PRE 2010 DOCSp�a
AppIcation for Power Planft and Nng. Yentii mjanR RddIsmijan and
Air Conditioning Spftnn and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARP! Milli: MTZ TOTAL
Furnace Shell & Duct Work ....... $10.00 =
Replacement of Furnace 6.00 $
Repairs & Alterations—up to $500.00 6.00 $_
Repairs & Alterations each add. $500.00 3.00
MECIL WARN ATA
Furnace Shell & Duct Work to 120,000 BTU ......
. $10.00
$_
each add. 60,000 BTU ....................
3.00
;
Replacement of Furnace
6.00
$_6P . "
Repairs & Alterations—up to $500.00
6.00
$
Repairs & Alterations each add. $500.00 .... ..
&00
$
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00
$.----
. ___Furnace
FurnaceShell & Line—to 640 sq. ft. EDR Kot Water
10.00
$_
Each add. 200 sq. ft. EDR Steam.
min
1st 3 Fixtures
Each add. 320 sq. ft. EDR Hot Water
3.00
$
OIL BURNER—to 3 gal. per hour 6,00 $
over 3 gal. per hour ---See Fee Schedule
BIAS BUR (up to 898,000 BTU)
5.00
$
oxer 199,000 BTU See Fee adtodule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures
/ x$ J()o
$UO
Additional Fixtures
x .75
$
Gas Range to 199.
x$ 5:
$
AIR CONDMOXING
FAN HEATING SYSTEM See Fee
schadale
V ITILATING SYSTEM
g
ALTERATIONS & REPAIRS
TOTAL PW
$_A9 501
ROUGH (SURCHARGE
Dept. of Bldgs. Phom 880-3M
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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. r�
Fridley, Minn- � � lg /�✓
Kind of Building
Used as
To be completed about
Estimated Cost,
Old—New. Building Permit No. Permit No. 6
TD -45 1 - r r
BEATING or POWER team, Hot Water, Warm Air—No—
Trade
ir NoTrade Name 4-4�2 Size No-f8Q 6 (r0
Capacity Sq. Ft. E.D.R_ ZZ176, L►'!Y/ BTU Alla.
Total Connected Load_�1 �Kind of FuelL01/
61
BURNER. — Trade Name Sias No
Capacity Sq. Ft. E.D.R BTU
Z�
(REMARKS -OVER)
r
10
SUBJECT
PERMIT NO.
City of Fridley_
1943
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
R EIPT NO.
• --_-_ COMMUNITY DEVELOPMENT DIV.
V -
PROTECTIVE INSPECTION SEC.
�
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/29/88
JOB ADDRESS 4578 - 231 Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
2
2
Plymouth, Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert Soukup 4578 - 2; Street N.E.
572-1597
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 X❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reside Dwelling
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Vinyl
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2 0�0
$ $1.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$32.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
LAN CHECK FEE
TOTAL FEE
$33.50
SIGNATURE OFCONTRACT ROR AUTIhAORIZED AGENT (DATE)
WHEN PROPERLY VjAIJDATED THI IS YOUR P MIT
BLDG INSP
ATE
SIGNATURE 0F OWN-DKIF OWZE.DERI IDATEI
10
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: ;'y
Legal Description: --
Owner Name & Address: .�� ' h � T So % Tel. # 6-7-2.
Contractor: S 4-�_Tel.
Address:
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.
DESCRIPTION OF IMPROVEMENT
Length Width
Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
1Y
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: Estimated Cost: $ �a4d
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel. #._%2 -LL?
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
25$ of Building Permit Fee
$.50/$1,000 Valuation
$ 5,50 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace $ 20.00
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace) $10.00
di
as Range $ 10.00
Gas Dryer $10.00
*Air Conditioning — All Sizes $ 10.00
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Com merciallindustrial
I% of Value of Appliance or Work
State Surcharge
TOTAL FEE
$ P. U�
Effective On January 1, 1993
JOB ADDRESS_ q 5-18- — 02 ' 'ge. -
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.
-- , 11-15-- 1994
OWNER
$ P
BUILDING USED AS
$ ESTIMATED COST1%fJd PERMIT NO.
.DESCRIPTION OF FURNACE AND OR BURNER
$
50
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION]AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name
BTU HP _
Size No.
EDR
Fuel Total Connected Load
Burner Trade Name
BTU
HEATING COMP
Signed By
Size No.
HP EDR
Tel No.13— 1--7 % 5�/
Approved B Rough—in Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
�;H1IVJNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes {) No { }
2. Is free from rust or deterioration .
3. Has no foreign objects lodged within
4. Is securely supported
5- Meets all current Code requirements for size
and total BTU's connected
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks:
BEATING CO:
Signed By:
Date:
Yes No
Yes No
Yes No
Yes ( ) No ( )
Yes No
Yes () No ( )
Su BJECT
P :---�
City of Fridley
0 7 3
AT THE TOP OF THE TWINS
BUILDING
PERMIT
• COMMUNITY DEVELOPMENT DIV.
^ ,
r PROTECTIVE INSPECTION SEC
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
5/19/97
JOB ADDRESS 4578 2 1/2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR,
2
2
Plymouth
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert Soukup 4578 2 1/2 Street NE
572-1597
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Lloyds Home Improvements Inc 1012 42 1/2 Ave NE, Columbia Heights 55421 788-5602
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
1798
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (18 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the 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
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
$1,485
@@
$.74
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-
$48.50
Fire SC $1.49
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
`
vw
License SC $5.00
$55.73
51 NATURE OFCONTRAC7 ORAUTHO z AGENT IDATEI
WHEN PROPE Y VA (DATED THIS IS YOUR PERMIT
4'
BL (NSP
q a�
BATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1 / 1 /97
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 4578 - 2-1, ATa NE
Legal Description:
Owner Name & Address: ROBERT SOUKUP
Contractor: LLOYDS HOME IMPROVEMENTS, INC
Tel. # 572-1597
MN LICENSE # 0001798
Address: 1012-42-1, AVE. NE.. COLUMBIA HEIGHTS, MN. 55421 Tel. # 788-5602
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: LMth WidthHgt/Ground Sq. Ft.
OTHER: ( %` t�6 t_P -f l ,AaT S'k -
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $ 2 18 sq.
(Fee Schedule on Back)
Ft x $ = $
DATE: Apr 29, 1997 APPLICANT:
Tel. # 788-5602
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ j, �-/�
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$
$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:
k i i Y UF FRIDLEY INcii 'C(, I IUN UIV. C �t'%`�2 S ,d /'fc '�1 Effective On Jan 1, 2000
6431'University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO.
RATE
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$ 7.00
Water Heater - Gas**
$10.00
Gas Range"
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required >(es () No
TYPe6-tj_ a&I,r V'rav-k'?/o-e� le -w-
$15.00
WW -f ire 5 22o.4
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
TOTAL JOB ADDRESS 72 ;�'8 ,5-r- C 6,17 'e 14—
State Surcharge $ 50
TOTAL FEE
The
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.
20 UCS
Owner
Building Used As
Estimated Cost 3 G 129
S� PERMIT NO.
PLUMBING COMPANY
SIGNED BY Z��� TEL NO. (lS`�—�—�—�
Approved By
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A
Rough -In Date Final Dade
COMMON VENT INFO ON BACK SIDE
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
been examined and is free from rust, deterioration, obstructions,
venting has
and is securely supported and firestopped where required.
Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
of elbows and termination.
Yes ( ) No ( )
specifications including sizing, length, number
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
Central Furnace Venting Tables for fan
include AGA -LAMA Category I
Yes () No ( )
assisted and natural draft appliances.
The existing combustion air is sized and installed to meet the current codes
Yes () No ( )
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
Yes O No ( }
To meet the current codes and manufacturer's specifications.
When installing a new venting system, the undersigned hereby verifies that
codes and manufacturer's
it is a listed assembly and meets the current
This does include AGA-GAMA Category I Central Furnace
No ( )
specifications.
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
Yes( )No( )
separately as per current codes.
Appliance Type and Size/Common Vent and Vent Connector Information
BTU Input Fan Assisted
Appliance #1 Type Fan Assisted
or Nat
or Nat
BTU Input
Appliance #2 Type BTU Input Fan Assisted
or Nat
Appliance #3 Type
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter
inches
Appliance #1 Vent Connector Height . ft Length ft Diameter
ft Diameter
in Type
in Type
Appliance #2 Vent Connector Height ft Length
ft Length ft Diameter
in Type
Appliance #3 Vent Connector Height
ALTERATIONS: Describe
HEATING CO:
Date :
Signed By:
1
CCiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
January 18, 2001
Robert Soukup
4578 2 1/2 Street NE
Fridley, MN 55421
Re: Final Inspection at 4578 21/2 Street NE
Contractor: Weld & Sons Plumbing
Dear Mr. Soukup:
A plumbing permit was issued on October 11, 2000 to install a pressure vacuum breaker
for an irrigation system at the above noted address. According to Section 4715.2800 of
the State Plumbing Code, a final inspection shall be conducted on the plumbing
authorized by this permit. As of this date no inspection has been called for.
The permit fee that was paid covers the inspector's time to check to make sure the
vacuum breaker was installed correctly.
You will be given thirty (30) days from receipt of this notice to respond. If we do not hear
from you, we will expire the permit and any inspections on this installation will require a
new permit.
Please contact me at (763) 572-3603 if you have any questions concerning this matter.
Sincerely,
WEJ)) EN
Buildinff Inspector
DJ/mh
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
FRIDLEY, MN55432-
//
ISSUED:06022010
(763)572-3604FAX: (763)502-4977
Permit #2010-00816
4578 2 1/2 ST NE
ADDRESS:
PIN:263024330102
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH
:LOT 2 BLOCK 2
PERMIT TYPE:HEATING - FIXTURE BASED
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:AIR CONDITIONING
NOTE: AIR CONDITIONER CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY
OWNER.
INSTALL REPLACEMENT
CARRIER 24APA524 2 TON
AIR CONDITIONING FEE35.00
APPLICANT
STATE SURCHARGE, MECH FLAT0.50
RIVER CITY SHEET METAL
TOTAL 35.50
8290 MAIN ST NE
Payment(s)
#39
CHECK1243435.50
FRIDLEY, MN 55432-
(763) 754-2199
Minnesota State License #: 7900654504
OWNER
SOUKUP ROBERT J & ROSEMARY
4578 2 1/2 ST NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction authorized
is not commenced witin 180 days or if construction or work is
suspended or abandoned for a period of 180 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 work will be complied with
whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any
other state or local law regulating construction or the performance of
construction.
Applicant____________________________Date________
6/2/10
Bldg Insp____________________________Date ________
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
ISSUED:06/02/2010
FRIDLEY, MN55432-
(763)572-3604FAX: (763)502-4977
Permit #2010-00816
4578 2 1/2 ST NE
:
ADDRESSPERMIT APPLICANT:
PIN:263024330102RIVER CITY SHEET METAL
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH8290 MAIN ST NE
:LOT 2 BLOCK 2FRIDLEY, MN 55432-
PERMIT TYPE:HEATING - FIXTURE BASED
PROPERTY TYPE:RESIDENTIAL(763) 754-2199
CONSTRUCTION TYPE:AIR CONDITIONING
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM
INSPECTION TYPEDATEINSPECTORCOMMENTS
AIR CONDITIONING FINAL07/06/10PDAVE
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.
Building MECHANICAL Permit No.�e .s U
Inspections RESIDENTIAL APPLICATION Received By: '
763-572-3604 ���� �� � � "tc)14-
l763-502-497 FAX EFFECTIVE 2-19-09
DATE IS- - ea IF o / 0 YOUR E-MAIL ADDRESS
SITE ADDRESS LJ S 7yc0l_
a_ s�� �" 6Q -1'0t �t
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME: (�.biott_t a i too
E��
ADDRESS: `i•S�-7 Q a t�� S6 Q $
CITY i i'Ll -0 t �
_
STATE "� j l
ZIP L
PHONE: I t - S "j',).- I f -%
CONTRACTOR
COMPANY NAME:
(SIke
SUBMIT A COPY OF
CONTACT PERSON:
YOUR STATE
STATE LICENSE #
EXP DATE
LICENSE WITH
ADDRESS: gX90 t-��tb �$ IJ6
CITY rlL(0 '
_
STATE�ZIP� _ q')-�
APPLICATION
-`
PHONE :3 (ckN `A S V
FAX
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY
❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW VREPLACEMENT
❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK EYISk 4 j 0
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: °� % ��e %-A- MODEL: 44 A SIZE/BTU e).T6- n
A/C $25.00
_AIR TO AIR EXCHANGEER $15
_BOILER $35.00
_CHIMNEY LINER $10.00
DUCT WORK $10.00
MFG:
MODEL:
MFG: MODEL:
_FMPLACE (GAS) $15.00
_FIREPLACE (WOOD) $35.00
_FURNACE $35.00
_GAS DRYER $10.00
GAS PIPING $10.00
SIZE/BTU
SIZE/BTU
_GAS RANGE/OVEN $10.00
NEW GAS GRILL $10.00
_GAS UNIT HTR $10.00
POOL HEATER $35.00
VENTILATOR $15.00
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and 1 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 PRINT NAME v2q,(J 1D DATE S ` 3 9- I
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
FRIDLEY, MN55432-
//
ISSUED:09202010
(763)572-3604FAX: (763)502-4977
Permit #2010-01660
4578 2 1/2 ST NE
ADDRESS:
PIN:263024330102
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH
:LOT 2 BLOCK 2
PERMIT TYPE:HEATING - FIXTURE BASED
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:FURNACE
NOTE: INSTALL/REPLACE FURNACE - CARRIER 58UVB060-14 60,000BTU
FURNACE FEE35.00
APPLICANT
STATE SURCHARGE, MECH FLAT5.00
CENTERPOINT ENERGY
TOTAL 40.00
9320 EVERGREEN BLVD SUITE B
Payment(s)
COON RAPIDS, MN 55433-
CHECK1313440.00
(763) 757-6202
Minnesota State License #: 22013346
OWNER
SOUKUP ROBERT J & ROSEMARY
4578 2 1/2 ST NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction authorized
is not commenced witin 180 days or if construction or work is
suspended or abandoned for a period of 180 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 work will be complied with
whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any
other state or local law regulating construction or the performance of
construction.
Applicant____________________________Date________
9/20/10
Bldg Insp____________________________Date ________
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
ISSUED:09/20/2010
FRIDLEY, MN55432-
(763)572-3604FAX: (763)502-4977
Permit #2010-01660
4578 2 1/2 ST NE
:
ADDRESSPERMIT APPLICANT:
PIN:263024330102CENTERPOINT ENERGY
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH9320 EVERGREEN BLVD SUITE B
:LOT 2 BLOCK 2COON RAPIDS, MN 55433-
PERMIT TYPE:HEATING - FIXTURE BASED
PROPERTY TYPE:RESIDENTIAL(763) 757-6202
CONSTRUCTION TYPE:FURNACE
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM
INSPECTION TYPEDATEINSPECTORCOMMENTS
START-UP OK
FURNACE FINAL10/11/10PDAVE
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.
Building
MECC
Permit No.: EV 101) 1 LoW
Inspections
RESIDENTIAL APPLICATION
Received By: •A.
763-572-3604Da��c
CITY OF LEY
2
763-502-491177 FAX
G(�✓13t (
EFFECTIVE 2-19-09
DATE—YOUR. E-MAIL ADDRESS
1 y�\
L45-1 aL �� E
SITE ADDRESS Gy
THIS APPLICANT IS: ❑ OWNER 11CONTRACTOR
PROPERTY
NAME: \-?-j0b'P_r 50L&
OWNER/
ANT
fL n 1^ >
ADDRESS: �-I �� p 311-z- �iT - I V 1. CITY �� ¢ e 1 STATEQ I KZIP4SA oZ
PHONE: —I CP :S " S—I I S9 -7
CONTRACTOR
COMPANY NAME: -- CENTERPOINT—ENERGY---- -- _-_ _ __ _-_------ _ _ - .-----_ --- ---_- -_
SUBMIT A COPY OF
CONTACT PERSON: JOANN ZINKEN
BOND 22013346 08/19/2009
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS:9320 EVERGREEN BLVD NW SUITE B cITYC00N RAPIDS STATE MN ZIP 55433
APPLICATION
PHONE 763-757-6202 FAX 763-757-6701
PERMIT TYPE
)SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL
DETAILEDnFR�RIpTTnN OF WORK elAk I &ey CLO -C— r Ack ct e .
FEES ARE BASED ON $10.00 PER FIXTURF XXCEPT WHERE NOTED. FIXTURES: (INDICATEOTAL �NUMBER OF E BELOW)
0d�L® GC)
v~'u1 SIZE TU
Equipment Installed MFG: it f t E i/ MODEL: ���L5
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 GAS GRILL $10.00
_AIR _NEW
_BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
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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 tha 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 all work whi h r Quires review and approval of plans. �j
� ' ROGER HOFFHEIN `1 j 1lolj b
SIGNATUREOFAPPLICAPRNTNAME DATE l
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ZEXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2: Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
FRIDLEY, MN55432-
//
ISSUED:10042010
(763)572-3604FAX: (763)502-4977
Permit #2010-01769
4578 2 1/2 ST NE
ADDRESS:
PIN:263024330102
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH
:LOT 2 BLOCK 2
PERMIT TYPE:ELECTRICAL
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:ELEC CIRCUITS
NOTE: CALL ROBERT CLAUSON AT 651-777-7885 WEEKDAYS FROM 7-8:30 AM FOR REQUIRED INSPECTIONS.
ADD $5.00 (MINIMUM) STATE SURCHARGE TO THE FEE OR IF OVER $1,010 MULTIPLY .0005.
WIRE/RECONNECT FURNACE.
ELECTRICAL PERMIT FEE35.00
APPLICANT
STATE SURCHARGE, ELEC FLAT5.00
CENTERPOINT ENERGY
TOTAL 40.00
9320 EVERGREEN BLVD
Payment(s)
SUITE B
CHECK1317140.00
COON RAPIDS, MN 55433
(763) 757-6202
Minnesota State License #: CA01796
OWNER
SOUKUP ROBERT J & ROSEMARY
4578 2 1/2 ST NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction authorized
is not commenced witin 180 days or if construction or work is
suspended or abandoned for a period of 180 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 work will be complied with
whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any
other state or local law regulating construction or the performance of
construction.
Applicant____________________________Date________
Bldg Insp____________________________Date ________
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
ISSUED:10/04/2010
FRIDLEY, MN55432-
(763)572-3604FAX: (763)502-4977
Permit #2010-01769
4578 2 1/2 ST NE
:
ADDRESSPERMIT APPLICANT:
PIN:263024330102CENTERPOINT ENERGY
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH9320 EVERGREEN BLVD
:LOT 2 BLOCK 2COON RAPIDS, MN 55433
PERMIT TYPE:ELECTRICAL
PROPERTY TYPE:RESIDENTIAL(763) 757-6202
CONSTRUCTION TYPE:ELEC CIRCUITS
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM
INSPECTION TYPEDATEINSPECTORCOMMENTS
ELECTRICAL FINAL
EXPIRED. NO FINAL INSPECTION SCHEDLED.
EXPIRED PERMIT10/04/11BOBC
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.