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E5 BUR DING , PERMIT t r ` N° 2338 Village of Fridley, Minn Jl d Date Ib ... � � Builder .......... 14�kww C ............... ...... . ,Owner Address p � ..... .?�..... Address � .............................. . LOCATION OF BUILDING N0.4.$ TT .4+' Street 1S. .:.;'.` :;' ..:..:.:.......... P of Lot .................:..... Lot OPS'.. .. Block Cm Addition or Sub-Division .,.r C� a!+�i� ...... Corner Lot III ....; Inside Lot ........... Setback ............ ....... Si{�gard , ......................... DESCRIPTION OF BUILDING j ;; To be Used as:; .. ...... ...... Front ..... Depth ..... Height .........q. Ft.......... Cu. Ft........ . .: Front /#.. Depth Height %, "I..... q. Ft.....:... Cu. Ft........ . Type of Construct on Est. Cost . To Completed �D ....... . I n In considera �Ij:I• n of the issuance to me of a permit to construct the buil g described above, I agree, to do the proposed wor In accordance with the description above set forth and inlcompliance, with allprovisions of ordinances of the village of Fridley., A%ir/ {. era 6express o� of the payment of a fee of $. `�:... ; permit is hereby ted to ..... . ..... to construct the building-Tr addition as described 'ove. This permit is granted upon ondi ori that the person to whom it is granted and his agents, ployees and workmen, in all work done in, around Fridley,Minneso d upon said building, or any part thereof, shall conform it 1' 0 respects to the ordinances l regarding location, Construction, alteration, maintenance, repair and moving of buildings Vii= in the village and this permit may be revoked at any time upon violati qiG; any of the provisions, pf' said ordinances. Building Inspector NOTICE• This per it does not oover the construotion, Installation or alteration {{or wiring; plumbing, gas heating, sl'wa Be sure to see the Building inspector for separate permits '#or these Itome. City of Fridley, Minn. BUILDING PERMIT � a � Date: Owner: - Builder i Address Address • nA- F OB�JILDING Street Part of Lot Lot _ . ---- Block Addition or Sub -Division Corner Lot Inside Lot _ Setback _ Sideyard Sewer Elevation — Foundation Elevation �57 '4 N° _'7434 DESCRIPTION OF BUILDING F BUILDINGT Used as• � Front Depth Height r Sq. Ft. Cu. Ft. Fro Deptheight Sq. Ft. Cu. Ft. Type of Construction , o Est. _ 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 setfbijh and in COM AAACs– iprovisions of ordinances of the city of Fridley. s In consideration of the payment of a fee of $ I 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 reg location, construction, alteration, maintenance, repair and moving of buildings within the city limits and permit may be revoked at any time upon Vi of any of the Provisions of said Ordinances. v' ,<e � 3 NOTICE: This permit don not cover the Bond. .don, hutallatien for Wiring, plumbing, gas hating, sewer or water. Be sun to we the Building hupeftr for separate permit for these hens. -ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to -assure construction is per approved plans. JOB LOCATION: , L OWNER/CONTRACTOR:��� !� ADDRESS:����' �� �`s.�=,r Ai PHONE: A. Determine the Total Exposed Wall Area as follows: 1. Total wall window area 2 6 ,% ell 2. Total door area 3. Total sliding glass door area 4. Total fireplace wall area S. Total wall framing area (average. _10%)/ 7 6. Total net wall area above floor(average.90%) 74 7. Total rim joist area Subtotal: Total exposed wall area above floor i® 8. Total foundation window area 9. Total net foundation area above grade E , Subtotal: Total exposed foundation area a GRAND TOTAL EXPOSED WALL AREA B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = Item I ; 0( C. Determine the Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area © A 11. Total roof/ceiling framing area (10%) 2 e, 12. Total net insulated roof/ceiling area l 0 GRAND TOTAL EXPOSED ROOF/CEILING AREA ® i� D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = Item II E. Determine the "U" value of each segment (1-9) and multiply by the area as fol lows : 1. 2G, GG X "un 2. X "U" _ 3. r. ® g flute 7g ..u.. ��a = �i 7 6.� g flan l �. _ �'JI 7. D, ®� x flu„ 6 �. = ' i 7. 8. g llull (�)= C 9. , kn�, X fluff ;f �a4 _ 71 e. / ADD 1-9 FOR TOTAL WALL.SEGMENTS ITEM III F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. V X "U" _ 11. F, % $Null / ® 3 �, _ /e 12. x fouls ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I 9 � ° 7� . + Item II J. Add Item III 7/., 3 + Item IV ON K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself *or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. By: &o-4 &-1 DATE: AN V I U t. UAKIo6UN- tk 'JUN II IU. 3200 FRANCE AVE. SO. ' 3rd. STREET N.E. ' 8O.6d 73 15 15 85 •----- LO awv_ �'•chd biap@ rN 044 6066 N N g05 , ( 24 2 d•^'•� .D O N c P l i � � LI.N. `�-7 ® i.,.• 4a.& r9.� ahoy <5.1 � N 6+�+ / / W , bTi Ch� � '40• � 1 , a ® -r- 28 27 — I - �4 - - - '^_� 2s I — I II M I� ! �— 70 — -- r -i_ Ld 24 23 22 ; cy6® a s;, � N • \pr° j -+-I 'r—�' 120 31,9 6f ' 21 75 1� S'\ ?y I r.•�• `. by //o./S I � =� N: r� ti Q` �\s Q� _-• M�, 10 it <r `` ?9 N ! 7 V :zz- -' 16 0 0927 `.c' .\ c'" :�-� 5 34 �� '�.v \ �\Q• '�2 2 Jg.20 SSB • �� ��• ° / o�S 5072,4' 4 - "z/t-- 14 b`t —45 _ -90 — _ OrBine a i �q 13 ,9}/ — -Il /t _ _ _ ✓tilr {%e� Ea2¢meni 10 a' �6 r 06 m rra ao.z .� ry_.i az 2 n cg a 2 p O 5069x50 N l$•P. 4 N 401, } - 5017 o yO - iJ j.3 GGGLfL�fJJ N N 40.1� P I I h N' ,c "� �c K an xa "� '� B5 < •89.4/ � ' CLEARVIEW S'TREE'T 1, OI t � � �I � .! • ..1 by ib =•' l / h � � � *�♦� •t�9BdJr ._.._ .•o��ti/ fA `' � �1 c� yd ,; o •_Q• c7 't •� `�►•M of O � Y / ` ai as i hl,� � DO af• _� co �► Irl `1,.ro v I ', .mob J p a y .- , �? ..•,f, 4 ti w'ygM.Oli.SP. b�A?'ti$ d %, l b®' B .• T t 'FS 'd �, ' of rF•�P,�•i�r/ 1 r r , t 1 — • r na o „'y e o s��P�.e o a6eBJ �;o,'_ ..v N cow � ♦ a:t r1t•j • O� O9 e, ;Jy o s . s an 4 ICf ► N "n I O �n ' A - ------JO T Ifj y V O1 r 7L oj, __.. ' r M o I^ Ro t� • e / r •� el Nl ' c�lJl Si I'' O ice' at,l VV' • f' +�. '•� all y r ; �• q • a', dC''•v 1;., On , V, ET. ♦ti M IscowIscoIIII 1y I r1 N J • , r ` L �I d C9 p �i Y (Oa r��l.�r Q�r V►a�t' �� I �t +�i'� �a�� ��•:.P•,n ql `i �UI.��i .. qr •• f icj ` u w,@n�w 111'. rI' �' 1 r `r• : R. I+ O.o ti7 9 �� �� t Zg /: ' • 8a♦ � fifr: 1 ~ �Y\lo® � � ��� �.. •• 5'y !� ( •a= a7• 9p.s 'I '•J � 1'6➢'lwJrV j,l � 0 I S . P1 1 i I v. � f .. a ��• tg .,�`ye J 1 w..t a.3'J''. t Jv -- Ln to N •. F �, • � • � �.p `n ti � ., S . P• N � w ♦` „ l� Q� O w (� � H. 'Zi• al U� �D la• ql• •w // aI. ; 1 d • moi'' I M• ••� °e s ♦ ' iY ` i e' q0. "46a im SUBJECT RMIT NO. City of Fridley1 14084 AT THE TOP OF THE TWINS BUILDING PER IT . ; RECEIPT NO. � `L -_____ COMMUNITY DEVELOPMENT DIV. e PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE FAGE OF APPROVED BY �---' %.J 612-560-3450 910-F15 5/16/77 JOB ADDRESS 5090 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 5 Carlson's SuICQCIi.t Manor South Ad SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Manley Mills 5090 - 3rd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Professional Roofing Services 5048 Girard North 521-6888 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP I PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Lj REPAIR I MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO I STIPULATIONS 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 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 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 $750.00 $.50 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- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE o �7 $8.00 S NATURE OF CONT ACTOR OR AUTHORIZED ENT (DATE) WHEN PROP RLY VALIDATED IS YOUR PERMIT \THIS � 1 C. � - DATE � - BLDG. INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) •F±J� im CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: . BUILDER: ®c e -r Address: �f� -� Address: Tel. No . -S;�zR/J 14 No.: �Q 7 Street:---- �/Zo �j ��� 1 /(/ . L LOT: r' S BLOCK: ADDITION: 0-S6L'S SuOMiE /}iA 0,e CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS: zo I "q'Dt)Ri Applicant attach .to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: k -L e -no I- Front: Square Feet: Front: Square Feet: Depth: Height: Cubic Feet: Depth: Height: Cubic Feet: Type of Construction: "4-7— Estimated Cost: $ S �® �r s To Be Completed: '� 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 work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional information. DATE: 4 , d SIGNATURE: '/c% -,,/, it Stipulations: 17.0 0, do City of Fridley SUBJECTP 0. 15533 AT THE TOP OF THE TWINS BUILDING PERMIT f ECEIPT NO. 1 ; _""""_ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. r ' c_ I , , = CITY HALL FRIDLEY 55432 NUMBER TEv DATE PAGE OF APPROVED BY 612-571-3450 910-F1I 10/26/79 JOB ADDRESS 5090 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 5 Ca.rlson's Summit Manor South SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Larry Mills 5090 - 3rd Street N.E. 560-5469 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Landgra.ff Construction 521 - 53rd Avenue N.E. 560-5827 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 20' x 14' Addition to back of House 9 CHANGE OF USE FROM TO STIPULATIONS PERMITS REQUIRED FOR WIRM SEPERATE HEATING, PLUMBING AND SIGNS. 'ct,P� . ;, , F ditty; ,(EP110 , c 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 $7,100 $3.55 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- $45.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. a PLAN CHECK FEE TOTALFEE p 0�L //$11.25 $59.80 SIG URE OF CO RACTORORAUTH ED AG roAT ,WHEN PROPER V LIDATED THIS IS YOUR PERMIT BLDG INSP r)ATFj SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) I ADDRESS:` TEL NO: 5V ,; STREET NO: TO LOT: STREET: B U I L D E R : ' 1.11 ADDRESS: TEL NO: J -91a2 Construction Location BLOCK: -5— ADDITION: Corner Lot: �_ Inside Lot: Setback: 107 5 Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: �z Depth: Height: �� I Squane. Feet: 'agb Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: L Estimated Cost: $ 100 To Be Cbmpleted: /'Zz ��^77 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 work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: -®L�Z9 SIGNATURE: Stipulations: o wa< _ r7109. Ol- 71 () u (4 0 A q II , aS IX 3' SuBjECT PERM Q. City of Fridley 2 8 049 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. _ ____ 1 L • PROTECTIVE INSPECTION SEC r . �/ & _C6 r 1 NUMBER REV DATE 9/3 8 PAGE OF APPROVED BY I ""'1 CITY HALL FRIDLEY 55432 �'""� ��� 612-571-3450 910415 10B ADDRESS 5090 3rd Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 1 Summit Manor - South SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Ron Brock 574-9137 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Roofing & Siding 18979 Gladstone Blvd Ma le Grove 55311 416-4804010 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 O ADDITION O ALTERATION Iax REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house (21 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 f ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1799 .90 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 $56.75 $1.80 PLAN CHECK FEE TOTAL FEE License SC $5.02 1$64.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE. WHEN PROPER VALIDATED BLD -NSP THIS IS YOUR PERMIT /11 119 S-GNATURE OF OWNEROF OWNER BUILDER, 15ATE, RM -28-1998 NEW [l ADDN [ ] ALT c •,��-;•i _ ..._:.,._ice 10:04 FROM CITY O FRIDLEY R CI',pY OF FMLEY SINGLE FAIMMY AND DUPLEXES R-1 AM R-2 MiLDIN+G PERMIT APPLICATION 0 4164805 P.01/02 FIfective 1/1198 Owner Mame & Address: ry�rrr K Tel. # Contractor- - ( 1 - MM LICENSE #_��' Ate: r'- -D Tei. -- Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to gale. LIVING ARRA: L=rh_ Width Hei& Sq. Ft. GARAGE MINA: 1a9th Width height Sq. Ft. DECK AREA: Length � Width Hgt/Ground Sq. Ft. :onsteusdon T Estimates Cost: $_ �,. ) -7 I (Fee Srhecahzla on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft Ft x S = $ PPLICANT: Tel. J My Um Pamir Fee $ 6 (Q � � 5 Fs* Schedule on Reverse .Side Fire Surcharge $ 7 D .0f31 of 'I'ecrmk Valuation (1/10th%) State Surcharge $ , 9 $.50/$1,0Valuation SAC Charge $ $1000 per SAC Unit Lk=n Surcharge $ $5.00 (State Licensed Residential Cor om) Driveway Escrow $_ _ Alt. "A" or Alt. °B" Above Prosioa Control $ $450.00 Conservation Plan Review Park Fee $ lee Determined by Engineering Sewer Main Charge $ Agr+eemem Newry I ] Not Necessary [ ] TOTAL $ ' a. (, Is SM JLATIONS: CITY OF FRIDLEY PERMITO.: 2004-019 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 10/19/2004 572-3604 FAX: (763)571-1287 ADDRESS : 5090 3 ST NE PIN : 263024230103 LEGAL DESC : CARLSONS SUMMIT MAN SO ADD : LOT 25 BLOCK 5 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, BRYANT, 88000 BTUS). # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 2390 APPLICANT STANDARD HEATING & AIR COND CO 410 WEST LAKE ST MINNEAPOLIS, MN 55408-2998 (612) 824-2656 5090 3RD 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 consyuction or the performance of construction. ADDlicant_ ( I Date. Bldg Insp� Da 11 HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 11880 QRDAR ATF DRRMTTQ 1?F()1TTRRTI Rl1R UlnVY nTUPR TW AV T%PQrRTRRTI ARMM CITY OF FRIDLEY BUILDING INSPECTION R 5 54 0 Effective 4/1/2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 763-572-3604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS � o r S RATE SCHEDULE Fee Total • Fr44-16— Residential Owner FurnaceShell and Duct Work, Burner & �- also Replacement Furnace $35.00 $ Building Used As (tS /Se.,cc/ $10.00 $ ESTIMATED COST �3� o Gas Piping (New Furnace, Fireplace, Insert) PERMIT NO Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ # of Heating U 'ts Circle One (Steam) (Hot Water) ( arm ' Trade Name Size No. *Air Conditioning - All Sizes $25.00 $ BTU HP EDR Fuel _ a Acf4 re. Total Connected Load All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Burner Trade Name Size No. Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/Industrial/Institutional and representations stated in this application are true and correct. State surcharge $ HEATING CO STANDARD HEATING& AIR CONDITIONING CO. J 410 WEST LAKE STREET MINNEAPOL.IS,1 55408-2998 TOTAL FEE $ ` `'� Sig 612-824- REINSPECTION FEE $50.00/HOUR FAX # C� �— 73 �v �3a'0 Date (O /y 0 *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved Rough -in Date Final Date 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 installind a new ventino 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 (L 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 (P.� No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type FCL BTU Input f . (000 Fan Assisted or Nat AikFA Appliance #2 Type vu T,& BTU Input -Doo c? Fan Assisted or Nat AJ A-r— Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input 13Too(-) Common Vent Type 01A-5-� Vent Height / d Diameter inches Appliance #1 Vent Connector Height -73 ft Length /0 ft Diameter in Type U W T - Appliance #2 Vent Connector Height ,,a_ft Length _eft Diameter in Type e V &vJT Appliance #3 Vent Connector Height ft Length ft Diameter `:in Type a M1 HEATING CO:L-- Signed By: Date: f® '� f CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 NWAK11L R MWIC ADDRESS 5090 3 ST NE PIN 263024230103 LEGAL DESC CARLSONS SUMMIT MAN SO ADD LOT 25 BLOCK 5 PERMIT TYPE HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION �-v a 10 -t -in PERMIT N .: 2004-01936' DATE ISSUED: 10/20/2004 , VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL AN AIR CONDITIONING. # A/C UNITS 1 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT STANDARD HEATING & AIR COND CO 410 WEST LAKE ST MINNEAPOLIS, MN 55408-2998 (612) 824-2656 OWNER FRANK MASCARI 5090 3RD ST NE FRIDLEY, MN 55421 2760 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 regul construction or the performance of construction. Applicant a Date I HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 25.50 PAID WITH CHECK # 11884 anrructl i n rnuvu i s rcnyuucnv r un w uus u i rink i ntuv 1jr'0u unnL tnnv v n. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 10/6 of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater 8 15 5 6 5 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS !S O P'� he,�S 7— Fee Total Owner r4„, /4, MA--SC44L' $35.00 $ Building Used As !:Qe, ca/ $10.00 $ ESTIMATED COST `�' PERMIT NO ~ $10.00 $ $10.00 $25.00 $;?5-10 Commercial/industrial/institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No. 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 $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ • sO HEATING C10 STANDARD HEATING & AIR CONDITIONING CO. 410 WEST LAKE STREET 41— �` SI-00Signed MINNEAPOLIS, 55408-2998 612-824-26rag ' FAX # W �— '�{3 ro Zk-3ft%::) Date / © - a-6 _ 0 7' *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved k Rough -in Date Final Date 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 installina 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 ( ) 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 Common Vent Type Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 HEATING CO:I v 0 et - V By: Date CITY OF FRIDLEY PERMIT NO.: 2005-00035 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/07/2005 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 5090 3 ST NE PIN : 263024230103 LEGAL DESC : CARLSONS SUMMIT MAN SO ADD : LOT 25 BLOCK 5 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 1 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) 883 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) 0.00 0.00 GAVIC AND SON'S PLUMBING 12725 NIGHTINGALE STREET NW PLBG FIXTURES (EXIST OPENINGS) 0.00 COON RAPIDS, MN 55448- WATER TREATMENT APPLIANCE 0.00 (763) 755-6468 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS 0.00 0.00 0.00 OWNER HOWIE PELTON 5090 3RD ST NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55421 TOTAL 35.50 PAID WITH CHECK # 11109 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 atter 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 ive authority to violate or cancel the provisionso any o er state or local law regulating construction or the p rform ce of construction. Applicant Date Bldg Ins D/eo SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ITY OF FRIDLEY INSPECTION DIV. (R31 University Ave NE idley. MN 55432 63) 572-3604, FAX (763) 571-1287 a - I Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT NUMBER LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ew Fixtures cid Opening, New Fixture ear Dispenser low Oft Basin -atch Basin :ain Warr Leader -urnplReceivhtg Tank dater Treating Appliance Vater Heater -Electric Vater Heater - Gas** ',as Range" " 3as Dryer" tack Flow Preventer Required { )Yes () No Type $10.00 $10.00 $'{0.00 $10.00 $10.00 $10.00 $10.00 $3x.00 $35.00 $35. 00 $1000 $10.00 $15.00 19 teinspection Fee $50.001Hr iv 1LL OTHERS ANDIOR REPAIRS AND ALTERATIONS '4 1.25% of Value of Fixture or Appliance 3 S • JO INSTALLED ON The undersigned hereby makes application for a permit for the work her speclfted agreeing to do al work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the fact and representations stated in this application are true and correct. DATE /,2/3/ OWNER 1kcatV-1 Auyo� BUILDING USED AS dtVd[ 1 4:g4 ESTIMATED COST.3 • PERMIT NO.�,�' L PLUMBING COMPANY SIGNED BY Approved By State Surcharge $ .50 33'.0 r MI U F F u TOTAL FEE $ 33.0 OF THE if agff Mf ,OMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION E04(A) AND TABLE 6-A. Sons � b TEL N0. 7103 — %SSj�'SF7`Y-` Rough -in Date Final Date "PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BUIkNING APPLIANCE PERNTS COMMON VEttITi VENT CONNECTOR AND COMBUSTION AIR V iRIS9 TIBN When reulacina an exiMino furnace, the undersigned hereby verifies that the venting has been examined and Is free from rust, deterioration, obstructions, " .� Yes No( ) and is securely supported and firestopped where required. tr The venting system is plastic/PVC and meets all current codes and menufacsurer Yes No { ) s catiorm including sizing, length, number of elbows and terminatidn. (VK The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This dbes include AGA -LAMA Category 1 Central Furnace Venting Tables for fan Yes No ( ) assisted and natural draft appliances. (0/ The existirm 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 h%tralled to meet the current codes and manufacturer's specifications. Yes( No ( ) When Installing a new venting system, the undersigned hereby verities that It is a listed assembly and meets the current codes and manufacturer's. s fiecfficetions. This does include AGA-GAMA Category I Central Fumes Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and instar correctly after an applianoe has been removed from the common vent and vented Yes No( ) separately as per current codes. Aooliance 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 Tetal Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Heigh ft Length ft Diameter „ in Type_ Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTEWL71ONS:1Describ2i HEATING CO: Signed By: Date: _ jd�3ila S0iS0 ' d ATia I szi d0 Al I ] 90 : zT mw-w-o3a