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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N°5 7 7 s Date: ole Owner: -ze% -pit, Builder Woolf Address Address LOC TON OF BUILDING No. street _ ' __ _ _ , Part o Lot Lot Addition or Sub -Divisions' Corner Lot — Inside Lot _____+rim Setback_ Sideyard % Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING o Used �, ,,%�l Front 4 Depth Height _� Sq. Ft./ Cu. sQ o DepthHeight Sq. Ft. Cu. Ft. Type of Construction Fst. Cogt".'"�.� 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 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 de express condition that the person to whom it is granted and his agents, employees and workmen, in all work ine in, around and upon said building, or any part thereof, 'shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteratipn, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violatitl3i of any of the provisions of said ordinances. _ A� 11 Building Inspector 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 items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Address 67,7 2o Addr ass _S2 (2-o LOCATION OF BUILDING Noe. eg J/ % O , street_ .`, ��, Y Part of Lot ,� Lot,,, Additionr S divi�lion______r_, Corner Lot Inside Lot Setback SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Front tre " Depth ,, Height% Sq. Ft. %�14 r9 - Cu. Ft. Front __.Depth sleight Sq. Ft. Cu. Ft. Type of ConstructionAIU4_te� Estimated Cost' /Z O -0 d. To be Completed The undersigned hereby makes apolication for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATEE�� d%' _ SIGNATURE (schedule of Fee Costs can be found on.the Reverse Side). 0 City of Fridley, Minn. BUILDING PERMIT Date: June 13, 1969 Owner: Delbert D. Sloan Builder Gorco Blders Address 5870 4th St N E. Address 3384 Browmlow Ave. No. 5 87 0 Street Lot _ _ 1 —__ Block z17 C✓ d -;?- N9 -? -N° 10284 LOCATION OF BUILDING 4th S t . N. E. _ _ — Part of Lot 4 Addition or Sub -Division _ Bennett Palmer Addn. Comer Lot — Inside Lot . _ Setback -- Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Dh1P SaagnFront24' Depth 22 � Height 10' Sq. Ft 528 Cu. Ft 5280 Front Depth Height Sq. Ft. Cu. Ft Type of Construction Frame Est Cost ^ $2590.00 __ To be Completed Blacktop Driveway In consideration of the issuance to me of a permit to co tract the building described above I agree to do the proposed work in accordance with the description above t forth and incompIt with 21 provisions of ordinances of the city of Fridley. —j pry In consideration of the payment of a fee of $ X00 , permit is hereby granted to Gorco Blders . to construct the building or addition as described above. This permit is grantedupon 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 violation of any of the Provisions of said ordinances. A Clarence Belisle NOTICE: M peenh don not cover the constrocHen, hutaWan for whbg, phnabing, ga holing, sewer or wabr. Bn sore to an the BoihMg hopomr for separate permhs for than Mme. I. - APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER Is NAME_p (' BIIILDER ADDRESS /� ADDRESSXlrcf T i *. it LOCATION OF BUILDING NO. STREET LOT ^ BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT x SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING 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: 1 s � r,-Front Depth a 2 Height Square feet . C2 Cubic Feet Front Depth Height Square feet Cubic Feet 19 Type of Construction Estimated Cost �IX®G ®c To Be Completed C' ''� 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. 14 DATEL�% T� SIGNATURE T Schedule of Fee Costs can be found on the Reverse Side.) Application for Power Plants and: Healing. Coding, Ventilation..Refrigerarkm and "'" Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU. 4-7470 GRAVITY WARM AIA: RATE TOTAL. Location— Furnace ocation 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 am Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 16 each add. 60,000 BTU ....................... 2.00 $ — Replacement of Furnace §.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 ................. 1 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) ....................... 5.00 $ ®� GAS FITTING FEES: NO RATEdaiAL 1st 3 Fixtures x $1.50 $ ame" Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE $ � ROUGH F1'NAIr 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_ , 19 _ OwnerS r�'� fw +0 RI Ar t� 4a .Kind of Building I ��i Used as oto To be completed about - 49- Mir —4c.? Estimated Cost, $ / If co I.& ,_ Old New Building Permit No. ��—Z / e Permit No. r DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water, arm Air— o �ss- Trade Name L O iy &#ox Size No 42w Capacity 000 Sq. Ft. E.D.R BTU H.P. Total Connected Load -jag d of Fuel �� 04 �► BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signed, /__4A0jL4!!ft r By � � 1-4z 2M 7-s9Bj-)u il1iTCshoneAND o 4410 EXCELSIOR BLVD. R O NEA IONINLIS 16, MINN. (REMARKS—OVER) WA. 6.6567 / r / 01 SUBJECT City of Fridley 25" 5 " AT THE TOP OF THE TWINS BUILDING P E R M I T r � RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. ---'- fr PROTECTIVE INSPECTION SEC. r ; CITY HALL FRIDLEY 55432 NUMBER REV DATE P PAGE OF APPROVED BY 612-571-3450 910-F15 5/23/97 JOB ADDRESS 5872 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. L 4 1 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rwei Tsang Chen 5872 4 Street NE 404-9720 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 Duplex 7 CLASS OF WORK ❑ NEW ❑ ADDITION �1 ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 6 DESCRIBE WORK Install basement egress window 9 CHANGE OF USE FROM TO STIPULATIONS Window must meet the State Egress 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 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 2 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 $800 $.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- $29.25 Fire SC $.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE 4'i AL FEE Fk' $30.55 -: - "- ' D THIS IS YOUR PERMIT TOR OR AUTHORIZED AGENT IDATEI ASIGATUIREDFCON.RA EOF OWN iIF NER BUILDER) IDATEI B1crG INSP PATE / r / 01 ADDN l 1 CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: S f Legal Description: Owner Name & Address: Contractor: / I C61 -e Address: Effective 1/1/97 -rsX-3 Z t — ^Crlw g Tel. # 4/6 L nt-crl ri, r 6'-t`_ MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EUPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width. Hgt/Ground OTHER: L 'w • "- " � -,.2 C- C /. Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Tel. # Sq. Ft. Sq. Ft. So. Ft. Estimated Cost: $ v (Fee Schedule on Back) Ft x $ = $ DATE: APPLICANT: sal Cle--,t Tel. # STIPULATIONS: .. r CITY USE ONLY Permit Fee $ • Fee Schedule on Reverse Side Fire Surcharge $ A -C) .001 of Permit Valuation (1/10th%) State Surcharge $ • S $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ -$450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer. Main Charge $ Agreement Necessary [ ] Not Necessary ( ] TOTAL $ (� •S STIPULATIONS: .. r SUBJECT City of Fridley 27418 AT THE TOP OF THE TWINS BUILDING PERMIT r T NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � 1 � � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 8/26/98 JOB ADDRESS ' 5870 4th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 4 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE McLean Leucic920-7652 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Paul Kothrade Const 1522 -?138 90100485 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 xR3 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 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 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 SPEC$ HEREIN NOT. THE GRANTING OF A PERMIT $1834 .92 DOES NOT PRESUM T GIVE A ORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF Y HERS E O LOCAL LAW REGULATING CON- STRUCTION O HE RFOR C CON RUCTION. t59.50 ire SC 1.83 LAN CHECK FEE TOTAL FEE LIcense SC $5.00 1$67.25 SI ATURIDAEIEO WHEN PROPERLY BLDG INSP VALIDATED THIS IS YOUR PERMIT GATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW I ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: SfS -) 0 %�# ->7-" Legal Description: ,,, Owner NameZdd,ess: �li6, �aC) C Tel. # _ 7 ' Contractor:/1D j/%� i �� MN LICENSE # � GDJ�6 Address: Aj� . l%A Ls / Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER:T L' Construction Type Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = _ Ft x $ _ $ Z TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $�• �� Fee Schedule on Reverse Side Fire Surcharge $ l c° .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: SUBJECT -41ERMIT NO. City of Fridley 2 7 52 7 AT THE TOP OF THE TWINS BUILDING PERMIT r o COMMUNITY DEVELOPMENT DIV. _ v PROTECTIVE INSPECTION SEC. r I , NUMBERREV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/2/98 JOB ADDRESS 5870 4th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 4 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Melean Leuck386-8127 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Paul Kothrade Cons - 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 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 24 S 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 S0. 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SA TO B RUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCE_ G VE NG THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SP I HEREIN OR NOT. THE GRANTING OF A PERMIT 2056 $1.03 DOES NOT P ES GIV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIOO A,,NYd,. THEM STATE OR LOCAL LAW REGULATING CON- STRUC x6 TA)tVP FO MANCE F CONSTRUCTION. $74.75 FirM SC $2.06 T FEE License $5-0V.84 SIGNATOR OFC ACT RAUTHORIZED AGENT - IDA iii6i THIS I$ R PERMIT gaTE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] ADDN [ `] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:� %v Legal Description: Owner Name &/A.ddress:./"/f 1-ZzgnJ Contractor: Address: AXX( 1` bl, GU, f �l Effective 1/1/98 4� Tel. #-3 ( ' a 1 MN LICENSE # 2z� �GG�ti jjLG,� Tel. #�r''�f�0 Attach to this application, a Certificate of Survey df the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: fc- 71 Construction Type)�/� l% �i�/� Estimated Cost: $ fie✓ /yOf�l,' 4 �jg(p (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Z/& APPLICANT: A111-16 rJJ' Tel. # ��✓�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $ S . do Park Fee $ Sewer Main Charge $ TOTAL . STIPULATIONS: 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 [ ] SUBJECT city of Fridley =79�2� AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. T NO. r PROTECTIVE INSPECTION SEC. �� E l A �r��;'� CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY --•. L J` 612-571-3450 910-F15 9/22/98 JOB ADDRESS 5870-72 4th St NE T LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I 1 4 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kwei-Tsang Chen 3425 Lawndale Ln N Minneapolis 55447 404-9720 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house & garage (16SQ) Tear-off; Reside - West side 9 CHANGE OF USE FROM TO STIPULATIONS Reroof - Underlayment must comply with the State Building Code. Reside - Call for building wrap inspection before covering. 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 $2,371.00 $1.19 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTA EE $78.31 S&NUR�O�CON'RAC/fTiORORAUTMORiZEDAGENT iDATEi N P OP ALIDA HIS IS UR PERMIT Q BL -NSP L �lA1E S E O�OWEf7 1-i OWNER BUILDER, IDATE, NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION J" ConstructionAddress: .59 70 (2 Z- - L-1 Legal Description: Owner Name & Address: �C�,,(/ l _ l ,S �It�G C ��j'� Tel. # y(� V- g 720 Contractor: 'Ty 2 s LA W"N"a- f -A ti MN LICENSE # Address: Tel. # 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: & Construction Typ : ()C3C S/ In/ dL)�- Estimated Cost: $ !2�l CIO 12:C PLA ci�:- (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: - ZZ- 9F APPLICANT: Ll "� Tel. # 1-16 1/c Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: 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 [ ] SUBJECT NO. City of Fridley 2944 1 AT THE TOP OF THE TWINS P, BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. SEC a6�� r PROTECTIVE INSPECTION ---I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L „ 612-571-3450 9t0 -F15 5/10/99 JOB ADDRESS 5870 4 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 4 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kwei Tsang Chen 5870 4 Street NE 404-9720 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 8 USE OF BUILDING Duplex 7 CLASS OF WORK O NEW O ADDITION O ALTERATION Cj7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Install replacement windows 9 CHANGE OF USE FROM TO STIPULATIONS Bedroom windows to meet the State Egress Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 2 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 $5,200 @ $2.60 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC C GE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION W 125.25 $ 0 Fire SC PLAN CHECK FEE /51 f0rl.'41i 33.05 SIGN UR WLOA$ACr0 EDAG IDATEI �A r , RO VALIDA THIS IS tu'�MIT A _C7`/ S, NATO EOF OWNEROF OWIER BUILDER, IDATEI PHEN ,NSD rIATE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �� 1 � COQ Construction Address: -70 -7z� Legal Description: / ` r i ` 07e-0 Owner Name & Address: l�/ �'1 l _ 7`9 6 N 6- C-14 6-%V Tel.#' 7 P Contractor: MN LICENSE # Address: Tel. # 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: Construction Type: DESCRIPTION OF EM PROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. /t/ Ck/ h// AA00KZ S Estimated Cost: $ S 20 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: �%i '�S��cJ� Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ �O .001 of Permit Valuation (1/10th%) State Surcharge $ 6G $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ CS STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes Ail Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $10.00 $ 25.00 State Surcharge TOTALFEE JOB ADDRESS, — 4 The undersigned hereby makes application for a permit for the work herein TOTAL 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. Y $ OWNER .BUILDING USED ASf, ell—leo $ ESTIMATED COST ��7 PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating UnitsCircle One (Steam) (Hot Water) (Warm Air) Trade Name Size No, BTU HP EDR $ Fuel ' Total Connected Load $_�50 Burner Trade Name Size No. BTU HP EDR HEATING COMPANY,,��y MINIMUM FEE FOR' ANY HEATING/COOLINGNENTILATION 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. Signed Approved FILL OUT BACK SIDE REPLACEMENT FURI Tel No. Rough—In Date STACK VERIFICATION ON 60: CHIMNEY AND STACK VERIFICATION The, undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes O No ( ) 2. Is free from rust or deterioration Yes O 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 Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: it.1.42CO4 / _.. List ALTERATIONS Being Done: HEATING CO: Signed By: Date: I G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 29, 2002 Ms. Alisha Manns 5870 4 Street NE Fridley, MN 55432 Re: Final Inspection at 5870 4 Street NE Contractor: Reliant Energy/Minnegasco Dear Ms. Manns: A mechanical permit was issued on March 27, 2001 to install a dryer at your address. According to the 1991 Uniform Mechanical 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. Sincerely, DJ/mh G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 (763) 571-3450 - FAX (763) 571-1287 - TTD/ITY (763) 572-3534 October 12, 2007 c� Kwei-Tsang ChenA 3425 Lawndale 10 Plymouth, MN 55447 RE: Building Permit Application Kwei-Tsang Chen: All construction work done on rental property is required to be done by a state licensed contractor. Therefore, I am returning you permit application and check for your rental property at 5870 4t St for an egress window install. Sincerely, Tina Bec� feld Permit Technician City of Fridley 763-572-3605 beckfeldtCaDci.fridley. mn. us V Building BUILDING Permit No.: 'Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 � 20 �;C�c4• O It 11 CITY OF FRIDLEY -DATE loapJ 1.4 E-MAIL ADD C� e . !moi ' �✓j�i d'J-`- SITE ADDRESS 62 ��yy .yLYOUR G! / THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME:— /sS�� TENANT ADDRESS: it ls-g.&)zJ7 CITY zq PHONE: d �! Z® �,� 2 CONTRACTO NAME: STATE LICENSE # EXP DATE SUBMIT A C Y OF YOUR STA LICENSE ADDRESS: CITY STATE ZIP WITH LICATTON PHONE FAX PROPERTY TYPE ❑ SINGLE FAWLY/NEW CONSTRUCTION SIZE J4VO FAMILY/NEW CONSTRUCTION STO PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIl14MNG POOL TYPE OF WORK: ❑ NEW❑ DITION 13MAINTENANCE/REPAIR ODELING DESCRIBE WORK BEING DONE: 6 S civ OR OFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other WINDOWS / ❑ Fascia &" %r06� A �(� L/ �/v NC `O and proposed project. 2. Two sets construction plans 3. Energy Calculations al IN EXISTING OPENINGS es ON. TI2N.0 W OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & / TYPE OF WINDOW TO BE INSTALL NUMBER OF WINDOWS ALL FEES ARE BASED &N VALU�AATIIOO�N, INCLUDING THE COST OF LABOR AND MATERIALS: (USINGjTOTAL JOB VALUATION $ 5 e/ , -570 U.B.0 FEE OCCUPANCY TYPE Permit Fee $ 3 , See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Zai . Make checks payable to: City of Fridley Attach Stipulations 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which r,pgyires revilew and approval of plans. ; , „ SIGNATURE OF APPLICANT A1141--4,. - /4, PItM-NAME X14 /& e14 _L- Wv �'��6? Building $ 50, 9<-- BUILDING Plan Review Permit No.: 2� ail l0 InspectionsRESIDENTIAL Fire Surcharge APPLICATION cei 763-572-3604 _$ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge CITY O F FRIDLEY x��#' D toec 763-502-4977 FAX $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review EFFECTIVE 1-1-09 $ Fee Determined by Engineering 3 "10-0? $ Agreement necessary ( ) Non Necessary ( ) DATE YOUR E-MAIL ADDRESS Make checks payable to: City of Fridley Attach Stipulations SITE ADDRESS CX '/ 34W, THIS APPLICANT IS: ❑ OWNER ,CONTRACTOR PROPERTY OWNER/ NAME: A ICS TENANT ADDRESS: CITY D,t . STATE�ZIP / ? l//��j PHONE: 6- " 7/ 7 / 0 P 27 CONTRACTOR NAME:._ �Q S J Z�{D�/[//�(o SUBMIT A COPY OF STATE LICENSE _c►�,�(�O7!/5 STATE LICENSE #®(/ S^Y 02 0� EXP DATEYOUR AND CERTIFICATE OF ADDRESS: / 90.0 1� 0?!U ^' CITY/Vajd �/t — STATE�WZIP j INSURANCE PHONE v 9 6' FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING P(OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR PrREMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yeso LOCATION Op WINDOWS // OR FOR NEW OPENINGS-DESC BE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: JOB VALUATION $ jwe� (USING 1997 U.B.0 FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $ 50, 9<-- See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge _$ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ =l`� Make checks payable to: City of Fridley Attach Stipulations 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I 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 accordance with the approved plan in the case of all rkk which requ' es r iew and approval of plans.� / �/ `% SIGNATURE OF APPLICANT 0";,,�7 PRINT NAME hk/Yh/ 70N�R,69DATE �(/ —0 Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date 'D: MA 763-502-4977 FAX EFFECTIVE EFFECTIVE 1-1-09 DATE 3 —3 - O a % YOUR E-MAIL ADDRESS SITE ADDRESS 5—o %Ji THIS APPLICANT IS: ❑ OWNEREONTRACTOR PROPERTY OWNER/ 1, NAME: TENANT ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR NAME: cp S SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # a ®o sy�ao2 EXP DATE AND CERTIFICATE OF ADDRESS:P. �U �Dy / i� CITY/$TATEIP S S INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS 'BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ;WREMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED' NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USINCTHE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 1000 at-/— OCCUPANCY TYPE_ Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary Make checks savable to: Citv of Fridlev THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED Attach I hereby apply for a building permit and I acknowledge that the information 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 I 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 accordance with the approved plan in the case of all rk which r au' es re iew and approval of plans. SIGNATURE OF APPLICANT � ? PRINT NAME / /�/�� < � ;� DATE 3-31-4 Building MECHANICAL Permit No.:" Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY 14 Date Recd: 763-502-4977 FAXOO EFFECTIVE 2-19-09 DATE Zf Z- 2-0 a / YOUR E-MAIL ADDRESS L � SITE ADDRESS � q 0 44k �l rY i be n, THIS APPLICANT IS: %g OWNER 13CONTRACTOR PROPERTY ^ NAME: K W e,` ^ T:S4r► 2 a411—M/ ADDRESS: CP 342- LAWn dAl-c- "-,f-CITY /1&4� r®V STATE '"ZIP OWNER/ TENANT PHONE:c'7 CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE 'D SINGLE FAMILY 0 TWO FAMILY [3 TOWNHOUSE TYPE OF WORK: ❑ NEW E3 REPLACEMENT LTERATION/RE M0DEL DETAILED DESCRIPTION OF WORK Lq C c"��--, irLG �c WrJ'r FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGWOVEN $10.00 AIR TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 $35.00 _FIREPLACE _FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER HIMNEY LINER $10.00 S DRYER $10.00 _POOL HEATER $35.00 tW DUCT WORK $10.00 �S PIPING $10.00 VENTILATOR $15.00 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a pennit; that the work will be in accordance with the approved plan in the case of all (ork which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 0 9 t) C6�_ 6-033A' DATE — Z— 2-d City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC 0 NEW HOMES/ADDITIONS ❑ EXISTING HOME 0 MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC 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 IMC 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 air calculations. 4 If 9.7 Building COMPANY NAME A f - MECHANICAL Inspections CONTACT PERSON: --T— RESIDENTIAL APPLICATI 763-572-3604 STATE LICENSE # EXP DA7` 763-502-4977 FAX ADDRESS: �_ J 1 � f 44 CITY OF FRIDLEY APPLICATION _DUCT WORK $10.00 EFFECTIVE 2-19-09 DATE 12' �p YOUR E-MAIL ADDRESS SITE ADDRESS r, E `. THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: C OWNER/ TENANT ADDRESS: fs CITY PHONE: �I �� .s l °D i /� CONTRACTOR COMPANY NAME A f - MODEL: SUBMIT A COPY OF CONTACT PERSON: --T— MFG: _A/C $25.00 YOUR STATE STATE LICENSE # EXP DA7` LICENSE WITH ADDRESS: �_ J 1 � f 44 —CHIMNEY LINER $10.00 APPLICATION _DUCT WORK $10.00 _ _GAS PIPING $)0.00 PHONE& FAX PERMIT TYPE ❑ SINGLE FAMILYTWO FAMILY 0 TOWNHOUSE TYPE OF WORK: NEW REPLACEMENT 11 ALTERATION/REMODFL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTA4 Equipment Installed MFG: MODEL: MFG: MODEL: MFG: _A/C $25.00 MODEL: (GAS) $15.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _BOILER $35.00 _FIREPLACE FURNACE $35.00 T —CHIMNEY LINER $10.00 _ GAS DRYER $10.00 _DUCT WORK $10.00 _ _GAS PIPING $)0.00 Number of fixtures @'$,10.00 x $10.00 _ $ Number of fixtures @ $15.00 x $15.00 =;$ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge MINIMUM FEE $35.58} Total = $ Permit No.: Oh•-�q - N IReceived By: L Date Recd: k_ Z_ TEMZIP5 y TAT)zIP L NUMBER OF EACH BELOW) SIZE/BTU SIZE/BTU-Pe, ereV SIZE/BTU _GAS RANGE/OVEN $10.00 _NEW GAS GRILL $10.00 _GAS UNIT HTR $10.00 _POOL HEATER $35.00 VENTILATOR $15.00 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota COIstruction Codes; that I understand this is not a permit but only an appli tion for a permit and work is not to start without a permit; that) the work will be in accordance with the approved plan in the case fall rk which re view and approval of plans. SIGNATURE OF APPLICA PRINT NAME r -"-71 j err e DATE Z " 3 " e Ep PLEASE NOTE: SEPARATP>�RMITR ARF PV(11UPlPnFn„rn cr t? Rt in nUT Eu., AXlt6%sa,.. TrA%.., ....... , City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 X4'1'7 Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: A 1 763-502-4977 FAX EFFECTIVE 2-19-09 DATE Z ` Equipment Installed MFG: YOUR E-MAIL ADDRESS SIZEIBTU SITE ADDRESS MODEL: 6p std WA T Af6 S I— MFG: THIS APPLICANT IS: ❑ OWNER ONTRACTOR _FIREPLACE (GAS) $15.00 PROPERTY NAME: _GAS _FIREPLACE (WOOD) $35.00 NEWGAS GRILL $10.00 OWNER/ ADDRESS: !'s CITY STATE ZIP, TENANT PHONE: ✓ / _POOL _GAS PIPING $10.00 VENTILATOR $15.00 (p CONTRACTOR COMPANY NAME: a4yyL4164- .4 '4 CONTACT PERSON: j 7' SUBMIT A COPY OF STATE LICENSE # ��'��r? EXP DATE �� ,� YOUR STATE LICENSE WITH APPLICATION ADDRESS: �(� ��lzl� CITY —Qjj� ��e 7 PHONE"FAX 7 �� STAT ZIP PERMIT TYPE ❑ SINGLE FAMILY XTWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL /� DETAILED DESCRIPTION OF WORK 6,0 /,.,—?1 ��ur�eq �� qI� �1 a�i� (� WzJ A4Nr FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: 6p std WA SIZE/BTU MFG: MODEL: SIZEIBTU _A/C $25.00 _FIREPLACE (GAS) $15.00 RANGEIOVEN $10.00 _AIR TO AIR EXCHANGEER $IS _GAS _FIREPLACE (WOOD) $35.00 NEWGAS GRILL $10.00 _BOILER $35.00 _NEW _FURNACE $35.00 UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00 _DUCT WORK $10.00 _POOL _GAS PIPING $10.00 VENTILATOR $15.00 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an appli tion for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case fall rk which re view and approval of plans. SIGNATURE OF APPLICA PRINT NAME (1�� (9� , 5`r&_,,4)gC_ -DATE ` 2-� ,3 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977