOCK:DITION:
Corner Lot:Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
a
cont:Depth: Height:
Square. Feet: Cubic Feet:
Type of Construct
Front:
square- Feet:
Depth: Height:
Cubic Feet:
Estimated Cost: $ �)
2b Be Completed: I
Alt. A Alt. B
Proposed Driveway Width If New opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings. and herebv declares that all the facts and
representati((s stated in this applica
DATE: B SIGNATURE:
Stipulations:
3
'
SUBJECT
City of Fridley
2 101
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r)
` COMMUNITY DEVELOPMENT DIV.
-_ _
PROTECTIVE INSPECTION' SEC
r � �
1 � �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910 -Ft 5
10/5/98
JOB ADDRESS 6014 Woody Lane NE
T LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
4
1
Meloland Addition
SHEET
2 PROPERTY OWNER MAIL AODRFSS
ZIP PHONE
Jim & Joan Hunter
571-9383
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Right Way Roofing 16475 45th Ave N Plymouth MN 55446
557-8678 3999
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 0 ADDITION 0 ALTERATION 3ft REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (22 S Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
ZONING
S0. 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
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1885
$.94
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$59.50
Firg SC $1.88
PLAN CHECK FEE
TO WLFEE
SIGNATURE Of CON TRACTOR OR AUTHORIZED AGENT iDATE,
67.32
EN R
- L ,NSR
Y ALPATED THIS IS/YOUR PERMIT
�i
6 MATE
S-GNATURE OF OWNER, of OWNER SUILOERI ,DATE,
0
NEW j" Effective 111/98
ADDN [ J CITY OF FRIDLEY
ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
)
COnStMCdonAddreSS: 6 014 Woody Lane
Legal Description:
Owner Name & Address: Jim or Joan Hunter, 6014 Woody Lane Tel. # 571-9383
Contractor: R i dht Way Roofing MN LICENSE # 3 9 9 9
AddrM: 16475 45th Ave N Plymouth MN 55446 Tel.# 557-8678
Attach to this application, a Certificate of Survey of the
lot, with dw proposed construction drawn on it to scale.
DESCRIPTION OF RKMOVEMENT
LIVING AREA: Length Width H[eight Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Width Hgt! Sq. Ft.
OTHER: Tear off and reroof, applZ ice and water ghield
,�. Xmas-, 74 _
Construction Type. Single Family dwellina EStinUWd COSI: $ 3/', . 0-0
(Fee Schedule on Sack)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
-Right Way Roofing
DATE: 9/29/98 APPLICANT: Karen Oberg Tel. # 557-8678
Permit Fee
$ , iT'o
Fire Surcharge
$ 1
State Surcharge
$
SAC Charge
$
License Surcharge
$ �L _ co
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL
9 PULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1110th %)
$.501$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractom)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary I J
CITY OF FRIDLEY INSPECTION DIViSION
(� I Do
Effective On January 1, 2000
6431 University Ave NE
Fridley, MN 55432 APPLICATION
FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
vlj
OWNELS
Residential
Rate TOTAL
Furnace Shell and Duct Work, Burner -
30,00
BUILDING USED AS
Also Replacement Furnace
$ 30.00 $
(Side Vent - Fill Out Back)
ESTIMATED COST
PERMIT NO. !"7
Gas Piping (Needed with new furnace,
$ 10.00 $
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range
$ 10.00 $
No. of Heating Units Circle One
(Steam) (Hot Water) (Warm Air)
Gas Dryer
$ 10.00 $
Trade Name
Size No.
*Air
�� G�4
BTU HP EDR
Conditioning - All Sizes
$ 25.00 $
Fuel Total Connected
Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name
Size No.
1% of Value of Appliance or Work
$
BTU HP
EDR
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
.50
$��s�
r%® -
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
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
DATE /`, '7°'
SEEM- Y -M
*Air Conditioners can not be placed in a side yard without Approved BRough-In Date Final Date l-3 --+dC4
written permission from adjoining property owner.
Ay
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina 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: 4'z ud'a/
Signed By: Date:
011
SUBJECT
City of Fridley
3368
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
'7
_
PROTECTIVE INSPECTION SEC.
01
1
NUMBER
11Ev
GATE
PAGE OF
APPROVED By
i CITY HALL FRIOLEY 53432
763-571-3450
910-F15
7/10/03
JOB ADDRESS 6014 Woody Lane NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
1
Meloland Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
James Hunter 6014 Woody Lane NE
763-571-9383
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Standard Water Control 5337 Lakeland Ave N, Crystal, MN 55429 763-537-4849
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
1522
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION 11 ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install drain the system
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels
of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash all
exterior openings.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED 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
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VAI UATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,594.00
$.80
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
Licea SC $5.00
$64.44
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE,
W EN PROPERLY VALIDATED
f
BL G iNSP
THIS IS YOUR PERMIT
gA YE
S,GNATURE OF OWNER,1F OWNER BUILOERi iDATE,
011
FROM FAX NO. : 7635371882 Jul. 10 2003 07:33AM P1
f�1 � p � 0
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 8431 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:
Legal Description: -_,
Owner Name & Addre
Contractor. p/ ,
Address:.
Attach to this application, a Certificate of Survey of the
lot with the proposed construction drawn on it to scale.
DESCRIPTIQN1 OF IMPROVEMENT`
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Gmund Sq. Ft.
OTHER:
Construction Type: Estimated Cost: S_ 7�
Driveway Curb Cut Width Needed: t~t. + 6 Ft = Ft x $ = $
DATE: APPL{GANT• Tel. #24�5.
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 e Fee Schedule on Reverse Side
Fire $ur&.c-rge. $. ..00 of Permit Valuation (IAOth*A)
State Surcharge $ — ' $.50/$1,000 Valuation
SAC Charge $ $1275 per SAC Unit
License Surcharge $, 00, 00 $5.00 (State Licensed Residential Contractors)
Curb Cut Escrow $ Alt. 'W or Alt. 'B" Above
Erosion Control $ $450.00 Conservation Plan Review'
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary[ j Not Necessary [ .J
TOTAL $ 66� 4°`,
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