PRE 2010 DOCSN° '788
Owner, �-
Architect
Builder 'I
r�
Village of Ridley, Mims.
BuHMnvG rEBX[r
Office of INSPECTOR OF BUILDINGS
A
Fridley, Minn., P 19
` /LOCATION OF BUILDING
No. 75r Street e-2 fc/:a Rl�
Part of Lot
Lot '= Block-----`--' Addition or Sub -Division
DESCRIPTION OF BUILDING
Front = Depth Height Stories <i
Manner of construction—
To be used asp' �� z To be completed=`t�-�-estimated Cost -L)',
Permit is hereby granted tothe building described in the above statement. This permit is granted
upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all
the work done in,'', around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley,'', Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limit% and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Inspector 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.
Subscribed and sworn to before me at Fridley, Minnesota,d this
day of F"``g a e' -_v A.D. 19
City of Fridley, 31inn.
BUILDING PERMIT
Date:
Owner:
Address
Builder
Address
TIC�EI OF BUILDING
No.. Street _ _.. n_ ._.__ _. P of t _— — --.
i __ _
04 Lot _ _ _ _ _ ._w Block '. Addition or Sub -Division ._ _ . ___--
Corner Lot _ Inside Lot __._ Setback .—....__._..... Sideyard
Sewer Elevation _ _ Foundation Elevation
DESCRIPTION .OF BUILDING
To Iced as:
a
s
• ' Front --••••— Depth Height _ Sq. Ft. Cu. Ft,r
Front Depth
Height Sq. Ft. Cu. Ft.
___ _
Type of Construction p
i Est._ Cos To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
xwy
In consideration of the 'payment of a fee of $ _ _ _ _ , permit is hereby granted to._....
to construct the building or -addition as described above. :This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon- said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon viola" of any of the provisions of said
ordinances. _ ., d' 9
Building Inspector
k fir. ,t -
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items
4
APPLICATION FOR BUILDING PERMIT
CITY OF FR.IDLEY, MINNESOTA
Address
No.
LOCATION OF BUILDING
of Lot
Lot Block. Addition or Sub.Div.
Corner Lot Inside Lot Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as: ¢
V- 2�' Hei /0
V Ir
Front �srth S�t
I t.
Sq. Ft. R Cu. Ft. ;2 X 6
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction 4-i Estimated Cost
To be
The undersigned hereby makes application for a permit for the work herein 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 representa-
tions stated in this application are true and correct.
DATE%®% ��� SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
Mir/S
: ITY OF FRIDLEY INSPECTION DIViSION
5431 University Ave NE
=ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
;79-1tind REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB AD
Effective On May 10, 1999
a11J°
c6'
V
RATE SCHEDULE OWNER 1� �_
3esidential Rate TOTAL
Furnace Shell and Duct Work, Burner - e BUILDING USED AS
Also Replacement Furnace $ 30.00. $ '
(Side Vent Fill Out Back) ESTIMATED COST a00 PERMIT NO. =�
Gas Piping (Needed with new furnace, $ 10.00 $
but not replacement) DESCRIPTION OF FURNACE AND OR BURNER
Gas Range $ 10.00 $ _
No. of Heating U its I Circle Cne (Steam) (Hot Water) arm
Gas Dryer $ 10.00 $ Trade Name_iud _ Size No. 11a eh 0(pBTU (.x.15 ) HP EDR
*Air Conditioning - All Sizes $ 25.00 $ Fuel_ - Total Connected Load
�J
All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No.
1% of Value of Appliance or Work $ BTU• HP EDR
Cftx
q %0 o
Commercial/Industrial
1.25% of Value of Appliance or Work $ 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 ar
State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
TOTAL FEE $!55" lepoaaiQUAun.;NC•
2R2170-5040, CN RAPIDS. MN 55433
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION :EAT4d-?7j-
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 r�
PLUS THE $.50 STATE SURCHARGE ' `%�� DATE---
X
AITE-�
REINSPECTION FEE $47.00/Hr /
*Air Conditioners can not be placed in a side yard without Approved BRough-in Date Final Date l
\,{written permission from adjoining property owner.
• FILI.OUT BACK SIDE -R STACK VERIFICATI ON REPLACEMENT FURNACE
M
.List ALTERATIONS Being Done: r;' C
Q 5.
r n ry via
D'
dc tu
DEPENDABLE i AIRpUALITY, INC.
2619 COON IDS BOULEVARD
COON MN g.t!-!
HEATING CO: (612) 757
Signed By:
Date: 5 -;7- 3 —®D
CHEMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes XA Yv
No ( )
2.
Is free from rust or deterioration
Yes �.
No O
3.
Has no foreign objects lodged within
Yes (`)
No
4.
Is securely supported
Yes P<-).
No ( )
-- 5.
Meets all current Code requirements for size
-
and total BTU's connected
Yes
No ( )
6
Has total heating BTU's of ��, 50D
All other BTU's
TOTAL BTU's /®(�, 06 o.
7.
Has a liner been provided for water heater
Yes
No ( )
8.
Has combustion air been provided for water heater
Yes P'0'-
No ( )
Remarks:.
.List ALTERATIONS Being Done: r;' C
Q 5.
r n ry via
D'
dc tu
DEPENDABLE i AIRpUALITY, INC.
2619 COON IDS BOULEVARD
COON MN g.t!-!
HEATING CO: (612) 757
Signed By:
Date: 5 -;7- 3 —®D
sueiEti
P MIT NO.
City ®f Fridleyr?
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
' • COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
572-3604�I
NUMBER
pEV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L 612-571-3450
f 910-F11
5/22/01
JOB ADDRESS 4756 2 1/2 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5,6
6
1 Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Patrick Thoennes 4756 2 1/2 Street NE
763-572-0952
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Lifetime Siding & Remodeling 355 21 St, Newport MN 55055
651-458-0844 1780
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE N0.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Replace existing windows
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.
77
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING.
TYPE: OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. '
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
@
$2,752.75
$1.37
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOT FEE
_
Licen $5.0
-/
92.37
SIGNATURE OF CONTRACTOROR AUTHORIZED AGENT IDATEIEN
PROP ALIDATE THIS IS R IT
'00�V
8 69G INSP
DATE
S-GNATURE OF OWNEROF OWNERSUILDERI IDATEI
NEW Effective 11112001
ADDN L j CITY OF FRIDLEY (763) 672-3604 Bldg Insp
ALTER [ j SINGLE FANLY AND DUPLEXES R-11 AND R-2
BUILDING PERMIT APPLICATION
Construction Address.• 5& / F
Legal Description:
Owner Name & Address: Tet. #-
Contractor. 4 MN LICENSE;
Address J/ Tel #,L y%o4
Attach to this application, a Cerfficate of Survey of the
lot, with the proposed construction drawn on if to scale.
DESCRIPTION OF WROVEME'+IT
LIVING AREA: Length V& th Haight � Sq. Ft
GARAGE AREA: Length Width Height Eq. Ft
DECK AREA: Length Width HgVGround Sq. Ft
OTHER:
Construction Type.. &djn,WARS Estimated Cost: $ (7) " e L �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x = 3
DATE: -/ -bl APPLICANT: a Tel. # /�-3- 5Yd 3k6
gry USE ONLY - Gall (763) 572.3604 for PermYt Fees if mailing In application
Permit Fee $ 73,0 Fee Schedule on Reverse Side
Fire Surcharge $ c2. 71-5 .001 of Permit Valuation (1110th%)
State Surchar,000 ValualJon
SAC Charges $ $1150 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. W or Alt. V' Above
Erosion Control $ $450.00 Conservation Plan Review
Parte Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary i l Not Necessary 1
TOTAL $ I om.:(
STIPI,iLATiONS %�p
zo/S0'd sgeTeGIPTS9 Ol A3" MW d0 A110 WOE SS:10 TOOZ--60-834
CITY OF FRIDLEY PERMIT O.: 2004-00s
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 06/02/2004
572-36U4 YAX: (763) 571-1257
ADDRESS : 4756 2 1/2 ST NE
PIN : 263024320078
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOW/DOOR REPL
VALUATION : $ 2,100.00
NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317
OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS..
INSTALL ONE WINDOW WITHIN EXISTING OPENING.
STATE LICENSED CONTRACTOR 1
APPLICANT
JANSICK INC (8618)
6480 SQUIRE DR NE
FRIDLEY, MN 55432-5243
(763) 574-9679
OWNER
THOENNES PATRICK W
4756 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 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
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 cons tor the performance of construction.
Appl Date& -Z-0
Bldg Insp r C TJVi Dat � -064
BUILDING PERMIT FEE 83.25
FIRE SURCHARGE 2.10
STATE SURCHARGE, VALUE 1.05
LICENSE SURCHARGE 5.00
TOTAL 91.40
SEPARATE PERMITS REQUIRED FOR WORK `OTHER THAN DESCRIBED ABOVE.
NEW [ J CITY OF FRIDLEY gAt,30P6 Effective 4/1/2004 CC-
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION 5 9
Construction Address: 4/
Legal Description:
Owner Name & Address: iti % ® e- I1 n c 5 _Tel. # %� 3-.�7e"� -C� 9S9
Contractor. C12�q X15 )�� ' Ks zmc MN LICENSE
AAA -.e . 1.410., 4 f' Tel. # 7g�!. __,577 i-l67,f
LIVINGAREA:
GARAGE AREA:
DECK AREA:
9THER:
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.
Hgt/Ground Sq. Ft.
Construction Type: Estimated Cost: $ 4!!-.2 '119
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: Io Z -O APPLICANT:
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
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Fee Schedule on Reverse Side
$ — 65% of Permit Fee
$ 0 .001 of Permit Valuation (1/10th%)
OS $.50/$1,000 Valuation
$ $1350 per SAC Unit
,j7777a OO $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 [ ]
TOTAL $ _ 9l STIPULATIONS:
4 �
f
}: rt!/C�t'R�{d�f;Vi4C3W{�Il'i�i ��/1J�i�iMi7��7tl
6480 SQUIRE DRIVE FRIDLEY, MN. 55432 • (763) 5749679 • LIC. NO. 8618
91
SIZES WILL VARY SLIGHTLY
--�) 12S�l 461 E.0 4;eeAe
WINDOW:
ANDERSON C25-2
CLAD (WHITE)
CASEMENT
4-9/16°
Y
HEADER
�
�e®V`
8'-0 7/8"
0
Ln
REI
OF
C
B
FDDENCE
Insp to
o
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 Q®65` -006-90
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Floor €> G ter Heater
Wash lr[rtl�......... oi<>> Auto.<>...... as l ....: we Heat
tories �ff:�� Urinal Tray ��!i;�}�`y.�.�L > Drain Was y] s>> Range 3?�y,��(; `€ Gas Elec
S her
:)iiY•`hT:M1:i:::.. .. ..•.14:i:..... .F.�141T!':�:...:.
9
as ment <>'>">>'
B e
Fto or 1xxX.
Floor 2
Floor 3
FI
oor 4
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
NO. RATE TOTAL
Water Heater - Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$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 $
JOB ADDRESS IN `
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: d-11oq 6 .20
OWNER O� ° ° �� I� ne S
BUILDING USED AS I CJQ�
ESTIMATED COST jj PERMIT NO.
PLUMBING COMPANY PI
SIGNED BY TEL N0.K1 -3V5' 13`t0
Approved By
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
Rough -In Date Final Date
lie]:
**PROVIDE COMMON VENT INFO ON BACK SIDE
,-5
4
0
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 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.ven# 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 _
Appliance #2 Type _
Appliance #3 Type _
Total Appliances
_ BTU Input
BTU Input
_ BTU Input
Total Btu Input
Fan Assisted or Nat
Fan Assisted or Nat
Fan Assisted or Nat
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 :