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City of Fridley, Minn. BUHDING PERMIT N? 3760 Date: .................... 7�7 ............. Owner ....................................... Builder ...... Address ...................................... Address ............................................. ATION OF BUILDING No. Street ..................... Part of-I—oot ......... Lot R.973.0111ock ........... Addition or Sub -Division ....... . o% e. f� ............. Corner Lot ............ Inside Lot .2( ........ Setback Sideyard ;0� -. DESCRIPTION OF BUILDING To be Used as: ee I Front 'W. -P Depth 9?e- Heigha'0 '�� Sq Ft. J. Cu. FIL .................... Front ........ Depth ........ Height Sq. Ft. ........ Cu, Ft . ........ Type of Construction ................... Est. Cost. . ...... To be Completed ................... in consideration of the issuance to me of a permit to construct the building desribed 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. /� ................................................. 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 with - In the city limits and this permit may be revoked at any time upon violation of of the provisions of said ordinances. 11 ......... /Building Thepector NOTICE: This permit does not cover the construction, Installation or alteration for wIrIng, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. City of Fridley, Minn. 112 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: - A»g» c r 5� 1971 ownw; H. W. Knutson guilder Miles Lumber Co. ,Adm 5357 4th Street N.E. Address 4500 Lundale AVenue North LOCATION OF BUILDING No 5357 Street 14th Street N.E. part of Lot Lot —2g. 0 Block 14 Addition or Sub -Division Rami 1 t -nn I S gin to Mpt,'h Corner Lot X Inside Lot – Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: G_ arage Front 22' Depth 20' Height 10' Sq. Ft. 484' CIL Ft, 4840' Front Depth Height Sq. Ft. Cu. Ft. Type of Construction _ Frame Est. Cost .$2, 000.00 To be Completed Sept. 1. 1,71 (1,927.00) Provide a hard surface drive. In consideration of the issuance to me of a permit to construct the building described the proposed work in accordance with the description above set rth and in compliance ordinances of the city of Fridley. I agree to do Provisions of In consideration of the payment of a fee of $_ -, permit is hereby granted to Miles Lumber Co . 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 buildiaga Within the� city limits and this permit may be revoked at any time upon violation of any of the provisions of said `•C�uilding Inspector HANK WHICH NOTICE: This permit does not 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. r APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : L.Ul I N l%T S o A BUILDER: t e Sy til 4 eO,- ADDRESS : ,� 57'2 LI %i �'L1. AIT ADDRESS: 4(5 ep r 11)V p 1 j e— A10, v NO: .5 3.5 % STREET: LOT:BLOCK: % ADDITION: CORNER IAT:L'.--- INSIDE LOT: SETBACK: SIDEYARD: 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: e, Front: -2 Depth: Rral Height: Square Feet:YCubic Feet: Front= Depth: Height; Square Feet; Cubic Feet: Type of Construction: -LRA'M e_ Estimated Cost: $ c�zrn p Im To Be Completed: !" The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stlict 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. DAZE: C��� a _, �% SIGNATURE: (See Reverse Side For Additional Informat n.� t LOT 29 AND 30, BLOCS 14, HAMILTON'S ADDITION TO MECHANICSVILLE, FRIDLEY, ANOSA.COUNTY, MINNESOTA. I CERTIFY THAT A BOUNDARY SURVEY WAS MADE BY ME CSF' THE ABOVE DESCRIBED PROPERTY ON JUNE 199 1971. GEORGE A. ZDON MINK. 2848. • . .' M gyp'' CER T/F/CATE O 1URVEY -71- Z Z ' 5357 4th ,.E. �o 54th AVE. - e' � t2 30- � 34.2 Z4 A G _ �JG • n z 291 2 SCALE I31 =40� c&. IA � � � O IRON PIN t 1ao.72-- 28 3 �, LOT 29 AND 30, BLOCS 14, HAMILTON'S ADDITION TO MECHANICSVILLE, FRIDLEY, ANOSA.COUNTY, MINNESOTA. I CERTIFY THAT A BOUNDARY SURVEY WAS MADE BY ME CSF' THE ABOVE DESCRIBED PROPERTY ON JUNE 199 1971. GEORGE A. ZDON MINK. 2848. • . .' M gyp'' CITY OF FRIDLEY INSPEC°I iUN DIV. u 1 6431 University Ave NE 1�5 Fridley, MN 55432 AV Iv 763-572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2001 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range” NO. RATE TOTAL I Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.001Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS 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. BREMEMAN, RICHARD 5357 4TH AVENUE NORTHEAST FRIDLEY, MN 55421 Owner_ (763) 571-9348 /l/,? ° , 2001 Building Used As R -e-51 �1 G'e- — Estimated Cost qn �e--? PERMIT NO. PLUMBING COMPANY (h16*W SIGNED BY TEL N0. (70,82 7 Approved By 2L Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOK ��.:.•�. ...T!x '�i:{�; Wash if °i�:. �. �'��"��=<:::::: �4,,;��>.: Floor > Auto. �Lai_�. i-:•}>,-ll,.�•'::: :::;�: Gas �....f.�.•,.�.•.•,•.•.s.••.<:..�: s : :?>:•f•7{!:'s?:i::%?+ .:5� Water Heater ♦ :i Stories },:.,...:: ....:—Shower�: �el<� Urinal i�11�„ . � .<::�. Tray r. .'02•}:ii\;Qi::};�i I�It�:::>::;>::> Drain .:: . »<..! BI�S(t1�:�< Washer y: n e . �;>;.,::.:. R a •<<�' : Gas Elec ,:.r.4rt ':� ..:xw:. •.�. :•}:3:}:. :•::tt=;?.•, _ Basement R ,;:<;>}:>;!>Y':: .::......: . :.? <.:.. h ....�. � :::;�,�!4..�,!;:,, .... ::.::.�:.:;::,:>>:�.:::: is •.:•..... ..:'.}•,:.:::::::::}!::: I 1 F oar Floor :•}}Y: i.}ri•}:•Y6%i..: .!...........,. ::: : }}Y.`.::5�!.. wiv: M, :.:::. ... @}}}::tid:-:?:::v.•. :: iii:ii::i::iiiiv Floor2 vv v: }: Floor 3 Floor 4 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range” NO. RATE TOTAL I Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.001Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS 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. BREMEMAN, RICHARD 5357 4TH AVENUE NORTHEAST FRIDLEY, MN 55421 Owner_ (763) 571-9348 /l/,? ° , 2001 Building Used As R -e-51 �1 G'e- — Estimated Cost qn �e--? PERMIT NO. PLUMBING COMPANY (h16*W SIGNED BY TEL N0. (70,82 7 Approved By 2L Rough -In Date Final Date 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 COMBUSTION AIR VERIFICATION When replacing an existing 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 ( ) 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 manufacturers 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 ( ) 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) HEA71NG CO: Signed By: Date : CfiYOE FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 7, 2003 Mr. Richard Brememan 5357 4 Street NE Fridley, MN 55421 Re: Final Inspection at 5357 4 Street NE Contractor: Norblom Plumbing Co Dear Mr. Brememan: A plumbing permit was issued on November 16, 2001 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh Building MECHANICAL Inspections RESIDENTIAL APPLICATION 7.63-572-3604 CITY OF FRIDLEY DATE 2' 13' O So YOUR E-MAIL ADDRESS _ crT'1 C /j5:;,_ SITE ADDRESS _r— THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR D OWNER ADDRESS: COMPANY NAME: Home E n Permit No.: ' Received By: Date Rec'd: STA CONTACT PERSON: SUBMIT A COPY OF STATE LICENSE # EXP DATE SE YOUR STATE CITY Plymouth STATE MN zIP_UAG LICENSE WITH ADDRESS: 15200 25th APPLICATION PHONE 763-476-1990 FAX 763 476 X143 :pEtRNHT TYPEl6 SINGLE FAMILY D TWO FAMILY D TOWNHOUSE D NEW X3 REPLACEMENT D ALTERATION/REMODEL TYPE WORK: DETAILED DESCRIPTION OF WORK 111! 3t 4�� PER MS 16B.665 the permit fee is a minimums ('Th of $15.00 or 5% of the total cost up to $s should reflect only thechever is r, for the co t of labor ) improvement, installation or replacement of a residential fixture excluding the fixture Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor _____ x.05= FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FF1�� S: (� KATE TOTAL NUMBER OF EACH BELOW) MFG. �� V�Ci h MODEL45v'�_L Equipment Installed MODEL: SIZElBTU MODEL: �— SIZE/BTU MFG: GAS RANGE/OVEN $10.00 A/C $25.00 _FIREPLACE (GAS) $15.00 NEW GAS GRILL $10.00 —AIR TO AIR EXCHANGEER $15 r=�U LACE (WOOD) $35.00 GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 — BOILER $35.00 PACE $35.00 —POOL HEATER $35.00 GAS DRYER $10-00 TOR $15.00 GAS PIPING $10-00 'A . a _r)i1CT WORK $10.00 a: gxr tihuixF�>. �, Number of fixture @ $10.00 10.00 = s x$ $ Permit Fee $ Number of fixtures @ $15.00 x $15.00 = $ Surcharge 50 TOTAL DUE.� Number of fixtures @ $25.00 x$25.00 = $ Number of fixtures @ $35.OS�te �Surcharge = $— Total = $ O. S G THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in d this is conformance with the ordinances and codes of the azCiWo kFslnot o start with withouMinnesota perm; th t the work will be in that with the not a permit but only an 'cati a permit approved plan in the case f a hich requires review and approval of plans. SIGNATURE OF APP C PRINT NAME i µ o , sem,- City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel NC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas 1MC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a- Required on new construction IMC 1346.0312. 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up airy calculations Building �� 1ITSIlNG THE 199 BUILDING TOTAL JOB VALUATION Permit No.: Inspections Permit Fee RESIDENTIAL APPLICATION. See Back Page for Fee Schedule Received By: 763-572-3604CITY 65% of Building Permit Fee OF FRIDLEY r�A $ , 3' CJ Dat ' QD: AI I 763-502-4977 $ ;2, P-6 .0005 x Permit Valuation Minimum $.50 License Surcharge .FAX $5.00 (State Licensed Residential Contractors) I EFFECTIVE 1-1-08 $ $1825 per SAC Unit (Plans to MWCC for determination) © $ ft + 6 ft = ftx $21= $ DATE YOUR E- ADDRESS $450 Conservation Plan Review SrM ADDRESS 5,3"5 W F, Fee Determined by Engineering THIS APPLICANT IS: ❑ OWNER WONTRACTOR Agreement necessary ( ) Non Necessary ( ) PROPERTY OWNER/ NAME. Q� Make checks payable to: City of Fridley Attach Stipulations TENANT ADDRESS:.6-3577 y ,J-1 77E, CTfY STATF/WhZIP J67elO- PHONE" 17/— 78 7? NAME: CONTRACTOR ADDRESS: 4714•CTfY !/1tD SIATE� NZIPu�SO� SUBMIT A COPY OF PHONE 41 -� 8q—.2 & S((o FAX YOUR STATE LICENSE STATE LICENSE # /74 EXP DATE 04 1oZd l D PROPERTY TYPE -MINGLE, FAMILYMENSMOSMWAGUM SSE ❑ TWO FAMILYMEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH RrROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWwmiNG POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION SMAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOM MOUSE ONLY NUMBER OF SQUARES �7 ❑HOUSE 8c GARAGE BASEMENT REM DELING SUBMIT: GARAGES ❑ATTACHED GARAGE 1, . 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Som ADDITIONS & PORCHES R M T, ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed p%lect• WrMWS 2. Two sets of construction plans INEXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS Ate, rr;r:a ARE BASED OIN VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: �� 1ITSIlNG THE 199 C FEE SCHEDULE) TOTAL JOB VALUATION $ 'y` SDCJ - �" OCCUPANCY TYPE Permit Fee U4,,Jb $ -_75 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge r�A $ , 3' CJ .001 times the total job valuation Surcharge $ ;2, P-6 .0005 x Permit Valuation Minimum $.50 License Surcharge $ . B $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ftx $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $1, Agreement necessary ( ) Non Necessary ( ) Total Due $ r Make checks payable to: City of Fridley Attach Stipulations THIS IS hN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the informatio above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in acco cc 'th the approved nU6 in the case of all work which requires review and appro al of plans. SIGNATURE OF APPLICANT PRINT NAME Ju. C/4017Q �DATE y 4!0 9 APPROVED BY DATE