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PRE 2010 DOCSCity of R ialay Application for Plumbing and Gas M;ng Pe it • Dept. ®f aid -.Z. Phone x...3.553 ,! DISCUPT309 OF WORD ,� S / • ' I&VAbet, Kind and Losagew of FiXt0*6 03 $~IU~I°�I '5-.Jg7e� Used as.. � i�7 •� i WATER MTR. % cws Eu<G To be completed about 'Estimated PARMAL KATE SCHEDULE Cost, S (Ol -New. Building Permit No.______-.. Pa�)txo. pi xMBtNG FIXIuRic P%AT'zS,. J;O. RATE TOTAL : Signed Number Fixtures .... • ......... • • e..�---� x 5100 $ ' F`sture Fixture Opening ............ X 51.53 $ _.- y Businc= Phone No i? 7- - :Cew Fixture Old Oprnirg. • . • • :'• • • • _---._- x 51.50 3:d 1 � i x53.25 S Catch Basin ........'............ _� Water heater 'Up to 99.0W BTU) .... .'x 53.CA $ � ROUGH . • ::e:+ Crcurd Run Old Bldg.......:: x- E'•c;r.: V1atar F:t.:to:........... a_ -_.o_ s .Si2.Cn7 s F`i:`riir ,L,��! City of FT-idley: _ The undersigned hereby makes application for a permit for L`se• specified, a„rccing to do all .«c:k in s:rc: accord,: --e w.'*h the C:t7 and ruling of the Dopa: tercet of Bu e.:=P, and hereby declares that a • and representations statc i Ln .: is 4prl:ca'ca are true and correct Fndley, 9finnd Owner '.... c, Kind of Building-- - Cennoct W 5-- .. • Fu°.r• C-=c:-o7ea. �:s Save&d' '5-.Jg7e� Used as.. � t X•v ii: -hire, .Old To be completed about 'Estimated PARMAL KATE SCHEDULE Cost, S (Ol -New. Building Permit No.______-.. Pa�)txo. pi xMBtNG FIXIuRic P%AT'zS,. J;O. RATE TOTAL : Signed Number Fixtures .... • ......... • • e..�---� x 5100 $ ' F`sture Fixture Opening ............ X 51.53 $ _.- y Businc= Phone No i? 7- - :Cew Fixture Old Oprnirg. • . • • :'• • • • _---._- x 51.50 x53.25 S Catch Basin ........'............ _� Water heater 'Up to 99.0W BTU) .... .'x 53.CA $ � ROUGH . • ::e:+ Crcurd Run Old Bldg.......:: x- E'•c;r.: V1atar F:t.:to:........... a_ -_.o_ s .Si2.Cn7 s F`i:`riir ,L,��! GAS E'1MNC FUSS h0. Rn'1 TOTAL • . Ist3Fixtures ••••••••••••. x52.00 $ - x S .75 $ -- Adda:onal F.xtures............... �.-- Cas le.A.000 BTU • .. • .... .::ze .o X $5.00 .50 State ' Ja3RS ac �L'TRAYE®N�-fse.lso Coif ,Surcharge .pesaa'�4ioa.....:......0.................,.......... + O , •. ' • TOTAL �"r %• _vim----� SUBJECT PER O. City of Fridley o 18910 AT THE TOP OF THE TWINS BUILDING P E R M I T _ r RECEI COMMUNITY DEVELOPMENT DIV. y r PROTECTIVE INSPECTION SEC. 1 � � NUMBER REV. DATE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/28/87 7;PAGE JOB ADDRESS 4590 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 Rearrangement of Bl. 13,14,15, Plymouth SHEET 2 PROPERTY OWNER. MAIL ADDRESS ZIP PHONE Syneva Reno 4590 -- 3rd Street N.E. 572-1533 3 CONTRACTOR MAIL ADDRESS ZIP PM NE LICENSE NO. Iandgraff Construction 521 _ 53rd Avenue N.E., Fridley w 72•-9016 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 ] 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 $1p80Q $.9.0 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI IONS DF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $29.50 STR TION OR THE PERFORMANCE OF CONSTRUCTION. J p PLAN CHECK FEE TOTAL FEE $3 0.40 SIGN RE OF CONTRACTOR ORAUTK EDAqVT Ir (O EI WHEN PROPERLY VALIOIATED THIS IS YOUR PERM T BLDG INSP ATE00, SIGNATURE OF OWNER dF OWNER BUILDER) IDATEI NEW [ 7 ADDN. [ ] ALTER. [ ] Construction Address:. Legal Description:_ Owner Name & Address: Contractor:_ a" Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: City of Fridley R-1 AND R-2 Building Permit Application n Effective 4/1/846 Tel. Tel. 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 Length Length Width Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot LM Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Estimated Cost: $ Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation 91577 KTel. # DATE: 2 APPLICANT: CITY USE ONLY Permit Fee $o Fee Schedule on Reverse Side Plan Check $ 25$ of Building Permit Fee State Surcharge $ CD - $.50/$1,000 Valuation SAC Charge $ $525 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ JAMi Agreement Necessary [ ] Not Necessary [ ] TOTAL $ , STIPULATIONS: /F(3 a s-0 0— /G, 0 SUBJECT City of Fridley 270464 AT THE TOP OF THE TWINS BUILDING PERMIT � te------� COMMUNITY DEVELOPMENT DIV. U' PR6TECTIVE INSPECTION SEC. r I _ CITY HALL FRIDLEY' 35432 _ UMBER- " REV DATE PAGE Of APPROVED BY 612-571-3450 910-F15 7/5/90 JOB ADDRESS 4590 ^ 3rd Street N.E. 1 LEGAL LOT NO. TRACTOR ADDITION SEE ATTACHED DESCR. 1 1 J.BLOCK 1 Rearrangement of Bl. 13,14,15, Plymouth SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Pamela J. Robinson 4590 - 3rd Street N.E, 574-1981 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 1j ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 141 x 141 Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, WARNING Before digging call for all utility locations 454.0002 REQUIRED BY LAW SEPARATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION' SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,424 $.71 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TRE'. PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $35.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $35.71 S NATUR FCON-RO ORAU,THORIZEDAGENT IDATEI HEN PROPERLY VALID TED THIS IS YOUR PERMIT BLDG INSP d-1 SIGNATURE OF OWNER IIF WNER BUILDERI IDATEI.+ NEW [ ] ADEN [ ] ALTER [ ] Construction Address: i Qo Legal Description: R-1 AND R-2 Building Permit Application 6to '�f �6' L Effective 1/1/90 Owner Name & Address: YRdQ 0 —Tel. # Contractor: �a VWA - Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. 0. Im ZI 0 U fA•; • LIMG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DDCR AREA: Length 1yr Width 1V� Hgt/ Sq. Ft. OTHER: el Corner Lot [X] InsideLQt [ ] Yd Se ck Side Yard Setbacks Type of Construction: I I Xr—a Estimated Cost:$ ' Approx. Completion Date: G � `4, Ud Proposed Driveway Width If New Opening Is Desired: Width + 6' See Back Page DATE: APPLICANT': (:)" 0 56n, Tel. / CITY USE ONLY Permit Fee $ �- Fee Schedule on Reverse Side State Surcharge $.50/$1,000 Valuation SAC Change $ $600 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreeiment Necessary [ ] Not Necessary [ ] TOTAL $ STIPMATIONS: ox Pit (0).- Sr� x C -o F-PX714 I if. 7 mpe4� ,160 Z'4`)c "AA L C --r L-1 t .l I tie I'm I FIRE DEPARTMENT MEMO /BUILDING TO. INSPECTION ASSESSING SUBJECT: FIRE DAMAGED STRUCTURE DATE: 11/11/92 FIRE HAS OCCURRED AT 4590 3rd St. (ADDRESS) 11/11/92 DATE OF FIRE FD -7 Richard H. Larson SUBJECT P City of Fridley 2166 8 AT THE TOP OF THE TWINS BUILDING PERMIT f CEIPT COMMUNITY DEVELOPMENT DIV. f _ v PROTECTIVE INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ,'j 612-571-3450 910-F15 11/20/92 JOB ADDRESS 4590 - 3rd Street NE 1 LEGAL LOT NO. BLOCK 1 TRACTOR ADDITION SEE ATTACHED Rearrangement of Bl. 13,14,15, Plymouth SHEET DESCR. 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pam Robinson 4590 -- 3rd Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Giertsen Company 860 Decatur Ave N, Golden Valley 546-1300 1395 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ki REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Fire,Repair (.trim, doors, windows, sheetrock) no structural 9 CHANGE OF USE FROM TO STIPULATIONS Call dor demolition inspection before reconstructing. SEPARATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $32,00.0 $16.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AU HORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTH ST EOR OCAL LAW REGULATING CON- $297.50 Fire SC $32.00 STRUCTION O THE PERFOR A OF ONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $350.50 SIGNATURE OF CO IRAOR R AUTHORIZED AGENT (DATE) EN O LY VAL DA ED THIS IS//YOUR �JPERMIT - 0f1 J DG )NSP MATE (� SIGNATURE OF OWNER IIF OWNER BUILDER) WAI-I NEW [ ] Effective 3/1/92 ADDN [ ] CITY OF FRIDLEY ALTER[ ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: Legal Description: 90 /. 6L i i Owner Name & Address: �� ` l r N S �� Tel. Contractor: G' 7� C� �v /MN LICENSE # 5 Address: �� Cf� t12 /�.ue �j 0 T_Tel. # Q LIU'3 010 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to . scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length Length Length DESCRIPTION OP IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Comer Lot (] Inside Lot [ ] Ft. Yd Setback _ Type of Construction: Approx. Completion Date: iZ 1 43 Side Yard Setbacks Estimated Cost: $ 3 ;�-1 0'0 a (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: !'f �D APPLICANT: Tel. # y V(Z JO O MkA�MMIAWINL Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $, ,o ad".001 of Permit Valuation (1/10th%) State Surcharge $ 16,06 $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ 0 0 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ QC) , 0 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 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 Water Bath Stories Closet Urinal Tub Shower Wash Drink. Floor Catch Auto. Gas Sink Tray Fount. Drain Basin Washer Appl. Gas Misc. Water Heater Range Fixt. Gas Elec Basemen PLUMBING FIXTURE RATES: NO. RATE Floor 1 JOB ADDRESS 4590 3rd St. N.E. Rain Water Leader Floor 2 Sump/Receiving Tank $ 7.00 Floor 3 $10.00 Water Heater -Electric Floor 4 Water Heater - Gas $10.00 w,=' �L /ii/+G� /XP / w it w A&"v dN L�z i 4,L5 , ,;ds PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 4590 3rd St. N.E. New Fixtures _3 $ 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 ( )Yes ( ) No Type $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge .50 TOTAL FEE $�� 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. Nov. 30 , 19gi1 2 Owner Building Used As Estimated Cost*?=. PERMIT NO. %i PLUMBING COMPANY Klamm Mechanical Contractors, Inc. SIGNED BYYa�� ___ - TEL N0. 890-4868 Approved By �� Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT _IS_$15.00�� PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1 1998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICESZJ p 7 J0 -e- JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate rnace Shell and Duct Work, Burner - TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, hereby declares and that all the facts and Also Replacement Furnace $ 30.00 $ �(J f� representations stated in this application are true and correct. (Side Vent - Fill Out Back) / — / '1990 Gas Piping (Needed with new furnace) $10.00 $ OWNER �� ,ip AJ Gas Range $10.00 $ BUILDING USED AS AJ 61_ 1 Gas Dryer $1p,00 $ ESTIMATED COST � (� PERMIT NO. `7 *Air Conditioning - All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs $ Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade NameG JL [ No. Commercial/Industrial BTU 7 s-ooV HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name_ n Size No. BTU TOTAL FEE U MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. EDR, Sharp HEATING CO ANYJ Heating and Air Conditioning C umbia Hei his s .' N 55421 Signed By Tel i1 U.2; 572.04 9 i Approved By R gh-In Date Final Date l �o�1-G% FILL OUT BACK SIDE R STACK VERIFICATION ON REPLACEMENT FURNACE 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: . List ALTERATIONS Beim Done: HEATING CO: Signed By: Date: Yes C AND STACK VERIFICATION No The undersigned hereby verifies that the existing chimney or stack: No 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported . Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: . List ALTERATIONS Beim Done: HEATING CO: Signed By: Date: Yes No Yes No SUBJECT City of Fridley 733142..:t!::� AT THE TOP OF THE TWINS BUILDING PERMIT O r.� COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 1 . � NUMBER REv DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 763-571-3450 910-F15 10/8/02 JOB ADDRESS 4590 3 STREET NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 REARRANGEMENT OF. BLOCKS 13,14,15, 13LYMOUTHSHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pam Robinson 4590 3 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advanced Home Imp 9 Central Ave, Osseo, MN 55369 763-424-2979 s ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 2017269 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE S DESCRIBE WORK Reroof House (16 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 1 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 $1,852 $.93 WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS QFAANY OTHER STATE OR LOCAL LAW REGULATING CON- $66.20 Fire SC $1.85 STRUCTI70HE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT FEE 0,- Licens SC $5. 0 3.98 S� NAruRE Oor#NTFiACTOA OR AUTHORIZED AGENT iDATE, HE PR Y VALID T D THIS IS YOUR PERMIT �<AOG s S,GNATURE OF OWNERJF OWNER BUILDER, (DATE, ANSA FdA1E NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �d.s 9 d .3 d d s-/ . 44 C Legal Description: Owner Name & Address: P __ Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: MN LICENSE # -Q-60/2,a & 7 Tel. # Y I & 3 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/Groy�nd Sq. Ft S s 7--e,, Construction Type: 9W9 Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: /Q/0 ? /cy)L- APPLICANT: Tel. # Call (763) 572.3604 for Permit Fees If mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by'Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ U STIPULATIONS: L. FRIDLEY INSPECTION DIViSION Effective On January 1, 20161 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES.n JOB ADDRESS6ql) RATE SCHEDULE it OWNER/ Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $ n (Side Vent - Fill Out Back) ESTIMATED COST _)0 025, .2 PERMIT NO. Gas Piping (Needed with new furnace, $10.00 $ but not replacement)A�b DESCRIPTION OF FURNACE AND OR BURNER Gas Range $10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade/Name-. Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load Ali Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1%, of Value of Appliance or Work $ BTU HP EDR 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and C representations stated in this application are true and correct. TOTAL FEE $ • c� / DATE 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. FEATING CID? Signed --TEL# Approved 13'.)yv� Rough -In Date _ Final Date BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VEVTdONNEC` 'R AN" COMOUS"''ON AIR "" ''r'IFICAe"n" When re L"'ng ar, , existing, furance, the ; idersigned hereby verifies that the venting has l cen e;.amirod -:nd is free fron ust, de.erioration, obstructions, and is secur ly sup sorted and firestopped � iere required. Yes O No ( ; TI ' : nting ystem is pLisk PVC and meE all curi ent codes arld manufacturer specification, including : izin;. , length, numl r of elbows and termination. _ Yes O ao ( ) The undersi, sed also w that the replG �ment unit is a listed =vicembly and meets to J current c 1,, and manufact,;rev's spucifications. This does includo AGA JAMA Ca 'r to I Central Fur, ice Venting Tables for fan assisted anc' inturz I dr. ,!lances. Yes O No( The e..istin, combust r is sized anc' ;called to meet the current codes wnd wanufa `urees spe `ic :ions. Yes( ) Nc When requir. J to inrta: 7L .-!combustion air, it will be sized arca installed to mer,i the , irrent cod s and manufacturer's specifications. Yes( ) Nc 1 `,"dher inst,?s a ne°-af !en! ng zystem, the undersigned hereby vcri les that is a Fisted ,sembly c,' d M. ccs the current codes and manufacturer's speci7 cation This do(-; inc Jde AGA-GAMA Category I Central Furnace Venti ig Tal; : s for fan ,.:sist .d and natural draft appliances. Yes O No Is tl,, comi m vent ar. `. '=. connectors sized and installed correctly after an af: Mian{ has been • Mme, °ed from the common vent and vented sep^rately cx per curre. t coy -�s. Yes( ) No Appfl;., ca and and SizelCommoia Vent and Vent Information Appliance # i + ype 41& BTU Input f an Assisted or Nat Appliancc I#2 Type BTU Input Fan Assisted or Nat _ i p Appliance #3 Type BTU Input Fan Assisted or Nat TotalAppliances _ _ Total Btu Input Cos nmon Vent Type _, _! Vent Heigh,' Diam'3tcr inches ApI,fiance 41 Vent Con. 3cto !eight ft Lengti ft Diameter in Type Appliance #2 Vent Cons 3ctcF Height ft Length ft Diameter in Type Apr liancc 43 Vent Conr �ctos Height ft Length ft Diameter in Type AL i-EIZA'JONS. (Gest =be _ HEWING CO: Sig ied B.: Date ,, O ITY OF FRIDLEY INSPECTION DIV. -31 University Ave NE idley, MN 55432 63) 572-30%, FAX (763) 571-1287 Floor 1 Floor2 Floor 3 Floor 4 Effective April 1, 2004 O PLUMBING AND GAS FITTING PERMIT g -o! �* APPLICATION FOR P �� d MARK NUMBER OF FIXTURES - Wash .UMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 'A5q ® - -rG S• n �- .w Fixtures d Opening, New Fixture ter Dispenser ow Off Basin etch Basin ain Water Leader imp/Receiving Tank ater Treating Appliance titer Heater -Electric titer Heater - Gas" I' as Range' as Dryer's ick Flow Preventer Required ( )Yes () No Type Heater $10.00 The undersigned hereby makes application for a permit for the work herein $10.00 specified agreeing to do all work in strict accordance with the city codes $10.00 and rulings of the Building Division, and hereby declares that all the facts $10.00 and representations stated in this application are true and correct. $10.00 $10.00 DATE: $10.00 $35.00 OWNER P C 111,3rlNA- �n $35.00 $35.00 BUILDING USED AS $10.00 $10.00 ESTIMATED COST PERMIT NO. $15.00 :inspection Fee $50,00/Hr ` `RI"O'C-ev'¢" -L OTHERS ANDfOR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge $ . 50 TOTAL FEE $ 5.5O PLUMBING 1 11 SIGNED TEL NO, 9 Approved By Rough -in Date Fatal Data MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 50/6 OF COST OF THE IMPROVEMENT WHICHEVER 19 GREATER ON WORK LESS THAN $300 OMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROV@E COMMON VENT INFO ON BACK SIDE