PRE 2010 DOCSApplication for Power Plants and Heating. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
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 ............ 8.00 $
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .....
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ..
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water .... ...........
2.50
$
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU)O 6
................ 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $_1s19
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 $�
Dept. of Bldgs. Phone 560-3450
Location — T 1-t •
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.
Fridley, Minn 5��d y 19roy�
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Building Permit No.
!,-
17
Permit No. ' ` 9.5 11
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Nam ,10'0�� Size No All — 2,0 A
Capacity. Sq. Ft. E.D.R BTU H.P.
Total Connected Load • :?_2 Kind of Fue:
BURNER — Trade Name Size No
Capacity. Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
S CA
..�01Business Phone No-
SUBJECT ,
P d.
City of Fridley
32516
AT THE TOP OF THE TWINS
BUILDING PERMIT
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
(—ly
j PROTECTIVE
i A �r��� �,� CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
._-•
L J\ 612-571-3450
910415
4/19/02
JOB ADDRESS 5614 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8
4
Hamilton's Addn to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Daniel Kelley 5614 4 Street NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Gardner Contracting 17022 Round Lake Blvd NW, Andover MN 55304 763-213-1300
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 IR REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House (9 Sq) Tear -off; Reside House; Replace 6 windows and sliding glass doo
9 CHANGEOFUSEFROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive
barrier be placed over exterior sheathing to protect the interior wall covering.
Exceptions for this provision would be if sheathing is an approved weatherproof
panel or when the siding is an approved weather barrier. Vinyl siding is not a
weatherproof covering unless the manufacturer states this in their application
guidelines. Call for inspection of wrap before covering. Caulk and flash all
exterior openings. Underlayment must meet the State Building Code.
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform 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 ABANDONQO 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
$10,745
$5.37
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
PROWS I SOF ANY OTHER STATE OR LOCAL LAW REGULATING CON -
$195.25
Fire SC $10.74
R CT OR THE PERF MANCE OF CONSTRUCTION
PLAN CHECK FEE
OTAL FE
G
License 5.00 12
$2 .36
slyNATURE OF CC TQRORAUT+OR12EDAGENT ,DATE,
N PR PERLY A ATE T S IS YOUR ERMIT
0 04
BLDG SP - rIA
S-GNATURE OF OWNER „F OWNER BUILDER, ,DATE,
NEW [ ] CITY OF FRIDLEY Effective 1/12002
ADDN [ ] 6431 University Ave NE, Fddley;•MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
l 'S(
Construction Address: J (o 4
Legal Description:
Owner Name &' Addre s: 1�r ^� A (� 9 y Tel. #
Contractor. 614 27A, e z C C9 AA- / C MN LICENSE # S
Address: 17 0 ;2 2 go - — J " A r 131-J, /u/", 4J,,,,, 55 3 m 4 Tel. # 7 63 - a 13" 1 3 o o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT 0 - (�
, �✓
11
f C"P r
LIVING AREA: Length Wth ' Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: ,�� 2 0 0 (2e S; .l z G ,.> d o_ s `'i' T11 j"
Construction Type: ° L j "� Estimated Cost: $
Driveway C rb Cut Width Needed: F + 6 Ft = Ft x $ _ $
DATE: `I / n a APPLICA Tel. #� A 3
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.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
Fee Schedule on Reverse Side
$ iO , %y .001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$ $1200 per SAC Unit
$ 5- O Q $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 [ ]
$o °-3(o STIPULATIONS: