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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N° 4'50, Date: -. �" V Owner: '" "'' .. L` °�° .. Builder Address ...+_l...... ..__.___.._... _ _ Address ........... .......1_.......... _................. __.... �(�'�„ NF BUILDING No. �..1........ Street _. .. ....._ *_..d�..!r..!........_............._......._..... Part o Lot ..... . Addition or Sub-Divisi _. 7idei Lot ................ 'Block ....... __./..._............................__ ^ .._...r._ .___.. ComerLot ............... _ ......... ...... ... Inside Lot ....._.. ..._........ Setback ... .-......._...._....... ard ....._..4. �..._..._............._.............---___.. Sewer Elevation_..._........_..._............._.............___........._......._...._......._...._........ Foundation Elevation DESCRIPTION OF BUILDING T beU � / / �° _.................._ _ .._..._. _.._ Front -- _.. Depth ...-- Height -- ----•- Sq. Ft.'!._..�P . Cu. Ft. 196 ...._ .............._............_......._.............. Front .... ......... ......... ....Depth ........... r Sq. Fit. ...................... Cu. Ft. ..... _................. Type of Construction r %�°''` .. Est Cost ........ }............................_........ To be Completed ....._........ ................................... T{-1; ilii; iJtii. �w�'� �T ` i_i f i7Ji(3L.F `'i ±7 .I'..'IL I`f/-',;`! L, ice; L)��,�;! 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 untm vlolatioi of any of the provisions of said ., ordinances. -5 - Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builder Address �� _s_�7.P LOCATION OF BUILDING Szh-►�C'_ 15 Z_ A?- -e_ No.,f V % 6- Street Z' S T N Part of Lot Lot . �� :Block Addition or Sub.Dive 14-1 l Corner Lot Inside LotE_§et Back �� Side -Yard, SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUIMING To be used as: r/ Front 7 r Depth 4 Height Sq. Ft. _ // f. �I Cu. Ft. 2 2� 6 Front Depth Height Sq. Ft. Cu. Ft. Co Type of Construction k- kn -e Estimated Cost z© � 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. DATE SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) I�l Application for Power Plants and. Heating. Cooling, Ventilation, ReFrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU, 4-7470 GRAVITY WARM AIR: RATE TOTAL, 1. 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 .............................. .x.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 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 VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE -P f 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,,Mm/3nn- �� 19 Lo Owner, Ownez�C-.c. �✓r zC-�/ ! �-��1C-�B�Z_al Kind of Building���� Used as To be completed about V to Estimated Cost, $ N Old New, Building Permit No. -� Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Sam, Ho�tt W -a ,Warm Air—/ o Trade Name- �' � � P �� t�� Size No 46, Z1 Capacity Sq. Ft. EM.R- BTU H.P. Total Connected Load 7"� 0 Z,;Kind of Fue BURNER. — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. RAY N.WELi ELeo H,�_.—oe Ie,L L 4637 CHICAGO AVE. Signed MINNEAPOLIS 7. MINNESOTA By .Qaw4;! 2M 7_59 Business Phone No (REMARKS -OVER) N 't D-36 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows Doors Reference Out. Wall Int. Wall Ceding Roof Floor es IfYe's-:_No 19— 1 — m I r -- P__ I I ...th VV;.4th P b 14p;crht 11 1 Fl_I , Windows and Doors—Crackage and Area Width Height No Ares 9 Lineal ft. No. of pane or pane to of crack sq. ef.. Area sq. ft. L Coef. Btu Coef. Btu Infiltration Glass Btu Glass ' Net exp. wall Exp. wall Int. wall Glass Net exp. wall 1.2 Floor Int. wall Exp. wall Ceiling Exp. wall Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 17, Windows and Doom—Crackage and Area Width Height No of Lineal ft. Area No. of pane of pane lights of crack ta. ft. Area sq. ft. L Coef. Btu Infiltration JCoef. Glass Btu Exp. wall ' Net exp. wall Infiltration Int. wall Glass Ceiling 1.2 Floor e Total Btu. -i I � ..z I" - 411/ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 'R IFl-1 'k--Rnnm I Lenath� 0 -4 Width 14eiaht Windows and Doors—Cracka;e" and Area Width Height No. of Lineal ft. No. of pane of pane lights of crack Area sq. ft. 4� L Infiltration JCoef. Glass 7 Btu Infiltration Infiltration ' jCoef. Btu Infiltration Int. wall Glass Ceiling ly, 4 1.2 Glass Exp. wall Exp. wall Net exp. wall Net exp. waH Inc. wall Int. wall Ceiling Ceiling Floor —Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I -x 4— Insulation Kind How Applied Re%nm I I Pnath i Width i Windows and Doors—Crackage and Area Width HeightNo. of Lineal ft. AreaNo. of pane of pan,, lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration JCoef. Glass 7 Btu Infiltration Infiltration ' Net exp. wall _z1v Int. wall Glass Ceiling ly, 4 4. Floor Exp. wall Net exp. wall Inc. wall _1z Ceiling Floor Total Btu. A -- _4 Required sq. ft. E.D.R. or3q. ins. W.A. Leader area iml Rnnm I Lenath Width Height Windows and Doors—Crackage and Area Width HeightNo. of Lineal ft. AreaNo. of pane of pan,, lights of crack sq. ft. Width Height No. of Lineal ft. Area No.— of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass 7 Btu Exp. wall ' Net exp. wall _z1v Int. wall Glass Exp. wall 4 Ceiling ly, 4 4. Floor Total Btu. 4" -' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area P -, & Width I I %,- Rnnm I Lenath Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No.— of pane of pane lights of crack sq. ft. Coef. Btu Infiltration ' ) '.o t � ': '-_ Glass Exp. wall 4 dv 2L, - Net exp. wall Int. wall Ceiling _1z Floor Total Btu. V-3 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley Application f r Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures s PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL— Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $� New Fixture Old Opening .............. Z $ Catch Basin ............................ WATER HTR. $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL - O0 �go < �°d �U' 4n (�90 F N GAS ELEC. rn Base do 1st 2nd _ 3rd 4th • Future Connection Openings I Connected with Sewer � New Fixture, Old Openings Cesspool s PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL— Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $� New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL - x $1.50 1st 3 Fixtures ..........................—� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE o W City of Fridley: Off( 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 qre true and correct. 19d4j Owner Kind of Building Used as To be completed about — Estimated Cost, $ Old -19 Building Permit FINAL 4 z 2M 7-39 • r� u City of Fridley, Minn.. BUILDING PERMIT N® 6480 -Address Address woa,4 P,ILDING No. Street �._-..._ Part Lot Block _—�_ Addition or Su sion _ Corner Lot . Inside Lot. _ filrtback _ _ -SI yard Sewer Elevation — Fo dation Elevation DESCRIPTION OF BUILDING To Front Depth -deAe- Height Sq. Ft�� Cu. Ft, �) rl Depth Height -7 -0 - Sq. Ft. Cu. Ft. Type of Constructlo _..._. Est. To To be Completed _ In consideration of the issuance to me of a permit to construct the buildin described above, I agree to do the proposed work in accordance with the description above set forth and in cm fiance v all provisions of ordinances of the city of Fridley. _ I �/ A In consideration of the payment of a fee of I lor-45�1p— , 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 ante city limits and this permit may be revoked at any time uponolatien of any of the provisions of said Building Inspector NOTICE: ihb pennk does not corer the condracdoe, hoot tion for wbb& plumbing, gas heating, sewer or water. Be ams to no the Building Impeetor for separate pwmhs for these kerns. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWI "R Is NAME ��BUILDER ADDRZSSG �,E&S % e I)I , HIJLEV ADDRESS LOCATION OF BUILDING No. -5-776 Street HJT AAF. Part of Lot aE41C Lot Block Additirz_on or Subdivision Corner Lot Inside Lot �' back Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; " RA GI Front '�z ' I Depth ,2 Z s height % I-t-111"01®ot Sq. Ft. '5'2? Cu. Ft. Jc"90%v Front Depth Height Sq. Ft. Cu. Ft. Type of Construction _Estimated Co t 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 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 AA (Schedule of Fee Costs can be found on the Reverse Side). W 0 0 Lj(LE � - Ll�l/V�LL VUIL—DI 6- .5q 76 AE. r-KIV, Er No Sc.,44E' -- ---2 APoRaac . i� r LP -- A.PA DAI C -AM t N ®� _r a-.4 fc, getr LIN V4 -- ---2 APoRaac . i� r LP -- A.PA DAI C -AM t N ®� • r 1 U is City of Fridley, Minn. BUR DING PERMIT Date: June 22, 1965 Owner: Lyle D. Linnell Address 5976 5th Street N. E. No. 5976 Street Lot 2 & 3 _ Block r ,f Ron - Jon Builders Xenia Ave. So. LOCATION OF BUILDING 5th Street N. E. part of Lot — 14 Addition or Sub-DivWm Hyde Park Corner Lot ._ Inside Lot Setback Sewer Elevation To be Used as: Sideyard Foundation Elevation DESCRIPTION OF BUILDING Front Depth Front Depth Type of Construction Fast. Cost Storm Damage Repair ,;, �10 7,31 N° '7985 Height Sq. Ft. Cu. Ft. Height Sq. Ft. Cu. Ft. $5, 700.00 _ To be Completed In consideration of the issuance to me of a permit to c the proposed work in accordance with the description above ordinances of the city of Fridley. I above.11 agree to do with ail provisions of In consideration of the payment of a fee of •S 10 -NZ , permit is hereby granted t,Ron Jon Builders, Inc to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work. done in, around and upon said building, or any,_ thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regardinglocation, itmay be revokedoka t any time upon titeration, maintenance� n of any of the proand tons of satd within the city limits and this ordinances. Allen Jensen Building Inspector NOTICE Sk peri don not emu the eonslrneflon, knialldlon for whfeg, plumbhtb an heaft, sewn or water. Be sues to no the Bolmine hes now for npwab psrmbs for thea bona. APPLICATION FOR BUILDING PERMIT `.CITY` OF ft MEY, MINNESOTA OWNER'S NAME r /� a ` BUILDER, �c't ADDRESS ADDRESS �ADDRESS LOCATION OF BUILDING' ; No Street Parc of Lot LOT 4 . BLOCK J._ADDITION OR SUBDIVISION Cornet"Loth Inside LOT-' '_ Setback ;Side--i-Yard' SEWER EL$VATION FOUNDATION EUVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on thesa Certificates. " 'DESCRIPTt©N OF BUILDING To be used as: Front Depth Height Sq. Ft,. Cu. 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 o£ Fridley Ordinances and rulings. Of `.the' Department of Buildings, and hereby'declaidi that all -the facts and representations' stated. ib' this' application axe -true artsi correct.= G DATE SIGNS - -— - — (Schedule of Fee Costs can be found oia fie Revers,"ide). SUBJECT P IT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT CEIPT NO. 1 ; COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 46-71 71 "^ CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 10'15-81 10B ADDRESS 5976 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED. DESCR. 293 14 Hyde Park SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Douglas Linnel 571-9077 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Lloyd's Home XNNX Improvement 1012 42 1/2 Avenue N.E. 788-5602 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 4( REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK re-roof 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 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 960.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 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 18.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE SIGNATURE OF CONTRACT ROR RUTHO Z AGENT IDATEIEC.�� LY V LIQATE�DTHIS IS YOUFj/PE�VIT BLDG INSP HATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIOJ FOR RESIDENTIAL BUILDING PER14ITS (New, Alterations, Additions, or Repairs) OWNER: ADDRESS: J TEL N0: 7/— 0 i % STRUT NO: � ` -;7 X BUILDER: .L vo ADDRESS: Z(% T TEL NO: Construction Location STREET: �� o LOT: ; BLOCK: a� 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. Front: DESCRIPTION OF CONSTRUCTION Depth: Square.Feet: Cubic Feet: Front: Square -Feet: Height: Depth: Height: Cubic Feet: Type of Construction: Zb Be Completed: �y Estimated Cost: $ 4 e"' ` E� 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 ♦.pork herein specified, agreeing to coo,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: Stipulations: SUBJECT P City of Fridley /( 26446 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. -� L'_ r PROTECTIVE INSPECTION SEC. �� �® i NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 ti.__.Jl.' '•� 612-571-3450 910-F15 7/6/98 JOB ADDRESS 5976 5 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2,3 14 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lyle Linnell 5976 5 Street NE 571-9077 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D L Builders 1166 14 Ave SE, Mpls., MN 55414 378-0950 20096711 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 Cj REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (30 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 1 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 $2,502 $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- Fire SC $2.50 S UCTION OR THE PERFORMANCE OF CONSTRUCTION. $74.75 PLAN CHECK FEE TOTALFEE License SC $5.00 $83.50 SIGNATUR CO RACTORORAUTMORIZEDAGENT IDATEI WHEN PROPERLY BLO INSp ALIDATED THIS IS YOUR PERMIT c _ ^� av f1ATE SIGNATURE OF OW NER OF OWNER BUILDE RI IDATEI NEW [ J Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� u BUILDING PERMIT APPLICATION ConstructionAddress: S 'Y7(Q S 5T • �1 Legal Description: Owner Name & Address: L �Avzx_-- Tel. # S71 " 107 i Contractor: MN LICENSE # ZDO 9 to -711 Address:. 144 S&- Tel. # Z-2 9 CSS a LIVING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF U"ROVEMENT Length Width Height Length Width Height DECK AREA: Length Width OTHER: it c F kref. Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: Jet Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: 04rlj n M 101-a 61-1 Tel. # %9 c CIT SE ONLY Permit Fee $ S~ Fee Schedule on Reverse Side Fire Surcharge $ c2 -SO .001 of Permit Valuation (1/10th%) State Surcharge $ 4 ,2j�__ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ J TOTAL $ �O STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUM MARK NUMBER OF FIXTURES TO BE !> Wash Oriel PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance_ $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $,-Cri, .5"® , . Effective On January 1, 1997 1S FITTING PERMIT EACH FLOOR tcl Auto. Gas Gas sre> Washer 'AccF<<>< Ran 7� Water Heater Gas I Elec The unite by makes application for a permit for the work herein specifi . - to do all work in strict accordance with the city codes and rul- eBuilding Division, and hereby declares that all the facts and -rept ons stated In this application are true and correct. .1998 Owner 141/116-zz Zyzez' 00 Building, PLUM SIGN "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) PERMIT NO. 3,S MR. ROOTER OF ANOKA COUNTY Ramsey, MN 55303 TEL No. 1 -6198 -FAX gh—In Date Final Date MINIMUM SIZE 9 SO INCHES. 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 BE INSTALLED ON EACH FLOOR Effective On May 10, 1999 Stories . Urinal :.. r Shower t#IE`�`�i�� Wash Tray ? `: `: •: I"<:?.:::::•.. Floor Drain ;; Auto. WG :r>:: •.. Washera . M :>. Water Heater .: rf:- .... Gas EI ;,:?:....... ec Basement Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance Floor 1 Water Heater -Electric $ 7.00 Water Heater - Gas*` $10.00 Gas Range** $10.00 Gas Dryer** Floor 2 i�i F•::�+'• Back Flow Preventer Required ( )Yes () No Type $15.00 Floor 00 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas*` $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 U TOTAL FEE $� JOB ADDRESS 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 Building Used Estimated Cost NJ PERMIT NO. PLUMBING COMPANY_ _5Xlag n S /i C SIGNE TEL NO. S� Approved By Rough -In Date Final Date (.�J **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. 1999 l SuBJEGT City of Fridley'2 9 7 2 6 AT THE TOP OF THE TWINS BUILDING P E R M I T r � ECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. F � � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 61211 99 10B ADDRESS 5976 5th Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED OESCR. 29 3 14 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lyle Linnell 571-9077 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Scott Schwaab Const. Servs,, 850 138th Avp NW Andnypr 95,1114 720-328 0147229 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONEI LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION x® ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Lower level 3/4 bath (7° x 71) 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan. Smoke detectors on all levels, adjacent to and in all Osleeping rooms. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5000 $2.50 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- $111.25 STR CTION OR THE PERFORMANCE OF CONSTRUCTION Fire SC $5.00 PLAN CHECK FEE TOTAL FEE License SC $5.00 1$123.75 SIGN A TURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN PROPER BLD INSp I ALIDATED THIS IS YOU PERMIT TIA TE SIGNATURE OF OWNERIIF OWNER BUILDER) IDATE" NEW [ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FA 1ILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: X76 J-;", -f�z Legal Description: Owner Name & Address: Tel. # Contractor:, fes,,, �,,J,r MN LICENSE # 2 o / Al %2247 Address: `f /,7j14' iXz 6 y Tel. # q2v -.? Z o'1i Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length _2 Width 7 Height — 7 Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: A, -,a/ lam/ 0 #�*Estimated Cost: $ sego, `- Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ M DATE: 6 -0_ 13FR APPLICANT: _P'4�� Tel. # 72 o - 3 z �l Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ / IZ- $ "-00 Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] t' R �� SUBJECT city of Fridley d7l 4 7 7 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. _--- COMMUNITY DEVELOPMENT DIV. ------ r E PROTECTIVE INSPECTION SEC. &q J0 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-Ft5 10/12/00 JOB ADDRESS 5976 5 Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2,3 14 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mary/Lyle Linnell 5976 5 Street NE 571-9077 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wellington Window & Door Co 3938 Meadowbrook Rd, St Louis Park, MN 55426 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 952-953-6300 City 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION REPAIR 0 MOVE 0 REMOVE B DESCRIBE WORK Replace windows 9 CHANGEOFUSEFROM TO STIPULATIONS 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. Permit Inspection cards Will B6 Mailed To Homeowner Ti) Post SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 $9,350 $4.67 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT FEE Cit icen 195.27 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) W ENP RLY VALIDA� HIS Is PERMIT LD -NSP 0&TE S,GNATURE OF OW NERIIF OWNER BUILDER) IDATEI NEW [] ADDN [] ALTER [ ] Construction Address: LO Legal Description: Owner Name & Address: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/2000 (763) 572-3604 Bldg Insp 1 Tel. # 22 :NSE # Tel. #/Ud,� 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: I Construction Type: ---6 I �(� Estimated Cost: Sr� Driveway Curb Cut Width Needed: Ft. + Ft = Ft x $ _ $ DATE: 0- APPLICANT: Tel. # 3 - (� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $_ mks Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ �,6 $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ 7i -$5:00-(State-Licensed-Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] J TOTAL STIPULATIONS: su6�EtT PERMIT .. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 7 7 6 r RECEIPT NO. �• ______ COMMUNITY DEVELOPMENT DIV. v INSPECTION SEC d� r PROTECTIVE NUMBERREV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F11 7/12/02 JOB ADDRESS 5976 5th St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2,3 14 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lyle & Mary Linnell, 5976 5th St, Fridley, MN 55432 763-571-9677 3 CONTRACTOR MAIL ADORES ZIP PHONE LICENSE NO Egress Window System, 5932 53rd Ave S, Fargo, ND, 58104 612-722-5862 2031151 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 OX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Install window in basement 9 CHANGEOFUSEFROM TO STIPULATIONS 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. Caulking and flashing for all exterior openings. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1,200.00 $.60 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- $,44.85 Fire SC $1.20 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK F TOTAL F E Lice $5.0 $5 .65 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI HE PR P Y ALIOAT D HIS IS YOUR PERMIT S,GNATURE OF OWNERIIF OWNER BUILDER, IDATE. 8L G INSFP T,ATf NEW [ ] CITY OF FRIDLEY Effective 1112002 ADON [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 5 917 (o Legal Description: Owner Name & Address: Lti L I 4 rte, �- Aio't_ Tel. # Contractor.. 1E -GO -7-5-1 (,,f I Sao 4•J S J MN LICENSE # Address: S 9 % (. S 12"— S % 1� - IF _ \ Tel. # L 6; 7 2-2 - 5T (, i 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 Construction Type: 0 ► jJv3-)a 1a Estimated Cost: $ 1 Z- s s Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ __=$ DATE: %- 1 -2- 1-6-'- APPLICANT: '��2�M �4''''— Tel. # %1147,-L 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 CITY USE ONLY - $� �� Fee Schedule on Reverse Side $� 1,9-6 .001 of Permit Valuation (1/10th%) $ to O $.50/$1,000 Valuation $ $1200 per SAC Unit $ -5-00 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by'Engineenng $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ -5 1. 6< STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 kAX: (763)571-12N7 ADDRESS : 5976 5 ST NE PIN : 233024210128 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01225 DATE ISSUED: 07/30/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT DEPENDABLE ELECTRIC INC 2619 COON RAPIDS BLVD NW COON RAPIDS, MN 55433 LINNELL LYLE D & MARY JANE 5976 5TH ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and convect. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 28658 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 5976 5 ST NE PIN : 233024210128 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION 3 < PE NO.: 2004-01240 DATE ISSUED: 08/02/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, RUUD, UNKNOWN BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT RIVER CITY SHEET METAL 9928 BLUEBIRD ST NW COON RAPIDS, MN 55433- (763) 754-2199 LINNELL LYLE D & MARY JANE 5976 5TH ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application 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 does not pres to give authority to violate or cancel the provisions of y othe tate or local law regulating construction or the p ormanc of construction. Applicant Date- , Bldg HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # •13522 SEPARATE PERMITA'REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0.00 35.00 0.00 0.00 25.00 0.00 0.50 60.50 CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater q1 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Fee Total owner $35.00 $ Building Used As $10.00 $ ESTIMATED COST PERMIT NO ✓1"�' a� $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ # of Heating U�nit-s��_Circle One (Steam) (Hot Wate Warm Air) Trade Name !p Size No .07 $25.00 $ BTU HP EDR t Fuel Total Connected Load ✓SIr- Rd, L(i9t c 44- V., SAz. Burner Trade Name Size No. BTU HP EDR Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR 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. $ HEATING CO $�oO.So Signedp—z1 u,,Qa Tel J X03 *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE FAX # Approved Date Rough -in Date Final Date o` FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furnace, 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 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( ) Appliance 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: Sr 71e- r*h S7-Iv4�-r FILL IN COMPLETELY FOR REPLACEMENT FUEL BURN ERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 fA 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 ?C) 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 16 No( ) Appliance Type and Size/Common Vent and Vent Connector Information 0 Appliance #1 Type ,e(e. 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 I ft Length Z 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 10A/ HEATING CO: Signed By: Date: 7— PLUMBING RESIDENTIAL APPLICATION City of Fridley Z0©4p, By Date Received NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE i 2- I Z- O YOUR E-MAIL ADDRESS IV SITE ADDRESS J �'% S� I THE APPLICANT IS: (CIRCLE ONE) OWNERONTRACTO NAME V -e j 4,Q PROPERTY OWNER/ ADDRESVIIP -be— TENANT CITY STATE ZIP PHONE # 5- 7 /- %c 7 -7 NAMELICENSE # sSS `L4 h/1 PIPEWORKS o . ADDRESS SIM riy,%DP'1 ROAD CONTRACTOR CITY ►(;s AIV 55123 STATE ZIP PHONE # (651) 3651340 FAX# PERMIT TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK ❑ NEW �REPLACEMENT DETAILED DESCRIPTION OF WORK�a &a :(eZ W �leC Cf - FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION WATER METER OTHER a� Permit Fee $ MINIMUM: $15:00 or 5% of cost of the improvement -whichever is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ 35.5-0 Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT - NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 approvalof plans. / � NAME OF APPLICANT V'r ' DATE P16 or print I'W, — SIGNATURE OF APPLICANT ih at:ata t i,2 ti iS4sl r rW''� Ix ix` l ��,; PLEASENO)E '3EpARAiEPERMT&�.p yf' .�IN�1F11 {dr�a'f `h' 4r w1 w°..I'R,t t r. f�tii CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT 6431 UNIVESITY.AVENUE NE, FRIDLEY, MN 55432 (763) 572-3604sT� Building PLUMBING Permit No.: 1-00:W0 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat4 6:l- P DATE— Z YOUR E-MAIL ADDRESS SITE ADDR SS :C926 THIS APPLICANT IS: 0 OWNER WONTRACTOR PROPERTY NAME: ; ,� OWNER/ ADDRESS: CITY STATE—ZIP- TATEZIPTENANT TENANT PHONE: 7C3 -,r7/- Fe 2 ? CONTRACTOR NAME __^.L4ov_, STATE LICEN # EXP DATE A7 SUBMIT A COPY OF YOUR STATE ADDRESS: d(CITY �41L/�� STATEIf kZIP LICENSE WITH PHONE 7CJ a( (2—'(f V IP- FAX APPLICATION PERMIT TYPE XSINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: IOj EW 0 REPLACEMENT DETAILED DESCRIPTION OF WORK ell PER MS 1613.665 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 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 DRAINS SHOWER _ WATER PIPING _ _FLOOR _ GAS PIPING (NEED crrrrrc&m) SWIMMING POOL WATER SOFTNER ($35) —BATHTUB _ _ WASHER KITCHEN SINK CLOSET ! BACKFLOW PREV. ($15) _CLOTHES _ —WATER —DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER i OTHER Permit Fee $_ — Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ ' _�. State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work' which requires review and approval of plans. SIGNATURE OF APPLICANT�/J��tdr�✓ PRINT NAME��IA2�r✓ DATE D i__.FC?1.1 ., ..: '... I11i�'+ , City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977