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PRE 2010 DOCSVillage of }Fric:ey, Minn. BUILDING PERMIT o N • 7810 Office of INSPECTOR OF BUILDINGS Fridley, Mina., � 19, LOCATION OF BUILDING No. 7` is Street - '�2n'd P�t Part ofLot Lot`` ° ;Block Addition or Sub -Division �` rr+"`} �8 '` IV DESCRIPTION OF BUILDING 9 Front `� Depth "f Height Stories -`y :. Manner of Construction r„ To be used as To be completed' .y` 4 estimated Cost Permit is hereby granted toy y �9 K iJr' ° &_ _ _ to the building ''= described in the above statement. This permit is granted upon the express co tion that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, mound and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, *inn., 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. of Buildings. AGREEMENT AND SWORN STATEMENT In consideration 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 sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. i! Subscribed andd'sworn to before me at Fridley, Minnesota, this day 19_ ,/ U 1 ;ny:P SUBJECT PERMIT NO.. _ City of Fridley 2116 0 AT THE TOP OF THE TWINS B U I L ®I PERMIT •IIECEIPT 1�p ® NO. _ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. ! _�1/� �0 /•"1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY '.' 612-571-3450 910-F15 11/20/91 JOB ADDRESS 4844 - 2nd Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7,8 4 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John/Shirley Roberts 4844 - 2nd Street NE 572-8990 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW El ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X B DESCRIBE WORK Construct a 161 x 161 Addition; a 20.1 x 12t Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 'T® �� SEPARATE PERMIT Before digging call IN WIRING, ' REQUIRE® HEATI� FQp. PL�M�ING all utility locations ' AND $i 454.0002 QIN,, REQUIRED BY. LAW 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 I 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 $15� 300 $7.65 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $171. OQ. Fire SC $15.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 3,95 .TUREO CONTRA R AIDATEI s tWFEN ROPERLYOU P RMIT SIGN ER OWNER BUILDERI IDA TEI SP DATE ,/ U 1 ;ny:P NEW O Effective 1/1/91 ADDN CITY OF FRIDLEY ALTER () SINGLE FAM LY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: _ �% �`�'/t. T A.1, 6F-,�- Legal Description: Owner Name & Address: ab 1;,'A-- — 5 H` 2 Lt y A 0 A e -/L7--5 Tel. - q Contractor: ® U -J A-,,, Gr -/Z— Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. All LIVING AREA: Length /6/ Width _/ Height Sq. Ft. .7-5- (. 0 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length 2 o' Width A Z' Hgt/Ground .21 Sq. Ft. 0 OTHER: Corner Lot [ ] Inside Lot ( Ft. Yd Setback Side Yard Setbacks Type of Construction: w ® ® P FOL A Estimated Cost: $ Silo() Approx. Completion Date: li-- .Z3 / 9 2 Driveway Curb Cut Width Needed: DATE: / / / 7-2/ Mae a on*) Ft. + 6 Ft = Ft x $ Permit Fee $ 11))1 66 Fire Surcharge $ i 5'4°h State Surcharge $e ( " SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above = S Tel. #-5-77-- F 9 9 o Fee Determined by Engineering Agreement Necessary [ I Not Necessary [ ] s s ou rz� as �DD'A) dG OS 6A-a6466- Iyx z® x ®y 6 x 3 <®g-®(--> I 3S` 1 SUBJECT PER Fridley City of l� 2 2 ®� 7 AT THE TOP OF THE TWINS BUILDING PERMIT r R O. l • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r "1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ►►►Jl.� �'� 612-571-3450 910-F15 8/27/93 JOB ADDRESS 4844 2nd Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7,8 4 Plymouth. Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Roberts 4844 -- 2nd Street NE 572-8990 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q. REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Partial reside of garage and breezeway 9 CHANGE OF USE FROM TO STIPULATIONS Provide smokedetectors as Per URC 1210 adjacent to all sleeping areas and in basement. 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $17400 $,70 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- $33:00. Fire SC $1,40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $35.10 I F CON T R TOR OR A TH R D AGENT (DATE) _ WO ERVALIDATED THIS IS YOUR }ERM! Si N TU OF O E UFO E UILDE i (DATE Y B� G I 17F TE NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: -4944 _---A—n— ` S/ % l/lJ f Legal Description: L9,71"M UT -11 Contractor: Of R, 7 Effective 5/26/93 MN LICENSE # F Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF RAPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length� _ Width Hgt/Ground: Sq. Ft. OTHER: S-1 -f�&V,- U-wa (:�- u rj-i> ag Corner Lot [ 41 InsideLot[ ] Ft. Yd Setback Type of Construction:&�ZIIL-J-QGzAvZ Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: APPLIC Permit Fee $ 00 Fire Surcharge $ I. �/ o State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Side Yard Setbacks Estimated cost: $ / `7c U a -z) (Cost on Back) Ft x $ _ $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Conservation Plan Review $450.00 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ) TOTAL $' I STIPULATIONS: M SUBJECT P O. City of Fridley 2 713 3 AT THE TOP OF THE TWINS BUILDING P E R M I T P RECEIPT NO I• COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � 1 � NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/12/98 JOB ADDRESS 4844 2 St NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7,8 4 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kathleen Driscoll 502-9024 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Four Seasons Roof & Remode 7930 Univesity Ave NE Fridley 795-9410 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20138780 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION XW REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (22 Sq) 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 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 $1834.80 $.92 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS ANY OTHER ATE LOCAL LAW REGULATING CON- STRUCTI N THE PERFOO AN IF CONSTRUCTION. Fire SC,' 1.83 �� �J PLAN CHECK FEE TOT FEE IGNATURE OF CONTRACT ROR AU ORIZEO AGENT IDATEI N P OP �ATHIS IS R PERMIT r SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI BLD INS P naTE Effective 1/1/98 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION a -,-xistructionAddress: I j Description: Name & Address: Tel. i,:4 MN LICENSE �ctor: 9..)o a&w!� q�)6,f nd4g j,14 Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT G. AltE A: Length 'Width Height Sq. Ft. AltEA: Length Width Height Sq. Ft. I)E'CK AREA: Length Width Hgt/Ground Sq. Ft. 6T11E R: -P "hy,—ee CL ke—o I&C!4�'e'. ad& - -ruction Type:/ I q 3L/I Estimated Cost: $- (Fee Schedule on Back). Cufb Cut Width Needed: Ft. + 6 Ft = —Ft x $ $ -7 APPLICANT: Tel. # qq5-qql� TOTAL 6 7. ? 1,ii-IULATIONS: CITY USE ONLY 2A Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) Surcharge $ $.501$1,000 Valuation -,62 Charge $ $1000 per SAC Unit License Surcharge $ o Q $5.00 (State Licensed Residential Contractors) - ay Escrow Alt. "A" or Alt. "B" Above Control $450.00 Conservation Plan Review Fee Determined by Engineering (viain Charge Agreement Necessary Not Necessary TOTAL 6 7. ? 1,ii-IULATIONS: CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Rate Furnace Shell and Duct Work, Burner . Also Replacement Furnace $ 30.00 (Side Vent . Fill Out Back) Gas Piping (Needed with new furnace, $ 10.00 but not replacement) Gas Range $ 10.00 Gas Dryer $ 10.00 *Air ConditioningAll Sizes $ 25.00 Q-. V - V y'Z; e_ T. -So v All Others/Rep },a rs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On May 10, 1999 JOB ADDRESS_ 7 TOTAL OWNER_ L teems lJ V►�Se©` BUILDING USED AS ESTIMATED COST _ 7 PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name 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 an 50 rulings of the Building Division, and hereby declares that all the facts'and $�� S� representations stated in this application are'true and correct. Rough -In Date Final Date I CHIIi INEY `AND STACK VERIFICATION The undersigned hereby- verifies that the existing chimney or stack: 1. Has been carefully examined Yes O No ( ) 2. Is free from rusts or deterioration-,-. Yes O No 3. Has no foreign objects lodged within. Yes O No ( ) 4. Is securely supported Yes O No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes O No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 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) 11Y. of Value of Appliance or Work - Commercial/Industrial 1.25% of Value of Appliance or Work Effective On January 1, 2000 JOB ADDRESS W10 4 4 — ;).rnC1 Si. N E OWN Rate TOTAL $ 30.00 $_36. 0 $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ S. O 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 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 $ BUILDING USED AS_ jN(o ESTIMATED COST y31J0 . 00 PERMIT NO. -- DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) (Hot Water) Warm Air Trade Name_ C66 -2 -Aft-, Size No. BTU $�_ 000 HP EDR Fuel SIV A'x . C.P'S Total Connected Load Burner Trade Name Size No. BTU HP EDR W 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. River City Sheet Metal, ,A • 9928 Bluebird HEATINGV41,,i,7-,n Rapids, MN 55433 (612) 754-2999 Fax (612) 754-2906 Signed r 9 TEL # Approved ByAy__ Rough -In Date Final Date tPll® COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes1, No( ) j 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 manufacturers 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 A 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. YesA No( ) Appliance Type and Size/Common Vent and Vent Connector Information � Appliance #1 Type �Z BTU Input 14'1 4CO Fan Assisted or Nat ri A;513 re -D Appliance #2 Type -7rge-,4*&F BTU Input b— g Fan Assisted or Nat ' Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Inputs 6-00 Common Vent Type s ��D`� Vent Height W/171L Diameter inches Appliance #1 Vent Connector Height ft Length _Z_ft Diameter �'` in Type eo-C Appliance #2 Vent Connector Height ft Length __S' ft Diameter °' in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type I ALTERATIONS: (Describe) HEATING CO: �:U C int S�e %.-T A, Signed By: Date : �" SUBJECT IT NO. City of Fridley 32461 AT THE TOP OF THE TWINS BUILDING PERMIT r T NO. COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/12/02 JOB ADDRESS 4844 2 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7,8 4 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kathleen Driscoll/Polly Philbalst 48442 Street NE 763-502-9024 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Rusco Inc 5558 Smetana Dr, Minnetonka, MN 55343 952-935-9669 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 2173 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION O ALTERATION REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Replace nine windows into existing openings 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. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORKOR CONSTRUCTION ZONING SO.FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN BO 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 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 $17,777 $9.00 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- $293.25 Fir SC $17.78 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT FEE Licensw S $5.0 X325.03 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT [DATE) HENOPE ALIOA HIS IS YOUR PERMIT S-GNATURE OF OWNEROF OWNER SUILDERI IDATEI BLD INS'' RATE NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY 612-5723604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: r Owner Name & Address: •4 MPba4ei.# �i43 hJOrZr�� Z Contractor: MN LICENSE # a� Address: J Tel. # v Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP 110N 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: (UAL W (,OJOVIS (.i�''a Estimated Cost: $ � � I • � o a�,,bh K� o �Pukas - au,.,t" ),,c �6ap Driveway Curb Cut Width Needed: 7U.Ftx $ _ $ DATE: 'Z11 ® APPLICANT: CITY USE ONLY - Call (612) 572-3604 for Permit Fees If mailing in application Permit Fee $ a1 3' Fee Schedule on Reverse Side Fire Surcharge $ 17•'IS .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge $ $9100 per SAC Unit License Surcharge$ cJ 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 $ STIPULATIONS: i� Z- CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT HADD All IMRGR ng: 1=IxT1 IRFG TC) RF INSTAI I Fn ON FACH FLOOR Effective On Jan 1, 2003 Urinal Wash S:.:.:::. '��::::: Shower lt��:>� Tray:>�?�i. #'31:::::>:::: Floort :.:�.•:•: <:::::::: Drain :.::::: . �:::.:.....: �:a�t�:..:. Auto. Was her :t"aS:::::::::> Gas �.. ��`�"` i Ran a .#� .:....:>..:.:.::: ;E4ki�r.,c<:::>:: Water Heater .:.:..... . <�...... Gas EI ec Stories ? Base ment $ 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. Ft or1 $ 7.00 �3 20 D 3 Rain Water Leader $ 7.00 , Sump/Receiving Tank $ 7.00 e, // �"" l..uf4 "OH oFor2 $10.00 Owner Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As ted ,Floor3 $10.00 `yV �C�S Gas Dryer**' $10.00 Estimated Cost l PERMIT NO. Back Flow Preventer Required ( )Yes {) No /L FooI 4 r $15.00 PLUMBING COMP NY!%5-e ( f Reinspection Fee $47.00/Hr SIGNED BY TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS. 1.5% of Value of Fixture or Appliance 0 `1 G" ��'�®� 0 r' PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS w` • 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 �3 20 D 3 Rain Water Leader $ 7.00 , Sump/Receiving Tank $ 7.00 e, // �"" l..uf4 "OH Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As ted Gas Range** $10.00 `yV �C�S Gas Dryer**' $10.00 Estimated Cost l PERMIT NO. Back Flow Preventer Required ( )Yes {) No /L Type $15.00 PLUMBING COMP NY!%5-e ( f Reinspection Fee $47.00/Hr SIGNED BY TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS. 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $20.00 TOTALFEE $ a0.5o PLUS THE $.50 STATE SURCHARGE 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 When rap acinn an pYictinO hiranep,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. The p..ietine cnmhnctinn air is sized and installed to meet the current codes and manufacturer's specifications. When required to ante+all a new nomh"stinn air it will be sized and installed to meet the current codes and manufacturer's specifications. When i allinn naw venting Syg m, 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 Yes ( ) No ( ) Yes ( ) No ( ) Yes( ) No( ) Yes( ) No( ) Yes( ) No ( ) . — BTU Input Fan Assisted or Nat — BTU Input Fan Assisted or Nat _ BTU Input Fan Assisted or Nat 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 HEATING CO: Signed By: Date: SUBJECT City of Fridley (73'833 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. (04- t 1 NUMBER REV DATE PAGE OF APPROVED BY 0--1 CITY HALL FRIDLEY 55432 763-571-3450 910-F15 8/27/03 JOB ADDRESS 4844 2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7,8 /+ Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kathleen Driscoll 4844 2 Street NE 763-502-9024 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE O REMOVE R 8 DESCRIBE WORK Install a 2nd story bathroom - flooring 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT •50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CH CK FEE TOTAL FEE $40.25 SIGN A TUBE OF CONTRAC TOR OR AUTHORIZED AGENT (DATE. HEN PROPERLY VALIDATED THIS IS YOPR PERMIT _ r, S,GNATURE OF OWNERoF OWNER BUILDER. (DATE. B G INS ,. F(A E NE' / ` [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN j ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: �`®` sf IU r_ Legal Description: h �" Owner Name Sd 2--10� Contractor. MN LICENSE # Address: Tel. # 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: GARAGE AREA: DECK AREA: OTHER: Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length I Width Hgt/Ground 6 5 Sq. Ft. 1 r Ax�' Construction Type: ���Gry Estimated Cost: $ l QUO 0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ -i�77 L 3 41 DATE: �� -5 APPLICANT: 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 Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ �s $ __ SD 41 TOTAL $~^ C) �S Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ] Ft. 4 1801 L 9 I -s+ w N ; I o - CL -- e 3 Ni ia� :� u y O_ ol V tD .�.1.. M 0 Q Ja a. � 0 c �. M r. 0 c h, 1 /1 , . I 3 n Building PLUMBING Permit N0.00&7- Inspections RESIDENTIAL APPLICATION Receimy:A 763-572-3604Date CTI`'Y OF FRIDLEY DATE April 13, 2007 YOUR E-MAIL ADDRESS wnelson cC)i larsonplumbing.com SITE ADDRESS 4844 - 2nd Street NE THIS APPLICAA'T IS: 13 OWNER IMCONTRACTOR PROPERTY NAME:Polly Philblad OWNER/— ADDRESS: 4844 - 2nd Street NE cITY Fridley_ sTATEMN zip 55421 TENANT PHONE: 763/502-9024 CONTRACTOR NAME: Larson Plumbing, Inc. STATE LICENSE #3341 PM EXP DATE 12/31/2006 SUBMIT A COPY OF YOUR STATE ADDRESS: 3095 -162nd Lane NW cny Andover STATEMN zip 55304 LICENSE WITH PHONE 763/427-7680 FAX 763/427-9448 APPLICATION PERNUT TYPE Ild SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: o NEW N 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: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS —SHOWER WATER PIPING _ ,FLOOR _GAS PIPING wzD cmumw4 _ SWIMMING POOL WATER SOFTWER ($35) —BATHTUB CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET BACKFLOW PREV. ($15) � _ DISHWASHER _ LAUNDRY TRAY —WATER BEATER ($35) FOR IRRIGATION WATER METER OTHER —+'•'spc-i:."•'^:�?.o:�✓.,.�;h.W:r.?.5`'W:t;'?1?csr'�ve.. r' lj ��':I2�fi�i~T�1±,07t.• ���:i�Ti .r • •Fk' <>... ,.e. . N. ,-�...�; ;�:: ;,,� �7'��1G`'FC?7t. Permit Fee. $ 35—.0 Number of fixtures @ $10.00 x $10.00 = $ Surchar •e .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 plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT '' PRINPNAME,_Wendy Nelson DATE 4/13/07 , i, • .. 1, ...• :. .; o .� . t' .. f %J:7'' °'. 2V1'rJ' t)'.1 °.:.tV3 tiS17'11.�llir' r`i !!YS...RI):1i; ...r....•a . 7J= +©' l'J !:7N<'.>�:,'' City of Fridley Building inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 )07