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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 airs"_..� "' --?a .,u.;::; ^vy, # xt }_,.� 3 k� :y<`3i Yi" +'is,rFhB "E•a "" ,.' �/s "S,�Z±.a -r'nxP S' -.ir T l c. E S : F .F �.,+};Ia: � z�y '•M.' .'-byy.S i. �y � k F -P ;e�C 4�{,�_R k� � 2 � �H•� % � C t%'.. � ^Y �rLv>.� Y f. i �t. _ ii tI - >L�y't `�'`' " r' i � '"�'m iy}sA FtX �1�.0 ft�''S �, �y3?�n �>"r'e'�.e"G i➢t..�' #j t7 � : ,C'���'ity. h ::, C�� �7:ah R' y�i '.. s�, �+s�d. 7' ��{�'?' 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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.