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PRE 2010 DOCS® Application for Power Plants and Heating. Ceding, Ventilation, ReMgeration and 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 Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM A Furnace 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 $ ti 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 $ 4 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $/ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE REMARKS: Dept. of Bldgs. Phone SU 4-7470 Location 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 1ue and correct. Fraley, AUnn_ l� a 195_ Owner �- .�!"i 7'T -O-�-�"�,..•�� — 195— Kind of Used as To be completed about 195— Estimated Com $ Old—New. Building Permit No.� DESCRIPTION OF WORK HEATING or POWERPLANTS--§team. Hot Water, Warm Air—No Trade Name f�� r�'J�e''- Size No y2 .ter Capacity LT �Sq. Ft. E D.R BTH.P. Total Connected Load Kind Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Sign4 , a� t ' _ r By 5 -_ 11 POST 1M-12-58 Business Phone No _ N saes aaP� -VIA 'sut bs Jo a� N pay€Tbam _ F a.e aapre>•I v .'el sul hi io lel" 1. 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I ytg'h� - � j y18ud S '. uJtw?I �'� iii t'� I.1 UN -- -- t- 1 — al dd MU —__ /UO ` UU dill Ia - -Ca t l 11: JJujjj a i SJUU 1 bmu ul P .I d H _ F !, « i. _ cl ( I .) i II _ - I 91 ,n tJ ► ap�lri� ii I P ,� uoiaelnsul j� ` N uaiJ�naasuoj J �1 ""11"J41eat City of Fridley, Minn. BUILDING PERMIT No s Date: Owner: ... ? 4.._...ttt�-- ..._........... Builder �AddressAddress _�__....__s".1._,.................. _......... ...... ... ..... LONA OF BUILDING No. __.. Street �.._.." --._. ...! •......_ ...�..... ..11yd . ............................... Part of Lot .-----.._..._.._.._. _.�...._.._._...._./_�._.� Lot .....----....... B�Iock----- _------------- ----------------------- --------- Addition or Sub-Diviislon .._............ ... _.. _ .... ...._" !.-•--•-•-- Corner Lot ........... Inside Inside Lot ....._ ............._................. Setback . @:J•._.•••••._.............. ideyard ....._..�..2.1. 5 -�-........ - ..._.. Sewer Elevation ..__..----._..____-----.--....._.._ .............. _...._......._......._...._..._... Foundation Elevation DESCRIPTION OF BUILDING To Ne Used as: e ._ ----.....__..:..... ._ ....._....._ .. Front ..._....---• --•- Depth -- ...._.. Height .._- Sq. Ft. .��° � Cu. Ft./,..;.6709 ..--- - --- �nt .. Depth .__//. Height ..... _.. Sq. Ft. ',,w!'� Cu. Ft. _•�-�!L..� Type of Construction -.7".... Est. Cost...l.::.1...1/'��...... To be Completed .....- ............._..._........_......._........ CAUTION THIS PERMIT _ 1 ES NnT AUTHORIZE VIOLA T . ION Or ANY PRIVATE LAND COVENANTS AND BUILDING RESTRICTIONS. RICTIONS. 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 $..pFi `'`._...., 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 tim upo violation of y of the p ovisions of said ordinances. 7 uilding 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 hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA a Owners Name Builder 106/ - Address�/�- J�-�---� Address - LOCATION OF BUILDING No. Street � Part of Lot Lot -YZ Block ��_ Addition or Sub.Div. ot. Corner LotInside Lot_,_,_ Set Back - Side-Yard-X— SEWER ELEVATION _ %� ® FOUNDATION ELEVATION / a Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To beas: C Front 174Depth Height 5q. Ft. Cu. Ft. Ir Front Depth Height Sq. Ft. Cu. Ft, Type of Construction_ ..?f���� 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 Departmept of Buildings, and hereby declares that all t�-facts and representa- tions stated in his app cation are true and correct. DATE 159 SIGNATURE 4((Aoheduie o Fee costs can be found on the Reverse Side.) City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location - Number, N Z . • WATER HTR. 8� Saa3 ��gu �O F N GAS EIEC cs Base 1st 2nd _ 3rd 4th • Future Connection Openings Conne6ed with Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number FixturesSO .............. x$1.50 $�3' 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 .......................... x $1.50 $--L. J 6 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................ $ TOTAL FEE $-L-1, i 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 - 19 L" Owner C/� ���'r/ ✓�� -�� —� Kind of Building Used as To be completed about Estimated Cost, $ 4e�®. Old—New. Building Permit No'�� Permit No. 00. Signe By Business Phone No MAY 2 4 1960 ROUGH FINAL a x 2M 7.59 City of Fridley Application for Plumbing and G= Rifting Permit Dept. of Bldgs. Phone 560.3450 DESCRIPTION OF WORK 6281 NE 5 St. Number, Kind and Location of Fixtures Location N $ x $1.50 $ x $1.60 $ x $3.25 Z x $3.00 C Z 8,� Z V� W < t�9 •� W C�9 Sa Z �O + F • N WATER HTR. GAS ELEG Base 1st r® ol 1 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... Future Fixture Opening ............... New Fixture Old Opening ............. Catch Basin ...... .................... Water Heater (Up to 99,000 BTU) ..... New Ground Run Old Bldg. ........... Electric Water Heater GAS FITTING FEES: x $2.00 $ x $1.50 $ x $1.60 $ x $3.25 $ x $3.00 $ x $325 $ a $2.00 $ NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 Additional Fixtures x $ .76 Gas Range to 199,000 BTU.......... r(. p 1 1 x $5.00 REPAIRS & ALTERATIONS—Refer to Code $ 3.00 City of Fridley: 879.01 The undersigned hereby .makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the facl and representations stated in this application are true and correct - Fridley, Minn `� o t 67 is_ Owner W Simms Kind of Building fr Used as r e s To be completed about 9 Oct Estimated Cost, $ 00 i Older. Building Permit N 3• Signe a_, j N ROUGH FINAL Description ................................................$ TOTAL FEE $ 3.00 42 Business Phone No 7 SUBJECT PER City of Fridley ?4 6 AT THE TOP OF THE TWINS BUILDING P E R M I T Ir I �• COMMUNITY DEVELOPMENT DIV. LV ------, r i PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/9/95 JOB ADDRESS 6281 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 38 2 1 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brad/Colette Hanson 6281 5 Street NE 571-2444 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace steps and landing 9 CHANGE OF USE FROM TO STIPULATIONS 3 foot landing required on exterior entrance. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 I 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 $300 $.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $15.00 PLAN CHECK FEE TOTAL FEE $15.80 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI PROP LY VAyIDATED THIS IS YOUR PE IT WHEN sWbG INSP 6 DATE' SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI 7 NEW ( ] :.:ADDN ALTER () Construction Address: ;:... ..._ :.....CITY OF -FRIDLEY ...... SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Na Effective 1/ 1/95 Legal Description: Owner Name & Address: 6NeLCO O e"dd U p} ka )o �! � h 5i . 0~ zTel. # Contractor: ' MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey -of the lot, with the proposed construction drawn on it to scale. (Cost on Back) 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: Permit Fee Comer Lot f ) Inside Lot [ 1 Type of Construction: - Approx. Completion Date: _ Ft. Yd Setback . Side Yard Setbacks . . Estimated Cost: $ 3 D° TOTAL $ �S' so STIPULATIONS: e (Cost on Back) Driveway Curb Cut Width Needed: F + 6 Ft = Ft x $ _ $ .I„ DATE: `�/ e -- APPLICANT: '�=��-- Tel. CITY - USE ONLY Permit Fee $ i On Fee Schedule on Reverse Side Fire Surcharge $ 3,0 .001 of Permit Valuation (1 / 10th %) State Surcharge $ FD $.50/$1,000 Valuation SAC Charge $ $850 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 $ �S' so STIPULATIONS: e SUBJECT ' City of FridleyC `-7 1 0 AT THE TOP OF THE TWINS BUILDING PERMIT -14 RECEIPT NO. Ir ` L ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC r I � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY ------ 612-571-3450 910-F15 10/22/96 JOB ADDRESS 6281 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 38 2 1 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brad Hanson 6281 5 Street NE 571-2444 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF'BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q. REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (21 Sq) 2nd Layer 9 CHANGE OF USE FROM 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. 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 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,302 $.65 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $1.30 STRUCTION OA9 THE PERFO MANCE OF CONSTRUCTION $45.75 PLAN CHECK FEE TOTAL FEE LjL I () Z _ � 1 $47.70 SIGNATURE OFC NTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERA VALIDATED THIS IS YOUR PERMIT BLD A INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI IRA ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress:4 � 2 s S-- A) Legal Description: p o -� S , o rn Effective 3/1/96 Owner Name & Address: �jr� I� 5®„� &2 -fl 'S4u S-� Tel. # E71--2 q (4 q Contractor: a1 I vh f 'Ay MN LICENSE # 1?- 52 S -M A, 1--V Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlUPROVEIVIENT Tel. # • LIVING AREA: Length Width _ Height Sq. Ft. • GARAGE AREA: Length Width Height -Sq: DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER:R ao st , � �ad2A� f � `2- Corner Lot [ J Inside Lot] Ft. Yd Setback Side Yard Setbacks Tyre of Construction: �-R'Y'0'e, Estimated Cost: $ �, Soo. Approx. Completion Date: r-_ Driveway Curb Cut Width Needed:Ft. + 6 Ft Ft x $ = $ DATE: APPLICANT: Tel. # STIPULATIONS: CITY USE ONLY . Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ - ¢ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $900 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 DIViSION 6431 University Ave NE Fridley, MN 55432 572-=3604 RATE SCHEDULE Effective On January 1, 1998 APPLICATION FOR POWER PLANTS AND HEATING. COOLING, VENTILATION, -AEFRIGERATIONANDAIRCONDITIONtNI SYSTEMS AND -DEVICES___. --- JOB ADDRESS !U Residential Rate Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) $10.00 Gas Range $10.00 Gas Dryer $10.00 *Air Conditioning - All Sizes $ 25.00 All Others/Repairs & Alterations (LIST ON B/►CK) 1 % of Value of Appliance or Work Comrnercial/I ndustrial 1.25% of Value of Appliance or Work State surcharge TOTA FEE , TOTAL U2. 00 $ 1�� MINIMUM FEE FOR ANY HEATINGjCO01ING/VMTILATION REFRIGERATIONJAIR 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. The undersigned hereby makes application for a permit for the wofk 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.. Jam, .7 ,1995 OWNER grg� d, 4 ill e�n5c�n BUILDING USED AS �)e5i"Jg! C ESTIMATED COST 7R), CZ PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units j Circle one (Steam) (Hot Water) 0!4rm Ai Trade Name �°C� r� e- r Size No. BTU HP EDR Fuel p,:,j . ��s Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY e r c� n t pec n Signed By_0 %� r3RX) Approved By Rough -in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE i i CHIMNEY AND STACK VERIFICATION Th� under*gigned hereby verifies that the existing chimney or stack: 1. Hai been carefully examined Yes (0 No ( ) 2. y` Is 'I from rust or deterioration 'I Yes (✓1 No ( ) 3. I4ak no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes (✓) No ( ) 5. ' Me;# all current Code requirements for size ano total BTU's connected Yes (&4 No ( } 6 H40 °total heating BTU's of am J n Al'`other BTU's i TTAL BTU's 7.! Hays a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes (} No ( ) Rgmarks: i Litt ALTERATIONS Being Done: 4ATINP:" CO: Si ed By: D Sired CITY -OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS1-91 57-11 4& < New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 ©J? ©� v Sump/Receiving Tank $ 7.00 .200 Water Treating Appliance $10.00 Owner 4 L Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range*" $10.00 Gas Dryer** $10.00 / Estimated Cost PERMIT NO. k2 gyp 00,0 Back Flow Preventer Required ( )Yes () No � A - Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Hr SIGNED BY TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ .50 MINIMIJ FEE Fa ANY PLUMBING1GAS PERMIT IS $20.00 TOTAL FEE $�• PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UN?C SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 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 BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date CCiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 11, 2002 Bradley Hanson 6281 5`h Street NE Fridley, MN 55432 Re: Final Inspection at 6281 5�' Street NE Contractor: KCJ Enterprises — Mr. Rooter Dear Mr. Hanson: A plumbing permit was issued on March 23, 2000, to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections 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 permit 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. incerely, Inspector DJ/ls 110 SUBJECT P73118 City of Fridley 01 AT THE TOP OF THE TWINS BUILDING PERMIT r �` ______ COMMUNITY DEVELOPMENT DIV. - *572-36041 RECEIPT NO. PROTECTIVE INSPECTION SEC. � 0 NUMBER REV DATE PAGE OF APPROVED By I CITY HALL FRIDLEY 55432 '•j 612-571-3450 910-F15 5/7/01 JOB ADDRESS 6281 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 38 2 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Collette Hanson 6281 5 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO American Eagle Exteriors 19512 Country Cir E, Rogers, MN 55374 763-420-3107 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 B DESCRIBE WORK Replace soffit & fascia 9 CHANGE OF USE FROM TO STIPULATIONS Install soffit ventilation to meet the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 @ $2,000 $1.00 R SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE TO GIV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE OVISIONS OF ANY ER STA R LOCAL LAW REGULATING CON- $69.25 Fire SC $2.00 S CTION OR THE PERF MA STRUCTION PLAN CHECK FEE TOTAL FEE Licens C $5 7.25 SIGNATURE OF AUT IRATE. _ HE P P VALIDAT G .NSF' IS IS YOUR PERMIT _of �IAiE S-GNATURE OF OWNEROF OWNER BUILDER. IDATEI 110 NEW [ ] Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: % en A)1:` Legal Description: Tel. # MN LICENSE #_/ Tel. # 76 -9/20 /07 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: 5o 4A 4- -1- r s e,,e* Estimated Cost: $ P(GAAA Driveway Curb Cut Width Needed:+ 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ 69, Fee Schedule on Reverse Side - Fire Surcharge $ ®G' .001 of Permit Valuation (1/10th%) State Surcharge $ 400 $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ 5-.00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 2,7 ®?S- -MI7111IMN1161 z E,�i TO: FROM: DATE: SUBJECT: Background of + Y City of Fridley 3RANDUM William W. Burns, City Manager PW03-097 Jon H. Haukaas, Public Works Director November 26, 2003 Sewer Services 6281-5'h- Street The house at 6281 5t`' Street was constructed in 1960. The house has a sewer service that goes west out to 5"' Street The main line sewer was installed in 1959. There is very little difference in elevation between the basement floor elevation and the sewer main elevation which, therefore, does not allow much pitch in the service pipe over the approximately 70 feet between the house and the main line sewer. His tory None of our records indicate any sewer problems at this location prior to May of 2001. Early that month, we were called because of a sewer backup. The main line was clear and, therefore, the backup had to be in the service line. On May 14, 2001 the City Sewer Department televised the service line from the house out to the street We still have this tape on file. The televising showed severe back pitch in the portion of the service immediately outside the house. We could not evaluate the condition of the service in the first 3040 feet because of the water being held back in the pipe by the pitch problem. Once past the water, we saw that there was some minor root intrusions and that the boulevard stub was in good shape and had pitch to the main line. This was evident because the pipe drained freely to the main and was dry. At this point, the Hanson's had the sewer cleaned by a private sewer cleaning company (1 believe it was Roto -Rooter). We explained to the Hanson's that they should have this done on a regular basis because the service held water and it could have problems in the future. Later that summer, the Sewer Department was contacted by Olson's Plumbing Service because the Hanson's had hired them to replace the sewer service line. No permit was pulled to initiate contact because no permit is required for repair to private sewer services outside the building and not in the right-of-way. Olson's Plumbing contacted us because that is their own internal policy of working with the City. This allows the City an opportunity to visually inspect the condition of December 4, 2003 Page 2 the service stub while it is exposed. Olson's Plumbing informed the Hanson's at that time that the service may still hold water due to the lack of elevation. In May of 2003, the Hanson's experienced another sewer backup. Again, the main line was clear and the blockage was in their own service line. The Hanson's would not allow us into the house to televise the service line. The reason given was that 'Roto -Rooter broke the clean out last time and the City would have to fix it now if we wanted to use it: We do not do any work on internal plumbing for any private properties. Since we wanted to be sure of our system, we hired Infratech on May 8, 2003 to use their remote camera to televise the service from the main line toward the house. The stub from the main was still in good condition but the rest of the service did hold some water due to a small amount of back pitch. Our Sewer Department staff again recommended regular (annual) service cleaning as a preventative measure. The flrst contact the Engineering Department had regarding this was in late August 2003 because the Hanson's were considering having their sewer service replaced again. After reviewing the sewer main record plans, they were told that additional sewer elevation could be gained by running the service north to 63rd Avenue rather than to Sh Street This was again discussed directly with the Hanson's in a meeting they had with Greg Kottsick and myself at the Public Works building. It was again explained at this meeting that the sewer service is the responsibility of the homeowner including all regular cleaning and maintenance and that if they elected to replace the service, all costs, including street repair, would be their responsibility. They elected to again replace their sewer service from the house and this time go all the way to the main. On September 25, 2003 Joe Munn of Joe's Sewer Service pulled a Utility Line Repair Inspection Request This was done because their work extended into the right-of-way. Our contract construction inspector, Kris Giga, performed the inspection and visually observed that the sewer service was connected to the wye at the main line sewer with an approved adapter. The contractor was then allowed to backfill the hole and the street and curb was scheduled for restoration. The street and curb restoration totals $1,030. Inspections When a Request for Inspection is called for, the only thing this covers is a visual inspection of the work and recording that it was done. The inspector looks to see that the proper pipes are hooked together and approved connectors are used. As simple as this sounds, we unfortunately do occasionally have a contractor who may confuse the storm sewer with the sanitary sewer (or even a water main). Our inspectors do not stay on the site to observe the entire process of excavation and backfill. We do not have the personnel to do that Our inspectors also do not go into a contractor's trench or hole for inspections because we cannot be certain of the safety of the excavation. The contractor is responsible for their own work. We do not verify slope on the service pipe with a level. The majority of the time, this can be seen visually. Otherwise, the contractor needs to make sure it will flow. December 4, 2003 Page 3 Recommendation Despite the fact that the Hanson's claim the City should have helped with this project, they will not allow us access to televise the sewer service to verify its condition. We believe that Olson's Plumbing did the best job they could with the restrictions in elevation they had to work with. We believe Joe's Sewer also did good work with the only difference being that the homeowner hired them to extend the service replacement work all the way to the main. All this work was done electively by the Hanson"s. Alternatives did exist Should the Hanson's allow the City to televise and make a record of the service line and if the Council feels generous, we could waive the costs for the street repair. Otherwise, the City has no other responsibilities in regards to this issue. JHH:cz FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 December 4, 2003 PWO3-O72 Mrs. Collette Hansen 6281 5 h Street NE Fridley MN 55432 Subject: Street Repair for Sewer Service Replacement Dear Mrs. Hansen: The City of Fridley provided services to you for the repair of curbing and pavement In conjunction with your sewer service replacement These items should have been paid for by your contractor at the time the repair permit was applied for, but was not The work consisted of - Replacement of 20 LF concrete curb & Gutter ® $17.5O/LF $350.00 Pavement restoration 6 It x 18 It ® $400/1st 5 SY + $40/each additional SY $680.00 Please remit $1,030.00 to the City of Fridley to cover the cost for this. work. Sincerely, Jon H. Haukaas Director of Public Works JHH:cz City of Fridley Y e TO: William W. Bums, City Manager PW03-097 FROM: Jon H. Haukaas, Public Works Director DATE: November 26, 2003 SUBJECT: Sewer Service: 6281 Vh Street Background The house at 62813' Street was constructed in 1960. The house has a sewer service that goes west out to Sh Street The main line sewer was installed in 1959. There is very little difference in elevation between the basement floor elevation and the sewer main elevation which, therefore, does not allow much pitch in the service pipe over the approximately 70 feet between the house and the main line sewer. H tory None of our records indicate any sewer problems at this location prior to May of 2001. Early that month, we were called because of a sewer backup. The main line was clear and, therefore, the backup had to be in the service line. On May 14, 2001 the City Sewer Department televised the service line from the house out to the street We still have this tape on file. The televising showed severe back pitch in the portion of the service immediately outside the house. We could not evaluate the condition of the service in the first 30-40 feet because of the water being held back in the pipe by the pitch problem. Once past the water, we saw that there was some minor root intrusions and that the boulevard stub was in good shape and had pitch to the main line. This was evident because the pipe drained freely to the main and was dry. At this point, the Hanson's had the sewer cleaned by a private sewer cleaning company Q believe it was Roto -Rooter). We explained to the Hanson's that they should have this done on a regular basis because the service held water and it could have problems in the future. Later that summer, the Sewer Department was contacted by Olson's Plumbing Service because the Hanson's had hired them to replace the sewer service line. No permit was pulled to initiate contact because no permit is required for repair to private sewer services outside the building and not in the rightrof-way. Olson's Plumbing contacted us because that is their own internal policy of working with the City. This allows the City an opportunity to visually inspect the condition of N December 4, 2003 Page 2 the service stub while it is exposed. Olson's Plumbing informed the Hanson's at that time that the service may still hold water due to the lack of elevation. In May of 2003, the Hanson's experienced another sewer backup. Again, the main line was clear and the blockage was in their own service line. The Hanson's would not allow us into the house to televise the service line. The reason given was that 'Roto -Rooter broke the clean out last time and the City would have to fix it now if we wanted to use it` We do not do any work on internal plumbing for any private properties. Since we wanted to be sure of our system, we hired Infratech on May 8, 2003 to use their remote camera to televise the service from the main line toward the house. The stub from the main was still in good condition but the rest of the service did hold some water due to a small amount of back pitch. Our Sewer Department staff again recommended regular (annual) service cleaning as a preventative measure. The first contact the Engineering Department had regarding this was in late August 2003 because the Hanson's were considering having their sewer service replaced again. After reviewing the sewer main record plans, they were told that additional sewer elevation could be gained by running the service north to 63rd Avenue rather than to 5ffi Street This was again discussed directly with the Hanson's in a meeting they had with Greg Kottsick and myself at the Public Works building. It was again explained at this meeting that the sewer service is the responsibility of the homeowner including all regular cleaning and maintenance and that if they elected to replace the service, all costs, including street repair, would be their responsibility. They elected to again replace their sewer service from the house and this time go all the way to the main. On September 25, 2003 Joe Munn of Joe's Sewer Service pulled a Utility Line Repair Inspection Request This was done because their work extended into the righNof-way. Our contract construction inspector, Kris Giga, performed the inspection and visually observed that the sewer service was connected to the wye at the main line sewer with an approved adapter. The contractor was then allowed to backfill the hole and the street and curb was scheduled for restoration. The street and curb restoration totals $1,030. Inspections When a Request for Inspection is called for, the only thing this covers is a visual inspection of the work and recording that it was done. The inspector looks to see that the proper pipes are hooked together and approved connectors are used. As simple as this sounds, we unfortunately do occasionally have a contractor who may confuse the storm sewer with the sanitary sewer (or even a water main). Our inspectors do not stay on the site to observe the entire process of excavation and backfill. We do not have the personnel to do that Our inspectors also do not go into a contractors trench or hole for inspections because we cannot be certain of the safety of the excavation. The contractor is responsible for their own work We do not verify slope on the service pipe with a level. The majority of the time, this can be seen visually. Otherwise, the contractor needs to make sure it will flow. 6 December 4, 2003 Page 3 Recommendation Despite the fact that the Hanson's claim the City should have helped with this project, they will not allow us access to televise the sewer service to verify its condition. We believe that Olson's Plumbing did the best job they could with the restrictions in elevation they had to work with. We believe Joe's Sewer also did good work with the only difference being that the homeowner hired them to extend the service replacement work all the way to the main. All this work was done electively by the Hanson's. Alternatives did exist Should the 1'lanson's allow the City to televise and make a record of the service line and if the Council feels generous, we could waive the costs for the street repair. Otherwise, the City has no other responsibilities in regards to this issue. RJiliR.T ORDINANCE NO. AN ORDINANCE AMENDING CHAPTER 402 OF THE FRIDLEY CITY CODE PERTAINING TO WATER AND SEWER ADMINISTRATION - REPAIRS TO CONNECTION THE CITY COUNCIL OF THE CITY OF FRIDLEY DOES ORDAIN AS FOLLOWS: That Section 402.06 is hereby amended as follows: 402.06 Repairs to Connection After the initial connection has been made to the water curb stop box or the sewer lead at the property line or a water service or sewer lead has been extended to the property line for connection, the applicant, owner, or the occupant or user of such premises shall be liable for all repairs required to any water line or any sewer lines necessary for connection of the premises from the property line to the premises. The City will be liable for all repairs required from the property line to the street mains, including any necessary street repairs. It shall be the responsibility of the applicant, owner, occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the curb stop box at such height as will ensure that it remains above the finished grade of the land or property. (Ref. 638) PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF FRIDLEY THIS _13TH_ DAY OF AUGUST, 2001. SCOTT J. LUND, MAYOR ATTEST: DEBRA A. SKOGEN, CITY CLERK Public Hearing: July 23, 2001 First Reading: July 23, 2001 Second Reading: August 13, 2001 Published: August 23, 2001 Fridley City Code Chapter 402 Section 402.07 B. For service to property to which service lines have been run previously to the property line but have not been paid for, the owner, occupant or user shall pay in cash or agree to pay charges in the form of Special Assessments to be levied against the property to be spread over a number of years coincident with the maturity requirements of any Special Improvement Bonds sold for the purpose of financing the construction of such water and sewer lines and service connections serving the property. Said cash payment or Assessment charge shall be in principal amount not less than the payments made by or charges placed against comparable properties for like services of such water or sewer, i.e. FOR AN "EQUIVALENT LATERAL ASSESSMENT", or an amount as may be established by the City Council. In the instance of services run to the property lines as provided under Section 402.03.A, the payment to the City Treasury of any amount required under Section 402.03.B shall be reduced by the amount paid to the City under Section 402.03.A. Payment to the City Treasury in the form of a Special Assessment charge shall be in the form of equal annual installments together with interest on the unpaid balance from year to year, which interest shall be computed at the current rate of assessment. 402.05. PERMIT FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or building for which the application is made, the owner or contractor shall be required to obtain a permit for such connection, and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made, the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connection. 402.06. REPAIRS TO CONNECTION After the initial connection has been made to the water curb stop box or the sewer lead at the property line or a water service or sewer lead has been extended to the property line for connection, the applicant, owner, or the occupant or user of such premises shall be liable for all repairs required to any water line or any sewer lines necessary for connection of the premises from the property line to the premises. The City will be liable for all repairs required from the property line to the mains, including any necessary street repairs. It shall be the responsibility of the applicant, owner, occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the curb stop box at such height as will ensure that it remains above the finished grade of the land or property. (Ref. 638, 1156) 402.07. CONSTRUCTION OF PRIVATE SEWER SYSTEMS PROHIBITED The construction of new individual sewage treatment systems (ISTS) is prohibited in the City of Fridley. Existing individual sewage treatment systems meeting MN Rules Chapter 7080 standards may and shall be permitted to continue in use and operation until system is deemed failing by a licensed inspector during a biennial inspection or the property owner expands kitchen, bathroom, or bedroom areas. The use of a cesspool, outside toilet, or any other individual sewage treatment system not meeting standards set forth in MN Rules Chapter 7080 is strictly prohibited. 79- -b 8/6 / ?s 402.10. Department within a reasonable time and upon demand therefore, the water service and supply to said premises may be shut off or discontinued as determined to be in the best interest of the City. 402.06. REPAIRS TO CONNECTION REPAY TO CONNECTION After the initial connection has been made to the water curb stop box or the sew er lead at the property line or a water service or sewer lead has been extended to the property line for connection, the applicant, owner, or the occupant or user of such premises shall be liable for all repairs required to any water line or any sewer lines necessary for connection of the premises from the property line to the premises. The City will be liable for all repairs required from the property line to the street mains, including any necessary- repairs. It shall be the responsibility of the -applicant, owner, occupant or user to maintain the curb stop box at such height as will ensure that it remains above the finished grade of the land or property. (Ref. 638) ' 402.07. TAMPERING PROHIBITED TAMPERING PROHIBITED It shall be unlawful for any person to tamper with, alter, by-pass or in any manner whatsoever interfere with the proper use and functioning of any water meter owned by the City. 402.08. SEWAGE AND WASTE CONTROL SEWAGE AND WASTE The "Sewage and Waste Control Rules and Regulations for the CONTROL Metropolitan Disposal System" as adopted by the Metropolitan Waste Control Commission, December -1, 1977, is hereby adopted by reference and incorporated into and made a part of this Code as completely as if set out here in full. 402.09. CONSENT TO REGUTATIONS CONSENT TO REGULATIONS Every person applying for water or sewer service and every owner.of property for which any such application is made shall be deemed upon making such application to consent to all rules, regulations and rates set forth in this Chapter, and such further rules, regulations and rates as may thereafter be set forth and adopted by the City.Council. 402.10. METER READING AND PAYMENT FOR SERVICES METER READING AND 1. The City may provide.a system of water meter reading by post -card, PAYMENT FOR meter -reader, or any other method deemed suitable to the purpose by SERVICES the City Council. The City may also establish billing areas or districts and provide for the readings of meters and billing charges -by calendar quarters or monthly quarters, or such periodic intervals as the City Council shall determine suitable and necessary from time to time to the needs of the City. In the case of a post -card meter reading, each consumer shall mail or return the meter card on or before the due date. 2. Each consumer shall be assessed a one dollar ($1.00) penalty.for any card not returned within seven (7) days of the due date. 6/92 402-3 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ,63) 572-3604 FAX: (763) 571-1287 ADDRESS : 6281 5TH ST NE PIN : 143024310066 LEGAL DESC : UPLAND 2ND ADD : LOT 38 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 14,900.00 PERMIT N .: 2004-00447 , DATE ISSUED: 04/06/2004 fA (l W� NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. BASEMENT REMODEL PER APPROVED PLAN STATE LICENSED CONTRACTOR 1 APPLICANT DAMONT INC (20228197) 1638 CO RD 10 NE SPRING LAKE PARK, MN 55432- (763)785-4274 OWNER HANSON BRADLEY D 6281 5TH ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to viol Ethe provisions of any other state or local law re atin Fcel sion erformance of constru o . ADDd1C g d�1�s p Date V�16 Y Bldg BUILDING PERMIT FEE 251.25 FIRE SURCHARGE 14.90 STATE SURCHARGE, VALUE 7.45 LICENSE SURCHARGE 5.00 TOTAL 278.60 PAID WITH CHECK # 12218 ARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY P 1 q (0a ctive 1/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION p Construction Address: O 1 � 6L Legal Description: Owner Na ddress: H09 r (fz Ar ` Tel. # 7 C� 3 S7/ -2 L/5/ Contractor/gv v c.. MN LICENSE # Do? � 8 t? -7 Address: it 3 a G.S'"Al C, —Vze`z 44At PaLk Tel. # 76 3 7 23— Y -'A y Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT J LIVING AREA: Length Width 3 0 Height Sq. Ft. B O GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width OTHER: Hgt/Ground Sq. Ft. Construction Type: X LOO )-r9 ^ ! ` Estiated Cost: $ / Y4 !2d Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ - �_-$ DATE: 6O APPLICANT:Z A Q ct— I—nO/J L Tel. # 7l0 3 .50 Call (763) 572-3604 for Permit Fees if mailing in application. 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 Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - $ Fee Schedule on Reverse Side 90 .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1350 per SAC Unit $ ,S' $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 [ ] TOTAL $ / . W STIPULATIONS: Q P P 9 4 ill 21'-6" C 38'-8" qwCS acl r ,117, ,FC NO WORK IN THIS ROOM L- �28W a � � 3 — �HYIF �QeR So� �fr.N`i �vidE gRn�HS IN R�I dtKu. 10'-2" NO WORK IN THIS OOM Nc` l�C 10'x" (o�m6j �l UMC VIEWF lo7e� 4 011ME Project to include: Demolition By owner Damont to supply dumpster, share proportional costs with owner. Dumpsters are $360.00 Exterior Walls Frame walls with 2 x 4" studs and plates(0 Install R-11 insulation Sheetrock one side, tape and sand Wall at staircase to remain block Interior Walls Frame in new furnace room enclosure Frame walls with 2 x 4" studs and plates Sheetrock one side, tape and sand Doors Furnish and install (1) new 5' bi-fold door at furnace room Windows Furnish and install (5) vented glass block windows Plumbing Turn water heater 45 degrees for service accessibility through bi-fold door HVAC Furnish and install one additional ceiling drop supply Revise return air Electric Furnish and install electric outlets to code Rewire existing switches to new light openings Insulation Furnish and install R-11 batt insulation to new exterior walls Ceilings Furnish and install new drywall, tape, sand and spray texture All ceilings except bathroom, furnace room and laundry room Furnish and install soffitts as necessary Millwork -Trim Furnish and install new oak Princeton baseboard and casing as necessary Cabinets Reset existing cabinet into workout room Specialties Furnish and install new stair railing Furnish and install new grip able railing Flooring By owner Painting and Staining By owner Cleanup Final cleaning by owner Permits All necessary permits included in bid Miscellaneous Owners to move all personal items out of construction site. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57Z -36U4 YAX: (763) 5 71-IZ5 7 ADDRESS : 6281 5TH ST NE PIN : 143024310066 LEGAL DESC : UPLAND 2ND ADD : LOT 38 BLOCK 2 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE VALUATION NOTE: INSTALL GAS PIPING FOR FIREPLACE APPLICANT NORTH SUBURBAN HEATING & AIR 19066 JASPER ANOKA, MN 55303 FITIITWI!11 HANSON BRADLEY D 6281 5TH ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating constrLT or the performance of construction. Annlic�t� / I Date Bldg Insp PERMIT NO.: 2004-0050 DATE ISSUED: 04/14/2004 HEATING PERMIT MINIMUM FEE STATE SURCHARGE, MECH FLAT TOTAL QFDAD ATT; DP11?T%ATTC 1D1Pr)TTT1?1F7r) F(1R Wnl?Y (1TT-TF12 TT -TAN T1FCrRTRRTI AROW 15.00 0.50 15.50 CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Effective 4/1/2004 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 763-572-3604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS I RATE SCHEDULE Fee Total Residential Owner Furnace Shell and Duct Work, Burner & also Replacement Furnace $35.00 $ Building Used As Gas Piping (New Furnace, Fireplace, Insert) $10.00 $ ESTIMATED COST -3 t7© PERMIT NO 42004J Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. *Air Conditioning - All Sizes $25.00 $ BTU HP EDR Fuel Total Connected Load All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional $ Burner Trade Name BTU HP Size No. EDR 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. State Surcharge $ TOTAL FEE $ S0 REINSPECTION FEE $50.00/HOUR _ *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Tel # 93 FAX# 2' Date Approved by I Rough -in Date Final Date A` �2 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The 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 BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 t'AX: (763)571-1287 ADDRESS : 6281 5TH ST NE PIN : 143024310066 LEGAL DESC : UPLAND 2ND ADD : LOT 38 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-00536 DATE ISSUED: 04/20/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE BASEMENT # INSPECTIONS APPLICANT AEM ELECTRIC SERVICES 1600 CO RD 10 NE SPRING LAKE PARK, MN 55432 OWNER HANSON BRADLEY D 6281 5TH ST NE FRIDLEY, MN 55432 2 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp ELEC PERMIT FEE - MIN (RESI) 40.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 40.50 PAID WITH CHECK # 7135 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building See Back Page for Fee Schedule BUILDING Permit N6.-2"- 100 li'► `� $% .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 Inspections $5.00 (State Licensed Residential Contractors) RESIDENTIAL APPLICATION Received By: 763-572-3604 ft+6ft= ftx$21=$ CITY OF FRIDLEY qKlycW9 763-502-4977 FAX Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ _ �j`"— Make checks payable to: City of Fridley Attach EFFECTIVE 1-1-08 DATE a —( 3 -0 5-� o YOUR E-MAIL ADDRESS � AC-7,&14J/_M44-0 SITE ADDRESS o? S%/F` s;,— /AJ &— THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ / NAME: &-)/-/ � f�W/US2 �A ADDRESS: -? S S7-- A r CITY (--A-'/ D STATE AAZIP TENANT PHONE: 7Co `3 -• X571- o221 NAME: — ADDRESS:_// % _—,7 -/!_Lc r?F1l 9 VL6 AA CITY ( G?--I;f E STATER%iZIPS�i�Z CONTRACTOR SUBMIT A COPY OF PHONE 6�' 7 ^ 3o 7s - 9G % FAX YOUR STATE LICENSE STATE LICENSE # P_ -V ��j� �(� �' EXP DATE �'y PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES [ PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED INDOWS ❑ BASEMENT FINISH ❑� RO,�O..�� ❑ DRAIN TILE ❑ DECK 'SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: I SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used. PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDIN ADDITIONS & PORCHES SUBMIT: myl ❑Soffit 1. Site Plan/Survey showing the existing structures C Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS IN EXISTING OPENINGS ON, LOCATION OF WINDOWS \ 3. Energy Calculations Ples -4S7' S/AE OR FOR NEW OPENINGS -DESCRIBE SIZE OF ill l5//U /OU�7 C/6 J OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED D44- MA 2V1I13 NUMBER OF WINDOWS Z ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ g5w9(oc) `K OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ % %I See Back Page for Fee Schedule $ 65% of Building Permit Fee $% .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ _ �j`"— Make checks payable to: City of Fridley Attach 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 an ith 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 on site; that the work ill be in accordance wit the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPL C4", � a � PRINT NAMES �/]O(/�Llt�c�'�/� DA,T,E�Z�^ 7 -t3 APPROVED BY �� ��� ---