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PRE 2010 DOCS0 0 City of Fridley, Minn. BUILDING PERMIT Date: ... 4-! ..... ...... ..... ................ . Ownereo .. Builder Addressi � ^v . Address N° 3103 V LO TION _OF BUILDING No. ®.j Street .. .......................... Part of Lot . .......... 6 Lot ....r ..... Block ....? ...... Addition or Sub-Divisio .......... .. .... Corner Lot ............ Inside Lot ............ Setb .. Sideyard ......... ....... DESCRIPTION OF BUILDING To,1le Used as: / ...... Front ......... Depth e�.'. !a : `. Height/94-.1741 Sq. Ft. ... Cu. Ft. ........ ........ .......... Fro ........ Depth `s t . Sq. Ft. ........ Cu. Ft. Type of Construction ........... t. CosYl..;....... To be Completed ..... ` 9 of— a In consideration of the issuance to me of a permit to construct the buil ' g desribed above, I agree to do the proposed work in accordance with the description above set forth an compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $.. e t is hereby granted to .... 1Vi�FrQ....... ......................... to construct the buildin 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. NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. • c,� 1716 City a o City of Fridley, Minn.. N° 7802 BUILDING PERMIT Date: June 91 1965 Owner: Orval Keith Jr. Builder Strand Const. Coo Address 69AI, 5th St. N. E. Adams �� W 6th St. LOCATION OF BUILDING No. 6043. Street 5th Street N. E. Part of Lot Lot S _ Block 2 Addition or Sub -Division Add. Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: Type of Construction Front Front • Storm damage repair 0 DESCRIPTION OF BUILDING Depth Height Sq. Ft. Cu. Ft. Depth Height Sq. Ft. Cu. Ft. ____ Fast. Cost A3 0 000.00 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 and in comp ce with ail provisions of MUM== of the city of Fridley. In consideration of the payment of a fee of permit is hereby granted to Strand Const. Co. 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 wiord nthe. city limits and this permit may be revoked at any time upon violation of any of the provisions of said Allen Jensen Building Inspector NOTICE: Ibis poem* do= not emver the constracttw, batatl an for wldag, plambing, gas bad hM sawar or waHr. Bo wre to we tin &dlding Mor for aparato paemh for dn" hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME l% I 1� tZ f i� /� BUILDER ADDRESS��yADDRESS, tZ/ (,A) is CyA, LOCATION OF BUILDING No. Street Part of Lot LOT BLOCK �' ADDITION OR SUBDIVISION�o Corner Lot Inside LOTv-'.-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 used as; !ll &M,4J kCW AJAFront Depth _Height Sq. Ft. Cu. Ft. JO '-L-V1- (4.4c' Front j� Depth ��_Height Sq. Ft. Cu. Ft. Type of Construction yP <.�C /�°?�l�l �P���r�g Estimated Coat y 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_ y ___._)_SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side. J SUBJECT PER . City of Fridley 17 519 AT THE TOP OF THE TWINS BUILDING PERMIT r • __ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 NUMBER DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ".j 612-571-3450 910-F15 TREV 5/31/84 / / JOB ADDRESS 6041 - 5th. Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 2 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Delores Keith 6041 - 5th Street N.E. 571-2135 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548 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 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be. 2nd layer but not 3rd. Install ridged galvanized valleys where necessary. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $•60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1200 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE R LOCAL LAW REGULATING CON- $20.50 ST ION OR THE PERFOR NCE CONSTRUCTION � PLAN CHECK FEE TOTALFEE S �, & IL/ $21.10 SIG ATUREOFCONTRACTO OR uTHORIZEDAGENT DA EI WHEN PROPERLY V DATED THIS IS YOUR PERMIT fOATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) J CITY OF FRIDLEY APPLICATIM FOR RESIDENTIRL BUILDING PEW4ITS (New, Alterations, Additions, or Repairs) OWNER: tt 4-a 2 ADDRESS: �� �/ - S% • D� TEL n0: Effective Aug. 1, 1981 BUILDER: i �4-aA/ �1 a�VAsm ADDRESS: -S-1 3 (20 If >-i C- 4� f/V TEL 140: 7 ;f/ — f -FV Y Construction Location STRMT NO: © CL._L_ STREET: J V S / C LOT: BLOCK: 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 Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: cubic Feet: _ Type of Construction: A.L Rb Be Cbripleted: LP off. Estimated Cost: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE PEVERSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the work herein specified, agreeing to do•all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and represent.1 ns stated in this application are true and r re t. � r DATE: / b SIGNATUIE: Stipulations: CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE OT. QTTILM.1M7 1 T Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) RATE TOTAL $ 20.00 $ .2'0.o0 $ 10.00 $ /o• a --O . $ 10.00 $ $ 10.00 $ All Others/Repairs and Alterations 1% of Value of Appliance or Work $ 10.00 $ la.00 N COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work $ State Surcharge $ .50 TOTAL FEE $ r� o Reinspection Fee ($15.00) $ Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE Attach stack verification form with replacement furnace permits *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Job AddressZ706Z// - S(l"'+ /" Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 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. j7 Fridley, Minn. / / , 190 OWNER Jq KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST '? r6 U — OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER LANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity 7r, eW-0 Sq. e Ft. EDR BTU V1, HP Total Connected Load �Z7" 41 Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company .Standaarrd/Heating & A/C Signed By Tel. No. 824-2656 CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (�) No ( ) 2. Is free from rust or deterioration 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 Remarks Company _ Signed By Date STANDARD HEATING & AIR CONDITIONING CO. SMIHG THE TWIN CITIES SINCE 1930 HEAT LUSS CALCULATIUil FUR KEITH -6041 5T11 ---------------------------------------------------------------------- ST.H.E. 91488 LK MAIN LEIIGTR 43 WIDTH 21 ---------------------------------------------------------------------- HEIGHT 8 11INdUriS is DOORS — CRACKAGE AND AREA WIDTH HEIGHT 110. LIN F! AREA NO. PANE PANE LIGHTS CRACK SQ FT 1 36 22 1 11.2 7.5 4 24 43 1 54 41.2 2 36 2U 2 35.3 25.6 3 32 16 2 46 23.5 1 32 80 U 16.7 17.8 1 36 80 0 19.3 20 COEFF OTU 107 R.FT INFILTRATION ................. 184.5 20 3690 GLASS .............................. 140.6 50 7030.001 EXP:dALL ........................... 107 NETEXP BALL ........................ 715.4 11 7869.401 BELOW GRADE...... 0 ................ U 5 0 CL'1LING ............................. 903 11 9933 FLUOR............................... 0 0 0 VENTILATIUW...... 0 ................ 0 0 0 TUTAL BTU ................................................. 28522.4 ---------------------------------------------------------------------- MAIN LENGTH 21 WIDTH 1.5 ---------------------------------------------------------------------- HEIGHT 8 WINiJOiiS & DOORS — CRACKAGE AMU AREA WIDTH HEIGHT NO. LIN FT AREA NO. PANE PAiE LIGHTS CRACK SQ FT 2 20 40 1 23 15 2 32 16 2, 30.7 19 COEFF OTU 24 R.FT IIIFILTRATIUN ................. 53.7 20 1074 M GLASS ........................... 34 50 1700 ' EXP 1iALL ........................... 24 ' NET EXP WALL ........................ 158 11 1738 BELUll GRADE...... 0 ................ 0 5 U CEILING............................. 31.5 11 346.5 FLOOR............................... 0 0 0 VENTILATION...... 0 ................ O 0 0 TOTALOTU ................................................. ---------------------------------------------------------------------- 4858.5 BASEMENT LENGTH 43 idIUT11 21 HEIGHT 8 ---------------------------------------------------------------------- WINDOWS & DOORS — CRACKAGE AND AREA U10TH HEIGHT 1.10. LI11 FT AREA 110. PANE PA14E LIGHTS CRACK SQ FT ' COEFF OTU 107 R.FT INFILTRATION ................. 0 0 0 GLASS.............................. 0 0 0 EXPBALL ........................... 107 NETEXP BALL ........................ 0 0 0 OELO11 GRADE...... 3 ................ 856 5 4280 CEILING ............................. 0 0 0 FLUOR ............................... 903 3 2709 VENTILATION...... 0 ................ 0 0 0 TOTALBTU ................................................. ---------------------------------------------------------------------- 6989 OASL' iEld'! LEidt:TH 21 1•iIUTH 1.5 HEIGHT 8 ---------------------------------------------------------------------- 11INU&S & DOORS — CRACKAGE AND AREA WIDTH HEIGHT NO. LIN F! AREA 1.10. PANE PANE LIGHTS CPACK SQ FT COEFF OTU 24 R.FT INFILTRATION ................. 0 0 0 GLASS.............................. 0 0 0 EXPMALL ........................... 24 14LTEXP biALL........................ 0 0 U BELOW GRADE...... 3 ................ 192 5 960 CEILING............................. 0 0 0 FLUOR.—sass—as ......... a .... , ... o 31.5 3 94.5 VENTILATION...... 0 .............1.. 0 0 0 TOTALOTU ......................... 4....................... 1054.5 TOTAL BTU OF ALL ROOkS/FLOORS....................................... 41424.4 SUBJECT PEO. City of Fridley 26575 AT THE TOP OF THE TWINS BUILDING PERMIT F? CEIP 1 L T • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REVDATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7-13-98 JOB ADDRESS 6041 5TH St. NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 1 Bonny SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Delores Keith 571-2135 3 CONTRACTOR MM IL ADORESey St, Anoka, 55303, XXZIP LaFrance Exteriors, 34� MORMlXX 712- 1IE 200817 NO, 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 IN REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Re -roof house (18 Sq) - tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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 $1,501 $.75 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- $51.25 Fire SC $1.50 STRUCTION OR THE PE FORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE Licens C $5. 58.50 Si OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N ROP ALID B G INSP THIS IS Y UR PERMIT 9 / 7-1Z F'AATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: _ Legal Description: Owner Name & Address: Contractor: 3-1 Address: CITY, OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION bql Emu Effective 1/1/98 Tel. # :571- d-1 U MN LICENSE # ;,0071'T Tel. # J_/0- " Jn 10 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: Len Wi th Hgt/Ground Sq. Ft. OTHER: z 1_ -0 v� Construction Type: Estimated Cost: $ l (Fee Schedule, on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: - " 0 (� APPLICANT: A /it "` Tel. # Fr CITY USE ONLY Permit Fee $% Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ < `l� $.50/$1,00 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 . 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** Urinal APPLICATION FOR PLUMBING AND GAS FITTIN I PERMIT MARK NUMBER OF FIXTURtS TO BE INSTALLED ON EACH FLOOR Wash Floor ;..::..::...: Auto. '> Sh ower Tra �<��>' Drain f1i�I� v Feil>::>:..... n ........: ;-:`.: B���€<:€ Washer �tl NO. RATE I Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Effective On Jan 1, 2000 TOTAL JOB ADDRESS m -w AS (,D wfja(z Water Heater Gas I Elec 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. KEITH, DELORES' 200-0 6041 5TH STREET NORTHEAST Owner FRIDLEY, MN 55432 (612)571-2135 /D Building Used As ife 6 ! c c z-- Estimated Cost / PERMIT NO. Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance _®• &Z State Surcharge PLUMBING COMPANY A Jevy-lb 1"-n _Pla4nb�n SIGNED BY TEL NO. Z — 33 Approved Byz Rough -In Date Final Date TOTAL FEE $Z®'G)PLUS THE 5.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE Wn "17 r ('j� ix COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing 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 existing 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 Appliance #2 Type Appliance #3 Type Total Appliances Common Vent Type _ BTU Input _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Vent Height Diameter inches 11111111111110— 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: CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Effective On January 1, 200( Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES q7% JOB ADDRESS_ (Oa// S�"' S n RATE SCHEDULE ULE Residential Rate TOTAL OWNER_S.I Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 $ 30, D o BUILDING USED AS �lW III 11/1 q (Side Vent - Fill Out Back) ESTIMATED COST aha®o PERMIT Gas Piping (Needed with new furnace, $ 10.00 $ NO. but not replacement) Gas Range DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ Gas Dryer $ 10.00 $ No. of Heating nits Circle One (Steam) Hot Water) Warm Air Trade Name QY1f 1 IU—Size No. *Air Conditioning - All Sizes $ 25.00 $ BTU HP EDR Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ ' BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ .21a o The undersigned hereby makes application for a permit for the work herein State Surcharge $ 50 specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE $ 30-0 representations stated in this application are true and correct. DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed TEL # S% ajq REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In DateFinal Date 1:247- written permission from adjoining property owner. ,� 4�0'0y/ S`"" '5�' fi F , kolld7 COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing 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 (k�'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 (k�-<o ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (Vj"'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 (y' 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 (v�`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 (L-I'No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type Fuo BTU Input (o,&, evo Fan Assisted or Nat FAIV Appliance #2 Type W a& BTU Input 38Q" Fan Assisted or Nat A10 -K Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input q.1, "v Common Vent Type P`Vent Height ��_ Diameter P' inches Appliance #1 Vent Connector Height _Zft Length _L_ft Diameter in Type %3 Appliance #2 Vent Connector Height _j_ft Length _ft Diameter min Type 0, Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO:'i Signed By: Date: SUBJECT City of Fridley 355 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. 1 fr __--� COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. � NUMBER REV DATE PAGE OF APPROVED BY �•"1 CITY HALL FRIDLEY 55432 763-571-3450 910-F15 5/27/03 JOB ADDRESS 6041 5 Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED OESCR. 8 2 1 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ryan & Sara Gantner 6041 5 Street NE 763-571-7906 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Custom Remodelers Inc 474 Apollo Drive, Lino Lakes MN 55014 651-784-2646 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 1748 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Replace one window in existing opening and wrap window 9 CHANGE OF USE FROM 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. Caulk and flash all exterior openings. it InspecHA= Cards Will B6 Mailed TO HOMeowner To Post 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 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 $1,838 $.92 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 $66.20 Fire SC 1.84 PLAN CHECK FEE TOTALFEE License SC $5.00 $73.96 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT 4DATE, WHEN PROPERLY VALIDATED THIS IS YOUR PE IT SIGNATURE OF OW NEA iiF OWNER BWLDE Ri iDATE, SLOG INSR �__ T1ATE NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 2m-LM401f] -W-j4--V' Legal Description: / Owner Name & Address: �-j ,`�i W 4( Tei. # 76-6-S-11 '' q D I Contractor. MN LICENSE # Address: -4-74E() i Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: _ Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 5ra -© d- APPLICANT: Tel. # 7 (0 Llb -age, Jw t) -t - CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing In application Permit Fee $ ® Fee Schedule on Reverse Side Fire Surcharge $ �, �i'+ .001 of Permit Valuation (1/10th%) State Surcharge $ Q $.50/$1,000 Valuation SAC Charge $_$1 100 per SAC Unit License Surcharge $__5 SL_$5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 13.q6 STIPULATIONS: Building BUILDING Permit No.: 7g, -t� (P Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY 'd, &j9 DATE 10/19/09 youREmAILADDRFss estherd®probuiltam.com sITEADDRESS 6041 5th St NE THIS APPLICANT IS: 0 OWNER 000NTRACTOR PROPERTY OWNER! NAME: Kate Karrick TENANT ADDRESS: same as site CITY STATE ZIP PHONE: CONTRACTOR NAw: ProBuilt America STATE LICENSE # BC -20356847 EXP DATE 03110 551Q9 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 2211 11th Ave E cry North Sin STATE ZiP WITH APPLICATION PHONE 651-770-9315 FAX 651-770-0495 PROPERTY TYPE 0 SINGLE FAMILY/NEW CONSTRUCTION SIZE 0 TWO FAMII.YA MW CONSTRUCTION STORIES PERMIT TYPE 0 ADDITION O GARAGEISHED 0 wINDOwS 0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE 0 DECK 0 SIDING 0 OTHER 0 SW M3ofl NG POOL TYPE OF WORK: I 0 NEW 0 ADDITION 0 MAINTENANCEMEPAIR 0 REMODELING DESCRIBE WORK BEING DONE: Replacing 7 window, SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. $WFR1iG 0 HOUSE ONLY NUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 0 ATTACHED GARAGE 1. Existing Floor Plan2 SIZE: O DETACHED GARAGE 3. flow plan List of sttucMW members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vicryl OSoffit ADDITIONS. & PORCHES SUBMIT: 0 Alomiumn 0 Trim 1. Site PlantsurvW showing the existing structmes 0 Other 0 Fascia and proposed project 2. Two sets ofconWw ion plans VViDOWS IN EXISTING OPENINGS OYes 0No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & 7 TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS.- (USING ATERIALS:(USING THE 1997 U.B.0 FEE SCHEDULE) rl rl Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge :t v is tt $ lQ 9 See Back Page for Fee Schedule $ 650/o of Building Permit Fee $ d'll 9 .001 times the total job valuation $ 9 C1' .0005 x Permit Valuation Minimum $.50 $ 19 ,G) 0 $5.00 (State Licensed Residential Contractors) $ $1675 per SAC Unit (Plans to MWCC for determination) $ i3+6$= $x$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) 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 Esther Dahl DATE 10/19/09