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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N?5195 Date: .... _.., Address Address _ OCAT OF BUILDING No- /4043k Street : e" +� _ _ P o Lot Uh Lot___ Block Addition or Sub -Division. r Corner Lot ___ _ r Inside Lot Setback _sY Sideyard Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING To Used W zz Front Depth Height Sq. Ft CLi Cu. FtJ A" Depth Height Sq. Ft Cu. Ft Type of Construction 0o Est Costl. 4;;-5... �- ._"_o 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 aft 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 building lis within the city mits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. --% ^ 'e? -•.....,i Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, easheating, Sewer or water. Be sure to we the Building Inspector for separate permits for these items. 6 -460-�. , - 10 .APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY; MINNESOTA Builder 5 Owners Name _ , Address- Address LOCATION OF BUILDING No. 43-l< Street �� Fart of Lot Lot,,. �. • Block Addition or Sub.Div• Corner Lot Inside Lot__,L�,_Set Back 5� 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: Front �' Depth K� 'Height Sq. Ft. �K . Front Depth Height Sq. Ft. Cu. Ft. Type of Construction /`/' Estimated Cost To be completed The undersigned hereby makes application for a permit for the work herein specified.,' - agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares thatall the facts and representa- tions stated in th s application are true and corre#, DATE `,`,� SIGNATURE F (A Schedule of Fee costs can be found on the Reverse Side.) 0 46 MINDER ENGINEERING lNe,Co., ENGINEERS AND SURVEYORS LANG SURVEYING SOILS TESTING CIVIL y. MUNICIPAL ENGINEERING LA-NO PLANNING 6418-SG'rw AVENUE N. MINNEAPOL13 77, MILAN. KE 'T- 3637 SURVEY FOR Tom :SIL.VI5 N LLi ` lRar: __....�1ROrJ P L r S-Ilb' 1 T) LA SrkLE I" 540. r , I M� T I ` 3. LO �I L 0 T 3 ���. L D®'N. WE HERESY CERTIFY THAT T1415 IS A TRUE AND CORRECT REPRE5ENTATI0N OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON , AND ALL VISIBLE ENCROACHMENTS, IF ANY FROM OR ON SIVA LAND. MINDER ENGINEERING CO., INC. DATED THIS OI►Y OF NOV. A.0.195 EV461N P-12 AND v%Ls by � � � '� ✓ ��Yoo�-�� 61K Application for Power Plants and Heating. Cooling. Ventil4tion..Re igeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE 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 $s -- each add. 60,000 'BTU ... _. .................. 2.00 $ Replacement of Furnace €§.00 $ Repairs & Alterations up to $500.00 ...:e ............ 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 TQTC%L 1st 3 Fixtures x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ - AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FFE $ A ROUGH- 61.X OUGH FINAL Dept. of Bldgs. Phone SSU. 4-7470 Loc aflo 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, P +nn {� % "`a , 18 Owner \ 1,Z)` �! �� 'c �1 n w u --i ci j�) Kind of Buildingt Used as? To be completed about Estimated Cost, $ Old—XesP.-BiMding Permit No. � Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade Name � O- Size NO—CGU I (r -i Capacity VI C) I)00 Sq. Ft. E.D.R BTU H.P. Total Connected Load (- T_ t 5 Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signers �J<-, C� -7—)\ 2 By. 42 ZM 7.59 Business Phone No City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: �1 K Gj y a x Z $ 0 = N Y� ui Z� Z O= 1.00 w ? 8 WATER HTR. � O 3Ci x 2.00 New Ground Run Old Bldg . ............ 3� 3.25 $ Q� $m NO. RATE TOTAL 1st 3 Fixtures ..........................T Z x F N GAS El EG 01 x .50 m� m x 2.00 OLL N LLp a3 c�a U4a (90 Base 1st f 2nd 3rd 4th ° Future Connection Openings Connected atilt New Fixture, Old Openings Seger Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ 0 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 1st 3 Fixtures ..........................T Z x $1.50 $� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FES DePL of Bldgs. Phone SQ 4-7470 Location (� -2 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, 11/finn_ L /0 V Owner Kind of Building 119 Usedas To be completed about Estimated Cost, Old—New. Building Permit No Phone Na- Connection Permit No . ........................................................ Water Sewer Meter Deposit 11 1 M-8-58 City of Fridley, Minn. N° 7734 BUILDING PERMIT �� 452 - Date: 52 - Date: dune 4, 1965 Owner: L. D. Nelson Builder Thomas S. Silvis Address 6231 5th Street N. E. Address S8 6o2o wynawood Road LOCATION OF BUILDING No. 6231 street 5th Street N. E. Part of Lot Lot 33 _ Block 2 Addition or Sub -Division Uplands, tad Addition Corner Lot Inside Lot Setback ` Sideyard Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost J30,00_ To be Completed • Stom damage repair • In consideration of the issuance to me of a permit to construct building described above I agree to do the proposed work in accordance with the description above set f and in c:ompliange with adl provisions of ordinances oP the city of Frldley. l l �, In consideration of the payment of a fee of $ 10-00 , permit is hereby granted toThomas S. isi lei; 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 paw thereof, shall conform in all respects to the ordinances of Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Allen Jensen NOTICES rob puma don not corn do cmdrudim, Ias aWan for whim& plumbing, gn hating, ewer or water. Be errs to ae tho Wring W" ter for aparaq permhe for thea Herm. Y _X% LOCATION OF BUILD NG No.� Street part of Lot LOT BLOCK 2- ADDITION OR -SUBDIVISION corner Lot Inside LOT Setback -. ':.. Side -'card ` SEWER ELEVATION FOUNDATIOW EL VATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF' BUMbUG'' To be used as; Front Dept 'Height ,. Sq. Ft. Cu. Ft. l Front Depth_y_Height` 5q. Ft. cu.'Ft. Type'of Construction $etimated Cost To be 'completed The undersigned hereby makes application for a permi't'for the'work herein specified, agreeing to do ail'work in strict accordance with the City of Fridley Ordinances and rulings of Che Department of Buildings, and hereby declares that all -the facts and represent ions ''stated in this' .application ar, t'rueand correct. DATES i� 6' siren URS: of Fee Costs can be found on the Reverse Side), n U L Proposal Proposal No. FROM ThO g S. 8ilTia Sheet No. 6M *=wood Pbad Date Wla., )dnn. 55422 544-3919 Proposal Submitted To Work To Be Performed At Name LaWrOMM Street aeon _ Cit), _ State-- Street CitY Mdley Date of Plans rchitect Architect----- State TelephoneNumber _ _Telephone We hereby propose to furnish all the materials and perform all the labor necessary for the completion of FA=fi-r"J r ahwthira ind_nnTbmlren carters- ranlaea roaring $, ding; rwlace two-see- r nair the aidaa Carniea; replace face boaida__r=m1r soffits, clean W nt�a• �.�place all broken id-do-slframes-COMWndtiinn windnUs nr tharoar parts —,Doom-replace--two eombinat" doara� r®jlaae front R. rte* daflr. Flown;-omal.- ad tiaish ask,-rept mes bath b f1mt entry-u 'f = t Chen US- G- mt 4 o ff; ale".fid-- Mde0oZata! all wS U M - AeMAMM—318=rml l i vi g rnem 061111109- pale& eiitr M exi:erio�r. exterior. 110ta. 23=W VOW-ce VMZ Meatdeer and rhe rk r21^Q4na. rep1nor, kitchen mink -_.Pjace three missinra arc=_ -:ells. All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of — Dollars ($ ), with payments to a ma a as follows: ^ur housand thrc:c hune.red thirty -ind no/1CC Ef-J;30.00 20"1 MAO& t Atm en CO2W.Mtian Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by y , Respectfully submitted Per Note — This proposal may be withdrawn by us if not accepted within Lea days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Accepted =n- XLM. Signatur ) ,' Date Signature ( TOPS FORM 3450 LITHO IN Y. S. A. 41 "If � � City of Fridley, Minn.. BUILDING PERMIT • Date: — May 9, 1967 Owners _, Larry Nelson • 0 Builder M Tom Silvis NO 9226 3 79 t// Address 6 231 5th S t . N.E. Address 6 020 Wynnswopd Rd ....._.. LOCATION OF BUILDING No. .._6231 Street __ 5th Street N.E. part of Lot Lot_ 33 __Block 2 Addition or Sub -Division ____ Upland 2nd Adda . Corner Lot _ _____ Inside Lot _ x Setback —_ _ Sideyard _ Sewer Elevation Foundation Elevation _ DESCRIPTION OF BUILDING To be Used as: Garage Front 19-6 Depth 24 Height 14 Sq. Ft, 470 cu, Ft Front __ _ Depth _ _ Height — Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost $2500 _ _ To be Completed August 1967 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 fo /and in compliance with.21,rovisions of ordinances of the city of Fridley. S In consideration of the payment of a fee of $ 7'00 , permit is hereby granted to Tom Silvis to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sura to no the Building Inspector for separate permits for these hens. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNERS NAME BUILDER ADDRESS },—i-ly/,n ADDRESS^G' LOCATION OF BUILDING N0. STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT x SETBACK SIDE -YARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form two certificates of survey of lot and proposed building location drawn on these two certificates. DESCIPTION OF BUILDING To be Used as: Front �y— Depth Height 17 Sq. Ft. Cu. Ft. Front Sq. Ft. Depth Height Cu. Ft. Type of Construction Estimated To Be Completed Cost "Z4"L) 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 Buildings, and hereby declares that all the facts and representations stated in this application ar9l-crue and correct. DATE _ Si (Schedule of Fee Costs can be found on the Reverse Side). To John Flora p2.; July 29, 1985 SpmdMcSSaW F rc -. NASIM OURESNI, CITY MANAGER'S OFFICE Subject DRIVEWAY CUT REQUEST PWSM-23-85 Larry Nelsbo, 6231 5th -.,Street, called Brian Goodspeed. He wants his driveway cut further back and says he would be willing to pay for the extra cut. Please talk to him and advise me of the appropriate action. Thank you, NMQ/ms M %r- Jones Company _ 5 To: Nasim Qureshi From: John Flora Dated: 7/29/85 We will discuss this request with Mr. Nelson, identify a cost, and attempt to have our contractor accomplish it with a direct billing to Mr. Nelson. JGF:jmo F0 SUBJECT PERMIT NO. City of Fridley 213 7 7 AT THE TOP OF THE TWINS BUILDING PERMIT i � C • _ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 IL -'""j". , 612-571-3450 910-F15 6/4/92 JOB ADDRESS 6231 5th Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 33 2 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roxanne Ricci 6231 .5th Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Bob's Sheetrock & Tape 726 Edmund Ave, St Paul MN 222--3053 6335 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sczuares).2nd Layer 9 CHANGEOFUSEFROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 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 $1,060 $.53 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- $27.00 Fire SC $1.06 �QfjLCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE l'{\ Z License SC $5.00 $33.59 NATUREOR OR TAUTHORIZED.GEN (DATE) HEN OP LY TED THIS IS YOURPERMIT �-5=(?� LD11-421,"P DATE SIGNATURE OF OWNER of OWNER BUILDER) IDATEI F0 NEW [ ] ADDN [ ] ALTER [ ] Construction Address: Legal Description: Effective 3/1/92 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Owner Name & Address: Ra k an ne (['r Tel. # Contractor: a oe MN LICENSE # f 6 (0 3 3 Address: 7�I U 1V 11 d � 2 Tel. # —222—' 3 0 5-3 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 HgtlGround Sq. Ft. OTHER: k ey r LAED 6,4K6F —k® D o S .2 Jtr0 L4 Y E -/Z Driveway Escrow Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: P-16 C�-&5S W10J bL, C Estimated Cost: $ /060 $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: `� — l Z APPLICANT: obe V- S U C e Tel. # a22---13 �v CITY USE ONLY Permit Fee r$ c� % QO Fee Schedule on Reverse Side Fire Surcharge $ /, 0 !v .001 of Permit Valuation .(1/10th%) State Surcharge $ X53 $.501$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ 5-.00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ I Not Necessary [ ] TOTAL STIPULATIONS: N 01) SUBJECT IT NO. City of Fridley 3 3 294 AT THE TOP OF THE TWINS BUILDING PERMIT F , RE •COMMUNITY DEVELOPMENT DIV. 16 fr -----_ r E � PROTECTIVE INSPECTION SEC. y�'J� % V l`r17 NUMBER REV DATE PAGE OF APPROVED BY i ;'� CITY HALL FRIDLEY 55432 ----� L 763-571-3450 910-F15 12/13/02 1013 ADDRESS 6231 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 33 2 1 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Coleen Nelson 6231 5 Street NE 763-571-7884 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Concept Exterior Designs 12350 73 Ave N Maple Grove MN 55369 763-577-1900 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO, 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW D ADDITION 0 ALTERATION REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reside House; trim 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. Caulk and flash all exterior openings. 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 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 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 $9,400 $4'70 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. STR CTION THE PERFORMANCE` OF INSTRUCTION $181.25 Fire SC $9.40 PLAN CHECK FEE TOTAL FEE / ice se SC $5.00 $200.35 S-GNATURE OF CON'RACTOR OR AUTHORIZED AGENT iDATE. WHEN PROPERLY VALIDATED THIS IS Y R PERMI OG -NSP BATE S-GNATURE OF OWNEROF OWNER BUiLOER) iDATE, N 01) NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: /1�� Legal Description: Owner Name & Address: C�dl eefl /t/-EL5-0P*'-1 Tel. # 7G7 - 7Pkel Contractor. 0-cyxCej- EWIWi rie ©f5,10n MN LICENSE #�4a Address: / 275 7G; - ti ° Gam' �- �Ir�SS-��q Tel. # 7l?- S-7� 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: APPLICANT: Tel. #763°- 577 -/?00. 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 TOTAL CITY USE ONLY - $ Fee Schedule on Reverse Side $ /-/0 .001 of Permit Valuation (1/10th% $ 0 $.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'Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ 4dm 1 62S) STIPULATIONS: :,ITY OF FRIDLEY INSPECTION DIVISION b( Effective January 1, 2003 5431'University Ave NE ' -=ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, ;763) 572-3604 - REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 JOB ADDRESS G' a 3 S S FG RATE SCHEDULE Residential OWNER l�ev&_riff �rr�ne rs0 t� Rate Furnace Shell and Duct Work, Burner - TOTAL y BUILDING USED AS 'hE S�c��rLCes Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) ESTIMATED COST `�30®• CYX' PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) _ DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water)(arm Air) Trade m- Name C'_cx r r S Size No. ls�ll- ®� O Z. *Air Conditioning - All Sizes $ 25.00 $- BTU '-t©, Oo0 HP EDR "° Fuel �Av- 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 3ommercial/Industrial - Rv� .4- 1�0'�� CGLL( -7R-Z- a °t^ 1.25% of Value of. Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and 55 S� representations stated in this application are true and correct. TOTAL FEE $ DATE VIINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION CenterPoint Energy Minnegasco HEATING C013562 Central Ave NE, Anoka, MN 55304 REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 3LUS THE $.50 STATE SURCHARGE Signed aa�763--757=6202 REINSPECTION FEE $47.00/Hr FAX # 763-757-6701 'Air Conditioners can not be placed in a side yard without Approved By Rough -In Date' Final Date written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED r n MMnNyr=NT VENT r_f)NNFr`T Aran r`O I ISTI , When... ninn an emiction furaom, the undersigned.hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes (X) No( ) and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer Yes (�i No ( ) specifications including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly rer's specifications. and meets the current codes and man i F mace Venting Ttu ables for fan oes include AGA-GAMA Category I CentraYes (x) No ( ) assisted and natural draft appliances. The a GnMh, iminn airis sized and installed to meet the current codes Yes) No ( ) and manufacturer's specifications. When required to Installa ne��- ceme��sgmaij�jd will be sized and installed Yes No ( ) to meet the current codes and manufacturer's specifications. When lostallin .m, 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. insta Is the common vent and vent connectors sized: s been removed from the commonv vent alcorrectly after an appliance has and vented separately as per current codes. Yes f ) No( ) Yes (X) No ( ) Appliance #1 Type �� r �, Q e BTU Input "loo ay Fa�As or Natp BTU Input______ a or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type Total Btu Input Total Appliances Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Lengthft n Type Appliance #2 Vent Connector Height ft Length ft Diameter Diameter Type 3 ��� _— Appliance #3 Vent Connector Height —ft Length __ft Diameter in Type HEATING CO:CenterPoint EnP a. r• _ 13562 Centra] Ave NE, Anoka, MN 55304 Signed By: Date: `1-l4-®3 cw& mt. Energy Minnegasco ��''ii ADDRESS l,*wQ 31 61:1 J �' IVE OCCUPANT e ww-rjo^ HEAT LOSS Yes DATE HTO. INST, SOLD BY Electrical Work By Same TYPE OF HEAT FA SPACE HTR. II GAS DESIGN MAKE Qvud Model 4;SWA- D-70 Serial NPUT CQNTROLS THERMOSTAT WK 44 -® Heat Pi Value Limit S -le„ Limit Setting 17 0 Fan Setting Pilot Type or 5,JJ' e. caw;+.700 Pilot Make_ Pilot Model Pilot Timing 9P ca c Pressure '� S" w Pement CO2 711 nput CFH -77 02 7 Stack Temp, 3'7S ' Pement COQ APT. FLOOR CITY OWNER \ �vv%e, INSTALLED BY int Gas Line By ^'e UNIT HTR. OTHER CONVERSION Vent Size S KIND OF LINER • SIZE S" NONE rr Draft Hood iri4UL.44, Regulator. Filters Size i _o&A A Number _ Chimney Location Inside ✓ Outside Chimney Construction Q • ueh-t- Wiring ✓ Test Tag Lighting Inst. Date Tested 6a Company Testing CenterPoint Energy inne sco Name of Tester sae. &.1 w"