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PRE 2010 DOCS0 City of Fridley, Minn. BUILDING PERMIT Date: .. v�. l ..................... Owner ....................................... Builder .........r"; . N° 3284 Address ...................................... Address ............................................. LOCATION OF BUILDING No. ... Street .. ° ........................ Part Lot ...... ............ . . ............ Lot ...... .... Block ® ........ �......... Addition or Sub-Divisi�c ........ ... ... '•' ... t Corner Lot ............ Inside Lot ... ..... Setback �...... Side d .. S.. • .... . DESCRIPTION OF BUILDING To be Used as: �` a :r........ Front .... Depth qs..7... Height .... Sq. Ft.1 � q cu. Ft. ....... . Front ........ Depth ...... Height... Sq. Ft. ....... Cu. Ft. ................ . Type of Construction .... °K4/ ....... E10t. Cost. /�`0: ©........ To be Completed . �. !Y ....... . In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. o� Gtilu�ia In consideration of the payment of a fee of $?. �., permit is hereby granted t� ............. !.r"' ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. 1K .. n......... � 7 uilding Inspector NOTICE: leo- This permit does not cover the construction, Installation or alteration for wiring, plumbin as heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. r { IT A5 WK - r ' LJI •'j Ma qi i L� a low City of Fridley, Minn. BUR DING PERMIT N? Date:— - �I Owner: e o Builder'� i Address Address LO TIJOF BUILDING No. 11Street � _ _ Part of I * Lot _ Block Addition or Sub--TAon Corner Lot __ Inside Lot ` Otbac Se4e Sideyard Sewer Elevation _ Foundation Elevation DESCRIPTION OF BUILDING To Q = . �� W Front Depth � �"'- Height _� Sq. Ft. Cu. Ft. nt Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cosi yj�---- __ 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 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 violin of any of the provisions of said ordinances. _ r 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 Ossa items. .I: --e t m.. 0 4 0-�� APPLICATION FOR BUDDING PERMIT CITY OF FRIDIZY, IOTA e r Owner's Name Builder Address -�3�. __ i+l/.__;, Address® LOCATION OF BUIMING No. -1-93 Street /Y1% Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard 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 e Sq. Ft. _ 6 V d Cu. Ft. — Front Depth Height Sq. Ft. Cu. Ft. Type of ConstructionEstimated Cost�� o 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 tat all the facts and representations stated in this application are true and correct. — (A Schedule of Fee Costs can be found on the Reverse Sidi. I LY -77L `i'V 0- r Ab. BLOCK ADDRESS—,5 ADD. CD-F J,� 7 lie Sao ,W,4r- I . -3� .3 SIZE R X- 02 VALUATION Itl /got 0 tid • dye` f City ®f Fridley, Minn. N? 7558 BUILDING PERMIT Date: Na 25, 1965 owner: Peter Erochalk Builder Andrew Bratzig Address 5933 5th Street N. E. Address 4231 No Ul aaMrVe. LOCATION OF BUILDING No. 5933 street 5th St. N. E. Part of Lot Lot 10 __ Block Addition or sub -Division BoW Addition Corner Lot — Inside Lot + Setback Sideyard Sewer Elevation __ _ ___ Foundation Elevation To be Used as: Front Front Type of Construction DESCRIPTION OF BUILDING Depth Height _ Sq. Ft. Cu. Ft. Depth freight Sq. Ft. Cu. Ft. — Est. Cost 50 * 00 ___ To be Completed • Stom Damage Repair Rebuild to Original • In consideration of the issuance to me of a permit to construct the ding described ve agree to do the proposed work In accordance with the description above set and compliance th of ordinaaoea of the city of Fridley. I / In consideration of the payment of a fee of E10•00 , permit is hereby granted to tzig to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions 70a ordbnancea. NOTICES 'Ibis permit does net serer the construction, installation for wiring, plumbing, gas hating, awe or water. Be sum to sit the Building Inspector for separate permit for thea heam .o OWNER'S /A/ ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF. FRIDLEY, MINNESOTA a _ V71 LOCATION OF BUILDING No.Street Part of Lots_ LOT 9 BLOCK ADDITION OR SUBDIVISION, 0 � l r+ Corner Lot -Inside LOT_, , Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building locatioir'drawn on these Certificates. DESCRIPTXON OF BUILDING To b � fry_, Yront Depth Height Sq. Ft. Cu. Ft. Front Dept h Height G � Sq. Fti Cu. Ft. Type.of Construction Estimated Co �SZ> To be completed The undersigned hereby makes application for a permit•for the work herein specified, agreeing to da 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 SIGNATURE (Schedule o Fee Costs can be found on the Reverse Side). C • • Date: June 9, 1965 City of Fridley, Minn. BUILDING PERMIT N? 7781 owner: Fete Krockalh Builder drew Knatzig Address 5933 5th Street N. E. Address 931 No. mac Pr1m, LOCATION OF BUILDING No. 5M street 5th Street N. E. part of Lot Lot 10 Block 4 Addition or Sub-DivisionBomy Add, Corner Lot _ Inside Lot _ __ Setback —_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fast. cost 87.s.�W To be Completed Storm damage repair In consideration of the issuance to me of a permit to c the proposed work in accordance with the description above ordinances of the city of Fridley. zg described above I pgree, to do compliance wifir ns of In consideration of the payment of a fee of 10,00 , permit is hereby granted to Builder 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 add his agents, employees and workmen, in all work done in, around and upon said building, or any pari thereof, shall conform in aII respects to the ordinances of Fridley, BRinnesota 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 oY any of the Provisions of said ordinances. A.en Jensen BuildingInspector NOTICE: M perm* den not tour the condmeNw, hataMen for wiring, plvmblee, en hsn&& :war or wata. Be sure to »� tis Buliding hupecter for sspwab pwadit for thea Mena. OWNER'SNAM ADDRESS APPLICATION FOR'BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILD No. 4 "Street �0_ Part of Lot LOT 6 BLOCK ADDITION OR SUBDIVISION,�,�„ Corner LotInside L Setback Side Yard SEWER ELEVATION' FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING�� To be use as ; i�, L� / -" Roo Fr Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be completed The undersigned -hereby -mikes 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', SIGNATURE (Sch le of Fee Coats can be found on the Reverse Side). 9q 011 SUBJECT 0. City of Fridley 16396 AT THE TOP OF THE TWINS BUILDING PERMIT rp EEC `L _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. t✓ PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/18/81 JOB ADDRESS 5933 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 4 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Peter Krochalk 5933 - 5th Street N.E. 571-1129 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 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE % 6 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd but not 3rd roof. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt 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 1 ISTALLS I 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 $1,000 $.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- $17.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $18.00 SIGN RE TRACT OR T O ED,.AGGENJ WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT 1(DATE) +_ BLE I DA7 SI GNATURE OF OWNER IIF 0 ER UI DERI (DATE) 011 CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIV-4 FOR RESIDENTIAL BUILDING PEFU41TS (Netu Alterations, Additions, or 0WIIER:(.,-1 BUILDER: ADDRESS: ��� '�� - 3,T ADDRESS: TEL NO: TEL NO: j Constructi n ocation • STREET NO: 33 STREET: '5-0 LOT: A) BLOCK:�t ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION F Front: Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: _'�2 4 Type of Construction: �(( To Be Cbrnpleted: U 1 Estimated Cost: $ Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET The undersigned hereby makes application for a permit for the t:.,ork' 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 ie facts and repres Ztions stated in this application ar ue and correc DATE: / f — /) SIGNATURE: Stipulations:,% CITY OF FRIO'-EY INSPECTION DIV. Effective On March 1, 1596 6431 University Ave NE F 0 1- Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, Fridley, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEM AND DEVICES JOB ADDRESS � 9 33 - �h S RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace S30.00 S-30,00 representations stated in this application are true correct. (Side Vent - Fill Out Back) ,and Gas Piping (Needed with new furnace) S10.00 S OWNER A60f Gas Range S10.00 S BUILDING USED AS Gas Dryer S10.00 S „ r l ESTIMATED COST ��'%� ®` PERMIT N0. 'Air Conditioning - All Sizes $25.00 S5 ,yU DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work S No. of Heating Units_L Circle One (Steam) (Hot Water}2(Warm Air Trade Name v Size No._ S Commercial/industrial BTU S v HP EOR 1.25% of Value of Appliance or Work S Fuel 1,J44, 52j2S Total Connected Load State Surcharge S .50 Burner Trade Name Size No. BTU HP EOR TOTAL FEE s J`S� S(� SUBURBAN AIR 8419 CENTER DRIVE HEATING COMPANY tAI€ NEAPOLIS, MN 55432 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed Tel No. PLUS THE $.50 STATE SURCHARGE k�,/Z�� REINSPECTION FE S42.00/Hr Approved 9y Rcugh-In Cate Final Oate :\T *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE R STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE SUBURBAN AIR Pou.a-n,Md Fax Transmittal Memo 7672 TO Company � 1J �i�,� 'ee� .0 Ks Fax F 6- _71-1-47 Telephone i Ccmmeme xeS4-el — 6127944694 P.01 Ne.01paw / TodaybDO3V f Tlme From J COW -y Local" Depl. Cherpe Fax 8 Telephow 9 1spo l 13DDWM F1Relum ElCallforpiewp Dbpoeplon: 3-/7-'77 3/14/97 SUBURBAN AIR WORK ORDER JOB #4103 8419 CENTER DR., SPRING LAKE PARK, MN 55432 PHONE - 784-6100 ------------------------------------------------------------------------------- Builder Name: System changeout Lock box: Customer: Peter Krowchalk 571-1129 Job Address: 5933 5th St. NE Fridley Job Description: BS - CHANGE OUT ------------------------------------------------------------------------------.. JOB SPECIFICATIONS SYSTEM 1 SYSTEM 2 Complete ------------------------------ --------------------- ----- Furnace: Air conditioner: Coil: Humidifier: Ventilation sys: Thermostat: Zone system desc: Flues: Fresh air: LENNOX G23Q2/3-75 80% AMANA RCC18A2 12.5 SEER 1.5T HA10436 REPAIR EXISTING NEW LOWER PLENUM HW T87F H/C WITH DECOR RING NEW VENTING FOR THE YES RETAIN EXISTING RETURN AIR FURNACE & WATER HTR Gas pipe: CONNECT FURNACE & DO ORSAT Electrical: CONNECT FURNACE & A/C T_ Other: REMOVE OLD SYSTEM Other 2: REPLACE POWER PACK ON HW P50 AIRCLN ***************** ORSAT TEST AND SERIAL NUMBER INFORMATION ********************* ** SEE EQUIPMENT MAKE AND MODELS ABOVE ** Furnace Serial Number: ".V j G. h Air Conditioner Serial Number: ORSAT Information: CO2 $ 02 4n CO A/—,P ?T &,gete CFH INPUT 7, PRESS '3.S' STACK TEMP 3900 Gas valve im! Ignition Make Ignition type :Z'—e Filter size _ /6rg�g Vent size S" Heat anticipator setting _,.- Limit setting - fixod Fan on setting - timed VERIFIED BY:) s_ - ,,� DATE: N SUB.IEtT O.2 City of Fridley 8 072 AT THE TOP OF THE TWINS BUILDING PERMIT r EC ' fr ------ COMMUNITY DEVELOPMENT DIV. SEC_J r E PROTECTIVE INSPECTION E ---I '* CITY HALL FRIDLEY 55432 i NUMBER REv DATE PAGE O: APPROVED BY ---•�; l 612-571-3450 910415 10/2/98 JOB ADDRESS 5933 5th Street 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 4 1 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Peter Krochalk 571-1129 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite-Lennander Co 523 Central Ave. Osseo MN 55369 425-02930 2 8 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 O NEW ❑ ADDITION ❑ ALTERATION Eax REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 5488 $2.75 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 $112.25 Fire SC $5.48 PLAN CHECK FEE TOTA FEE TA frpn ts_Q/ 1 .48 SIGN A TURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI EN ROP VALID ED IS IS UR PERMIT B G -NSP 2 GATE S.GNATURE OF OWNEROF OWNER BUILDER, IDATEI N ~NEW [l ADDN [ J ALTER [ l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/97 ConstructionAddress: -k'5�A 3 _ -4 + W Legal Description: Owner Name & Address: k= C-10 1K Tel.# 57 L iii ndIli.�d rI q 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: Le Width Hgt/Ground Sq. Ft. OTHER: � l , - /} -7�-" -t, GC 9 Construction Type: P -e-- R -U17 -1c Estimated Cost: $ ��Q, QU (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ r DATE: 98 APPLICANT:IF Aj-'Z-aTel. #, /l. Permit Fee Sys$ Fire Surcharge State Surcharge $ SAC Charge 5a $ License Surcharge $ Driveway Escrow Erosion Control P CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes Type Reinspection Fee $47.00/Hr APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR NO. RATE TOTAL $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 ) No $15.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE $ JOB Effective On Jan 1, 2002 StAlE The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Owner ,20-0 Building Used As 4, af4�l.�=e_ Estimated Cost PERMIT NO. PLUMBING COMPANY SIGNED BY FAX # Approved By Final Date -1.2 -6 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 COMMON VFNTVFNT CONN _TOR AND CQMR1ISTION AIR tFRIFI CATION When rp In acingan exosfing, jran , the undersigned hereby verges that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( ) No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The existing nnmhnstinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new enmhustien Mr. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new vent a sy_9tem, the undersigned hereby verifies that it 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( ) 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 HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO RF INSTAI I Fn nm FAM4 Fi nnR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range"* NO. RATE Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 TOTAL JOB ADDRESS_ 54NIE7 Its du`IL)Ic- I— 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 6,uilding Division, and hereby declares that all the facts .and representations stated in this application are true and correct. 5jt5loa Owner /1 r0&C ipr7 Building Used As i;s6yD Vj cz Estimated Cost PERMIT NO.� PLUMBING COMPANY6P,044 uIEZ.t)A1(, Reinspection Fee $47.00/Hr SIGNED BYTE N0. AIZ 796V_ Q ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ` — — 1.5% of Value of Fixture or Appliance Approved By Rough -in Date Final Date 02 State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBINGIG S PERMIT IS S20 00 TOTAL FEE $20•5-0 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. COMMON VENT INFO ON BACK SIDE INmo• ' ? PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range"* NO. RATE Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 TOTAL JOB ADDRESS_ 54NIE7 Its du`IL)Ic- I— 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 6,uilding Division, and hereby declares that all the facts .and representations stated in this application are true and correct. 5jt5loa Owner /1 r0&C ipr7 Building Used As i;s6yD Vj cz Estimated Cost PERMIT NO.� PLUMBING COMPANY6P,044 uIEZ.t)A1(, Reinspection Fee $47.00/Hr SIGNED BYTE N0. AIZ 796V_ Q ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ` — — 1.5% of Value of Fixture or Appliance Approved By Rough -in Date Final Date 02 State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBINGIG S PERMIT IS S20 00 TOTAL FEE $20•5-0 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. COMMON VENT INFO ON BACK SIDE COMMON VENT _VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting:,system is plastic/PVC and meets all current codes and manufacturer specifications .including sizing, length, number of elbows and termination. Yes( ) No (* ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes( No( ) When Installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance;has been -removed from the common vent and vented separately as -per current codes. Yes( )No.( ) ,Ayollance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance#2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) - HEATING Co.. Signed By: Date : Building PLUMBING Permit No Inspections RESIDENTIAL APPLICATIONReceived By: 763-572-3644CITY OF FRXDL'� Date Rec'd: DATE May 2 2008 YOUR E-MAIL ADDRESS WnelsonWarsonplumbinc1.com SITEADDRESS 5933 5th Street NE THIS APPLICANT IS: O OVdNER ®CONTRACTOR PROPERTY NAME: Peter Krochalk ADDRESS: 5933 ---5th Street NE CITY Fridley STATE MNzip 55432 OWNER/ TENANT PHONE: 763/571-1129 CONTRACTOR NAME: Larson Plumbing Inc STATE LICENSE # 3341 PM EXP DATE 12-/31/2008 SUBMIT A COPY OF YOUR STATE ADDRESS: 3095 -162nd Lane NW CITY Andover STATEMN zip 55304 LICENSE WITH mom 763/427-7680 FAX 763/427-9448 APPLICATION PERAM TYPE IR SINGLE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: O NEW ® REPLACEMI✓NT DETAILED DESCRIPTION OF WORK Water Heater Replacement PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, 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 tabor 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 _ _ BATHTUB GAS PIPING OEM MyLI SE) _ SWIMMING POOL _ WATER SOFTNER ($35) —KITCHEN WATER CLOSET BACKFLOW PREY. ($15) _ CLOTHES WASHER SINK _ DISHWASHER LAUNDRY TRAY X wAATER EA ERR ($35) (IRRIGATION _ _ IR —OTHER v' • 5F" r.+A^.: :eJ:Y.,: .:'Ir:. ..R1iiT •.h a.•.,fi�'Jl...'.i . ..,.: •• r.. `:`i;.�-: :ORS •:540;: P�1�MI'�' �E'.�•R�i3ECT3 �`{�R"t7F..�:�`�flb'�� 1f , .� ;v; w a ,��,� ���;E)`3F,0`it P��;:.•.�:5.... •$ . Permit Fee. $ 35 Number of fixtures @ $10.00 x $10.00 — ___•00 Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 3_. 50- Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total — $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PRUCJ:�.tiJbu 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 Construe±ion 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 c4N all work w requires�eview and approval of plans. SIGNATURE OF APPLICA City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 TE May 2 2008 From: unknown Page: 215 Date: 4/29/2009 4:30:45 PM Building BUILDING Permit No.; Inspections RESIDENTIAL APPLICATION Received By; 763-572-3604 CITY OF FRIDLEY : D.KQ01P P R 2 9 763-5024977 FAX EVIR vE I.I.0 DATE 4 -Al -0? _ YOUR &MAIL ADDRESS STTBADDRPSS_'���' THIS APPLICANT IS; la OWNER ONTRACTOR PROPERTY OWNEW NA bffi: ADDRESS: CITY STATE_, TENANT PHONE; CONTRACTOR NAME SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE 0 I 14XP DA p AW AND CERTIFICATE OF A0DRES8: J n / S' ff�( Y"�. Al CITY F 2t14 STATE INSURANCE PHON o1. • ff&QC PAX •' 2— —PROPERTY PROPERTY TYPErGL>; PAMQ,Y/NSW CONSTRTJCTION SrlE ' O TWOU FAMILYJNEW CONSTRL"CITON STO 6 PZRMiT TYPE 0 ADDITION 0 GARAGEISM • EASEMENT FINISH 13 ROOF 0 DRAIN TILE O DECK 10 SIDINti 0 OTHER 0 SWIMMRrT L © NEW HOME CONSTRUCTION 0 ADDITION TYPE OF WORK © MAWTSNANCEIRBPAIR InBMODELINo DESCRIBE WORK BUING DONE: 7V7177 912E OF I PROV8I►+IHNT LENGTH W IDTR IREGHT $ FT ROdFING O HOUSE ONLY WW0DEL-IN0 9IrB= NUNSER OF SQUARES O HOUSE A GARAGE _wAa%rtstntT 1. gl"ft Floor Plea GARAGES O ArrACHED GARAGE 2, Proposed floor plan PROPOSED SIZE: O DETACHED GARAGE 3. List of sftWAU l ff=* 6 to Ire used PROPOSED lE3lt3HT FOR NEW CONSTRUCTION IlNCLUDINGDECKS. �� 5 Yiay1 OSoBii 1. Site pleot9urvey ahowinE the nxiating ahvalanat E3 Al�mb m 0 Trial �� and propand project. 0 other ❑Fascia 2. Two SM of amtrNtion plena 3. Ener$y Calculations 1N E UDS NGOPENINOSes ONO LOCATION OF WINDOWS 3 OR FORNEW OPE INGS• S SITE OF OPENING CWGES & TYPE Oy WINDOW TO BE INSTAL 3M NUM1MO1TWZMOWS ALL FEES -AM Plan Review Fire Surcharge Surcharge Llomse surcharge SAC Charge Cub Cut Escrow Erosion Control Park Fee Sewer Main Chargo ON VALUATION, INCLUDINI.� THE CC1ST OF LAN WA tur u LVLP* a r.RaA LMi -3 r(USINg THE 1997 U.B.0 FEE SCHEDULE) See Hack Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit valuation Nfluirnum $.SO $5.00 (State Licensed Residential Contractors) 52000 per SAC Unit (Plane to MWCC for determination) ft+6ft= $x$21 $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( )loon Necessary ( ) THIS IS AN APPLICATION POR A PERMIT•NOT VALID UNTIL PROCESSLD I Hereby apply fbr a building permit and I acknowledge that the Information above is complete and accurate; that the work will be in conformance with the ordinanoes and coda of the City of Fridley and with the Minnesota Construction Coda; that I understand this is not a permit but only as application fo permit I wpk is not to start without a permit on sire; that the work will be in accordance with the approved plan in the cue of 1huJ '.. _ e I . _ _ SIGNATURE EW APPLICANT /D g.al�,- Building BUILDING SING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ Permit No.: Inspections RESIDENTIAL APPLICATION. $ 7. a S See Back Page for Fee Schedule Received By: 763-572-3604 CITY OF FMLEY Fire Surcharge _ $ 4.00 Date ' t J 763-502-3604 FAX $ , o d .0005 x Permit Valuation Minimum $.50 License Surcharge $ . o6 $5.00 (State Licensed Residential Contractors) EFFECTIVE 1-1-08 $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow 17 • A-0.0 ft + 6 ft = ft x $21= $ Erosion Control DATE YOUR B- ADDRESS $450 Conservation Plan Review Park Fee SITE ADDRESS Fee Determined by Engineering Sewer Main Charge THIS APPLICANT IS: ❑ OWNER 9CONTRACTOR Agreement necessary ( ) Non Necessary ( ) Total Due PROPERTY OWNER/ NAME: TENANT ADDRESS: "• _CITY STATE�1 h = 55q8a PHO 3 5��^ �la CONTRACTOR ME NA: , ADDRESS: CITY 00 STAT ZIPQRW SUBMIT A COPY OF PHONECFAX YOUR STAT$ LICENSE STATE LICENSE # f % L%p ENP DATE PROPERTY TYPE INGLE FAMILyft4EW1e0N8TRWWN SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED Pq1NDOwS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 1,fi��NANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE. Ltd–�rUA.4 — SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE EASEMENT 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 ❑Sofa ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans V4NDONVS�� 3. Energy Calculations A& IN EXISTING OPENINGS ON, I,QCq,TIONWINDOj�(S / A� OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS Ar,L kLLb ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ DDS QO OCCUPANCY TYPE Permit Fee $ 7. a S See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge _ $ 4.00 .001 times the total job valuation Surcharge $ , o d .0005 x Permit Valuation Minimum $.50 License Surcharge $ . o6 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 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 $ Make checks payable to: City of Fridley Attach Stloulations THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information abov u complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota 9eqtruction Codes; that I d this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in acco cc the appro plan ' of all work which requires=,d,77rofplans. SIGNATURE OFNAME �JDATE7' . L� APPROVED BY DATE T