Loading...
PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT 4721 Date: Owner: �- _ .. Builder ''"..... r Address Address _ V LO � 10 - F BUILDING No.....�. Street _.. -' $ __ _.�....._... _,e........._.._..._..... Part of Lot ....._ ._..._ _.._.__.._._ Lot 0-7 ................ Block .... __..... ......t Addition or Sub -Division{, . �`�,P ""-., ..__..._ Corner Lot ...... ..................._..... Inside Lot ..----------........----- Setback ....._ _ .... Sideyard....._.fi.•t.._........_......-....._............-........_ Sewer Elevation ....._.._....._.._......._...._....._------------- _.......... _--- _............._------- Foundation Elevation DESCRIPTION OF BUILDING Tob Used a � ' Front ._"_.. Depth *Z/— Height _... Sq. Ft.. i/' Cu. Ft /-;% .,r�r ' ..... .............. _............ .......................... Front ..... ............. ._.. Depth ............. ..,g Height ............ �.._.. Sq. Ft. ...................... Cu. Ft. ................... - Type of Construction ......�6- Est. Cos ...V4-�-.?.2Cp':._" " To be Completed .................. _........... -....... L �-rHORIZE ViOLAT- Ia .,A �'E LAAAD COVENANTS AND L41Jt DING RCIETFi1trTICNS. 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 elation f any of the provisions of said ordinances. ,R ` fs'' �'' 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. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builder Address Address -LOCATION OF BUILDING No.Street J Part of:Lot Lot Block 21 Addition or b.Div. �/ - r t Corner Lot Inside Lot_ 1� Set Back J Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used -'as t ce ont ® Depth Height' t Sq. Ft. Cu. yt. �® Front Depth Height` Sq. Ft. ��Cu. Ft. Type of Construction Estimated Cost 08 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 LSIGNATURE =—S (A Schedule of Fee costs can be found on the Reverse Side.) 4 MlINDEaF.AwGINEEniNcy CoolINCO ENGINEERS AND SUIZV MORS LAND OUQVEYINO SOILS TESTING CIVIL &. MUNICIPAL ENGINEERING LANO PLANNING G418-5GT" AVENUE N. MINNEAPOLIS 2-f. MINN. KE 7- BG37 C a or i N i ftfa,t ff *IF 1110 lri► fi r' SURVEY t"or-� TOM SILVIS Ul Cid I�- iI i LC) I` --- - — 14 � I WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND P$OVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF AmY, THEREON , AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. MINDER ENGINEERING CO., INC. DATED THIS DAY GF ti7V ' A.0.195� ENCa11.lE R.�i AND Sy1RYE ORS • bye City of Fridley Application for Plumbing and Gas fitting Permit Dept. of Bldgs. Phone SII 4-7470 T DESCRIPTION OF WORK 6�.9 Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE TOTAL Number Fixtures x $1.50 $ • 01c, 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 $ • 6a New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $�0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & A.LTERATIONS—Refer to Code Description................................................$ TOTAL FEE $° City of Fridley: The undersigned hereby .makes application for a permit for the work herein specified, agreeing to do All work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn Q;ly`=� Owner e;�� Used as To be completed about Estimated Cost, $ Old—New. Building Permit ROUGH q-,2 5' -'' 0 FINAL 4 z 2M 7-59 (9 �n0 F N WATER HTR. GAS ELEG Base / 1st 2nd _ 3rd _ 4th _ • Future Connection Openings Connected withI Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE TOTAL Number Fixtures x $1.50 $ • 01c, 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 $ • 6a New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $�0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & A.LTERATIONS—Refer to Code Description................................................$ TOTAL FEE $° City of Fridley: The undersigned hereby .makes application for a permit for the work herein specified, agreeing to do All work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn Q;ly`=� Owner e;�� Used as To be completed about Estimated Cost, $ Old—New. Building Permit ROUGH q-,2 5' -'' 0 FINAL 4 z 2M 7-59 I Application for Power Plants and.. Heating, Cooling, Ventilation, .Refrigeration �d Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace S1.hell & Duct Work to 120,000 BTU ............ 8.00 $ $ a/ each add. 60,000 BTU .... . .................. 2.00 $ _ Replacement of Furnace . §.00 $ Repairs & Alterations—up to $500.00 ...:a ............ 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STE}1M or HOT WATER SYSTEM Yurnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $�� GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... x $1.50 $--L Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL I= $ ROUGH FINAL Dept. of Bldgs. Phone SII. 4-7470 Location to � :1 t S City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley,Minn-��-�� a'� 19 %Si Owner Kind of Building �� \ Used as To be completed about Estimated Cost, $ Old—Ne,Building Permit No. Permit N..'Z /�'�� DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water, nW � No c Trade Name �^� Size No Capacity 100 2 o O O Sq. Ft. E.D.R BTU H.P. Total Connected Load 32 R c? !< Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Sign By 4 z 2M7-,99 Business Phone No wl-�-� 3 - [ l 6- 9 t P,� , '�' � ,' -«a`� ;v_. _.sy. %� '•fir . , Vn ti d ? � pg' I �Pgnr.� i , 47 7 �, ski'^ f�w,�.•. 1' �y.r tl II v'a - -. .. - -- y �j �d5��'i. Pl �' «r °1tRr�t+w+a fiRd FJ-' Cen.'_,-r„ , �,g�� Aq f Q E..n 7:' �,rr 1� k: �5�,�� '�ti- ' I — — — AP® _...R��" w8px"rn•, I pgR'"R^---_.---_ 1, -. ;.r�--+--- ., ..0 n .•.��.. fo.._._j caw ..4 0666 Reqmimd 6qa #L F-DP mq. ;Am. '�✓� '�z 111 f - � �. � � $.ca�uy� :�. +Ap1�IR,M � F »-- }`�'�aR►�R f '� � .. _ � ppb�rrrr t rt�h�et�i R A6 @I.l sant - f ?irnr Vim,, "NO 16�E_R� bf era,_? rra�&� � .._._._ �;, f � '79®lnM� Al �,. r Zs. >� .a' (� > •_ -^--t`._.Ls`.:k..t.. �.'"..�'..,�__.:rr.;:..:x ' c.� �h .:, ,rte •��""" ay - ra ung '-"W4 nFlow 4no � ��. ea L i,, tb - - City of Fridley, Minn. BUILDING PERMIT w?s0 2 Owner: Builder Address _ LO ION OF BUILDING No. Street Part of Lot A. Lot � �--__ Block Addition or SO.- !204 , Corner Lot _ Inside Lot — offSetback ideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To as: Front Depth Height Sq. Ft. �Cu., Ft 6 O Fro Depth ---- Height Sq. Ft. Cu. Ft. Type of Construction _ Est. Cost 4�4r=.e.rr 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 ail 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 upon violation of any of the provisions of said ordinances. Building Inspector NOTICES ffib permh don sof cover the condructioe, hafeMon for wkh*, Plumbing, gn hearing, sewer or wabr. Be son to we the Building hopedor ler spm to pormits for thea Nona. - 0 40 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name ` Builde -; e' Address Address LOCATION OF BUILDING No.� Street���;Part of Lot Lot_z","A;�,, _ ,,� Block „� Addition or Subdivisio -� Corner Lot Inside Lot Setback LSSide-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 FrontDepth Height i Sq. Ft. FrontDepth Height Sq. Ft. Cu. Ft. _ �i Type of ConstructionEstimated 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 of Fridley Ordinances and ruling of the Department of Build ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SXMMTUFX (Schedule of Fee Costs can be found on the Reverse Side) . City of Fridley, Minn.. BUILDING PERMIT i Date: JULY 10, 1965 Mit. THEISEN Builder RECEIPT N0. 29701 N? 8169 CHESTER GLISAN REALTY CO. Address 6171 - 5th St. N. E. Address 519 - 10th St. N. W. Fridley 21, Minnesota New Brighton, Minnesota LOCATION OF BUILDING No. 6171 Street 5th St. N. E. ` part of Lot Lot 27 _ Block 2 Addition or Sub -Division ._ Uplands, 2nd Addition Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation _ Foundation Elevation To be Used as: Front Front Type of Construction • STORM DAMAGE REPAIRS i DESCRIPTION OF BUILDING Depth Height Sq. Ft. Cu. Ft. Depth Height Sq. Ft. Cu. Ft. — Est Cost 0,000,00 To be Completed In consideration of the issuance to me of a permit to constru a building described above I agree to do the proposed work in accordance with the description above set o and complian th a'!1 provisions of ordinances of the city of Fridley. a inconsideration of the payment of a fee of$ 10,00 , permit is hereby granted to CHESTER GLISAN REALTY COMPANY to construct the building or addition as described above. This permit is granted upon the ery condition that the person to whom it is granted and his agents, employees as workmen, in su work doneFridlnnesota iti:gardi>zg ion, yn etioal8 time uponola'tionany of the provisions of�said within city limits and thisordinan ALLEN G. JENSEN Building Inspector NOTICE 'Olde pam b den not eewr the eonshucHm, hm tdWlen for whine, phmd tne, an heathm sewer er water. Be son to see &e BuNing luspnter for apmft permhe for thea hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME ADDRESS 0 %2 �y ADDRESS�2y / I v LOCATION OF BUILDING N0. STREET PART OF LOT LOT .27 BLOCK ADDITION OR SUBDIVISION 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 location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Dept h Height Sq. Ft. Cu. Ft. Type of Constructior �timated Cost 7 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_ 7 J �°— 6 > SIGNATURE r (Schedule of Fee Costs can be found on the Reverse Side). °n&d • • PERMIT for Power Plants and Heating. Cool- ing, Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Heating Plants to be installed—altered—repaired Make Size ; Oil fired ; Coal fired ; Gas fired ; Gas Authorization No, Remarks Approved Final Inspection 19_ Inspector Permit N° 4704 Fee $ Office of the Inspector of Buildings City of Fridley City of Fridley, Minn., 19�Q Owner Location Z %�- `, �%�". A). 9— Kind, Kind of Building How Occupied(.t��Ja Work to be Commenced ,19_ To be Completed 919-0 Estimated Cost, $ YAC . D (CONew, Building Permit Permission is hereby granted to to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition tha&Ze persorltow it granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, gnd to the specifications set forth in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings 42 2M 11-67 V City of Fridley 53-84-S-915.51 Applicc-fanforr,.:rrand C7= FIMIng Dept. of Bldgs. Phone 980-3430 DESCRIPTION OF WORK '6171 N. E. 5th. Street Number, Kind and Location of Fixtures I'OCRHGI •�O S.�• ` � S Z fi C _ U� 5 < (79 1�9 q�. t71 G7 • • • N WATER MTA. GAS FLEC. Base 1st Intll Gas Grill 2nd 3rd 4th_ • Future Connection Openings • Now Fixture, Old Openings Coeunoelod wish Sower � Ccsapool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................. x $2.00 $ Future Fixture Opening ........... x $1.50 $ New Fixture Old Opening .....:.... x $1.50 $ Catch Basin .. x $3.25 $ Water Heater ;Up to 99,000 BTU) .... x $3.00 $ New Ground Run Old Bldg...... x $3.25 $ Electric Water Heater............... s $2.00 $ -VAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $2.00 $ Additional Fixtures ................. x $ .75 $ Gas Range to 199.000 BTU ............ x $5.00 $ City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the Citi Ordinance and ruling of the Department of Buildings, and ' hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn 6-25-74 19. Owner James R. Erickson Kind of Building Frame Res. Used as To be completed about 7-2-74 Estimated Cost, $ 10.00 . Old—MM. Building Permit No. Permit No. Signed By— Business Phone No ROUGH REPAIRS & ALTERATIONS—Rotor to Code .50 State Surcharge Description .... Installs Gas, Grill .............. 5.00 TOTAL FEE $ 5.5o Class -A® Surcharge .500 SUBJECT PERMIT N:0 �,_:\_ City of Fridley 112 '19821, AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. L • COMMUNITY DEVELOPMENT DIV. / r PROTECTIVE INSPECTION SEC. 1 � i CITY HALL FRIDLEY 55432 �.j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/10/89 JOB ADDRESS 6171 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 27 2 Upland 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ,Tames/Hilda Erickson 6171 - 5th Street N.E. 571-1753 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 XHK1 XX Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 20' Shed in Rear Yard 9 CHANGE OF USE FROM TO STIPULATIONS Remove existing shed within 30 days of completion of new shed. Maximum height of new shed is 14 feet. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 $1,500 $.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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE A. $30.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT BLDG INSP O - GATE SIGNATURE OFOWNER 0FOWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/86 ADDN. f R-1 AND R-2 I 1 ALTER. [ ] Building Permit Application Construction Address: P, 7 T)% -5- 7-. /1-6 Legal Description: Z e r' a 7 ®c,'e �, 4'& wp jNp D.D Tia T `3 Owner Name & Address: �� �5 Ao a ' R/C %/-S®!V Tel. # S71 -/7s Contractor Address 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: ® ` �' �' ? -'�r 0 Corner Lot [ ] Inside Lot [v1 Ft. Yd. Setback Side Yard Setback Type of Construction: 4/oe.A Estimated Cost: $ Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: `/ APPLICANT: a � Tel. 7/ - 0-S CITY USE ONLY Permit Fee $ :�O.EX9 Plan Check $ -r— State Surcharge $ "07:50 SAC Charge $ Park Fee $ Sewer Main Charge $ TOTAL $�i"s' STIPULATIONS: Q)X en J A-A__k0a-L7Z% MV -10 11490 Fee Schedule on Reverse Side 25$ of Building Permit Fee $.50/$1,000 Valuation $ 55Q per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] wG - IS, CW zeo,o0 R L- /I A 1 / At E�A-S T SUBJECT City of Fridley 20302_, AT THE TOP OF THE TWINS ? BUILDING PERMIT 1 RECEIPT NO � • COMMUNITY DEVELOPMENT DIV. (� ______ r PROTECTIVE INSPECTION SEC. � 8 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/17/90 10B ADDRESS 6171 - 5th. Street N.E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 27 2 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE James Erickson 6171 - 5th-Street N.E, 571--1753 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City Exteriors 6000 Bass Lake Road, Crystal, MN 55429 533--9201 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 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 $7,100 $3.55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $99.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. P N CHECK FEE TOTAL FEE $102.55 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) N HEN PROPERLY V D TED THT IS YOU{R/- PERMIT BLDG )NSP f1A E SiGNATURE OF OWNER) IF OWNER BUILDER) IDATEI NEW [ ] CITY OF FRIDLEY Effective 1/1/90 ADDN ( ] R-1 AND R-2 STM [ Building Permit Application Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn an it to scale. IPFIC�T OF naiuvEMERr LIV7M AREA: Length Width Height Sq. Ft. G RAGE AREA: Length Width Height Sq. Ft. DiDCIC AREA: length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot ] Ft. Yd Setback Side Yard tbacks Type of Construction: p �` Estimated Cost: $ r 7/00, Approx. Cmpletion Date:ZIY- f2 Proposed Driveway Width If New Opening I Desired: Ft. $ $ Wi + 6' See Back Page DATE: APPLICANT: 141 Tel. # CITY USE ONLY Permit Fee $ State Surcharge $ SAC Marge $ Driveway Escrow $ Park Fee $ Sewer Main Omrge $ STIPULATIC KS: Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT'PERMIT NO. City of Fridley 2 6 7 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ar 4gg � � 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 7/23/98 JOB ADDRESS 6171 5th St NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 27 2 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James. Erickson 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. All American Roofing & Remodeling 786-6676 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5160 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION M REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (24 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 2001 $1.00 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. $74.75 Fire SC $2.00 PLAN CHECK FEE TOTAL FEE - License SC $5.00 1$82.75 I NA U EOFCONTRACTOR ORAUTHORIZED AGENT IDATEi WHEN PROPERLY BLD ]NSP LIDAT 0 THIS ISS R PERMIT P MATE S.GNATURE OF OWNER OF OWNER BUILDER] IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 � lop - BUILDING PERMIT APPLICATION ConstructionAddress: L 1 `' ST !� Legal Description: Owner Name & Address:�� f S r /�,��,�S�s�J Tel. # Contractor: A LL A MEP_1CJW e 6 of i n C� (Ze mode 1 t r`y MN LICENSE # S l la o Address: yltLry a)f- , Istct(he SSoty Tel. # -I -a-c_ "iG 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 Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Q Ow a-&, e `F S Teaw-o�� Construction Type: Estimated Cost: $ Cx (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # eA CITY USE ONLY Permit Fee $ %S Fee Schedule on Reverse Side Fire Surcharge $ D 0 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ GYM $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 $ ?S, STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 6/20 5" Sf A-I1✓ 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 $ 30.00 $ representations stated in this application are true and correct. _ (Side Vent - Fill Out Back),1996 Gas Piping (Needed with new furnace) $10.00 $ r OWNERTGLI°Yli✓S -enc- iso /'1 Gas Range $10.00 $ BUILDING USED AS Gt(d) •2 P i ri q Gas Dryer $10.00 $ / / ESTIMATED COST l :5OOo D6 PERMIT NO. l �-�- *Air Conditioning - All Sizes $ 25.00 $ QS-, 00 gr yam,+ 5&3c0x oa`f DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Word $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State'Surcharge .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEES 5-0 ELAINE HT©. A/C ELECT., INC. 13662 CENTRAL AVE, N.E. HEATING C ANY N 55304 MINIMUM FEE FOR ANY HEATING( COOLINGNENTILATION o REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved ByRough-In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SI4ER STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CEMWgEY 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's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE 1) -'7,x"' APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $10.00 $ 25.00 State Surcharge TOTAL FEE Effective On August 1, 1995 JOB ADDRESS ,�,f ,7/—.. �-51%�� The undersigned hereby makes application for a permit for the work herein TOTAL 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. ,�c� 1 $ /% . BUILDING USED AS ESTIMATED COST /y7� PERMIT NO. �L DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ ,� Fuel, ` Total Connected Load 50 Burner Trade Name Size No. BTU HP EDR HEATING COMP&/}Jyi�il�C MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Signed Tel No �� 3�/✓�y� Approved BYA Rough -In Date Final Date FILL OUT BACK SIDE FCA STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATIO 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's connected Yes ( ) No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes (} No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CCIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 February 11, 2002 James Erickson 6171 5`h Street NE Fridley, MN 55432 Re: Final Inspection at 6171 5`h Street NE Contractor: Reliant Energy-Minnegasco-Blaine Heating Dear Mr. Erickson: A mechanical permit was issued on November 7, 2000, to hook up a dryer at your address. According to the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the work authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspection to make sure the work was completed according to the Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. OCT -20-2005 11:23 CITY OF FRIDLEY 3uilding Inspections 763-572.3604 )ATE_t®/'"� -L 1 ' 0 � WM ADDRESS (P %'l I V PHIS APPLICANT IS; PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING Pennit No.,_Q RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY Date Rev'd/ YOUR E-MAIL ADDRESS ❑ OWNER ONTRACTOR DESCRIBE WORK BEING DONE: SIZE OF M'ROVEMENT LENGTH �vvr ul� Q 1 -LOUSE & GARAGE NUMBER OF SQUARES GARAGES ❑ ATTACHED GARAGE PROPOSED SIZE: O DETACHED GARAGE PROPOSED HEIGHT' M DATE .2, 1 C0IC ❑ DRAIN TILE D OTHER SING OSoffit 0 vinyl M Alumm a inuTnm Fascia ❑ Othcr O WINDOWS IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & NUMBER OF WINDOWS TYPE OF WINDOW BE QdSTALLED ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF (USING THE 1997 U.B.0 FEE SCnEDULE) -rrl P. 02/03 A41 z�P HEIGHT _ Sq. Ft. BASFbUNTItF.MOD1EL&9 U5yT_ 1, Existing Floor Plan 2. Proposed floor plan 3. List of structural rnernbers to lu usad FOR NEM CONSTRUCTION INCLUDING DECKS, ADDMONS- A PORr'I� ES SUBMIT_ 1. Site PbmiSutvey showing the existing struemms and proposed project 2. Two seta of construction plans 3. Encrgy Calculations NAI1' I TOTAL JOB VALUATIONS Permit Fee plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ See Back Page for Fee Schedule $ NA11M- $ STATE LICENSE A $ .001 z Permit Valuation (11100%) $ -% ADDRESS4—�Z—I— $ 014E �y1 (� FA: GLE FAMII.Y/NEw CONSTRUCTION ❑ TWO FAMILYA-MW CONSTRUCTION ❑ ADDITIONGARAQE/SHl $ O BASEMENT FINISH ROOF ❑ DECK 0 SIDING rAake checks payable to: City of Fridley Attach D SWMOANG 1 DESCRIBE WORK BEING DONE: SIZE OF M'ROVEMENT LENGTH �vvr ul� Q 1 -LOUSE & GARAGE NUMBER OF SQUARES GARAGES ❑ ATTACHED GARAGE PROPOSED SIZE: O DETACHED GARAGE PROPOSED HEIGHT' M DATE .2, 1 C0IC ❑ DRAIN TILE D OTHER SING OSoffit 0 vinyl M Alumm a inuTnm Fascia ❑ Othcr O WINDOWS IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & NUMBER OF WINDOWS TYPE OF WINDOW BE QdSTALLED ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF (USING THE 1997 U.B.0 FEE SCnEDULE) -rrl P. 02/03 A41 z�P HEIGHT _ Sq. Ft. BASFbUNTItF.MOD1EL&9 U5yT_ 1, Existing Floor Plan 2. Proposed floor plan 3. List of structural rnernbers to lu usad FOR NEM CONSTRUCTION INCLUDING DECKS, ADDMONS- A PORr'I� ES SUBMIT_ 1. Site PbmiSutvey showing the existing struemms and proposed project 2. Two seta of construction plans 3. Encrgy Calculations NAI1' I TOTAL JOB VALUATIONS Permit Fee plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ See Back Page for Fee Schedule $ 65% of Building Permit Fee $ ("0005) times the total job valuation -- Minimum $.50 $ .001 z Permit Valuation (11100%) $ $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) S— ft+6ft= 9x$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ rAake checks payable to: City of Fridley Attach I hereby apply for a building p, conformance with the ordinances permit but only an application plan in the case of all work , SIGNATURE OF THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED P and I acknowledge that the information above is complete and accurate; that the work will be in codes of the City of Fridley and with the MinnesotaConstruction Codes; that I understand this is not a ermit and work is not to start without a permit; that the work will be in accordance with the approved requires review and approval of plans. 16 PRINT NAME/ DATE --- , —`--- From: unknown Page: 1/2 Date: 12/6/20101:56:11 PM Building MECHANICAL permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY .� � 763-502-4977 FAX � EFFEcnvEz-19-o9 DATE 1118110 YOUR E-MAIL ADDRESS dave®devesheatingandalr.com SITE ADDRESS 6171 5th St NE THIS APPLICANT IS: I7 OWNER 13CO'NTRACTOR PROPERTY NAME. JAMES ERICKSON OWNER/ TENANT ADDS: 61715TH ST NE CITY, FRIDLEY STATE MN �P 55432 763-571-1753 _ PHONE: _ CONTRACTOR COMPANY NAME: DAVE'S HEATING, AIR 8 ELECTRIC SU MIT A COPY OF CONTACT PERSON: AMY MADVIG _ YOUR STATE STATE LICENSE 0 EXP DATE LICENSE WITH ADDRESS.- 1601 37TH AVE NE CITY COLUMBIA HEIGHTS STATE MN Zip W21 APPLICATION PHONE 763-781-6801 FAX 763-789-8805 PERMIT TYPE �NGLE FAMILY ❑ TWO FAMILY CI TnwNHOUSE TYPE OF WORK. ❑ NEW MIEPLACEMENT O ALTERATIONIREMODEL DETAILED DESCRIPT[ON OF WORK LENNOX CENTRAL AIR M# XC14-024 FEFS ARE BASED ON $10.00 PER FIXTURE. F.XCF.PT WHERE NOTED. FIXTURES. (INDICATE TOTAL NUMBER OF EACH BELOW) Equipmeiu meddled MFG: MODEL: + SIZEATU MPG: MODEL: SIZE/BTU MFG: MODEL: SIZFJBTU C $25.00 FIREPLACE (GAS) $15.00 GAS RANGF,IOVEN $10.00 41R. TO AIR EXCHANGEER $1 S TREPLACE (WOOD) $35.00 NEW GAS (BRILL $10.00 _BOILER $35,00 1 lURNACE $35,00 GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 J==JAS DRYER $10,00 BEATER $35.00 _POOL DUCT WORK $10.00 _GAS PipING$10.00 VENTILATOR $0.00 Number of fixtules @ $10.00 x $10,00 = $__. Number of fixtures @ $15.00.. _ _ x $15.()0 w $ Number of fixtures @ $25.00 1 x $25.00 = $ 26.00 Number of fixtures @ $35.00 �- x$35= $ State Surcharge $00 INIMUM REE $35.50 T T14IS IS AN APPLICATION 116K 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 the1 cesatiand codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only, app icon 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 dase of d1l work which ires reapproval of plan . ((� SIGNATURE OFAPPLIC NT �1 �✓ RINTNAME PLEASE NOTE: SEPARATE PERMM I ARE &5 IRE FOR BUILDING f LB : CAL AND MWAANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 I From: unknown Page: 2/2 Date: 12/3/2010 2:38:47 PM Building MECHANICAL Permit No.: 7 b Inspections RESIDENTUL APPLICATION Received By: 763-572-3604 DAM `F CITY OF FRIDLEY 763-502-4977 FAX EFTECT1VE2-19-09 DATE 11/8/10 YOUR E- AIL ADDRESS daver&avesheatingendair.com SITE ADDRFSS 6171 5th St NE THIS APPLICANT IS: D OWNER DCONTRACTOR PROPERTY NAME: JAMES ERICKSON OWNER/ ADDRESS: 6171 5TH ST NE CITY FRIDLEY STATE MN ZI.P 55432 TENANT PHONE -.763-571-1753 CONTRACTOR COMPANY NAME: DAVE'S HEATING, j UR 8 ELECTRIC SUBMIT A COPY OF CONTACT PERSON: AMY MADVIG YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 1601 37TH AVE NE CITY COLUMBIA HEIGHTS STATE MN ZIP 58421 APPLICATION PHONE 763-781-8801 FAX 763-788-8805 PERMIT TYPE F71NGLE FAMILY O TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: D NEW OEPLACEMENT 13 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK LENNOX FURNACE- M#SLP98UH070V36B-01 FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Instullad MFG: — MODEL: mm"u-nvu— SIZII/BTU "Wo MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU C $25.00 TFIREPLACE ()AS) $15.00 _GAS RANGE/OVEN $10.00 IR TO AIR EXCHANGEER $15 REPLACE ( OOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 RNACE $3 ,00 OAS UNIT HTR $10.00 ,CHIMNEY LINER $10.00 k_—JAS DRYER 10.00 POOL HEATER $35.00 DUCT WORK $10.00 OAS PIPING 10.00 VENTILATOR $15.00 Number of fixtures @ $ l Q.00 _ x $10.00 = $ Number of fixtures @ $15.00 _ x $15.00 — $ Number of fixtures @ $25.00 _ x $25.00 = $ Number of fixtures @ $35.00 1 x $35.00 - $ 35.00 State Surcharge = $ .50 (MINIMUM FEE $35.50 Total. $40.00 THIS IS AN APPLICATION F R A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge th t the information above is complete and accurate; that the work will be in Fridley conformance with the ordinances and codes of the City of and with the Minnesota Construction Codes; that I understand this is not a permit but only plication 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 c e o all work whi vires r vi w and approval of p ns. _ ^ �' �� SIGNATURE OF APPI,ICA T PRINT NA TEAk--%— PLEASE NOTE: SEPARATE PE MTS ARE RE ED FOR BUILDING; ELECTRICAL AND NMWKHANICA.L WORK, City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-36041 FAX: 763-502-4977 1