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PRE 2010 DOCS1 1 it Alp _ � stq4 646saumN ,&aipTja 41e aw axoyaq o} uaoms pw pagtaosquS it •pa}tjo utaaaq} su anal aau 4ttuaad anoqu aq4 ui pautu4.uoo pus aut Aa palup s4vel aq} 1.1egj A139 puu a4vw": Agaxaq I 'uzoms Sinp 49ag Sutaq `puu `Aaiptaa jo sameugmo aqj jo suotstnoad atI4 o} 2utpa000u pub' q xoj 4as anoqu uot4dtaosap aq4 g3tm aauupaoaou ut -4aont pasodoad aqj op o} aaau Sgaaaq I 14TMaad anoqu atp ;o Aaipta a� ;o autpitng jo ao4aadsuj aq4 Sq auz off. `�faantiap pie ansst aq �o uot� aaptsuoo uI INaMRI 'ZS NUOMS aNV s nHMaHOV •saouuuFpao PF'es ;o suoFsFnoad atg ;o Sus ;o uonaloFn uodn attg4 Sue Iv pexonaa aq Aum 3Fuaad sM pue`9j#uff S3io eq uMIia s2uFpunq ;o 2uTAOta pine aredea 'aoureua;ureur 'uor<eaa}re 'uoF;ona;suoo eqj 2uWjv2ea '•uu'SaFplaa ;o saoueu -Fpao aqa o3 s3oadsaa nu uF utao;aoo ump `;oaaatn 3a<ed Su<e ao l2uFpUnq pyres uodu pue punoa� `uF auop 31aom aq; nu uF 'uauuFaoen pine seaSoldma `s}ua2e sTq pus Va4uvj2 sF 41 taot{m o3 uosaad ate 3 uoF;Fpuoo ssaadxa eta' uodn pajuea2 sF Ipmed qU juamalins anoqu aq3 IIF paggosep 2utpunq aq. V ea2 &geaatF sl jp=ad ,soo Pa3uums� pajalducoo aq oy se peon eq oy uoF4a� 3suoo ;o aauu saFao�g ��FaH x Adan woad ee ONIQ'I El do NOITId Iowa us ao UOPTPPV RooFg }oZ 'lo'I do -4-utfd . r. laaals OM(IrI El ao NOLIVO®Z d aaplIng 77 :. 4.11111W `ANPRa i ;aa�rgoay saxaanau ao nomaasm jo eawo 011 SD�I�id '�11�II[�Itl� ;q *um .K',COi]PI.JJ 30 ONNUTA •'i 97-8),-879001 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 u Future Fixture Opening 4Water $2.00 $ New Fixture, Old Opening Gl i� .i Catch Basin N $5.00 E -H M H $5.00 N � itl 14 p, W w $ Water Softener Heater •.i 41 b x G N Electric Water Heater 1J dl it F', A N RC 1st 3 fixtures i1 '$3,00 $ Additional Fixtures H GJ 0 $ Gas Range to 199,000 BTU ••1 $10.00 .G R R $ U 'M J $5.00 $ each add. $100.00 or fraction yb U a aroa P7 $ .50 3 A w ai $ U rd S cel o as lec 1st co net 4-in de 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3,00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) Job Address U15 NE 2 Street Department of Buildings 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 Fridley, Mn. 5-16-77 , 19 OWNER TNEO KELLY KIND OF BUILDING frame USED AS res. TO BE COMPLETED ABOUT frame ESTIMATED COST res. OLD - NEW BUILDING PERMIT NO. PET NO 1 1 C�'L�G/tel" Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. .? Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE l s�. "A" Surcharge .500 01 SUBJECTP IT NO. City of Fridley ® 18816 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 � ` "1 CITY HALL FRIDLEY 55432 ,.j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 3/10/87 JOB ADDRESS 4815 - 2nd Street N.E. 1 LEGAL LOT NO. BLOCK ADDITION SEE ATTACHED DESCR. 18 19 3 rACTOR Plymouth Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Patrick Keefe 4815 - 2nd Street N.E. 571-6757 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. S ame 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK j NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 221 x 221 Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide �m a hard surface driveway. WANING SEPARATE PERMITS REQUIRED FOR WIRING, HEATINGo PL�JMBJNG AND SIGNS, B�OP� �{$��IOC�{ Ur4li�t�J TELEPHONE - ELECTRIC - CAS Lic. REQUIRED BY LAS' 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 $6,950 $3.48 WITH WHETHER SPECIIF EDN EREINIOR NOT. THE GRANTING OF -AO PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW RIRPULATING CON- $62.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION- = LAN CHECK FEE TOTALFEE $65.98 ATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY IOATED THIS IS YOUR PERMIT 2 SL BLDG INSP p7 SONATUR OF OWNER IIF OV4NER BUILDERI IDATEI 01 NEW [ ]� City of Fridley Effective 4/1/86 ADDN. I ] �R-1 AND R-2 ALTER. 17 Building Permit Application Construction Addr4 Legal Description Owner Name & Address�Yf. (:SA9&C;z—iLS A `(L) Tel. # 511' VIS-) Contractor: t)C %% Tel. Address: -S_ .4& E A � LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length ZZ' Length DESCRIPTION OF IMPROVEMENT Width Width -Z-2- Width Z Width Height Height t 8 1 Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot (14 Ft. Yd. Setback Side Yard Setback Type of Construction: Wc�c A yNac Estimated Cost: $ (A 5o% - V4 Approx. Completion Date: 2 9�o AT i^ � Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: - i o `l APPLICANT : - Tel. # 1 -00 y CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $•50/$1,000 Valuation SAC Charge $ $525 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ J STIPULATIONS: 3k'�+f tYR4.±w�kl.F b� �+h,.fi' �,f�3„'�XS++�Fh$kit a•"i II�.M%i rill l $W+;4S 'fie i:. '9��j•Y,L'y't�t'��` �, d�..'�: 1 , t t.1 G 4 ^'= r r . �, , i- -1 'w .r�rs y i,i'°i .,C a•fgT'- �si'i k''C"�rg,,r m t F �,� & r F `-c�'{.Gf 4 �i y -5 K� y#�,': " „• �+� f.�", ��P"w OWN ,c,+;'l�kr'' .F '� ��,3 •r.= .mss,.- y x ".;' r r 4r, "' ,2rs -:. ��, R�'."':s`r•t X. r..5,. N"w� * -37 'i gs cFa� y u µ;hYrxa t,;wPn�1f�� 3ti .n q b :y is u yrrr rr s t e -. .. ts- +� A— WIN rli lid 7 NO 1"S 10A %01 Off r � ` `i -r N i r¢��r r, r7- , ny' ""fi, _ � 'I L i °1'�. d t{ .�'F✓i cc d S� .� }� k �..L �' 'L . P � s.+�. F '.A 9, s j „. 7777 a a>�+ urx.F s �'> rr �m l + xr s.m�''F n d' < - rtt' ✓ l =;eF r- r - �' 7p 7 �. ' ' ` C• x's�^A a' v i a� i -s” k c• k,:i" a, -i », ,fir.... �F - p�,� a z' `, ✓ f , " z r ;G [ 9.,uhr-'4 r' .Va$��e r-:T,'.�tr, rr S �:'':1 , y ', • "t - . m e p' C Fd Y� t°6 K 4• -r f ��' `� �,'��r•S;?�f'vG� � try.' *'� gyp', j a2 �g��.�'� r r µ:F5 �r'`�y� �� t T�3 �&'�e�.r �' K�'c"�� r ..{ h�' xr i �'i 5 }'v � �",'��.5�, r'.M'��r{7 £�'wa - h T 3s ay }-J1 6 iF g . 5 yo �; a ,+� y y r'{, `e #�a �. s ''. o' ✓ -� n �k t' f , �#' �- ^anr � s yN �r� r t S ,�, -2I rWHOM .<- r...,. t 4. _ , , 4T' .- ,.a..a.. 01/ SUBJECT IT NO. City of Fridley 28172 AT THE TOP OF THE TWINS BUILDING P E I r i L 1 �1 I t f REC NO. COMMUNITY DEVELOPMENT DIV. ECTIVNSPECTION E IFRIO 60FHALL NUMBER REV OATS PAGE OF APPROVED BY I,,f' EY 554 2 612-571-3450 910-F15 10/9/98 JOS ADDRESS 4815 2nd Street NE 1 LEGAL LOT NO.BLOCK I TRACT OR ADDITION SEE ATTACHED DESCR. 18 19 3 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Carrie De'arlais 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Const 20566-5229 Rfifi2x 20077950 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Cjx REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 20 S Tar -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1714 $.86 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 PE ORMANCE OF CONSTRUCTION S56,75 A re SC $1.71 ZO PLAN CHECK FEE //_0 OTAL FEE 1, - - C! f I 't () , 64.32 SIGNA TUBE F CON'RACTOR OR AUTHORIZED AGEN T IDATEi WH P BfOG -NSR VA A THIS IS YOUR P IT V IATE SIGNATURE OF OWNER09 OWNER BUILDER. (DATE- 01/ NEW ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Const mcnonAdd fl �5`— Legal Description: Owner Name & Address: Contractor. Ale ms d Address: _ Za cK Effective 1/1/98 V9,91 I D--,' Tel. # MN LICENSE # 46® '71:S -D Tel. # �a C 'S-�Z-Z- -�' Attach to' his application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEIVIENT LIVING AREA: Length Width Height GARAGE -AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: �. Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: AWEstimated Cost: $, (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. ++6 Ft =Ft x $ _ $ DATE: Tel.# ��'S�ZZ TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ f %/ .001 of Permit Valuation (1110th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ y ® $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 j ] Not Necessary j ] TOTAL STIPULATIONS: wig SUBJEtT City of Fridley 3 i 693 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. ` ______ 1; : v PROTECTIVE INSPECTION SEC. d i NUMBER REV DATE 3/21/01 PAGE OF APPROVED Br CITY HALL FRIOLEY 53432 612-571-3450 910-F15 JOB ADDRESS 4815 2 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 18,19 3 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE C. Jarlais 4815 2 Street NE 763-571-0937 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Exteriors Inc 8600 Jefferson Hwy, PO Box 266, Osseo, MN 55369 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-391-5514 2877 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION 0 ALTERATION J7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside House; Soffit & Fascia 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 PFli Inspection cards Will 00 M8118d To Homeowner To Post SEPARATE PERMITS ARE REOUIRED 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 1 ISTALLS 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 $6.10 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $12,198 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- Fire SC $12.20 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $223.25 PAN CHEC FEE TOTALFEE L e e SC $5.00 1 $246.55 SIGNA TURF. OF CON TRACTOR OR AUTHORIZED AGE NT IDATEI W EN PROPERLY VALIDATED THIS IS YOUR PERMIT � S-GNATURE OF OWNERoF OWNER BU0.DERI IDATEI:.3'_ BLDG -NSF' � riAIE wig NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor. 7&3 Effective 1/1/2000 •61572.3604 Bldg Insp Tel. #-763 - 57/ -e!�93 7 MN LICENSE # of� d' Tel. # c59/ -�S'.15 (3Z,9� sj:-116 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: Construction Type- , ' Estimated Cost: $ / Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$ DATE: APPLICANT: L%� Tel. #/ ell -01 CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (612) 572-3604 for Permit Fees If mailing in application Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ $1100 per SAC Unit (State Licensed Residential Contractors) "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5714287 oS--oar'7� Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Fee Total Residential Furnace Shell and Duct Work, Burner & 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 5% of cost of Improvement whichever is greater $35.00 $ $10.00 $ $10.00 $ $10.00 $ $25.00 Commercial/Industrial/Institutional 1.25% 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 JOB ADDRESS ` 11S Q&d 'k IL -e-_ ESTIMATED COST�,0,5 PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units �_ Circle One (Steam) (Hot Water) (warm Air Trade Name L Size No. . BTU 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 $ and rulings of the Building Division, and hereby declares that all the facts and representation tated in this application are true and correct. $ HEATING CO 0 46 �( & *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Tel #_ Wil'® FAX # ! Date j�'X 1=e �,cl� Approved by Rough -in Date Final Date FILL IN eC&PLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS Ali(/S" 129 COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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. 5) 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 TypeC G � � «34A-� -7� BTU Input �d� g 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 D VC -�- Vent Height J%ft- 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) T HEATING CO:— Signed By: C24=4�zj Date -0?/ -61-3 Building BUILDING Permit No.:' UL)Ir Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY mate Rec'd_/d':;;1.5-0 DATE /"'0O 6 YOUR E-MAIL. ADDRESS SITE ADDRESS 0�J � � Sl rr 7 Yi; �i G�jeo/ 511 / THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: CITY STATE ZIP. PHONE: CONTRACTOR NAME: S'/e. STATE LICENSE # -et' y SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:1%4('y '9' s WITH PLICATION PHONE OPERTY TYPEINGLE FAMILY/NEW CONSTRUCTION $ ❑ TWO FAMILY/NEW CONSTRUCTION PERMIT TYPE ❑ ADDITION ❑ GARAG $5.00 (State Licensed Residential Contractors) ❑ BASEMENT FINISH ❑ ROOF PROPOSED SIZE: ❑ DECK ❑ SIDING Curb Cut Escrow ❑ SWIMM EXP DATE y / CITY -G STATE f� FAX l�-Z� 4" POOL STORIES STORIES ❑ WINDOWS ❑ DRAIN TILE OTHER fj ,41, y t woc�J� TYPE OF WORK: ❑ NEW u "0111VA ❑ MAINTENANCE/REPAIR XREMODELING DESCRIBE WORK BEING DONE: 7--,- SIZE OF IMPROVEMENT WIDTH HEIGHT Ft. ROOFING ❑ HOUSE ONLY See Back Page for Fee Schedule Plan Review NUMBER OF SQUARES ❑ HOUSE & GARAGE Fire Surcharge BASEMENT REMODELING SUBMIT: .001 times the total job valuation Surcharge $ 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE $5.00 (State Licensed Residential Contractors) 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE Curb Cut Escrow 3. List of structural members to be used PROPOSED HEIGHT: Erosion Control $ $450 Conservation Plan Review SIDING $ Fee Determined by Engineering FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl []Soffit Total Due ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ e, 3-W • `�D OCCUPANCY TYPE Permit Fee $ See Back Page for Fee 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 $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 00 Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an 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 wh�icc wir/es review and approval of plans. / /�, SIGNATURE OF APPLICANT` �� G�:GG � PRINT NAME "4q {'q' ej";7'-14- DATE OZ �3Zd 1 ! ; i ___ z w i 01/05/2006 14:54 9528814491 SEDGWICK HEATING PAGE 02/03 r Lt S S� bate: 1/512006 RwAsion Date_ 1/5/2M Existing Construction: Pre 1994. site Information Address 1: 4815 2nd St ne Project #: dejarlais Address 2: i_ot: Block: City. fridley County: Subdivision: Application Information Business Name: Sedgwick Heating and Air MN Contractor License #: Conditioning Contact Person: greg sedgwick Office Ph: 952881-9000 Fax 952-881-4491 Cell Ph: Address 1: 8910 Wentworth Avenue South City: Bloomington State: MN Zip Code: 55420 Combustion ADO Water Heater: Natural Draft Input BTUs: 40,000 Common Vent Furnace/Boiler: Fan Assisted Input BTUs. 66,000 Common Vent Make -Up Air No Make -Up Air Required by Code Combustion Air Minimum Combustion Air Requirements Met. Applicant Name (print): Signature/Date: Code Official (print): Signature/Date: ® 2004 CenterPOint EnwW Minnegasco. 2004 Mechanical Code Cruidelines. page 1 01/05/2006 14:54 9528814491 SEDGWICK HEATING PAGE 03/03 .edgwick Heating Meohanical Code Questionnaire job # date Customer name O A -r it q v- 4 t Address City, Sta#e P � r LOe 1 Construction 2 Year guilt 3 Are we replacing a furnace or water heater? 4 Does new appliance have an input rating 30% greater than the original input rating? fi Did the combustion air previsions meet the code requirements at the time of the original installation? 6 Will our installation cause equipment we're not replacing to become unsafe, hazardous or overloaded? 7 Will we be installing an exhaust fan greater than 300 cfrn? 8 Total number of water heaters, furnaces and/or boilers r ,-- 9 The water heater is... 10 The water heater is venting— 11 The furnaceftiler is... 12 The furnacelboiler is venting 13 Is there a gas burning fireplace? 14 is gas burning fireplace... 15 Is there a solid fuel burning appliance (fireplace etc)? 16 What are the capacities of the first and second largest exhaust fans? 17 How many square feet are there in the house including basement? 18 How many combustion spaces (mechanical roams) for water heater and fumacelboiler are there? 19 What is the size of the combustion space (mechanical room)? now isting pre 1994 1984,2003 2004 or later yes no both yes no yes no size of existing comb air yv� Ond . yes Cno) sealed combustion Independently yes direct vent yes first STu,i �� Siete BTU +D# new em f common vent poweryent natural draft n no y second 2 other OV Sr j width length height sealed power natural combustion vented draft independently n cominor vent sealed combustion Independently yes direct vent yes first STu,i �� Siete BTU +D# new em f common vent poweryent natural draft n no y second 2 other OV Sr j width length height FEB -1-2006 04:42P FROM: TO:7635711287 P:2/2 Building M ECRANICAL Perrrit No...:? .z ry Inspections RESIDENTIAL APPLICATION Date nate 1�ec'd- RecBy: ea 763-5 72-3604 CrrX OF FRIDLE"Y ! � YOUR VMAIL ADDkESS SITE ADDRESS Tl-Iis APPLICANT IS: 0 OWE CONTRA=R PROPERTY NAIVlE: •� OWNEW -CITY—. STATE__ ?33F TENANT PHONE: GUNTRACTOR COMPANYW— Kline Corp. — SUBMIT A COPY OF CONTACT PER DBA: Practical Systems YOUR STATE STATEUCENs 4342E Shady Oak Road LICENSEwrrFt ,dntaRW:— Hopkins, MN 55343 STATE � APPLICATION PHONE 952-933-1868 PF,RWT TYPE WGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE ❑W O REPLACEMENT ?aUERAnOWREMODEL :T�Y�E(0)» wow: DETAILED DESCRUMON OF WORK M SIA „ J FER MS 169.665 the permit fee is a minimum of SIS -00 or 5°/a of the total cast up to SSQQ.QO, whichever is , for the impmvesnent, justalMon or replacement Of a residential fixture, excluding the fix -,ares. (7his should refteet only the cost of labor } Labor cost.tmder 5300 - $15.90. Labor cost between 5300 to 5500 = cost of labor X.05= FOR PR©JEM VViI>±R,E UU= EXCEED5 $500. "MARE BASED ON S10.00 PER FDCTURE. EXCEPT WHEK9NOS• FUMAM: OWICATE TOTAL NUMBER OF EACH BELOW) MFG. MODEL: „�. SiZErBTU , Egci u=t Inae OW _ ,MODEL: MFG MODEL: 510.00 SIZEffW 1id =LACE (GAS) (GAS) $15.00 GAS RANG A/C $25.00 NEW GAS GRILL $10.00 AIR TO AIR EXCeANGEF.R $15 __nREPL4CE (WOOD) 535.00 GAS UNIT' WM $10.00 BOILER 535.00 FURNACE 535.00 POOL HEATER 335.00 CHNNEY Li em 510.00 GAS DRYER $10.00 VENMATOg $15.00 DUCT WORK S1s00 GAS PIPING SI0.00 „� s„ moi�9b�r]M P"Wit Fee $ C _ Number of ftxttires (a X10.00 _ x $10'0() = Surcharge $ -50 Number of fiXtttres @ MAO x $15.00 TOTAL DUE Sd!!Z_•- v- Number of ftxtures (9 $25.00 x $25.00 = Sri Number of fixtures @ $35.00 x 535.00 State Surcharge .50 Totals $_ THIS IS AN APPLICATION FO& A PER MJT NOT YALi t) UNTIL PROCMED I hereby apply for a building permit,and 1 acknowledge that the information above i5 complete and accurate; that the work will be in confom rance with the ordinance and codes of the City of Fridley and with the ivI:atjesata CanstNction Codes; th$t t nndetsttmd this is not a permit but only an WE ' `on f a permit and work is not to start without z permit; that the work will be in accordance with the approved plan in the case w 'eh requires review and approval of pl Al SIGNATURE OF I PW ICA3,T PRIM NAM =.. ,r DAT City of Findley Building Inspections Department 6431 University Avenue NE, Fridloy, MN 55432 763-572-3604 FAX: 763-502-4977 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin NO. RATE TOTAL JOB ADDRESS l rZ�jd- Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range" Gas Dryer Back Flow Preventer Required ( )Yes () No $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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. DATE: 3 l 7 , 200(a OWNER BUILDING USED AS �%W e t ESTIMATED COST PERMIT NO.`.�` PLUMBING COMPANY SIGNED BY l Approved By Rough -In Date TEL N0. Z to`�S - `✓` ✓ (�' tri Final Date nn■vn■vn■ ■ vv ■ v•� n•. • • r.vo.v..v v. -.v • r....... .v w •v.vv v $ OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 verges that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date: