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r S-V3o� City of Fridley, Mian.. 11TH 4 BUILDING PERMIT �_'_ - __9 Date: December 82 1970 Owner: - Kontenia 8xji1 dPrG Inc. Builder Ramp Address -3621 Lancaater Lane No- Address Same LOCATION OF BUILDING No. 5373— Street r1 fth Street tv 1, Part of Lot Lot 28,29y'An _ Block 15 Addition or Sub -Division ._Hamiltatl's Addition to Me-nicsville Corner Lot —X Inside Lot Sewer Elevation Setback 3 5 --- Sideyard -35 Foundation Elevation DESCRIPTION OF BUILDING To be Used as: 2 Family Dwelling - Double Bungalow Dwe11_i'ng Front 6_ Depth --26— Height _20— Sq. FL 1716_ Cu. Ft. Garage Front 9-4 Depth _ 22Height —10__ Sq. FL _52R Cu. FL 59.2.0 Type of Construction 'Frame Est. Cost $35,000_ To be Completed 911,17M - except garage Sewer Location: 105' S. of Manhole Wye Elev. = 853.13 Top of Footing = 856.13 (Approx.) Water Location: 109' S. of Manhole 4' S. of Sewer Service Garage Slab elevation Minimum 18" above 54th Avenue Hard surface drive plus 2 parking spaces Survey verifying location of basement required. Drain toward streets - 18" rise in elevation 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 se fo and in com ce th a'll provisions of ordinances of the city of Fridley. _ In consideration of the payment of a fee of $ 111 - nn _, permit is hereby granted to Knot-eni a n„ i l tiers Inc • - 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 anypart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, constru on, alteration, maintenance, repair andmoving 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. 7 ,% Building Inspector HANK TvItTHTCH NOTICE: 'This permit does not cover the construction, installo ion for wiring, plumbing, gas heating, sowor or water. Be ams to see the Building Inspector for separate permhs for these hemm 0 is 4 f �k APLICATION FOR RESIDENTIAL, ALTERATION,' OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : _ o_T24A 9/J //_ �-�s _rpe, BUILDER: .5e9 i» e ADDRESS: A/An"�_;�;,e 4,✓, 10V ADDRESS: STREET:- r --S ?h 5% .Al LOT :Z9, 2 7, -4 a BLOCK: %.S ADDITION: y -r es CORNER LOT: INSIDE LOT: SETBACK: 3S' 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 2 4,4 in, 4)oj �Ze �fiarf-Fron J J : Depth • Height • Q Square Feet: Cubic Feet: Front: J OHeight: . Square Feet; -S-2 Cubic Feet.-- Type eet:Tape of Construction:�i�,g,?,� Estimated Cost: $ �3�� ee o To Be Completed: Sc�a� •as ����Q — o� 'y�.y� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE : ' �f /�' �'® SIGNATURE: (See Reverse Side For Additional Information.) r I .d • r" k. .I;d . u " WO J Appli uTion Oar P®weir Plug% and He ng. coping. venni COON, a0farlomm®n and r% e Air Candi2ionong Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SM -34500 GRAVITY WARM AIR: RATE TOTAL Locafiow-g::K �_ _ c J �/. U/• 7 Furnace Shell & Duct Work .......................... i M $ $10.00 Replacement of Furnace ............................. tj& $ 6.o0 Repairs & Alterations—up to $500.00 .................. k.p& $ 6000 Repairs & Alterations each add. $500.00 ............... $ 3.00 KECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $ 2-6,0 v$10.00 each add. 60,000 BTU ....................... $ 3.00 Replacement of Furnace ............................. $ 6.00 Repairs & Alterations—up to $500.00 ................. } $ 6.00 Repairs & Alterations each add. $500.00 .............. $ 3.00 STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... F& $ $10.00 Furnace Shell & Line to 640 sq. ft. EDR Hot Water ... gjtkx$ 10.00 Each add. 200 sq. ft. EDR Steam ............... . ...... jU& $ 3-00 Each add. 320 sq. ft. EDR Hot Water .................. JZ& $ 3.00 OIL BURNER—to 3 gal. per hour .... $ 6.00 over 3 gal. per hour-�ee Fee Schedule 199000 GAS BURNER (tip to ME: 5.00 $ O O GAS FITTING E: 1999000 BTU NO RATE TOTAL 1st 3 Fixtures .. x $ q,06 Additional Fixt res �...... x $ Gas Range to .......... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ 8 ROUGH • �L . 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. i 11 Fridley, Minn- I M 19 / Owner ,(iC''e,.. X F:i' A YO Kind of Building _ Z /- . Used as To be co Estimated Cost, $- f o ©Ll -� Old Building Permit No. _ Permit No._ '7-n New DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, HEil��Noot Water, 2— Trade NamP 019M f�[.rx_/1'� Size No-claJE202— Capacity. �Q, 6 U d -f2L Sq. Ft. E.D.R BTU H.P. $2.00 Total Connected Load Kind of Fuet __-/e o .75 BURNER — Trade Name Size No. $5.00 Capacity Sq. Ft. E.D.R BTU H.P. Signe By , ep�'^iL4-42 Business Phone No- qW6� �� o (REMARKS—OVER) Original• PERMIT for Power Plants and Heating. Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of A Heating Plants J / to be @ta�l—)altered—repaired Make ,A) ,Size a U, r— - s ; 6 Oil fired ; Coal fired—,- Gas fired—Z—; Gas Authorization Remarks Approved by. Final Inspection Date , 19_ Inspector s zh Permit N° 4872 Fee $-222-7- 'AD Office of the inspector of Buildings City of Fridley City of Fridley, Minn., A80- - 45- , 19-2a Owner & % 6A&A 6Lh SPS , Location Kind of 'Building�� How Occupied Work to be Commenced—,19— To ommenced ,19_To be CompletedQ,192 Estimated Cost, $ �aO®• 06 Old�uilding Permit No. Permission is hereby granted to K32,MA4,614 to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person t whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein Mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specificatio set rth in the approved application for this permit on file in the office of the Inspector of Buildings. y Inspector of Buildings City of Fridley 53-84—S-915-51 Applicatioe for Numbling mfd C"n R"I" hnsit Dept. of Bldga. Phone NO -3430 DESCRIPTION OF WORK ---5-375—N. E. 5th. Street Number. Kind and Location of Fixtures City of Fridley: r uture Connection Openings sawn + Now Fixture, Old Openings �l O PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ... • . • ... • • . x $1.50 $-- New_ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater ;Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Meatric Water Heater .............. x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... • ....... • x $2.00 $ Additional Fixtures ................. x $ .75 $ Gas Range to 199.000 BTU ............. 1 x $5.00 $ 5.00 REPAIRS & ALTERATIONS—Refer to Coda Description . • .. • ... • ..... •........... • • ..... • ....... ......S TOTAL FEE 8 5,00 The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings. and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn 4-29-71 19_ Owner Kootinia Builders Kind of Building Frame Used as Res. To be completed about 5-6-71 Estimated Cost, $ 10.00 QMV(--New. Building Permit No. P.. e - S CAR fiphmv-- r; _ 1 9 Business Phone No - ROUGH FINAL 811NOMM110 MEMO 0MIN MOMMEMEMENIN MEMOMMENMEMMUMIN 0 04M IN MINI .......... INMINEEMIN 0 r uture Connection Openings sawn + Now Fixture, Old Openings �l O PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ... • . • ... • • . x $1.50 $-- New_ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater ;Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Meatric Water Heater .............. x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... • ....... • x $2.00 $ Additional Fixtures ................. x $ .75 $ Gas Range to 199.000 BTU ............. 1 x $5.00 $ 5.00 REPAIRS & ALTERATIONS—Refer to Coda Description . • .. • ... • ..... •........... • • ..... • ....... ......S TOTAL FEE 8 5,00 The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings. and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn 4-29-71 19_ Owner Kootinia Builders Kind of Building Frame Used as Res. To be completed about 5-6-71 Estimated Cost, $ 10.00 QMV(--New. Building Permit No. P.. e - S CAR fiphmv-- r; _ 1 9 Business Phone No - ROUGH FINAL City of Fridley Applicatka for Phmd&g and Eos Fktkg Permb Dept. of Bldge. Phone NO -3480 DEScanrnoN OF WORK I.eeaften 7 ? 5 —® �� f Number. Kind and Location of Fixtures u, tl� PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ , Future Fixture Opening ............ x $1.50 $ _ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ O Water Heater :Up to 99,000 BTU) .... x $3.00 $ ' New Ground Run Old Bldg......... x $3.25 $ Electric Water heater .............. x $2.00 $ GAS FITTING FEES: NO. RATE �TOTAL 9 1st 3 Fixtures x $200 $� Additional Fixtures .................. x $ .75 $ Gas Range to 199.000 BTU ................ x $5.00 $ REPAIRS B ALTERATIONS—Refer to Coda Description ........................................... 1 TOTAL FEE $ 0 City of Fridley: The .undersigned hereby makes application for a permit for then work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings. and hereby declares that alit the fact and representations stated in this application are true and correct Fridley, Won 19, Owner 4 1�' Kind of Building Used as To be completed about Esti 410 mateddCC t, $ Old— eI� w. Building Permit No. Permit No. �A-�— ROUGH Business Phone 7 S iF IDA C V z e I e N WATER MTA. GAS ELEC. Base ,at �- 2nd 3rd 4th I .-Ftt i i i -1- • Future Connection Openings t New Fixturs, ON Openings connww with �u Cesspool ❑ u, tl� PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ , Future Fixture Opening ............ x $1.50 $ _ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ O Water Heater :Up to 99,000 BTU) .... x $3.00 $ ' New Ground Run Old Bldg......... x $3.25 $ Electric Water heater .............. x $2.00 $ GAS FITTING FEES: NO. RATE �TOTAL 9 1st 3 Fixtures x $200 $� Additional Fixtures .................. x $ .75 $ Gas Range to 199.000 BTU ................ x $5.00 $ REPAIRS B ALTERATIONS—Refer to Coda Description ........................................... 1 TOTAL FEE $ 0 City of Fridley: The .undersigned hereby makes application for a permit for then work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings. and hereby declares that alit the fact and representations stated in this application are true and correct Fridley, Won 19, Owner 4 1�' Kind of Building Used as To be completed about Esti 410 mateddCC t, $ Old— eI� w. Building Permit No. Permit No. �A-�— ROUGH Business Phone City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT P 16487 i Lfr .....�� COMMUNITY DEVELOPMENT DIV. r i PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 L 612-571-3450 RECEIPT NO. NUMBER 910-F15 REV. DATE 2/23/82 PAGE OF APPROVED BY JOB ADDRESS 5373-75 5th Street N.E. 1 LEGALLOT DESCR. NO. 28,29,30 BLOCK 15 1 TRACT OR ADDITION SEE ATTACHED Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ray TaFave 5375 - 5th Street N.E. 572-8099 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 Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE % 8 DESCRIBE WORK Install aluminum siding 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING HEATING, PLUMBING AND SIGNS. 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 AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $2,500 SURTAX $1.25 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. $38.50 $39.75 PLAN CHECK FEE TOTALFEE SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPER/ LIDATED THIS IS YOUR PERMIT SIGNATUR�.WNER WNER BUILDERI IDATEI BLDG INSP fJAT J CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: RC0.� ADDRESS: J ! '5, � TEL NO: -)I-- �i IM C 9 BUILDER: o� ADDRESS: TEL NO: Construction Location STRIET NO: j� --7,5--STREET: LOT: 'fig - "�`�3 BLOCK: I `J ADDITION: Corner Lot: L�-' Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. 'Re S+c1 Z Front: DESCRIPTION OF CONSTRUCTION Depth: Square.Feet: Cubic Feet: Front: Square -Feet: Type of Construction :� u w1 Zb Be Obrapleted: I U_� C le_� Height: Depth: Height: Cubic Feet: Estimated Cost: $ `_`5 ®0 Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the work, herein specified, agreeing to do•all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: �� b . �� � � �1 � '� SIGNATURE Stipulations: �o.sv CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Effective Date January 1, 1991 Job Address _55 / 3 S1 A/ Building Inspection Div. 6431 University Ave NE Tel. No. 572-3604 Fridley MN 55432 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are tree and correct ��I / �'2 Z , 19� OWNER /,-gw \7�-5 KIND OF BUILDING /e USED AS TO BE COMPLETED ABOUT 3 7 '� Z -� ESTIMATED COST 0'/ / � OLD - NEW BUILDING PERMIT NO. PERMIT NO. New Fixtures $ 7.00 - $�/f m Company lam/ �rRrrie7_ L v1 Old Opening, New Fixture S 4.00 - $ Beer Dispenser $ 5.00 - $ signed By Blow Off Basin x Tel, NO. Catch Basin Water m Y - 9 N $ 7.00 a $ H Water Treating Appliance $ 10.00 m $ Date 0 14•90 A aa1 p �m, Heater $ 10.00 - $ Date Gas Dryer $ 10.00 - $ , Back Flow Preventer Required ( ) Yes ( ) No APPROVAL FOR PERMIT Type $ 5.00 - $ yp tn U m3a. Gmaq� W" Vu � 3 O leC 1st 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (�) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Effective Date January 1, 1991 Job Address _55 / 3 S1 A/ Building Inspection Div. 6431 University Ave NE Tel. No. 572-3604 Fridley MN 55432 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are tree and correct ��I / �'2 Z , 19� OWNER /,-gw \7�-5 KIND OF BUILDING /e USED AS TO BE COMPLETED ABOUT 3 7 '� Z -� ESTIMATED COST 0'/ / � OLD - NEW BUILDING PERMIT NO. PERMIT NO. New Fixtures $ 7.00 - $�/f Company lam/ �rRrrie7_ L v1 Old Opening, New Fixture S 4.00 - $ Beer Dispenser $ 5.00 - $ signed By Blow Off Basin $ 7.00$ Tel, NO. Catch Basin $ 7.00 $ Rain Water Leader $ 7.00 - $ Sump/Receiving Tank $ 7.00 a $ ROUGH INSP. Water Treating Appliance $ 10.00 m $ Date Water Heater - Electric $ 7.00 - $ Water Heater - Gas 1_ $ 10.00 - $ ®.(o FINAL INSP. Gas Range $ 10.00 - $ Date Gas Dryer $ 10.00 - $ , Back Flow Preventer Required ( ) Yes ( ) No APPROVAL FOR PERMIT Type $ 5.00 - $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance s 10-o j State Surcharge $ .50 REINSPECTION FEE $30.00 TOTAL FEE /'5_' ED MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CITY OORIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 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, but not replacement) Gas Range Gas Dryer *Air Conditioning . All Sizes All 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 TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/A1111 CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.Q0/Hr *Air Conditioners can not.be placed in a side yard without written permission from adjoining property owner. TOTAL, $ .50 •: OWN Effective On January 1, 2002 BUILDING USED AS tyS IG�C�1�7'VIC.ci = ESTIMATED COST PERMIT NQ; DESCRIPTION OF FURNACE AND OR EILI NER No. of Heating nits Circle One (Steam). (Hot-AWater) ar r) Trade Name Size No BTU 8 HP EDR Fuel 11 ctA4 t'� I Total Connected Load Burner Trade Name Size No. BTU HP EDR The undersigned hereby makes application for a permit'for the work herein specified agreeing to do all work in strict accordance *' i f the. City Codes an rulings of the Building Division, and hereby declares that Ialljhe facts and representations stated in this application are true and co`rre; t. STANDARD HEATING & AIR =MCNM M 410 WEST LAKE .;TREET DATE 7� MINNEAPOLIS, MN 5540&2998 612-824.2656 HEATING CO Signed _ L # FAX # Approved BY4 Rough -In Date Final Data THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED comm N VENT, VENT CONNECTOR AND CnM8t13nm AIR Vmpr-ATinN When reply acing an:pYic_ting_fnrance, the undersigned herelay verifies that the _ 9 venting hasbeen exiOmine'i antl;is free from rust, deterioration 'obstructions, and is securely supported -and firestopped where regdired. Yes ( (:) 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 oxis ing rnmhustonn .air is sized and installed to meet the current codes and manufacturer's specifications. Yes (4"'No ( ) When required to install a new rrimhi is Linn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a naw vantinv syStem, the undersigned hereby verifies that itis 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 (V o ( ) Appliance #1 Type --f- BTU Input 0 (9 ® Fan Assisted or Nat (-� Appliance #2 Type 4'�` r'Yi- t BTU Input S o o o Fan Assisted or Nat _A) Appliance #3 Type Total Appliances - BTU Input Total Btu 'Input o 00 Fan Assisted or Nat Common Vent Type Vent Height Diameter. (0 inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height Appliance #3 Vent Connector Height ft Length ft Diameter in Type ft Length ft Diameter in Type HEATING CO: Signed By: Dater �T (.�1 I IUN UIV. 6431 University Ave NE Fridley, MN 55432 (763)572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 6375 .5-A New Fixtures _� $ 7.00 L bo The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 6e4- 20 DZ- Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner.Joe /�crryi7,c��n Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Re -g ,'Ct&'C 'ff_ Gas Range** $10.00 Gas Dryer** $10.00 Estimated Cost® PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Hr SIGNED BY TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX #�/,�, / r 1.5% of Value of Fixture or Appliance Approved Bye y Rough -In Date Final Date State Surcharge .50 TOTAL FEE $Z1__ ao PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMM VFNT� VFNT .ONNFCTQR AND COMRIIRTION AIR VFRIFICATION When ronla ing 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 (1 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The axonting_ _nmbuatinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to inctall a new cnmbustinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new wanting nystem, 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 #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 N HEATING CO: Signed By: Date: II SUBJECT RekMVT NO. `r City of Fridley 33161 AT THE TOP OF THE TWINS BUILDING PERMIT r E , W ______ COMMUNITY DEVELOPMENT DIV. R CEIPT N � r E � PROTECTIVE INSPECTION SEC. 1 • � UMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432N 763-571-3450 910-F15 10/11/02 JOB ADDRESS 5375 5 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 28,29,30 15 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joel Hansmann 5375 5 Street NE 612-559-1367 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same d 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 Basement alteration 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. 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. Caulk and flash all exterior openings. R RENTff eEOa aUIRED FOR: PLU'R 1� AND SNG GNS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,500 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE 6.25 SIGN 'RACTORORAUTMOR4E0AGENT iDATEi ►{ P LY VALIDA D THIS IS YOUR PERM 7CO �l �� �/ B DG NSP )AYE NATO EOF OVVNER-IF OWNERBWLDER, ATEA II NEW (j CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 14.) 375 6-167 s 7L Legal Description: Owner Name & Address: J0—C��4 e� 5 � = �i Tel. # � �Z - f s -13& 7 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. 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: Gr -3e411— A I -kl-a Construction Type: �� ��-°���- / Estimated Cost: $ /600 Driveway Curb Cut Width Needed: FL + 6 Ft = Ft x $ —=$ DATE: / // c-1 2- APPLICA � Tel. # 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 .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ J STIPULATIONS: J Q s LA-,.' o o >i. /:jfv%,�No� Building BUILDING Permit No.:' � -Inspections RESIDENTIAL APPLICATION Received By: ANA 763-572-3604 CITY OF FRIDLEY DatfMMIDEC R763-502-4977 FAX .001 times the total job valuation EFFECTIVE 8-19-09 $ ` DATE I Z ZI �/ o q YOUR E-MAIL ADDRESS $ SITE ADDRESS S'3 7 3 5+ S � N i- $ THIS APPLICANT IS: OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: m s i- x 2e r i 04t % $ TENANT ADDRESS: S3 73 Ft, S F CITY r-. JIC STATE_gafZIP-SS9ZI Fee Determined by Engineering PHONE: /B— 205-32 1 `+ $ CONTRACTOR NAME: 11424 f, A $ SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY lIti.nt STATE_ !Q �fUZIP INSURANCE PHONE — 4 I — FAX'74P_?—'12_Z—t97719 PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE 1806 rc n . 01 TWO FAMILY/NEW CONSTRUCTION STORIES_ PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED 0 WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER O SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAIINTENANCEIREPAIR 19 REMODELING DESCRIBE WORK BEING DONE: A d� , ,_ 'w -e 5 < GV , -1 0_1 SIZE OF IMPROVEMENT J 7J LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 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 alYes []No LOCATI N OF WINDOW FOR WINDOWS — PROVIDE U -VALUE AND , n OR FOR NEW OPENINGS -DESCRIBE SIZE OF W; n JCJL.w /ZO. x y MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 4175 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ y t 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 k 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 $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ °�� , (% 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 work which requires review and approval of plans. �— II'' SIGNATURE OF APPLICea /���- PRINT NAME JtK I�Gi Z S �+tiCi v, ., DATE C s �(�� �tn" >> Z;p � 3 � � � Mo F*41 M ----------v ts:� ,0o 7 o�ppv1,1 �s dSF�b 41oh X ,: IZ rni7� 31 V ZY 1 L�� tra �O le G 1� � 1