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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. N? 2383 Date......................... Owner,�1 ir...., Address . *if. 2j 1 } ...... V'. Lot ..... ,pr�..... Corner Lot ........I To be Used as: * ", *4 74, Type of In consideratic the proposed work ordinances of the i Builder."1�s?'!'�.......................... .40W '0'40*' 'cess ......................................... LOCATION OF BUILDING Street !'1.....!1�............... Part of Lot ....................... Block .... (ip.......... Addition or Sub -Division .. `".' • ................ ... Inside Lot ............ Setback.. 00 Sideyard 1,0 *,rlt/t............... DESCRIPTION OF BUILDING Frontk �� Depth .1.4.. Height 44f. Sq. Ft. �f + �. ` Cu. Ft. ........ Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft......... �.,� Est. Cost . A&;!...00 '........ To be Completed *140' ........... of the issuance to me of a permit to construct the building described above, I agree to do accordance with the description above set forth and in compliance with all provisions of age of Fridley. consider hof the payment of a fee of $../*101'. , permit is hereby granted to, i,, .. to construct the building or addition as described above. This permit is granted upon e express conditioi 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 garding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon vipla f any of the provisions of said ordinances.""" '_e V ..r ....... . .. Building Inspector NOTICE: This permitoes not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water, je sure to see the Building Inspector for separate permits for these Items. �7- 0 City of Fridley, Minn.. BUILDING PERMIT N° (4:7:4) Date: _-pl�_.�- © Owneuilder .................. Address _ Address ............ .._.._ _ ..... _. _.__.._..._..�_._...OF L T O OF BUILDING No. _._.. Street _._ w,..: � _....................._ _ Part of d`._7........ .. , Lot ....._..._ B� ..._... ..,.:..._........ Addition or Sub- on ... ...._. _..�._ Corner Lot, Inside Lot....._._!._...._.................I0back _........ _..,. Si eyard .... ....:4�-- ".- _-_--- Sewer Elevation ........................... ........... __._-------------_.._..._...._..--. ...._.._._. Fo dation Elevation DESCRIPTION OF BUILDING To Used �....... * a Front . Depth .. ..' Height..... Sq. Ft. Cu. Ft. -.................. ... _....................... Fro ...................... Depth..............._..._..�dfiight .................�, Sq. Ft....................... Cu. Ft. ....... ... ....._.. Type of Construction .. .:..,., r .. Est. Cost:......:. U:016.*""^"rb be Completed ................... _............................ THIS PER, = ` _rIO V �jl ,1- ION OF:_N .AOTHoR1ZE BUILDI,VAfvY P[itVATE LAND VIOLAT- G RESTRICTIONS, COVENANTS AND 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. 1110 42 r 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 anyt�"oryry;lation oij any of the provisions of said ordinances. /���� r ))) Building Inspector NOTICE: This permit does ',knot cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, IOTA Owners Name ri e LOCATION OF BUILDING No. 6 65-5 _Street_ / ,.�� a %� = art of Lot A Lo �` � ock � Addition or Sub. �t Corner Lot Inside Lot --e—"*' set Back Side -Yard' - SEM ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: C/ e Height �C1 Depth Fron � © ,! Sq. Ft. 7.� Cu. Ft..e C) Front Depth Height Sq. Ft. Cu. Fte A Type of Construction 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 co ec (A Schedule of Fee costs can be found on the Reverse 74 45�/ PL SUBJECT IT City of Fridley15 j��RM80 8 AT THE TOP OF THE TWINS BUILDING PERMIT ECEIPT N � COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 NUMBER REV.DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/14/80 JOB ADDRESS 6055-24 St N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 26.27 6 I3 a Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Theodore J_ Marchiniak 6055-235 St- N -E- rridlay 5412 S71-1692 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Man Pr 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ ElNEW % ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be second but not third. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING, Asphault 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 R 1 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 $750.00 $.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.50 PLAN CHECK FEE TOTAL FEE $8.00 S �IIATUR F CONT ACTOR OR AUTHOR( AGENT DATE( `� ,. WHEN PROP R/LY��V��LI��DAT D THIS IS YOUR PERMIT -�� BLDG INSP BATE S GNATURE OF NER IIF OWNER BUILDER) (DATEI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: 1A/1 BUILDER: ADDRESS: �C��S� ��/1 ��'" �� ADDRESS: TEL N0: `��%° a� �,� % TEL NO: Construction Location STREET NO: r,65 STREET: LOT: 07 BLOCK:_ ADDITION: Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. —addDESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: '014S'.� v_ Type of Construction: /,e To Be Oumpleted: jp 7 c3� Estimated Cost: $ ,�® Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET The undersigned hereby makes application for a permit for the wo rk'herei.n specified, agreeing to.do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and h by declares that all the facts and representatio s stated in this applicat' a tru d correct. DATE: SIGNATURE: Stipulations: F),, - 7.S� 97-8b-bi6o51 CITY OF FRIDLEY • APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE N r0. ?r N %'.:.-.ber Fixtures •� $3.00 o c^1t•�re Fixture Opening K d $ Water c am $ s2 x ro u T C a N u a $5.00 -� ++ ro u .+ ••+ w bp g $ Heater U .+ ••+ New Ground Rin Old Building x E -a ro u x N c= c: O, R i 4 1st 3 fixtures x $3.00 $ oo additional Fixtures x $1.00 $ C N - 4 O O S +� 41 N N $5.OQ $ v G $ VJ 3 O N W U lAro s �NQ U' l , �V �Nq C7 O dS kec V, U7 .'O� ' ls. 4 .d w rm Mo Alz Jpaceh at r T2011A 0, 00 T 3rd 14ta i = i•L•ture Connection Opening Connected with Sewer E(A) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUN3ING FIXTURE RATES: r0. RATE TOTAL %'.:.-.ber Fixtures r. $3.00 $ c^1t•�re Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water :eater - to 99,000 BTU x $5.00 $ 100,000 B:J to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Rin Old Building x $5.00 $ lectric Suter Heater x $5.00 $ GAS FITTI\G FEES: 1st 3 fixtures x $3.00 $ oo additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.OQ $ each. add. $100.00 or fraction $2.00 $ State Surcharge TOTAL FSE$ l , �V REINSPECTION FEE Job Address 6055 22 Street NE Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and ecrreet Fridley, Mn. 10-17-80 19 OWNER MARCHINIAK KIND OF BUILDING frame USED AS res. TO BE COMPLETED ABOUT 10-24-80 ESTIMATED COST 50.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. i r Company 4l1 9r e Signed By E. Tel. No. ROUGH INSP. Date FINAL INS?. 3 Date APPROVAL FOR PERXIT �yriY� MnaMUH FEE FOR ANY PLUMBING PM14IT IS $7.50 pLUS $.50 SATE SURCHARGE 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) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 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. Effective On January 1, 2000 $ 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 representations stated in this application are true and correct. 612-1 42nd Avenue No. DATE o� o1—d l Crystal. Mn 55422 HEATINGrA f2 Signed Approved By J� - Rough -In Date TEL #.7&3 --139— Final Date � �l JOB ADDRESS__��5� ST N OWNER IAVZ .8 Fri 6 - TOTAL BUILDING USED AS $ ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) (Hot Wate (Warm Air $ Trade Name C"f-c-E-le— Size No. roc BTU�,B00 HP EDR $ Fuel N A-7— G 9-s 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 representations stated in this application are true and correct. 612-1 42nd Avenue No. DATE o� o1—d l Crystal. Mn 55422 HEATINGrA f2 Signed Approved By J� - Rough -In Date TEL #.7&3 --139— Final Date � �l COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existina 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 �-rNo ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (,I"'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 (-J'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 (4No ( ) 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 (-I'No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from .the common vent and vented separately as per current codes. Yes.(') No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type fUktjA<.� BTU Input Kloo� Fan Assisted or Nat POLO e5re, Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) U g -7-v- P v'L F -'5u R-AJA-r-r-- -f- ZZ)oLdoL) Ci -I � k �� HEATING CO: CrysW, Win 55`2" Signed By: Date CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS._ 541TE 4"S dt L)lEe. 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 I.uilding 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 BERG, DAVID ! 031 Rain Water Leader $ 7.00 6055 2 1/2 STREET NORTHEAST , 2003 Surra/Racei,ing Tank $ 7.00 FRIDLEY, MN 55432 Water Treating Appliance $10.00 Owner (763) 574-7591 Water Heater -Electric $ 7.00 Water Heater - Gases _� 510.00 Building Used As Sas Rae ge** Gas Dryer- $10.00 $10.00 Estimated Cost PERMIT NO. Back Flcw Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANYo��l.�}t/ �PU)/y?aAJ4 t_ Reinspection Fee $47.00/Hr SIGNED BYQt--2'/e��J'_ TEL N0. 0- ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Dat% 1/0 3 State Surcharge $ .50 TOTAL FEE $M.550 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMEl1STIOE P IR VERIFICATION When replacing an existing furance, the undersigned hereby verWas that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes O No ( ) The venting: system is. plastic/PVC and meets all current codes and ; , r-�,nufacturer specifications .including sizing, length, numbe, of elbows and termination. - Yes O No The undersigned also verifies that the replacement unit is a listed assambly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace. Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance, ;has been -removed from_the common vent and vented separately as;per current codes. Yes( )No.( ) Apallance Tyne and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat' Appliance#2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft • Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date: �. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 E•10IM1111 R V.V.1F ADDRESS : 6055 2 1/2 ST NE PIN : 233024220032 LEGAL DESC : UNAVAILABLE 0.87 : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING VALUATION : $ 1,737.00 NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF HOUSE (15 SQ) TEAR -OFF STATE LICENSED CONTRACTOR 1 571-1287 PERMIT O.: 2004-00597 °> DATE ISSUED: 04/27/2004 APPLICANT BUILDING PERMIT FEE FIRE SURCHARGE 63.15 1.74 GRAYHAWK BUILDERS 3020 CENTERVILLE RD STATE SURCHARGE, VALUE 0.87 LITTLE CANADA, MN 55117 LICENSE SURCHARGE 5.00 (651) 486-9888 TOTAL 70.76 PAID WITH CHECK # 12909 OWNER BERG DAVID A & KIMBERLY K 6055 2 1/2 ST NE FRIDLEY, MN 55432 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 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 r Bldg Insp d Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW f l ADDN ALTER CnY OF FRIDLEY SINGLE FAMILY AND DUPLEXF R_1 AND R-2 BUILDING PERMITAPPLICATION Construction Address: y7_ lc- �1p-- Effective 1/)/2007 (763) 572-3604 Bldg bap Attach to this application, a Certificate of Surrey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMIPROVENENT LINING AREA: Length Width GARAGE AREA: Length Height_ Sq. Ft Width Height Sq. Ft DECK AREA: Lenge Wdth— R: Hgt/Ground Sq. FG a7HE ,onstruction Type:41� S > j Estimated Cost $ —� =..-eway Curb Cut Width Needed: _Ft + 6 Ft = Ft x $ �g ATE: APPLICANT: � Tel. aA— USE ONLY - Call (763) 572-3604 for Permit Fees if nuMin In 9 a ppfication armlt Fee �" �� Fee Schedule on Reverse Side re Surcharge $ -� .001 of Permit Valuation (1/10th%) Ate Surcharge $ $.50/$1,000 Valuation 4C Charge $ 89 $1150 per SAC Unit cense Surcharge $5.00 (State Licensed Residential Contractors) iveway Escrow $ vU Att "A' or Alt. 1-61. Above onion Control $ $450.00 Conservation Plan Review irk Fee � Fee Determined by Engineering -wer Main Charge $ Agreement Necessary { ] Not Necessary t ] TOTAL 20, 9& ILATIONS: t