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PRE 2010 DOCSApplication for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems -and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: 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 $ NECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ 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 ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ QIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 200 $ Additional Fixtures ................. x .75 $ Gas Range to 199, ........... x$ 5.00 $ • (FAIR CONDITIONING ) $_�rOU FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ 1 SIM ROUGH Dept. of Bldgs. Phone 560-3450 City of Fridley: The undersigned hereby makes application for a permit for the work hereiE 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 corrpit, Owner Kind of Building • Used as To be completed about Estimated Cost, $ 134 �01)dNew. Building Permit No. Permit No._ - DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air --No Trade Name Size No. Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load_ Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) A.. &, , j Signe By _ _ GEO. SEDGWICK HTG. & AIR-COND. CO <e Business Phone No Minneapolis 16, Minn. LI. 54611 SUBJECT PERM) City of Fridley 19632 AT THE TOP OF THE TWINS BUILDING PERMIT r R teQtLN0. • __ COMMUNITY DEVELOPMENT DIV. ' `..-- --, c, q r � � PROTECTIVE INSPECTION SEC. 4 1 ; � CITY HALL FRIDLEY 55432 �.__.11--' �•� NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 810-F15 8/18/88 JOB ADDRESS 6061 Woody lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 35 3 Moore Lake Hills SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Dave Sallman 6061 Woody Lane N.E. 574-9588 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 USEOFBUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION CR ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install skylight in kitchen (Belux, Model FS -6, 383i" x 2.111", Laminated) 9 CHANGE OF USE FROM TO STIPULATIONS 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1,000 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $25.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $25,50 CO A H IZED AGENT (DATE) WHEN PROPERLYVALIDATED THIS IS YOUR PERMIT 4IGNATURE0 GNAT R 0 OWNER BUILDER) IDATEI BLDG )NSP � TE NEW I ] ADDN [ ] AMER [ ] City of Fridley Effective 5/1/88 R-1 AND R-2 Building Permit Application ODnstruction Address: 6 0 (-, ( U C5-,nc� - Legal Description: (^ Owner Name & Address: VN.a -e- Tel. ODntractor : Tel. # Address: Attach to this application, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. LIVING AREA: Length Width Height Stu. Ft. GARAGE AREA: Length Widut - Height S3. Ft. Length Width ( Hgt/Ground,�,�// Sq. Ft. /DEEC�yKrpAREA: CDrner Lot [ ] Inside Lot [ ] A. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: Approx. Completion Date: Alt. A Alt. B Proposed Driveway Width If New OpeniIs Desired: $ . + 6' See Back Page DATE : - l - g& APPLIUM :().,7-2 Tel. # 7 q ' S' 9 CITY USE CILY Permit Flee $ Flee Scheele on Reverse Side State Surcharge $ $.50/51,000 Valuation SAC Charge $ $550 per SAC Unit Driveway Escrow $ Alt. 'A' or Alt. 'B' Above Park Free $ Fie Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIpULA�'IO[�: CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL ` Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations 19 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work RATE TOTAL $ 20.00 $ - $ 10.00 $ $ 10.00 $ $ 10.00 $ 10.00 $ State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit 1,0 MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Y $ .50 $ Job Address L-010\ IL) p(�,ay \,-2V,(2 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. ` C Fridley, Minn. ( i OWNER la \ ` �\�`�, � KIND OF BUILDINGt'ac�Q USED AS 12 G, -,k Aa c\ +.,,a TO BE COMPLETED ABOUT C(- ESTIMATED COST \4noo . OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Lxr<-ar Size No. 1 '�, SS a5 Capacity Sq. Ft. BUR BTU rI HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft, EDR BTU HP Company A Signed Tel. No. Fill out back side for stack verification on replacement furnaces Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. HEATING or POWER PLANTS, Steam, Hot Water, Warm` Air- No. Trade NameC ��%J'-�9—/ �E. Size NeZ �a s9 ��- !9q Capacity Sq. Ft. EDR BTU %1 0040 HP Total Connected Load Kind of Fuel /vel% <�,-45 BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By Tel. No. Fill out back side for stack verification on replacement furnaces CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE .... Job Address C'V d 0 Q( y RESIDENTIAL RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Ivr 0 Tel. #571-3450 (piping needed with neva furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. * Air Conditioning (all sizes) $ 10.00 $ Fridley, Minn. 'Sf--p r 19 LTJ '-Z> `4.e-� All Others/Repairs and Alterations OWNER 1% of Value of Appliance or Work $ Foe �4��-P� KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS i A.- !) C-- 1% of Value of Appliance or Work 1% $ TO BE COMPLETED ABOUT ESTIMATED COST 1 State Surcharge $ .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. f TOTAL FEE $ Reinspection Fee ($15.00) $/�� DESCRIPTION OF FURNACE/BURNER Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. HEATING or POWER PLANTS, Steam, Hot Water, Warm` Air- No. Trade NameC ��%J'-�9—/ �E. Size NeZ �a s9 ��- !9q Capacity Sq. Ft. EDR BTU %1 0040 HP Total Connected Load Kind of Fuel /vel% <�,-45 BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By Tel. No. Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes ,, ) No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company �� ��'�A.� ��r°�ts Signed By Da to a SUBJECT ERMIT NO. City of Fridley 25 531 AT THE TOP OF THE TWINS BUILDING PERMT ' NO. COMMUNITY DEVELOPMENT DIV. ~ e PROTECTIVE INSPECTION SEC. ®/ e NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/23/97 JOB ADDRESS 6061 Woody Lane NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DIE 35 3 I Moore Lake Hills I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Burton 6061 Woody Lane NE 571-0359 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. All American Roofing & Remodeling 4172 97 Ln NE, Blaine MN 786-6676 5160 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP 61Z8y PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION )7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (24 Sq) Tear -off 9 CHANGE OF USE FROM 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 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 VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF 'WORK WILL BE COMPLIED $2,001 $1.00 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- $74.75 Fire SC $2.00 STRUCTION OR THE PERF E OF CONSTRUCTION. e PLAN CHECK FE TOT FEE L e C $82.75 SI N TUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI HEN R VALIDATE THIS IS Y R PERMIT kC ' B G INS, rl(F 4ATE SIGNATURE OF OWNEROF OWNER BUILDERI IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: n 7 - Effective 1/1/97 6�1 Owner Owner Name & Address: o V\ � % VrTa n Tel. # S -11- o 3 5 9 Contractor: pt -t- A m p ez t c A%\j k o -of t ,n G &M64,41n a MN LICENSE # Sl Address: Li �L, Oil +1- AL L r\ I!`1 Tel. # 1 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Qe Y-00� gous-e -2,4 s (,Fe4r, ©�F Construction Type: Driveway Escrow $ Estimated Cost: $ 9C� Erosion Control $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT:�td ��� !�.�� i Tel. # CITY USE ONLY Permit Fee $ ; . ',E' Fee Schedule on Reverse Side Fire Surcharge 0 .001 of Permit Valuation (1/10th%) State Surcharge $ r L? $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $, U $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt_ "A" or Alt. "B" Above Erosion Control $ -$450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 13 >^ STIPULATIONS: 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 RATE SCHEDULE - Residential ,Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replace pent) /] 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 Effective On January 1, 2002 JOB ADDRESS ZZd4� � Z -/W " AI - OWNER_,, b P1 ►-�L�-� Rate TOTAL BUILDING USED AS $ 30.00 $ ESTIMATED COST PERMIT NO. � $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ 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 $ .50 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units / Circle One (Steam) (Hot Water) (Warm Air) Trade Name M�e_i4L _ Size No. BTU 'JZ 0 HP EDR Fuel 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. HEA FAX # TEL# ?SZ -0)-19q),_— *Air Conditioners can not be placed in a side yard without Approved By ii_ Rough -In Date Final Date written permission from adjoining property owner. THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLICATION WILL BE RETURNED When _rQ la -ing an existingf urs ante, 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. The venting system is plastic/PVC and meets all current codes and manufacturer', specifications including sizing, length, number of elbows and termination. 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. The Pxicti combustion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new combustion air,itwill be sized and installed to meet the current codes and manufacturer's specifications. When installing a new ventingyy.StSM, 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. 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. Appliance #1 Type_ Appliance #2 Type _ Appliance #3 Type _ Total Appliances BTU Input _ BTU Input _ BTU Input Total Btu Input Common Vent Type Vent Height Fan Assisted or Fan Assisted or Fan Assisted or Diameter Appliance #1 Vent Connector Height ft Length ft Diameter in Appliance #2 Vent Connector Height ft Length ft Diameter in Appliance #3 Vent Connector Height ft Length ft Diameter in HEATING CO: Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 r63) 572-3604 FAX: (763) 571-1287 ADDRESS 6061 WOODY LN NE PIN 243024210037 LEGAL DESC MOORE LAKE HILLS LOT 35 BLOCK 3 PERMIT TYPE HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE VALUATION NOTE: INSTALL GAS FIREPLACE INSERT (MAJESTIC, 32,000 BTU'S) APPLICANT WALTER MECHANICAL INC 1169 EAST CLIFF RD BURNSVILLE, MN 55337 OWNER BURTON JOHN & LUEHMANN SANDRA 6061 WOODY LN NE FRIDLEY, MN 55432 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 worl 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 construc#on or the performance of construction. Bldg Inspd 4;�j Date PERMIT NO.: 2004-00277 DATE ISSUED: 02/27/2004 HEATING PERMIT MINIMUM FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 25.50 PAID WITH CHECK # 5175 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building PLUMBING Permit No.: _ Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 Date • A P R 27 20 CITY OF FRIDLEY DATE YO JR E-MAIL ADDRESS 11 QQ II SITE ADDRESS b l i l LI ah ILh ------- THIS APPLICANT IS: 11 OWNER ON}TgRA�CTOR PROPERTY NAME: OWNER/ ` _ c ADDRESS: D� l w Ktiry q--1 ,l clL STATEN'NZIP -: � { TENANT PHONE7A U_ �J`5 CONTRACTOR NAME: ©1 CE STATE LICENSE Il EXP DATE L� �, b CITY_S?AT ZIP SUBMIT A COPY OF YOUR STATE LICENSE WITH ADDRESS: PHONE Z:)'&D L6 FAX APPLICATION PERMIT TYPE 0 SINGLE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: O NEW REPLACEMENT DETAILED DESCRIPTION OF WORK PERMS 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 cast of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) _ BATH SINK/LAV _FLOOR DRAINS _ SHOWER WATER PIPING GAS PIPING (vcEvcnTum. m) _ SWIMMING POOL WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) _ _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ _ WATER METER —OTHER Rf Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures 'c@ $15.00 x $15.00 = $ _ TOTAL DUE $ 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 of�ja11ork�icnequires review and approval ofdans. L� l (16- le—PRINT ` DATE l l SIGNATURE OF APPLICANT i NAMI J�1�6 .., ..' . p.:. ... : .......... .. F Ts7 ,•.i�y ��3 �;.' .�...I��i14V 1.a' 1`�C1v�L �1.. r r.. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building PLUMBING Permit No.: - Inspections RESIDENTIAL APPLICATION Remd y: 763-572-3604 CITY OF FR�LEY Dater DATE May 4, 2007 YOURE-MAIL ADDRESS wnelson0larsonplumbing.com SITE ADDRESS _-_-- 6061 Woody Lane NE THIS APPLICANT IS: 0 OWNER ®CONTRACTOR -- PROPERTY NAME: John Burton OWNER/ TENANT ADDRESS: 6061 Woody Lane NE crrY_ Fridley STATE INZIP 55432 PHONE: 763/571-0359 CONTRACTOR NAME: Larson Plumbinq, Inc. STATE LICENSE # 3341 PM EXP DATE 12/31/2006 SUBMIT A COPY OF YOUR STATE ADDRESS: 3095 -162nd Lane NW CITY Andover sTATEMN zip 55304 LICENSE WITH PHONE 763/427-7680 FAx 763/427-9448 APPLICATION _ PER.IMT TYPE IN SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: o NEW 0 REPLACEMENT DETAILED DESCRIPTION OF WORK Water Heater Replacement 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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (rNDICATE TOTAL NUMBER OF EACH BELOW) _ BATH SINKILAV FLOOR DRAINS —SHOWER WATER PIPING —BATHTUB GAS PIPING (x w cn7LicEna) _ SWIMMING POOL _ WATER SOPTNER ($35) _ CLOTHES WASHER KITCHEN SINK —WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER . •.y� ,: ,: ; .., .. , . �•r .. .,::• .r '. ..'? 't.%; ::.r,.:,=,y.,< :.. .a.,,;;yll;:._.n�. i,{�•'.7i~+ ;.-W�:. ;... ; •. :,Y•1r.+ �.:I?`R�S.IEET:�.!`•O� $DTi- ... );i1V�`ii' .................... _.. _.:..,...:.... ,.. _. ..,....:..3=:,�*.�. � r �L� x•.,rri.. ... r��,.�<�,;rs:> ��• � 1?Zfi`��� y�%�'C)�Z� `�'JE�T�>C)R� Q+��{IO`' Permit Fee. $ 35 00 Number of fixtures @ $10.00 x $10.00 = $ •e Surchar .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 35. 50 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 pian in the case of all wort which r es eview and approval of plans. SIGNATURE OF APPLICANT"`' / PRINTNAME Wendy Nelson DATE 5/4/07 a= City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 101 From: City of Fridley To: 651-203-0554 Page: 4/5 Date: 7/26/200612:02:13 PM ZCo2. Building Permit Fee BUILDING See Back Pago for Fcr Schedule Permit No.: � Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION $.001 Received By: 763-572-3604 $ CITY OF FRIDLEY License Surcharge Date 0 7 00 DATE_ C1 lyl%) Opt YOUR E-MAIL ADDRESS $ SITE ADDRESS 1, V( fL dC ( A I C4n4 NC— —THIS $ THISAPPLICANT IS: ❑ OWNER ')CONTRACTOR $ PROPERTY OWNER/ NAME: k s $ ADDRESS: 174,4rrre CITY STATE ZIP TENANT Agreement necessary ( ) Non Necessary ( ) PHONE: --,i I —C7z:Fjc $ CONTRACTOR NAME: �Nkr®r1r�L� QAr Q00,eft-1 CA STATE LICENSE 2c7WMO� EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE _ ADDRESS: U0r- CITY STATE JP 1:e - 12c e WITH APPLICATION PHONE i99a PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAIvULY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED❑INDOWS ❑BASEMENT FINISH ❑ ROOF DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR M�G Eve daC DESCRIBE WORK BEING DONE: ?% V-5 1 ate% SIZE OF RvIPPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. pR OFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT• I. Existing Floor Plan GARAGES 13 ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: C3 DETACHED GARAGE 3. List of sW aural 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 IN EXISTING OPENINGSes ❑No LOCATION OF WINDOYSr,,, d 3. Energy Calculations OR FOR NEW OPENINGS- ESCRIBE SIZE OF !! OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST Or' LAI3UK AINM 1v1Air.K LAJ.il: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S -.0U ``% OCCUPANCY 1 Xrh Permit Fee $ t See Back Pago for Fcr 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 $ $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 $ Make checks payable to: City of Fridley Attach Sti ulations 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 whichfequires revue and approval of plans. SIGNATURE OF APPLICANT NAME f1"1-041c� DATE ���� 52,qo- j OOL ) I i 1'2--5c7:5 0 Building MECHANICAL Permit No.: CI h Inspections RESIDENTIAL APPLICATION Received By: icy. 763-572-3604 CITY OF FRIDLEY Date-" 763-502-4977 FAX I EFFECTIVE 7-1-2010 q I C ® Q A- 50 40 /It -OL °czw DATE YOUR E-MAIL ADDRESS SITE ADDRESSDOCa®® Is THIS APPLICANT IS: ❑ OWNER 14CONTRACTOR PROPERTY NAME; '-30Y' V1 OWNER/ ADDRESS: ek t-- CITY STATE ZIP TENANT PHONE: `7 U 1-0,3 59 CONTRACTOR COMPANY NAME:' CONTACT PERSON: 5 � SUBMIT A COPY OF YOUR STATE LICENSE WITH STATE LICENSE # EXP DATE����pp� ADDRESS:` pp 13���'1 d5 STATI . JJ 3 TI APPLICAON PHONE Iry� -1 5'7 ®5b 40 FAx -i (o -3 --7 -5 -7 - .1`�` -1.5 1 PERMIT TYPE b4WQLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW MPLACRAENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK V"l� FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALL'S PER MANUAL2006 AS HANDBOOK �,5'?0 t Equipment Installed MFG: 0 (9C MODEL: SIZEBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 ./FURNACE $35.00 GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 _DUCT WORK $10.00 GAS PIPING $10.00 VENTII.ATOR $15.00 Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35-.00 = $ state surcharge = M-FaMUM FEE 540.00 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 dley and with the Minnesota Construction Codes; that I understand this is not a permit but only an appli a permit an ork i o start without a permit; that the work will be in accordance with the approved plan in tho 1 w rk which requir approval of plans. I If t SIGNATURE OF APPLICANT NAME �1 c -7 ° APPROVAL INSPECTORS SIGNATURE DATE PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDINGS ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977