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PRE 2010 DOCSCity of Fridley, Ylbm. N° FO44 BUILDING PERMIT Date: Ul June 11, 1979_. Owner: Harold Swanson Bider S, E. Templi4n Address Gardena Avenue Address 6184 Stinson Blvd. LOCATION OF BUILDING No. 6064 _ Street Woody L@Ae . , ._.._..... Part of Lot Lot 1 __ Block 1 Addition or Sub -Division Girdler Terrace Corner Lot _ ____ Inside Lot _ _ Setback ........... Sideyard Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING Dwe71ing Front 26' Depth 41'4" Height"I=y Sq. Ft. 1261_ Cu. Ft. 29, 700 Attached Garage Front 20' Depth 22' Height 10' Sq. Ft 440 Cu, Ft 4400 Type of Construction Frame Est, Cost $24,500. To be Completed Summer 1970 Verify Foundation Location by Survey. In consideration of the issuance to me of a permit to construct a buil ' described above, I agree to do the proposed work in accordance with the description above set fo and mplian wWl!- In provisions of ordinances of the city of Fridley. consideration of the payment of a fee of $.5.-. RD- , permit is hereby granted to S -. E .. TMUI i n_ 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 buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: This permit does not cover the construction, inataffafton for wiring, plumbing, gas heating, sower or wafer. Be sage to see the Building Inspector for separate pormha for these ham 4 0 Land Planni ng 6875 Highway No.65 N.E. Land Surveying Minneapolis, Soils Testing Minn. 55432 Civil Engineering Telephone 784-6066 Municipal Engineering Engineers & Surveyors Area Code 612 A/ Certificate of Survey for 5 6V/1,, 6-' lrorl Iron A - ti �'— Ar " ,LOT Iron G L O199 vV, (6WA I hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land, and of the tocation of all buildings, thereon, and all visible encroachments, if. any, from or on said land. As surveyed by me this {5th day of t-) LJ �q e– A.D. 19 SUBURBAN ENGINEERING, INC. GCO le Engineers Su Ive ors APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT NO:LQ (' STREET LOT: BLOCK:_ CORNER LOT: INSIDE LOT:SETBACK: SIDEYARD: A Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To a Used As• a rP� Front; Depth: � Height,. e� Square Feet: " Cubic Feet: Front : Depth:Height: Square F t; f -z Cubic Feet: e_1 J { Type of Construction: Estimated Cost: r- d To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations ted in this application are true and correct. DATE:'` SIGNATURE: V' (Seeeverse Side For Additional Information.) AGREEMENT illzg2 4 DATE L L.5_'�fhe owner of the following described property 4o6 �_/ �D (J Hereby agree to pay in cash $ / /�/1 r to the city of Fridley to cover m roporiiohate- share of the utility system, or in lieu thereof agree to have the City levy an assessment against the property described above to cover the cost of my proportionate share of the utility system as pro- vided in Section 2 of Ordinance No. 113, passed b the Council of the Cit of Fridley on December Y Y Y 11, 1955. OWNER'S SIGNATURE Tapping Permit No. . •q City of Fridley Applica" Dept. of Bldgs. Phone 980-3W DESCRIPTION OF WORK Number, Kind and Location of Fixtures Futur• Connection openingsI •••• sower 2--'* New Fixture, Old Opeaaings Po -1 ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. yy yy Number Fixtures ................ Wp 1{ GU $ / I/" Z � �pjg�{ � • ° 3 u ► WATER HTR. • N GAS ELEC. Future Fixture Opening ........... x $1.50 $___/5_10 New Fixture Old Opening .......... . x $1.50 $ Ram Catch Basin .................... x $3.25 $ Water Heater :Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ 1st Electric Water Hater .............. I d I GAS FITTING FEES: NO. RATE TOTAL. _ 2nd g $2.00 Additional Fixtures .................. x $ .75 $ 3rd Gas Range to 199,000 BTU.. . x $5.00 $ 4th Futur• Connection openingsI •••• sower 2--'* New Fixture, Old Opeaaings Po -1 ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ / I/" Future Fixture Opening ........... x $1.50 $___/5_10 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 Hater .............. z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL. 1st 3 Fixtures ............... - • ---- — g $2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU.. . x $5.00 $ REPAIRS & ALTERATIONS—Rotor to Code Description ........................... a............. ®... 4 TOTAL FEE 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 a3V true and correct Fridley, Kind of Building =moi F Used as 19 zo To be completed about —Z 2 0 Estimated Cost, $ Old—New. Building Permit No. Permit No.j?" �� o Signed Business Phone No ROUGH FINAL 5%% 2 T� Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and 6 Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ........... . each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations --up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. 8.00 $- 'F "-v 2.00 $--T?, 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ mach add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OILI BURNER—to 3 gal. per hour ....................... 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) 5.00 $ L • r� GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ a AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL 041 Dept. of Bldgs. Phone SU 4-7470 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 19 _ Owner Sam Temp 1 in Kind of Building Frame Used as Dwg . To be completed about Estimated Cost, $ MY -New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER steam, Hot Water, Warm Air—No 7 Trade Name .AFCO Size No GB11050HB Capacity. Sq. Ft. E.D.R. 8 0 M BTU - H.P. Total Connected Load 44,754 Kind of Fuel nat gas BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed mi I - City Heating Co. 4 2 Business Phone No 5 4 4 -15 01 PERMIT for Power Plants and bleating. Cool ing, Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of �/ / s ��it Heating Plantall Qz `s �_to be ins d ltered—repaired �l Make ru , Size 6.8 Oil fired—; Coal fired ; Gas fired t!L; Gas Authorization No. Remarks -z, JAAA,0AUP CYt�.� 'y` Q gd Approved Final Inspection 19_ Inspector Permit N? 4774 Fee Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. S' , 1c-90 Owner Location . 60(0'/ WaQd:y 6ay� Kind of Building— I &Mvt How Occupied p Work to be Commenced—, 19 To be Completed—, 19 Estimated Cost, 02- Yew, Building Permit Permission is hereby granted to to install—erect—use the material and devices described in the above statement. This permit is granted upon the express co ition that the p son to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications Ft forth in the approved application for this permit on file in the office of the Inspector of Buildings. — -�� Inspector of Buildings 42 2M 11-57 v - - N® 5171 Original Permit f®r PEOMBING AND GAS FIT' ING N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for permit inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permitFee®. ., DESCRUMON OF WORX II Number. Bind and Location of Fivtnren Stories IG- U z 0 z Y =N z z 3 G z U z Z G U -j WO WATER HTR. a J 'S U rc m F Q m Z tll < 3 N K O O LL S V) ° -C LL C Fa 6 U m Q D E J m K $ 4. 4 a O a zQ < K GAS ELEC. 13 Basement 1st 2nd 3rd 4th Connected with Gas Piping for Openings Permission is hereby granted E , • to do the plumbing and gas fitting in the building described in the statement hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date Inspector. 42 Ian -6-69-v City of Fridley 5 ,192 IrL A Al Owner Location 60 (o y wo-®d'u L �-►a Kind of Building ��1 Used as J, To be Completed_, 19_ Estimated Cost $_x,00® Old Building Permit No. Date Inspector of Buildings. 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 ` RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $_20.00 $ Gas. Piping $ 10.00 $ (piping needed with new furnace) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ • Air Conditioning (all sizes) $ 10.00 $ to All Others/Repairs and Alterations 1% of Value of Appliance or Work. $ COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work $ State Surcharge $ .50 TOTAL Fn $ 1� u6inspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PWS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Job Address 10C)�o q LoC`'C� A \I \-,' C^o 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 LA- \f) and correct. �g \\ Fridley, Minn. ` \t1 , lg 1 OWNER BIND OF BUUI)LDING USED AS TO BE COMPLETED ABOUT L\ s \�k - 11-1yESTIMATED COST JOC-y / / OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name �,�(—� Cr Size No. -3 6 T-- NCS "d cA Capacity Q 1 Sq. Ft. EOR BTU Io HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. CDR BTU HP Company Signedd-S Tel. No. 1�%\- (�'\\ \ Fill out back side for stack verification on replacement furnarps CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. Has been carefully examined Yes 2. Is free from rust or deterioration Yes ( ) 3. Has no foreign obJects lodged within Yes ( ) 4. Is securely supported Yes ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( j 6. Has Total heating BTU's of All other BTU's TOTAL Remarks Company Signed By Date No ( j No No ( ) No ( j No ( ) .r, 7- suaaEcr MIT NO. City of Fridley 2 0 5 $ AT THE TOP OF THE TWINS � B U I L ®I PERMIT BUILDING r vv m____ COMMUNITY DEVELOPMENT DIV. L _ �'� r � PROTECTIVE INSPECTION SEC. I i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/24/90 JOB ADDRESS 6064 Woody Lane 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 Girdler Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harold/lone Swanson 6064 Woody Lane N.E. 571-0775 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Arbor Construction 5307 Vincent Avenue South., M 1 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW I� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 246 U Deck Addition 8 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WARNIN Before digging calf for all utility locations 454-0002 REQUIRED BY LAW SEPARATE PERUMS r?FQUIRFD FOR WiRIM, HEATING, PLUMBfN(I AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 1 8Q0. $ F $ 90 WITWHH ER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT pERM1T FEE SAC CHARGE DOES T RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVI ION O AN OTHER STATE OR LOCAL LAW REGULATING CON- $41.100 TRU TION O HE ERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE S.0 $1 $43.70 SIG AT F CON ACTOR OR AUTHORIZED AGENT (DATE) W EN PRO RL I D THIS IS YOUR PERMIT BLDG INSP n TE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI N [] ADEN [ ] ALTER [ ] Construction Address: Legal Description: Owner Name & Address: Contractor: R-1 AND R-2 Building Permit Application Address: 630-+ \)'Vac.— " 9 Effective 8/16/90 Tel. #-b Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. nor- --- of LWV LIVIM AREA: Iengt+ Width Height Sq. Ft. GA A+GE AREA: Length Width Height Sq. Ft. DECK ARM: Imxjth Width 10 Hgt G�r�d �— Sq. Ft. b oma:Ao,rv� S!�CoLot Inside rner[ ][ ] Ft. Yd Setback Side Yafd Setbacks Type of Construction: Estimated Cost: $ 0 U Approx. Completion Date: Proposed Driveway Width If New s fired: Ft. $ $ Width + 6' See Back Page DATE: W / APPISCANT: Tel. # Permit Fee $ q0, oo Fire Surcharge $ h , ga State Surcharge $ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Land Planning6875 Highway Rio. 65 Pi. E. ®iAE'YY w ? Land Surveying �t ';�► • ,�/ ° � ,bpraa Minneopolis, Soils Testing l!/'11i cviee i '� Pd J�i�S.e Minn. 55432 Civil Engineering ((/9� Telephone 784-6046 Municipal Engineering Engineers $6, Surveyors si Area Code 612 Mortgage Loan Survey for sem. L07- ' f r s This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if a"# thereon, and oil visible encroachments, if any, from or on sold land. This survey is made only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. it is understood and agreed no monuments have been placed for the purpose of establishing lot lines, or boundary corners. acted thisof ac,r A. P. 19-Tt+. SUBURBAN ENGINEERING, ING, INC. Engines Surve Ob" by.t SUBJECT I N City of Fridley 2 34 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. t _ COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. _ �® 5 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 18/12/98 JOB ADDRESS 6064 Woody Ln I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 1 1 Girdler Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Swanson---- 571-0775 Harold 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Four Sea.,;onq 7930 ITnivers-Ity Ave Fridley 795-9410 20138780 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION Ak REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 26 SO Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 1 HEREBY CERTIFY THAT 1 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 $2168.40 $1.08 DOES NOT PRE E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS NY OT OR LOCAL LAW REGULATING CON- STRUCTI N R HE PE RMA OF CONSTRUCTION. $74.75 Fire SC $2.17 e6i:r 12ce PLAN CHECK FEE C 5. TOT L FEE 83.00 IGNATURE OF CONTRACT OR AUTHORIZED AGENT IDATEI HEN ROP r `. g G -INSIr VALID Tf THIS IS Jy�n'.). R PP//ERMIT M * r.G�� DATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI I I Effective 1/1/98 CITY OF FRIDLEY SINGLE FAMILY -AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ,'_'3fistructionAddress: U.J_0�94 'Description: Name & Address: 42064 W'"Clti LN Tel. #-j MN LICENSE # Q -)�.l A 44y "d'd: (u, Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT _i,/ ING AREA: Length 'Width Height Sq. Ft. E AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground _ Sq. Ft. 0""IfE R: -2""uv $5.00 (State Licensed Residential Contractors) Escrow $ Type: 2-cmay-p- d 2e,0 h" _R6 Estimated Cost: $ Parr Fee $ Fee Determined by Engineering .: iviain Charge $ eFement Necessary Not Necessary Agreement (Fee Schedule. on Back). ,:Iy Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ APPLICANT: TO. #,,27/-.017 5 TOTAL ULATIONS: CITY USE ONLY Fee 71A..?5 Fee Schedule on Reverse Side sr� barge .001 of Permit Valuation (1/10th%) Surcharge $.501$1,000 Valuation Charge $ $1000 per SAC Unit License Surcharge $ C) 0 $5.00 (State Licensed Residential Contractors) Escrow $ Alt. "A" or Alt. "B" Above rasion Control $ $450.00 Conservation Plan Review Parr Fee $ Fee Determined by Engineering .: iviain Charge $ eFement Necessary Not Necessary Agreement TOTAL ULATIONS: 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 replacement) 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 Rate $ 30.00 $ 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 Effective On January 1, 2002 JOB ADDRESS OWNER,r� TOTAL BUILDING USED AS�� d�-,✓t $ a1 ESTIMATED COSTPERMIT N0._ DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units / Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name 1°faz v A-- 9lrx4o Size No. - 4-J BTU --31, 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and $ � representations stated in this application are true and correct. DATE HEATING CO _�� ✓:rc<-�- *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. is a"G�i• C� � c4�°n G -i°°' Signed FAX # Approved B�_ Rough -In Date TEL #��-®��® Final Da NEW [ ] CITY OF FRIDLEY 015' ADDN [ J 6431 University Ave NE, Fridley, MN 55432 ALTER ° SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor. MoftEc Address: 'Aocc (� Effective 4/1/2004 (763) 572-3604 Bldg Insp (763) 571-1287 Fax MN LICENSE # 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: Construction Type: cj A''rW�Ck Estimated Cost: $ ?0(0-70 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: W l APPLICANT: a Tel. # 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 r Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 $ STIPULATIONS: