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PRE 2010 DOCSit 0� Village of Fridley....111i a. III BUHAING PEliJ= N° 637 Office of m1TspFx B OF BUXI.DAIT 4S, Iwner___ Lrchitec Fridley, Minn., "T 18 guilder � i. LOCATION OF BUILDING Jo. CGS O street ` Part of Lot got Block Addition or Sub -Division _ M rt DESCRIPTION OF BUILDING Front D4 Pth 3 -y ! Height Stories Manner of Construction To be used as To be completed �b�`"`^ a� rJI- �f Estimated Cost L II Permit is hereby �granw t0 � Y � 1 .4 wto the building CX -2 described in the above statement. This permit is granted upon theexpress edition that the person to whom It is granted, and his agents, employees and workmen, in all the work done around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridle Mina, regarding the 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. �.=-^- inspector of Buildings. I �k AGREEMENT AND SWORN STATEM= In conside%ation of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth' and according to the provisions of the ordinances' of Fridley, and, being first duly sword, I hereb state and say that the facts stated by me and contained in the above permit are true as therein I stated, Subscribes and sworn to before me at Fridley, Minnesota, this day AD. rig k SE WI 1, SUBJECT PE City of Fridley 24545 AT THE TOP OF THE TWINS ° BUILDING PERMIT( � � RECEIPT NO. • COMMUNITY DEVELOPMENT DIV _ L _ r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/10 (96 JOB ADDRESS 6096 Woody Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Moore Lake Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Skjonsby. 6096 Woody Lane NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Archadeck 2236 E 43 St M is., NN 55407 721-2190 8594 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASSOF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 17' x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility locations 454.0002 i lR.0 FOR `�� °L�11111 PERMITS RE UIR FO .RATE AND SIGNS.EQUiRED PLUM ING, HEATING, 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 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 1STALLS 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,060 $1.53 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- S R CTION OR THE PERFORMANCE OF CONSTRUCTION. $87.25 Fire SC $3.06 PLAN CHECK FEE TOTAL FEE L SC 5.00 $96.84 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI E PERLY VA 1PATED THIS IS UR PERMIT r O�r SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI LDG SP GATE 1, NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: (� () ` ( U/MOl Legal Description: Owner Name & Address: L`3 S Contractor: /Qw Address: S7 - Effective 3/1/96 Tel.# 9`7 -6 -7 b -3 MN LICENSE # ?� tK y2(0-7 Tel. # 7 2- • Z (6 j 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: D,-�' Len_ Width Hgt/Ground '/::o Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: WbaJ Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 t = Ft x $ _ $ DATE: APPLICANT: Tel. #—:ZL ( 2 C oo CITY USE ONLY -� Permit Fee $ e72 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /, 3 $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $�LcZ' $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 STIPULATIONS: IUM ENGINEERING /jj _ 'X" �1�9�-D`Blllingsgate u Richmond, VA 23233 ASSOCIATES, P.C. 24s April 5, 1995 Mr. John Hart U.S. Structures. Inc. 2112 W. Laburnum Ave., Ste 100 Richmond, VA 23227 Re: Allowable Girder Cantilever Lengths Archadeck of Twin Cities Dear John: We understand that questions have arisen concerning the deflection of double 2x10 girders with two -feet -long. cantilevers used on some Archadeck brand decks. As part of our continued technical support and in agreement with the design tables (December 21, 1993) we prepared for you, we have included here.a summary of the calculations used to determine acceptable.cantilever- lengths. Our analysis is based on the 1991 National Design Specification and the Design Values for Wood Constructiori..of the National" Forest Products Association. 'The allowable design. values for 2x.10, #2 southern yellow pine (when doubled and used as a`girder) are: Fb = 1050 psi; Fvh = 90 psi; E = 1,600,000 psi. Calculations are based on the maximum loads indicated Tab le 5 "Maximum Allowable unifrm Load for Girders we prepared for you; a live -to -dead load ratio of 7.5 (60psf/8psf); and arrangements of live load resulting in. the greatest possible deflection for both the cantilever and the anchor span. Calculated deflections -and the limits investigated follow: Case 1: Live load on Cantilever only: Anchor Span Cantilever Defl. Anchor Span Defl. 4' -0.053" +0.013" 83 -0.020" +0.0065" Case 2: Live load on Anchor Span only: Anchor Span Cantilever Defl. Anchor Span Defl. 4' +0.035" -0.025" 8' +0.105" -0.134" Maximum 2' cantilever stresses are: Anchor span Flexural stress Shear stress 4' 815 psi 85 psi 8' 263 psi 27 psi Mr. John Hart Allowable Girder Cantilever Lengths Page 2 Based on these results of our investigation, we recommend the acceptance of double 2x10 girders cantilevered up to and including two feet by the appropriate Building Officials. We hope this information is helpful. You are welcome to forward this letter to others as you deem appropriate. Sincerely, MULLER ENGINEERING ASSOCIATES, p.C. p,L7CI3 o PAUL S. MUuE4 p No. z v 13287 s/ONAt EV`��. Paul S. Muller, P.E. President SUBJECT City of Fridley 7277928 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. , d , PROTECTIVE INSPECTION SEC. 0 1 � NUMBER REVGATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/22/98 JOB ADDRESS 6096 Woody Ln NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Moore Lake Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Gates Roofing 4640 Ximines Ln Plymouth 55442 550-0043 6793 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION qc REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (29SQ) 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 80 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 $2,485.00 $1.24 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- STRUC NOR TME P ORMANCE OF CONSTRUCTION $74.75 Fire SC $2.48 PLAN CHECK FEE TOTAL F se Licen$5.0 83.47 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEi EN P OPE ALIDAT S PERMI �IS_t'QUR S,GNATURE OF OYVNER,IF DINNER 13UILOERI IRATE/ BLDOr INSP OA�E NEW ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 4 0 �G wo o� LU Legal Description: Owner Name & Address: S Contractor: Effective 1/1/98 Tel. # MN LICENSE # L, q3 Address: y «cam 5 ® W Tel. # 5S Q - 00 q j 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 H Ground Sq. Ft. OTHER: 1: _ _ t ,& - Construction Type: It ®r i � ko 6W Estimated Cost: $ 5 �`y s (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: `� 0 APPLICANT: oil Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ S Fee Schedule on Reverse Side $ © .001 of Permit Valuation (1/10th%) $ /. $.50/$1,000 Valuation $ $1000 per SAC Unit $ CSC) $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 [ ] SUBJECT P IT NO. City of Fridley 3 0 21 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T RECEIPT NO. i t V ____ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �/:; f � � PROTECTIVE �.✓ 6 E , NUMBERREv DATE PAGE OF APPROVED BY _ I CITY HALL FRIDLEY 33432 ""' 612-571-3450 910-F15 9/14/99 JOB ADDRESS 6096 Woody Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Moore Lake Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Skjonsby 571-0903 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite Home Imp. 8400 % 89th Ave. N Brooklyn Pk 55445 571-0903 20039258 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 O NEW O ADDITION O ALTERATION REPAIR O MOVE O REMOVE B DESCRIBE WORK Replace doors and windows 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the house. Permit inspection Cards Will Be Mailed To Homeowner To Post 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 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 $3590 $1<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- $97.25 $3.58 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION fire A PLAN CHECK FEE TOTAL E License S ,00 A$1 .63 SIGNATURE OF CONTRACTOR OR AurrIOR4E0 AGENT IOATEI N PR PE IS"YOURRT BLDG I SP S.GNATURE Of OWNER,IF OWNER BUILDERI iDATEI AW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: Legal Description: Owner Name & Contractor: IA2 Address: Ywon- . Effective 1/1/99 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION( f (1� L Tel. #`�� MN LICENSE i? Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF Ill�IPROViENT 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: ®®�, �)ZAACQ-5 Estimated Cost: $ 00 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 9- x--99 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL r. CITY USE ONLY Fee Schedule on Reverse Side Tel. # g.2� -?—ZZ"a .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] Az- STIPULATIONS:/ ._. , NE university Ave ., , . � .� c fUiVJI �V. � � � �� 3 —A Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604 MAKK NUMtiLK OF FIA I UKLS 1 U tit IN5 I ALLLU UN LAGH FLUUK TOTAL FEE $ COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE VC1"�✓ PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS S�;q_?a New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin 7.00/- $7.00L11-3 / Rain Water Leader $ 7.00 , 20 Sump/Receiving Tank $ 7.00 ^��9 / (�, Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 LkA t°',� Water Heater - Gas** $10.00 Building Used As Gas Range** $10.00 �� 3-3 L' fp'� Gas Dryer** $10.00 Estimated Cos � PERMIT NO. Back Flow Preventer Required ( )Yes () No I Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Hr SIGNED BY TEL N0 �q3 ` ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX # t� 1.5% of Value of Fixture or Appliance I Approved By Rough -In Date Final Date State Surcharge .50 TOTAL FEE $ COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED r COMMON MENTA VENT CONINIFCTOR AND COMBUSTION AIR VERIFICATION When re In acing.an taxostong gran _ , 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 plastictPVC 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 exic+ineg comhiisfinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new cembuafien airy it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new venting nya+em, 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 #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 r HEATING CO: Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6096 WOODY LN NE PIN : 133024430060 LEGAL DESC : MOORE LAKE HILLS : LOT 1 BLOCK 2 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT N .: 2004-01 DATE ISSUED: 10/11/2004 VALUATION : $ 5,925.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM MR, LENNOX, 70,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT DAVES APPLIANCE HEATING & AIR INC 160137 AVE NE COLUMBIA HEIGHTS, MN 55421 (763) 781-6901 SKJONSBY BONNIE 6096 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 ting of a permit does not presume to give authority to or cancel the provisions of any other state or local law kpnstruction or the performance of construction. Date HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 35324 TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 5925 0.00 35.00 0.00 0.00 25.00 0.00 0.50 60.50 CITY OF FRIDLEY BUILDING INSPECTION Effective 4/1/2004 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Bumer & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes All Other Repairs or Alterations (List on Back) 1% of value of Appliance or Work Minimum Fee $15.00 for Residential or 50A of cost of Improvement whichever is greater APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS dL:sL An Fee Total --I-- %/ _ \—I $35.00 $10.00 $ $10.00 $ $10.00 $ $25.00 Com erc al l dusiria lns tonal 1.251/6 of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge $� TOTAL FEE REINSPECTION FEE $50.00/HOUR *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City Building Used As ESTIMATEDC:OSTr PERMITNO����� DESCRIPTION OF FURNACE AND BURNER # of Heating Units___L__ Circle One (Steam) (Hot Water) arm Air Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name BTU Size No. 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 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furnace, the undersigned hereby verifes 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 No { ) to meet the current codes and manufacturer's specifications. Yes (} 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 No( ) Venting Tables for fan assisted and natural draft appliances. Yes () 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 SizetCommon Vent and Vent Connector Information Appliance #11 ype r �'� BTU Input -7 b CC) Fan Assisted or Nat _._. Appliance #2 Type i _�JL� BTU Input VQ,000 Fan Assisted or Nat A01 - Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances,.. Taal Btu Input inches Common Vent Type Vent Height Diameter inches #1 Vent Connector Height ft Length ft Diameter , in Type - Appliance #2 Vent Connector Height �_ft Length , C —ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: Describe HEATING CO: Signed By: ate: � City of Fridley Building Inspections Dept.G Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Perm it# d® Residential Application City of Fridl � 574 See Back Side For Re red Information Date110 Site Address: - ��- The applicant is: (cirice one) Owner Contractor Property Owner. Tri a Address: City; State: Zip: Phone: Cell: Fax: Contractor Information Fireside Hearth & Home Company Name: 2700 Fairview Ave. N. Contact Person: Roseville, NIN 55113 Address: 651633-1042 City: License # 20512060 Phone: Email: _ . & Exp Date Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: 6�- t � ,-r Equipment Installed: MFG: 7-✓ Model: Size/BTU: ua MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 A/C $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 Chimney Liner $10.00 _Gas Piping $10.00 !Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.00) Surcharge $ 0.50 Total Due $ Make check payable to City of Fridley _ J This is an application for a permit- not vara untn processeu I hereby apply for a mechanical 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 case of all work which requires review and approval of plans. - Signature of Applicant: Date: Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work Building BUILDING Perinit No.: Inspections RESIDENTIAL APPLICATION Received By: Wt 763-572-3604 CITY OF FRIDLEY DataG&SEP 16 20a DATE -13 S P OF) YOUR E-MAIL ADDRESS �'�C9��Q Op Cap I•[ (a C, • Cn-'r' SITE ADDRESS®/ � THIS APPLICANT IS: ❑ OWNER �ICONTRACTOR PROPERTY OWNER/ NAME: -10. -Q-D TENANT f ADDRESS: CITY STATE ZIP O NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, N 55113 f N —STATE—zip— TATEZIPWITH WITHAPPLICATION PHONE License #20130983 ❑ SINGLE FAMILY/NF PROPERTY TYPE E3 TWO FAMILY/NEW L 651-2-4777 13 ADDITION ❑ GARAGE/SHED-aWINDOWS PERMIT TYPE 13 BASEMENT FINISH E3 ROOF 13 DRAIN TILE 13 DECK ❑ SIDING 13 OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑NEW 13 ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: S i P f SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S ROOFING ❑ HOUSE ONLY . NUMBER OF SQUARES 13 HOUSE & GARAGE BASEMENT REMODELING SUBMIT• GARAGES 13 ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING 13 Vinyl FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit 13 Aluminum ❑ Other ADDITIONS 13 Trim 1. & PORCHES SUBMIT• Site Plan/Survey showing the existing structur, 13 Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ILL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 19,9-7 U.B.0 FEE SCHEDULE) Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due JOB VALUATION $ 5 c� - See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) 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 i conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not 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 approve plan in the case of all work whic requires re 'ew and approval of plans. /�,� SIGNATURE OF APPLICANT ���n���PRINT NAME Qt.C�, I^�eyxGn��DATE / �6 I4