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PRE 2010 DOCSCity of Fridley, Mims, BUILDING PERMIT 10) Date: Z. jr— 4 e) Owner: Builder Address Address ............ LO UILDING I .1 ..... ......... Part of JWt No.... --- ---- street --Ir- I Lot / *-Z Block ....._...,./`..........._ ................. Addition or Sub-Divisi 71 —0*214W Comer Lot .......... Inside Lot ---------------------------------- -- Setback' -.1$ ........ ............. Sideyard Sewer Elevation Foundation Elevation � DESCRIPTION OF BUILDING `r19 be Used as. . .. .... Front Depth Height Sq. Ft. Cu. Ftj<jU0 .... . ............. . .......... ......... .............. Type of Construction Front .................... Depth %-00- '"' Est. Height . .......... -0— dE; Cst..:7,r,160 .............. Sq. Ft . ...................... Cu. Ft....---................. To be Completed ..... . ........ . .......... ............. . ........ C--7,'4,JJT1()N1 THIS FE[.'C,11T r -; )T 7') - IF AU T H (D R I ZZE VIOLAT. 10f I OF A11)' F'FIVATE LAND COVENANTS AND BUILDINIQ RESTRIG11ONS. 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 c7nsideratlon of the payment of •a The of permit is hereby granted to....._...........__............_....:......._......._.. . to construct the building or addition as described above. This permit is granted upon the expr ss 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, rep d moving of buildings within the city limits and this permit may be revoked at any timeolation'of y of the ppvisions of said ordinances. Z-1, -) U71 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. 0 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name �, Builder- Address t%o T ,� Address LOCATION OF BUILDING No.Street� Part of Lot Lot a !'/V M ; r2 Block _ Addition or Sub.Div, h qm/ l 41 S Corner Lot -/\ Inside Lot _Set Back S� Side -Yard /0 r SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: S� Front, Depth_ � Height Sq, Fto ,� [1.z.. Ou• Ft�.� Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be completed 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 representa- tions stated in this application are true and correct. I l DATE SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side . eating Ventilation, .Refrigeration and . Apphcat�on dor Power Plants and"Heating. ,Cooling, , ; Air Conditioning Systems and Devices 3 c4' to PARTIAL RATE SCHEDULE Dept. of Bldgs.Phoa�� a S,,II��4-7470 GRAVITY WARM AIR: RATE TOTAL, Location, -I& �� 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 $ .r each add. 60,000 BTU ........................ 2.00 $ Replacement of Furnace 0.00 $ 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. IDR Steam....... 8.00 $ Furnace Shell & Line—to 640 A c� 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) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $fes ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL 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 4 -gr Owner Kind of Building Used as To be completed about l Estimated Cost, $ ,,,I s Old— e1Building Permit No.� Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS--Steam,of Water Warm Air—No Trade Name a?id?s-s J ° 9�6� Size No Capacity Sq. Ft. E.D.R. BTU H.P. Total Connected Load_ �/� Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) SS By 2M 7-59 Bus' ess /�IVY . Application for Power Plants and' Hearing, Coding, Ventilation, .Refrigeration and Air Conditioning Systems and Devices L) 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 0.00 $ 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) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $_ E ALTERATIONS & REPAIRS TOTAL FEE $ ROUGIj FINAL � Dept. of Bldgs. Phone SU. 4-7470 5� 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, Mrin g / Owner Kind of Building Used as �Y-ter✓-� To be completed about iv Estimated Cost, $ 4 .3 Old ew building Permit No.� Permit No. Zd DESCRIPTION OF WORK HEATING or POWER PLANTS–Steam,of Water Warm Air—No Trade Name C�LC��1i �% �' �� Size No -4 -.?–d Capacity Zr f Sq. Ft. E.D.R BTU H.P. Total Connected Load 'R Kind of rue BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) By C L 42 2M 7-59 Bu/siines si}sPhonBe�f�N�o-J� Application for Power Plants and Hewing, Cooling. Ventilation, Refrigeration tind Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU. 4-7470 -� GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace S1.hell & Duct Work to 120,000 BTU ............ 8.00 $ 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 .................. 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 RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL F= $ ROUGH FINAL Location L'1..&6—+C��-e i,6e. , --f z 4�0"�s 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_ 14,194-c ., Owner OF Kind of Building �i.FS Used as Awle" To be completed about Estimated Cost, $akfu®e' Old—New. Building Permit No. �! �� Permit No. DESCRIPTION OF WORK HEATING or PO PLANTS -Steam, of Wa Warm Air—No Trade Name Size No Capacity %.;Sr�J Sq. Ft. E.D.R BTU H.P. Total Connected Load 1 0 Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) . 42 2MI 7-59 Application for Power Plants and Healing. Cooling, Ventilation, ReMgeraHm tod de Air Conditioning Systems and Devices PJ.' 6 PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII, 4-7470 S-3 GRAVITY WARM AIR: RATE TOTAL, Locaffona. 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 §.00 $ Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 ............. 1 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR 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) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $�_ ALTERATIONS & REPAIRS TOTAL FEE $—� ROUGH 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 4O Owner Kind of Building-/e.�'4-.1 Used as Amzoe To be completed about +� Estimated Cost, $`�'PJ0 Old ew uilding Permit No. IS& ® Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS-Steam,of Wa Warm Air—No Trade Name �+�s� .�� Size No Capacity. ` `� Sq. ""Ft. E.D.R BTU H.P. Total Connected Load--,;Pd,Y_l® Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) C � Signe By f�✓ C L®, oa 2M 7-59 Business Phone No- Me Application for Power Plants and: Hewing, Coding, Ventilation, Reh igeralion 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 §.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) .................. 5.00 $ C9 0 C) GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures 3 x $1.50 $ /15-0 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 ya 2 Dept. of Bldgs. Phone SU. 4-7470 Location Z.3 910 — 3— 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, 19 to O Owner W Kind of Building Used as To be completed about Estimated Cost, $ Old ew. 011ilding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Bind of Fuel BURNER — Trade Name4"_ Jel- - - Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) a' -4z YM 7-59 Business Phone No e City of Fridley I11 ► P . . N��•►. Appticatton for Plumbing and Gas Ping Pemdt 6--3 e DepL of Bldgs. Phone SII 4--7470 DESCRIPTION OF WORK Number. Sind and Location of Fixtures Location - 6 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: RATE Number Fixtures ...................... �NO. x $1.50 .�TOTAL'•� $•`f C) Future Fixture Opening ................ o4a 1.20 S� New Fixture Old Opening .............. x as F N WATER HTR. 3.25 $ (Up to 200,000 BTU) ...... 3Ci 7 m m w 3F- OLL a L'o m 63t90 as GAS ELEG Base 1st 2nd 3rd 4th ° Future Connection Openings Connected with New Fixture, Old Openings Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: RATE Number Fixtures ...................... �NO. x $1.50 .�TOTAL'•� $•`f C) Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................. Water Heater x 3.25 $ (Up to 200,000 BTU) ...... x 2.00 $� New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ......................... NO. RATE &-- x $1.50 Additional Fixtures .................... x .50 Gas Range to 200,000 BTU .............. x 2.00 REPAIRS & ALTERATIONS—Refer to Code TOTAL Description ............................................... TOTAL Flims 0 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 appli a on are true and correct. Fridley, Man / 19 Owner 9e 19— Kind of Building 44M�- . 19— Used as i To be completed about /�✓ Estimated Cost, $ ZoS o-- Old New. uilding Permit 01 By Business Phone NO--& Connection Permit No. ....................................................... Water 7.4-0 Sewer A2. Meter Deposit ' Z7 -V '030011 IM -8-58 City of Fridley 879.01 Application for Plumbing and Cs= Ming Permit Dept. of Bldgs. Phone 560-3450 0 DESCRIPTION OF WORK 5382 5 St • Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ...... ................... Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 199,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code — x $2.00 3 — x $1.50 $ — x $1.50 $ — x $3.25 $ — x $3.00 8p� qz O i v1 3 Z • F • N WATER HTR. GAS ELEC. Base 1st re 2nd — 3rd 4th • Future Connection Openings * New Fixture, Old Openings I Connected with Sewer � Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ...... ................... Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 199,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code — x $2.00 $ — x $1.50 $ — x $1.50 $ — x $3.25 $ — x $3.00 $ — x $3.25 $ _ a $2.00 $ NO. RATE TOTAL x $2.00 $ x$.75 $ 1 x $5.00 $ 3.00 Description ................................................$ TOTAL FEE $ 3 • 00 City of Fridley: 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 * 3 Jan 68 19_ Owner Beverly Snhwamb Kind of Building fr Used as res To be completed about 9 Jan Estimated Cost, $ 5.00 Old—New. Building Permit No Permit No. s Si By Business Phone No. ROUGH FINAL •��' �' [ °- �° (J 42 City of Fridley SUBJECT 0. 0 18383 AT THE TOP OF THE TWINS BUILDING PERM _ r IPT N `y _ ____ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY %.J 612-571-3450 910-F15 4/17/86 / / JOB ADDRESS 5384 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 14 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Eugene Wright 1848 Pumice Street, Eagan, MN 452-3145 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. ACCAP Construction 8008 Highway #65 N.E., Spring Lake Park 784-2443 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. Jerry Mundt 4969 Olson Memorial Highway 7142 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Convert 4-plex to Supervised Living Area for Community Options LTD 7 CLASS OF WORK ❑ NEW ❑ ADDITION 1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Conversion of existing building - Interior Alterations 9 CHANGE OF USE FROM TO STIPULATIONS 1. Egress window in each bedroom must be provided. 2. Separate units as per life safety Code Chapter 21. 3. Provide handicap ramp to street (curb) . 4. See Fire Department memo dated 4/10/86.. 5. Adhere to Special Use Permit #85-01 stipulation dated 2/24/86. 6. Provide landscaping as per plan dated 4/17/86. 7. Screen dumpster from public view. 8. Provide $1,000landscape bond/letter of credit by 5/15/86. 9. Fence heights and locations subject to on-site review prior to construction. SEP TE PERMITS REQUIRED. MR WIRING, BEATING, PWIVIBI.NG, AND S14t 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 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 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 $20,600 $lO.3O 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- ST CTION OR THE PER M NCE OF CONSTRUCTION. $146.50 None PLAN CHECK FEE TOTALFEE - 17 - ? $ 95.23 PREPAID $156.80 Plus PREPA I )ATURE OF NTRACTORORA HORIZEDAGENT (DATE) WHEN PROPS Y VALIDATED THIS IS YOUR PERMIT BLDG )NSP nA7 ,IGNATURE OF OWNER 0F OWNE BUILDERI (DATE) I PC -023 Prepaid Plan Check $ 11.� Effective 4/1/84 Estimated Cost $ X&20 City Of Fridley Receipt # aQ 5R-3, COMMERCIAL & INDUSTRIAL Ci`� ,�.�tP Building Permit Application Construction Address: _,$mF,S1 Legal Description: Property Owner & Add Contractor & Address Architect b Address: . # -,2 Y .? .# 2 Engineer & Address: I - Reg.# Type of Work [ ]New [ ] Addition Alteration _ PL&X/ Q e USE OF BUILDING: APPLICANT SIGNATURE: a Tel. #2 Date: moi_ y 106 Size of Structure Length _ CT__._ Width__ OFC. AREA: Length WHSE. AREA: Length OTHER AREA: Length .__.._ Height —9-23 Sq. Ft. ,_160 # of Stories�,� Width Height Sq. Ft. ®® Width Height Sq. Ft. Amy_-_ Width Height Sq. Ft. VALUATION � Sq. Ft. X $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. X $ r Cost/Sq. Ft. = Valuation $ ) _ $ 0,6490 Sq. Ft. X $ Cost/Sq. Ft. a Valuation $ ) Total Type of Building Construction Occupup Class. %� Zoning Air Conditioned [ ]Yes �No Fire n System K Yes [ ]No. Permit Fee $ % �,So See Fee Schedule on Reverse Side Plan Check $ In excess of Prepaid Plan Check -See Back Pg. State Surcharge $ $.50/$1,000 Valuation (See Sched. for > $1 mil) SAC Charge $ $415 per SAC Unit Park Fee $ ®' Fee Determined by Engineering Sewer Main Charge $ Driveway Escrow $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE.SCHEDULE PLUMBING FIXTURE RATES: NO. RATE m New Fixtures $ > m Future Fixtures $ 3.50 o Old Opening, New Fixture 43 1.50 Water rd m m Blow Off Basin $ 5.00 1 a -ci m 5.00 $ -P W w gtopg Hydraulic Valve Heater 5.00 $ m $ 5.00 m Water Treating Appliance a a" $ v �x-P 5.00 dx "w 10.00 $ Gas Dryer $ 10.00 $ x g q e U a W 3 Q w m u a 3 lec rA o a� ao 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water RATE.SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $� Future Fixtures $ 3.50 $ Old Opening, New Fixture �,�- $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE $ .50 /6-S2 Effective Aug. 1, 1981 Job Address S ` 8 1± ZST . �11 o to—, Department of Buildings City of Fridley Tel. #571-3450 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 true and correct Fridley. Mn. OWNER C!L)MMLInI/ a , Opf1cos KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - BUILDING PERMIT NO. ROUGH INSP. Date FINAL INSP.v Date APPROVAL FOR PERMIT &L PERMIT NO. Company Signed By Tel. No. °757 - r7381 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE q CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE tESIDEbTIAL Furnace Shell and Duct Mork, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) RATE TOTAL S 20.00 $ $ 10.00 S $ 10.00 S $ 10.00 S $ 10.00 $ All Others/Repairs and Alterations It of Value of Appliance or Mork S CONMERCIAL/INDUSTRIAL 11 of Value of Appliance or Mork yy1► rl — S 10.00 State Surcharge $ .50 TOTAL !EE $ Reinspection Fee ($15.00) S)0.5a Rough Insp. ��"" Date Final Insp. (p v q -Cd Date Approval for Permit "I'Dwt AQm E P w I o o- u t,O&O "Ptaw-L it, Q I MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE Attach stack verification form with replacement furnace permits *Air conditioners can net be placed in side yard without written pt•nmission from adjoining neighbor. Effective Aug. 1. 1981 Job Address 53 O q J S T 0L Department of Buildings, 6431 University Ave. N.E.. Fridley. Nu SS432 City of Fridley Tel. #571-3450 The undersigned hereby maked 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 true and correct. Fridley, Minn. OWNER OWNER n i u iS Ct l a 7 a31 !Tl A L 1 C rl rJi.0 /l �Yl RIND OF BUILDII%NG USED AS l ��lYrl TU BE COMPLETED ABOUT 5 I i4 ESTIMATED COST ao�S OO SOLO NEW BUILDING PERMIT NO. PERMIT NO. C� DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS. Steam, Not Water, Warm Air- No. Trade Name else No. Capacity Sq. Ft. CDR STU up Total Connected Goad hind of lnsl BURNER - Trade Nave Size No. Capacity Sq. Ft. EDR BTU NP Company Signed By Tel. No. ANOKA COUNTY COMMUNITY ACTION PROGRAM, INC. 8008 N.E. HIGHWAY 65 - SPRING LAKE PARK, MN 55432 - PHONE 784-2443 DATE: 5-16-86 TO: City of Fridley FROM: ACCAP Construction SUBJECT: Certificate of Completion Donlyn Manufacturing and Pioneer Welding shall furnish the specified materials, labor, tools, equipment, service and all other items necessary or required to fully perform this scope of work. Item - 16 gauge cold rolled steel exhaust duct vent. Welded air tight, fabricated to drawings and instructions by ACCAP Construction. The above item completed: Date Donlyn 0Z -6-2s® Date Pioneer AN EQUAL OPPORTUNITY EMPLOYER JQ�A� 510E Y 1 E \N RANGE �Naab OUTSIDE .WALL l� 3elx 40 $: T 1 Z.. m e wt" d` Effective Aug. 1, 1981 CITY OF FRIDLEY APPLICAT04 FOR PLUMBING AND GAS FITTING PEFa41T Jo)'i Address �3 S RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ N m a u Old Opening, New Fixture M m $ Water m % .mi Blow Off Basin m,.[ti 5.00 g m m 5.00 m a f. a u• a Hydraulic Valve Heater M m Sump or Receiving Tank $ 5.00 m �qpC q C = pMppCi Hot Water Heater ® O .UC C Uy Gas Range C~I 10.00 $ Gas Dryer $ 10.00 $ ppppCi N W mq f�a U 00 00 N 3 A W U RI 3 l7 C7 leC lat 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (�) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture � $ 1.50 $ Beer Dispenser S 4.00 S Blow Off Basin $ 5.00 g Catch Basin g 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve S 5.00 g Sump or Receiving Tank $ 5.00 S Water Treating Appliance $ 7.00 g Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE Department of Buildings City of Fridley Tel. #571-3450 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 ftrue and (coorrrrect r Fridley, Mn. J (J , 19 0 (O OWNER . ` ? C r /g RIND OF BUILDING 171— ®%O USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company A 11i 16 '�? Qc le Signed By 04 14 Tel. No. 23 f 3 �— ROUGH INSP. Date FINAL INSP. 1 49 Date APPROVAL FOR PERMIT S 50 MINIMUM FEE FOR ANY PLUMBING PEP IS $10.00 PLUS THE $.50 STATE SURCHARGE 7 SUBJECT PE City of Fridley 20210 AT THE TOP OF THE TWINS BUILDING PERMIT _ i � I `y _ COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 I 12/4/89 I JOB ADDRESS 5384 - 5th. Street N.E. I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 14 Hamiltonse Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Community Options (Eugene Wright) 15100 Stone Road, .Wayzata 475-3180 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Picard General Contractors: 19605 Patrick Place, Corcoran, MCJ 55340 420-3664 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Group Home 7 CLASS OF WORK ❑ NEW ❑ ADDITION Cj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel one of four garages: into a meeting room 9 CHANGEOFUSEFROM TO STIPULATIONS See comment on plan on exit, 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 BO 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 $2 200 $1,10 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 W REGULATING CON- $54.00. STRUCTI NOR THE PERF RMAN OF CON�TR TION. .. PLAN CHECK FEE TOTAL FEE 4 35.10 $3.0,20 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI HEN PROPERLY VA DATED THIS IS YOUR PERMIT C� A; BLDG )NSP OAT SIGNATURE OF OW NER IIF OWNER BUILDER) IDATEI Prepaid Plan Check $ Effective 5/1/88 Estimated Cost $ CITY OF FRIDLEY Receipt # R-3, CMMERCIAL & 11KESTRIAL Building Permit Application Construction Address iv . (F S 3'f Zoning Legal Description L-0 d- I V- `� Lark f `% ��P� r` z� !a ®®•.r Property Owner/Address ®sari v L (J ,r Q� r%. W i+.� z.�hr� Tel . # Y 3 CIMMACIUR & ADDUSS 91 Tel . # `)a o - 3 L 4 N Architect & Address Reg.# Engineer & Address Reg.# Lec�+^�C — S �r.l C Q L� Lrc M'sC Ec. yds 14 j a — w W+ o 0 — . j TYPE OF WORK [] New [] Addition 1.� Alteration -Describe % q Cam-d-��, % LA Yc r eon ,r�I-a A n re�.P 3 A-,4,aro Applicant Signature � V, Tel # ��- a d9 Date MAL I- R OFC. AREA: Length WHSE AREA: Length OTHER AREA: length BUIIDn G DDOMIONS Width Height Sq. Ft. # of Stories Width Width Width Height Sq. Ft. Height Sq. Ft. Height Sq. Ft. Sq. Ft. x $ Oost/Sq. Ft. = Valuation $ ) Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Oost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Clmmt icticn Type Occupancy Group Air Conditioning []Yes []No Fire Protection Provided []Yes []No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee See Fee Schedule on Reverse Side Plan Check In Excess of Prepaid Amount - See Reverse Side State Surcharge jo $.50/$1,000 Valuation (See Sched. for > $1 Million) SAC Charge $ $575 per SAC Unit Park Fee $ Fee Determined By Engineering Spec. Assessments $ Agreement Necessary [] Not Necessary [] Driveway Escrow $ �� feet x $13.50/foot ADDIT101AL STIPULATIONS CK REVERSE SIDE pa" 1 a r "" z Svs , /M �S$,��5' �M 'X Mp,� r,,}� M 1•XZ �� I/ 1 � v 1 V ' F I 1 � s I/ 1 � v 1 I 3 C V i r v c� • s ri r _ y` r 3 C V 1 • t � f l 1 CITY OF FRIDLEY Effective Date January 1, 1991 .APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE kESIDEATIAL RATE Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 Gas Piping $ 10.00 (piping needed with new furnace) Gas Range a $ 10.00 Gas Dryer $10.00 si�zesl $ 10.00irCoditiog All Others/Repairs and Alterations It of Value of Appliance or Work .OMMERCIAL/INDUSTRIAL 1• of Value of Appliance or Work State Surcharge L7__ REINSPECTION FEE $30.00: Rough Insp. Date C� Final Insp. P _2 7 - Date Date Approval for Permit TOTAL MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE pig,,_Conditioners can not be placed in side yard without., written permission from adjoining neighbor. Job Address 5384-i L(Yh-tlu &06 5UL6� Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 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 true and correct. OWNER RIND OF BUILDING USED As TO BE COMPLETED ESTIMATED COSTo OOLD -_ OLD - NEW BUILDING PERMIT NO. PERMIT NO. - DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, tot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Lead Rind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company RicMMW & SCAB Or, W it ff QL Signed 4U-5182 West Broadway stat. N 55429 Tel No. Phnna RIL= Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. Has been carefully examined Yes (,) No ( ) ( ) ( ) 2. Is free from rust or deterioration b Yes 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 connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL I Rema rk s Company Signed By Da to CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Effect.* 4/V2004 Fridley, MN 55439 APPLICATION FOR POWER PLANTS AND HEATING, COOUNG, VENTILATION 763-572-3W4 FAX 763-571-U87 REFRIGsERA flN AND AIR CONDITIONING SYSTEMS AND DEVICES ,,a_ RATE SCHEN RWIftrGo,,— $ Fie Shell and Duct Work, Burner & �, also Replacement Fumare c�/ �{ $35.00 building Used Asa Gas Piping(New Furnace, Fireptace, Insert) fireplace insert u RWV Gas Dryer *Air Conditioning - All Sizes $10.00 $ $15.00 $ $9.0.M S $10.00 $ $25.00 $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum► Fee $15.00 for Residential or 5% of oast of Improvement whichever isgeatev on work less than $500.00 Commmc-ia-lAogustriaVinstitutional 1.25% of value of Apprance or Work (List on sack) Minimum Fee $35.00 for Commercial/Industriai/Institutional ESTIMATED COST A 200 • e PERMIT NO _.. 'i ► �. - 1, .1 11 a ;11I 1 Z' # of Heating Urnits "� Cirde One (Steam) t Water (Warm Air) c Trade Nam. iNo.CGA — 8TU ICA" HP _ 0,44,7- a Fuel nXG -- Total Connected Load,11 r �, , `'* n Burner Trade Name I3TU HP Size EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance vnith the City Cosies $ and rulings of the Building Division, and hereby declares that all the facts arui representations stated in this application are true and correct. State Surcharge $ 9:160 cif permit fee is over $1,000 multiply by .0005) 6a ` TOTAL FEE $ `�'�• *Air Conditioners can not be placed in side yard without written apprmral frc m adjoining property owner - copy 10 City HEATING CO 124iW /%1Sa%�v,e.LG. �jte Signed Tei #f6 t z • 7;9- 5-6 `/6 - FAX6 to=�J/ — 6 GS6 _-- Uate_ f0 7 — O-< FILL OUT BACK S(DE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -irk Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS _QWMQN VENT• VENT CONNECTOR AND COMBM3TIOlV AtR VERIFICATION When jne an Airnaokft 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 The venting system is plastic/PVC and meets all current odes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( } The undersigned also vedAes 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 (r} The exifi—do-- n combustion air Is sized and installed to meet the current codes and manufacturer's specifications. Yes (� When required to �tatl„_a now aombu air it will be sized and installed to meet the current codes and manufacturers specifications. Yes (✓) When WnsUfflng a now ven f►g gem, the undersigned hereby Verifies that it is a listed assembly and meets the current codes and manufacturer's specifications This does include AGA -LAMA Category l Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (r) 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 (A� ARP ian dn o an nt ne In alio y Appliance #1 Type 36BTU Input Fan AssistedCrNat y Appliance #3 ?y wit.. -he. BTU input a Fan Assisted r a ?I Appliance #3 T -�---- Total Appliances BTU Input _,__� Fan or or at �4 --�____. Trial Btu Input � Common Vent Type X_ Vent Height, Diameter inches Appilance 01 Vent Connector Height ft Length ft Diameter -in Type Appliance #2 Vent Connector Height —ft Length Appliance ___-_,ft Diameter in Type Vent Connector Height —ft Length ft Diameter _.`-,__,in Type No( ) No ("j No ( ; No ( ) No( ) No ( ) No ( ) eAv 05rw, ow n, HEATING CO: Signed By: _Date . t7o/,L,o*d A 110188 d0 Ali:I £5:9T S0027 -SS -88W t)tlaieNZe aw Your Cornperry Addrea. V"M, $i 04999"9588 Rhoner. 999aSSS1292 Fax 91*06.2121 MANUAL J: 7th Ed. I Nana Of Morn Entine House Whole house 2 Length of exposod Wall 140.4 ft 30.0 x140.0 It 3 Room d1menslons ft 4 Ceiings COMM Option 8.0 ftj d 8.0 ft he.wvc e TYPE OF CSTJ HTM Arca Load (BtUh) t Are$ LO PW& Area Hlg CI¢ EXPOSURE NO, Htg O19 On � Mtg � 5 Gem a 12C 8.3 2.3 1120 `"'• "°" 1120Exposed b 14A 46.9 9.3 0 ^°"° .... 0 �„ .... ,... .� ..« W is and C 1SB 6.8 0.0 1040 '°" ""`° 1040 p�arptions d 0.0 0,0 e 0.0 0.0 0 ""•" D ..". .... .«« «« $ %Mndmm and a 2A 43.7 •" 914 4982 ""`" 114 4082 glase doors b 0.0 o 0 °^°^ 0 0 Heating o 0.0 0 0�° 0 d o.0 •" 0 a o o t 0.0 "'0 0 0 0 - «« fj 0.0 "° 0 0 .°"" 0 0 "" 7 Windom and North 32.6 12 °""' 391 12 "°• $01 ° m glass doors NElNW 0.0 D 0 0 "' 0 EAN 90-6 e$ 69$9 68 •""d 61810 COd< 5E1SW 0.0 0 °"° 0 00 South 49,6 34 "•• a 16W 34 1686 AW9' E10F 0.0 0 °`OO a8 Other doors 29.4 8.2 42 1230 344 42 1239 344 0.00.0 0 0 0 0 00.0 4.0 0 0 0 D 09 Net 8.3 2.3 984 7982 2221 04 7982 2221 expos8d b 14A 40.9 9.3 0 0 9 0 0 0 walls and c 15B 6.8 0.0 1040 7080 0 1040 7080 0 Partitions d 0.0 0.0 0 0 0 0. 0 0 e 0.0 0.0 0 0 0 0 0 0 } 0.0 0.0 0 0 0 0 D 0 10 Ceilings a 96C 8.1 3.8 1240 9715 4582 1200 9715 4582 b 0.0 0.0 0 0 0 0 0 0.0 0.0 0 0 0 0 0 0 d 0.0 0.0 0 0 0 0 0 0 e 0.0 0.6 0 D 0 0 0 0 f 0.0 D.0 0 0 0 0 0 0 11 Floors a 21A 2.2 0.0 1200 2650 0 1200 2050 0 (Nate: room b D.o 0.0 0 0 0 ® 0 0 perimeter c 0.0 0.0 0 0 0 0 0 0 Is Ow. d 0.0 0.0 0 0 0 0 0 a for stab a 0.0 0.0 0 0 0 0 0 0 floors) f 0.0 0.0 0 0 0 0 0 0 12 Infiltration a 53-8 6.4 150 $= 1004 156 8398 9004 ao.» 42D41 - °°'" 42041 13 Su1a$6Za1lOgrf�+8..+q1*92 Loss tmmlef 0 Heatlnp Tediabibu$on114 DW 10*9 'O°0 ® °F" A °, w.. •�•� 0°/ 0 °""" 0 15 Total loss a 13$14 ""*" 42041 42041 16 Im galm: Ioople a 300 4 " 1200 4 . 1200 `� ... Appl, Q 1200 1 - 1200 1 1872890 17 Subtot RSH galnn7+8. +92+16 16789 ,,. 0 Less extfrrnal cooling .•� 0 0 Lela transfer 0 „�, .�.. 0 Cooling redlstr94tedor+ """" °'"® 0 18 Duct g8in 0 8 0 0"/ 0 . w 19 TOW RSH galnm(l7+l8rPLF 167$8 1.00 ""*' 187139 tea" 20 Air MCIU (nim) 1005 1005 °""• 1005 9005 's . Printout c*rffed-by ACOA to meet all Mquirements of M�uel J 7th Ed. �s-"�(Ye1t:��9e1� RIt8t4-$ultra Rasid'"" 6.`x.12 R9R90S]'3 200$•Sop"1411:49:90 A. C:WIyDVumerr =tigMwflhlVACW (OJW9aar Paye M1 Tl.r- T nn,-.r.T-I,-Tn UaUa TUTnJUUTga-, 0*7-TT C)n7-GT-.PJC NEW [] ADDN [] ALTER [ ] Construction Address: Legal Description: Owner Name & Address: Contractor. Address: � .SIU CITY OF FRIDLEY Effective 4/1/2004 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION '5-r" J-/- AtFIii G'il Te I. # 71/3 - 5 7:2- -0 00 '1 - MN 3-57:2--000'1- MN LICENSE # 2DZq;5&05 ZTel.# V_Q`103.61". 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 GARAGE AREA: DECK AREA: OTHER: Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: -'56 )UJ-'-nf# PH �_ Estimated Cost: $ % Z ®®® . er1aakvlk44 ytj Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: APPLICANT: Tel. #u5 - /03 —61441 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: 3uilding PLUMBING. Permit N Inspections R.ESIDENTL&L APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: i )ATE '6 1 O '7 YOUR E-MAIL ADDRESS ;ITE ADDRESS 53814 Sft� Sr Ide FMS APPLICANT IS: 0 OWNER 9VONTRACTOR PROPERTY NAME: CoyArvt OP+10-„ S ADDRESS: S3S!�j SL' Si: !06 C1TY +=nd ( STATE Al ZIP SS qa I OWNER/ TENANT J, PHONE: 703-. 5_7d- fit) CONTRACTOR NAME: Tr,,o tbtu la nct (w^+ �vn5 (�„�a tom, �' Pxx Fvc� STATE LICENSE # X340 l?M EXP DATE 143J %a77 SUBMIT A COPY OF YOUR STATE ADDRESS: 5.23 i'n h -A CITY OSsp STATE MN ZIP SiS'3b-5 LICENSE WITH PHONE -7(03 - 5.11- 04 S FAX _b3- 4AS— 71 61 APPLICATION PER1V T TYPE 0 SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW 1(REPLAC 0,4ENTT DETAILED DESCRIPTION OF WORK SO Co-.!(avm, N&kLL Gas In a -C& Ileo: PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor 1+40c ° x-05= FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV FLOOR DRAINS _ SHOWER _ WATER PIPING _ —_ GAS PIPING (NEEDc=zjmw4 _ SWINDAING POOL —WATER SOFTNER ($35) —BATHTUB CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION —DISHWASHER _ WATER METER , OTHER Permit Fee. $ as . Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE g.OL . SZ3 Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ THIS 1S 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 requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME d0l�ffLd- tr� h DATE lr 2 I O� Y e� 11 miff ..'T�a ate ,R��m g City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX. 763-50'-4977 Building BUILDING Permit No.*:_210"n Inspections RESIDENTIAL APPLICATION Received By: AA� 763-572-3604 CITY OF FRIDLEY Daf dmnv o 9 2nn9 763-502-41977 FAX EFFECTIVE 8-19-09 DATE I I 1 In ei'1� YOUR E-MAIL ADDRESS gw 3� e.0 V" SITE ADDRESS 3 l 57 -t 57 -- THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: I..J"M-y 6,4T-; ADDRESS: S(e/ CITY /_'C s ti CY7Z STATEA4AI-ZIP TENANT PHONE: CONTRACTOR NAME: T7tam pS—w SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # �e6 3 ®t/ 92 EXP DATE AND CERTIFICATE OF �^ ADDRESS: 7-7-573 Vc N CITY &5X; -i U -W- STATE MA -ZIP S -SV/ INSURANCE PHONE 6 /Z V4 -z- FAX '�— PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH WF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION AINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Pt= QgzE{�,cOw-tom, SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFINGMOUSE ONLY s� NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT; ��j 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: lJ ❑ 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 ❑ Feria and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF 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: ,-&SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 3 .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 $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ B/) Make checks Davable to: Citv of Fridlev 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 pen -nit 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. SIGNATURE OF APPLICANT PRINT PRINT NAMELY ®iDATE I I 101