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PRE 2010 DOCSCity of Fridley, Mme BUILDING PERMIT Date:_ _ Owner: Address N° 5799. Address L TION OF BUILDING No.Street — Part o t. 22 14 Lot -_ Block Addition or Sub -Division de 1 Corner Lot Inside Lot . Setback Sideyard - 1452 Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING =�Zl Front Depth + -�- Height Sq. Ft. Cu. Ft3"29 Front DepthHeight Sq. Ft. _ _ Cu. Ft. Type of Construction Est.. Cdgt t_ -;Oz _ To be Completed a In considerations of the issuance to me of a permit to construct the building described above, I agree to do the proposed work h accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Ffidley. In consideration of the payment of a fee of $ �A _, 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 viol of any of the provisions of said --nordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wirhgb plumbing, gas heathM sewer or water. Be sun to see the Building Inspector for separate permits for these items, APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. of Lot Lot �,�i Block Addition or Subdivision �..._. ... Corner Lot ___._Inside Lot Setback Side -Yard SEWER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: Type of To be Completed DESCRIPTION OF BUILDING ,1/ Front ,Y 6 , Depth % Height Sq. Ft. .�v�� N Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. ted Cost c3 d 0". " 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 representations stated in this application are true and correct. ,,, l/ SIGNATURE (A Schedule of Fee Costs can be found on the Regie Side.) APPROVED SUBJECT TO CONFORMANCE TO APPLICABL 0 INANCES. • BUILDIN CTOR CITY AZ MIDLEY, MINNESOTA Application for Power Plants and. Heating, Cooling, Ventilation, Ash igm end Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE DepL of Bldgs. Phone SII. 4-7470 GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ... — ............. . . Replac en{ent of Furnace ...... .............. . Repairs & Alterations—up to $500.00 ... ............ Repairs & Alterations each add. $500.00 .............. . STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam...... . Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... Each add. 200 sq. ft. EDR Steam ...................... Each add. 320 sq. ft. EDR Hot Water .................. OIL BURNER—to 3 gal. per hour ........................ . over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 8.00 $ 2.00 $ §.00 $ 5.00 $ 2.50 $ 8.00 $ 8.00 2.50 $ ' 2.50 $ 5.00 $ 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ / Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ............ x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule $ TOTAL FEE $telD i3 City of Fridley: 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 representations stated in this application are true and correct. Owne Kind Used To be Fridley. Mnn Estimated Cost, $ /�Oc�• Old—New. Building Permit No.� Permit No. DESCRIPTION OF WORK " HEATING or POWER team, Hot Water, Warm Air—No Trade Name ,.� L%+m'-�a.-•. Size No - Cap o - Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load -5— 34 -3 Kind of Fuel j' BURNER — Trade NameSize No L� (� i Capacity Sq. Ft. E.D.11_ ®5!57'0 BTU H.P. (REMARKS—OVER) Sionorl C42 ZM 759 Business Phone I Af I 1� / Gh %iii ?ATE ® rNAME G��' /AIV C 0 � ✓�0/�' H T G . C 0 N T R . [ADDRESS� JOB -42 �/ / W11 FL. % e.• +.y ROOM y LENGT ' WIDTH HEIGHT 4° FL. pROOMI LENGTH JA %, WIDTH HEIGHTjf WINDOWS AND DOORS-CRACKAGE AND AREA !/d1 f WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH No. OF LINEAL FT AREA HEIGHT LIGHTS OF CRACK SQ. FT. • • (py N0. WIDTH FT. AREA HEIGHT LIGHTS OIF CCK SO. FT COEF.1 BTU COEF. BTU INFILTRATION r"" 910 INFILTRATION GLASS GLASS -o Q f EXP. WALL EXP. WALL NET EXP. WALL CEILING FLOOR% �ia to P �'� ✓<,q �F Gi jo 'zeo -� NET EXP. WALL ��) P �� CEILING f iC ® FLOOR TOTAL BTU. +� TOTAL BTU. FL. ,I ��' '",":per ROOM LENGTH W 1 DTH ��HE I GHT FL. ROOM LENGTH �/Z W I DTH HE 1 GHT,�+ . WINDOWS AND DOORS-CRACKAGE AND AREA felt/ WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH HEIGHT N0. OF Lj NEAL FT. AREA LIGHTS F CRACK S0. FT. NO. WIDTH NO. OF LINEAL FT. AREA HE NO.OF CRACK SQ. FT. v _ S (/ COEF. BTU. COEF. BTU. INFILTRATION 7, 4� P INFILTRATION GLASS :a ® N --.Q GLASS EXP. WALL ��•f EXP. WALL NET EXP. WALL Nf. NET EXP. WALL CEILING CEILING.133�a FLOOR `'s r FLOOR �' TOTAL BTU. TOTAL BTU. FL. fh-•..; ROOM LENGTH I WIDTH " HEIGHT a FL. a w OOM LENGTH a WIDTH AS HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA A iJ�"� 1411WINDOWS AND. OORS-CRACKAGE AND AREA N0. WIDTH N0. OF LINEAL FT. AREA HEIGHT LIGHTS OF CRACK SQ. FT. i N0. WIDTH N0. OF LINEAL FT. AREA HEIGHT LIGHTS OF CRACK SQ.FTT. •MJF >7 '.! 'p J �! �('if V yrf ff IJ1 6 COEFj BTU. COEF. BTU. INFILTRATION t Q INFILTRATION GLASS30 +�� ,� GLASS EXP. WALL + EXP. WALL NET EXP. WALLAp� NET EXP. WALL CEILING "' y '� CEILING FLOOR .sem• FLOOR TOTAL BTU. TOTAL BTU.0 �. TOTAL BTU. HEAT LOSS) TOTAL E.D.R..STEAM TOTAL SQ. FT. H.W. HEATING UNIT.. NAV H T G. C O N T R. ADDRESS c. DATE NAME `) O B [ADDRESS FL. ROOM LENGTH �'_ WIDTH HE 1 GHT (, �' FL . ROOM LENGTH/,,4, ,W I DTH HEI GHT V WINDOWS AND DOORS-CRACKAGE AND AREA NO. WIDTH HEIGHT No. OF LINEAL FT AREA LIGHTS OF CRACK SQ. FT. / "� / / •i V WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK SO.''FT j I COEF. BTU COEF. BTU INFILTRATION INFILTRATION GLASS EXP. WALL V� 1� GLASS EXP. WALL • NET EXP. WALL�� iddle : �' NET EXP. WALL,,8 CEILING CEILING Z. FLOOR P'� �� FLOOR ` ow # 15 4 splavAt . - TOTAL BTU. I7° TOTAL BTU.P� FL. f . "�E? ROOM LENGTH ` W IDTH �'.�. HE I GHT f.1 FL. I C�ROOM LENGTH j-. W I DTH HE I GHT y WINDOWS AND DOORS-CRACKAGE AND AREA NO. WIDTH HEIGHT NO. OF, LINEAL FT. AREA LIGHTS OF CRACK SQ. FT. / . y f _ _ WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH HEIGHT NO. OF LINEAL FT. AREA LIGHTS OF CRACK SQ. FT. !� COEF. BTU. COEF. BTU. INFILTRATION d I INFILTRATION GLASS ' f41 !�� GLASS EXP. WALL 17 ,-1,T EXP. WALL NET EXP. WALL opp NET EXP. WALL .CEILING 'Je +-- CEILING FLOOR t �' ® FLOOR TOTAL BTU.,% y �,�• TOTAL BTU. g. FL..L,.- ROOM LENGTH WIDTH HEIGHT FL. ! /a,/�' ROOM LENGTH WIDTH'fmHEIGHT�f� WINDOWS AND DOORS-CRACKAGE AND AREAdC NO. WIDTH HEIGHT N0. OF LINEAL FT. AREA LSII*GH�TS OF CRACK SQ. FT. * t. � r, �� ,I�,......, IZ 1 � 450 WINDOWS AND DOORS-CRACKAGE AND AREAr r' L / / J N0. WIDTH HEIGHT NO. OF LINEAL FT. AREA LIGHTS OF CRACK SO. FT.on n fel ./► '�.O COEF; BTU. COEF. BTU. INFILTRATION INFILTRATION 4061 '' GLASS GLASS O EXP. WALL Gonpg e, EXP. WALL NET EXP. WALL NET EXP. WALLrld / r' CEILING FLOOR 9CEILING ! Lr FLOOR TOTAL BTU. TOTAL BTU. i TOTAL BTU. HEAT LOSS HEAPING UNIT TOTAL E.D.R..STEAM TOTAL SO. FT. H.W. I y r NAPE H T G. C O N T R. ADDRESS i y DATE 1 J O B NAME [ADDRESS FL. :r G'- 3f ROOM LENGTH r! WIDTH .,'�HEIGHT �,,. FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND OORS-CRACKAGE AND AREA NO. WIDTH HEIGHT No. OF LINEAL FT AREA LIGHTS OF CRACK 50. FT f v it0 f' 1 i WINDOWS AND DOORS-CRACKAGE AND AREA NO. WIDTH HEIGHT NO. OF LINEAL FT. AREA LIGHTS OF CRACK SQ. FT COEF. BTU COEF. BTU INFILTRATION I° q o n y INFILTRATION GLASS r �� GLASS EXP. WALL" EXP. WALL NET EXP. WALL I4 e" NET EXP. WALL CEILINGa.� 1 CEILING FLOOR FLOOR TOTAL BTU. �'y r0%, c TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA NO. WIDTH HEIGHT NO. OF. LINEAL FT. AREA LIGHTS OF CRACK SO. FT. WINDOWS AND DOORS-CRACKAGE AND AREA N0WIDTH HEIGHT NO. OF LINEAL FT. AREA . LIGHTS OF CRACK SO. FT. COEF. BTU. COEF. BTU. INFILTRATION INFILTRATION GLASS GLASS EXP. WALL EXP. WALL NET EXP. WALL NET EXP. WALL :CEILING CEILING FLOOR FLOOR TOTAL BTU. TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA NO. WIDTH HEIGHT NO. OF LINEAL FT. AREA LIGHTS OF CRACK SQ. FT. WINDOWS AND DOORS-CRACKAGE AND AREA NOWIDTH HEIGHT NO. OF LINEAL FT. AREA . LIGHTS OF CRACK SO.FT. f i COEK BTU. COEF. BTU. INFILTRATION INFILTRATION GLASS GLASS EXP. WALL EXP. WALL NET EXP. WALL NET EXP. WALL CEILING CEILING FLOOR FLOOR TOTAL BTU. TOTAL BTU. TOTAL BTU. HEAT LOSS HEATING UNIT TOTAL E.D.R.—STEAM TOTAL SO. FT. H.W. 4 City of Fridley Application for Plumbing and Gas Fitting Permit\ Dept. of Bldgs. Phone SII 4-740 DESCRIPTION OF WORK �'C�_ Number, Kind and Location of Fixtures Locatioa— IO 2 WATER HTR. O R N GAS ELEc Base 1st 2nd _ 3rd _ 4th • Future Connection Openings Cosa®cted with I Sewer Now Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $� Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater -(Up to 200,000 BTU) ...... x 2.00 1910 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ o �® Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do 411 work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Used as To be completed about Q – Estimated Cost, G Old—New. Building Permit No - TP1Permit No. — ROUGH FINAL as 2M 7-59 Business 0 2– PI SUBJECT PERMIT . •-. - City of Fridleyo 19 2 2 5 AT THE TOP OF THE TWINS BUILDING PERMIT r R CEIPT NO `L ______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. � i1 = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY --_-� .� L 612-571-3450 910-F15 10/2/87 JOB ADDRESS 5974 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3,4 11 Hyde Park SHEET 27 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Earl Norwood 5974 - 3rd Street N.E. 472-2951 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. B USE OF BUILDING 4 -Flex 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION? REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK ReroQf Structure (23 Squares) 9 CHANGEOFUSEFROM TO STIPULATIONS Roofing can be 2nd layer but not 3rd. Installed ridged galvanized valleys. 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 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 $11150 S i 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- $20.50 n STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. %•� / /� 1 LAN CHECK FEE TOTAL FEE $28.55 SI ATUREOFC TRACTORORAUTHORIZED GENT (DATE) WHEN PROPERLY VAGTI THIS IS YOUR PERMIT RE OF WNER(I NER BUILDER) (DATE) BLDG WSP p E PI PURCHASE ORDER I DATE IMPARTMENT PURCHASED BY THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY F THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US SUPPLIER _ ADDRESS � / CI I OF FRIDLEY PHONE NO. 6431 UNIV. AVE. N.E. FRIDLEY, MN 55432-4364 CONTACT 612-571-3450 PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW 'STATED ITEMS. PATE RECEIVED PAYMENTAUTHORIZED BY ACCOUNT QTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWING UNIT PRICE AMOUNT TOTAL THIS AGENCY HAS AGREED NOT TO'bISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AG�PEED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. EXEMPT FROM SALES TAX, AS A POLITICAL SUBDIVISON OF THE STATE OF MINNESOTA CITY OF FRIDLEY NO. 8030301 WHITE, VENDOR — YELLOW, PURCHASING — PINK, ACCOUNTING — GOLDEN ROD, DEPT. HD. Prepaid Plan Check $ -� Estimated Cost $ Receipt # City Of Fridley R-3, C10MMCIAL & INDUSTRIAL Building Permit Application Construction Address:X97 � A �Fo Zoning: Legal Description: Revised 1,/1/87 Property Owner & Address • ` oA 6, / V d j" - _ Tel. #-'PP 2 9r Contractor & Address: Tel. # Y 72- 2gJ-1 Architect & Address: _—Reg•# Engineer & Address: Reg.# Type of Work [ ] New APPLICANT SIGNATURE: a [ ] Addition [ ] Alteration fek f USE OF BUILDING: t _ Tel. # Z - j Date : 7 BUILDING DIMENSIDNS Size of Structure Length Width Height Sq. Ft. # of Stories OFC. AREA: Length Width _ Height Sq. Ft. _ WHSE. AREA: Length Width Height Sq. Ft. 0 HER AREA: Length Width Height Sq. Ft. �Lft60 � - UATION Sq. Ft. X $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. X $ Cost/Sq. Ft. = Valuation $ ) _ $ 11 Sq. Ft. X $ Cost/Sq. Ft. = Valuation $ ) Total Type of Const: Occup. Group: A/C [ ] Yes [ ] No Fire Prot. [ ] Yes [ ] No Performance Bond Amount $ See Reverse for Schedule Received [ ] Yes [ ] No. Permit Fee $® i0 See Fee Schedule on Reverse Side Plan Check $ In excess of Prepaid Plan Check -See Back Pg. State Surcharge �S� $ 0Sk $.50/$1,000 Valuation (See Seed. for > $1 mil) SAC Charge $ 525 per SAC Unit Park Fee $ Fee Determined by Engineering Spec. Assessments $ Agreement Necessary [ ] Not Necessary [ ] Driveway Escrow feet at $13.50/foot TOM )I�"'U tai STIPULATIONS: . a@— CITY OF'i=RIDLEY INSPECTION DIV, Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESS �� A- e RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated in this application are true and correct. Gas Piping (Needed with new furnace) $10.00 $ OWNER...2 at A/0 f" 60 00 Gas Range $ 10.00 $ . BUILDING USED AS d idle % 4 j Gas Dryer $ 10.00$ _ ESTIMATED COST �� d PERMIT NO.�L� *Air Conditioning — Ali Sizes $10.00 $ • DESCRIPTION OF FURNACE AND 08 BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating UnitsCircle One (Steam) (Hot Water) (Warm Air) Trade Name c aA et ng Size No. 2-0& W 10 Commercial/industrial BTU ,, HP EDR I% of Value of Appliance or Work $ Fuel ' Total Connected Load State Surcharge $ .50 Burner Trade Nance Size No. TOTAL FEE $.�„L BTU HP EDR 1�.. HEATING COMPANY i.�0 //2 -Me cha,4g[ LA.Z 4-,7C MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATIONAIR CONDITIONING PERMIT IS $15.00 Signed By Tel No. 622-3 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 2 Approved ByiliE Rough—in Date Final Date 4� *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (t, No ( ) 2.. Is free from rust or deterioration Yes (t NO ( ) 3. Has no foreign objects lodged within 'Yes (F No ( ) 4. Is securely supported Yes (✓f No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes (V No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's J Remarks HEATING COMPANY Signed By Date NAMPADDRE E H T G. C O N T R. [ADDRESSE DATE J O B SSo��£ FL. ROOM LENGTH Vd WIDTH HEIGHT FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH NE16NT No. OF LINEAL FT AREA N0, WIDTH HEIGHT N0. OF LINEAL FT. AREA L 1 GHTS OF CRACK S0. FT LO. GHTS • OF CRACK SQ. FT Y / INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR COEF. BTU. I I I I I COEF. BTU. INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR TOTAL BTU. TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA N0. I WIDTH I HEIGHT N0. OF LINEAL FT. AREA N0. WIDTH HEIGHT NO. OF LINEAL FT. AREA LIGHTS OF CRACK 40. FT. LIGHTS OF CRACK SQ. FT. COEF.1 BTU. I I I COEF. BTU. INFILTRATION INFILTRATION GLASS GLASS EXP. MALL EXP. WALL NET EXP. WALL NET EXP. WALL CEILING CEILING FLOOR FLOOR TOTAL BTU. TOTAL BTU. TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM TOTAL SO. FT. H.W. HEATING UNIT COEF. BTU COEF. BTU INFILTRATION INFILTRATION GLASS GLASS EXP. WALL Q� �jL EXP. WALL NET EXP. WALL NET EXP. WALL CEILING' / CEILIN.G FLOOR FLOOR TOTAL BTU. TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT FL. I ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH I HEIGHT I NLO, GNT8 OIF CRACK SO. FT. N0. WIDTH I HEIGHT LAREA �GHTS OF CRACK SO. FT. INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR COEF. BTU. I I I I I COEF. BTU. INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR TOTAL BTU. TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA N0. I WIDTH I HEIGHT N0. OF LINEAL FT. AREA N0. WIDTH HEIGHT NO. OF LINEAL FT. AREA LIGHTS OF CRACK 40. FT. LIGHTS OF CRACK SQ. FT. COEF.1 BTU. I I I COEF. BTU. INFILTRATION INFILTRATION GLASS GLASS EXP. MALL EXP. WALL NET EXP. WALL NET EXP. WALL CEILING CEILING FLOOR FLOOR TOTAL BTU. TOTAL BTU. TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM TOTAL SO. FT. H.W. HEATING UNIT 01 sueJEer MIT NO. City of Fridley 28416 AT THE TOP OF THE TWINS BUILDING PERMIT L5��— 0� 0 • COMMUNITY DEVELOPMENT DIV. i PROTECTIVE INSPECTION SEC. 1 � � �•j CITY HALL FRIDLEY 55432 NU.BEF DATE PAGE Oc APPROVED By 612-571-3450 910•Fl10/26/98 7RE JOB ADDRESS 5974 3rd Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3, 4 11 1Hvde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Nelia & Thomas Schaff 586-9947 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 a REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 4-plex Reroof a (34 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 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 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 2913 $1.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $74.75 1, Fire/1C $3.00 PLAN CHECK FEE TOTA F E S -GN TUBE OF CON' TO OR MQ iZED AGE T iOATE� -25 N ROP&ALIDAT HISS IS Y UR PERMIT BL iN$F' �O i QA TE SIGNATURE OF OWN of OVyAEP BUILDER (DATE- 01 NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: 7t'l- D Effective 1/1/98 M Tel. # 4Q�'wl-5l% MN LICENSE # Address: Tel. # -6-e5'7 '� 2 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 1111-1 3% � Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Le- APPLICANT: Tel. #371—e� � Z Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $, �' $ 3e-0 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 YAX: ( 763) 571-1287 ADDRESS 5974 3 ST NE PIN 233024220102 LEGAL DESC HYDE PARK LOT 3 BLOCK 11 PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT N .: 2004-01191 DATE ISSUED: 07/28/2004 VALUATION : $ 200.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER HEATER. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES # WATER TRMT APPLIANCES APPLICANT NEWMECH COMPANIES INC 1633 EUSTIS ST ST PAUL, MN 55108-1288 (651) 642-5558 THOMAS SCHAFF 5974 3RD ST NE FRIDLEY, MN 55432 0 # GAS WATER HEATERS 1 0 # GAS RANGES 0 0 VALUE (FOR MINIMUM CALC) 200 0 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 reco truction or the performance of co�}ction. An iDate I I Bldg Insp t Q;1 � Date ` —f P " PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 162754 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 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 PERMITe- a MARK NUMBER OF FIXTURES TO BE INSTALLED $10.00 ON EACH FLOOR ifJ YG 1 7 1 $10.00 �� Urinal :I.t::::> ' h er S ow Rain Water Leader Wash r T a :pry :. ' I:t�lrt��s<. o r FI o Drain > � �I�.. :.::: �:. Vin....... A o. ut W sher a "•�`. !......... '`:"•:1;}`}''. Gas Ran a IIi'Ii�'•i. ...,...... i='iC�'''<'. Water Heater Stories Gas EI ec Basement $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 ForI 1 0 Floor 2 Floor 3 Floor 4 **Replace owner furhished water heater PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 5974 — 3rd Street New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas** 1 $35.00 Gas Range** $10.00 Gas Dryer*" $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance 35.00 State Surcharge $---.2-5- 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: 7/22/04 ,20 OWNER Thomas S. Schaff BUILDING USED AS Rental (4-plex) al ESTIMATED COST $200 PERMIT NO. C/t"J ' / 91 PLUMBING COMPANY NewMech Companies, Inc. SIGNED BY TEL N0. 651-645-0451 Approved By Rough -In Date Final Date TOTAL FEE $.15.50 OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE 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 -LAMA 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 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 :