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PRE 2010 DOCS". h Village of Fridley, Minn. BUILDING PERMIT ° 1731 Date: .... '. !`.................... ........... Owner....................................... Builder ../.. .... ... ................... Address ...................................... Address ....�� 3-d.... .. 1!i......✓.. . LTI OF BUILDING No. ...� Street .... `' ... .............. Part of Lot.......... .... Lot .......... Block ..... /........... Addition or Sub -Division ...K.�?"`�............ L!T/. Corner Lot ........... Inside Lot .... Setback ... Sideyard ............................. DESCRIPTION OF BUILDING To be Us s: ........ ........ ....... ....... Front . s.� � Depth . �. � . Height . � ... �.' Sq. Ft. Cu. Ft. .................. Front ........ Depth ........ Height ..... Sq. Ft. ........ Cu. Ft. ........ 1® Type of Construction ....... Est. Cost ... &.. v� .... 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 all provisions of ordinances of the village of Fridley. In consideration of the payment of a fee of $..��.7., 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 with- in the village limits and this permit may be revs ed at any time upon violation of any of the provisions of said ordinances. s 6 ......... Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. City of Fridley, Minn.. BUILDING PERMIT Date: Owner. •'ABuilder Address ___. —� Address 3,.- CATI F BU , DING No.Street Part of Lot Lot Corner Lot Sewer Elevation Block — Addition or Sub -Division Inside Lot Setback Sideyard Foundation Elevation DESCRIPTION OF BUILDING T, U as: f �` Front Depth HeightI fSq. Ft. Cu. Ft. _ _ Depth _ _ Height Sq. Ft. _ Cu. Ft. Type of Construction fet a Est Cost _ To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do theproposed 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 li'rldley, Alinnesota regarding location, construction, alteration, maintenance, and moving of buildings within city limits and this permit may be revoked at any time upon on of of the provisions of said Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, acs heating,sewer or water. Be sure to no the Building Inspector for separate permits for these Items. APPLICATION FOR BUILDING PERMIT CIW OF 11 KDWSOTA Address LOCATION OF BUILDING No. of Lot Lot Block Addition or Subdivision Corner Lot _____Inside Lot Setback 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 s: A" /_. FrontDepth 9= Height Sq. Ft. zAv Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft,_ Type of Construction Estimated Cos 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 DAldings, and hereby declares that�'all-the facts and representations stated in this application are true and correct. 4 '? ^ ""? DATE �SIGNATW 1A (A Schedule of Fee Costs can be found on the Reverse Side.) original . PERMIT for Power P ants and Heating. Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Heating Plants &),4 eM 41 oe to be installed ltered repaired Make 01,W , Size d, UA �_, N L / D 6 ; Oil fired__.; Coal fired—, Gas fired ! ; Gas Authorization � • ft •� .'Z�r��iJul'(1��.+�"!1�'�3��L�rf�Tirl,1�!—f Approved Final Inspection Date , 19_ Inspector A'r /0,33 Permit N° 46 8 8 Mm $ Z/00 Office of the Inspector of Buildings City of Fridley City of Fridley, Minns,MfiPM &I , 1920 Owner Fce 6V_sCA) Location �o _ ,5-7-/1j Kind of Building�Arn How Occupied &J"! -ILL, n1 ro Work to be Commenced—, 19— To be Comple1, Ig- ,19-120 Estimated Cost, $ ��0 UO Old- ew, Building Permit No. Permission is hereby granted to v to install—erect—use the material and devices described in the above statement. This permit is granted upon tM express condition that the pers to whom it is 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 herdn 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, and to the specifics ' ns set rth in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings e42 2M11 -67V o App len for Power Piatnts and Henthi . Cooling$ Ventila ftne ReMejeroiOn amd Air Conditioning S"ems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ...........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace . 6.00 $, 6.6-6 Repairs & Alterations --up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 5.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & lines—to 400 sq. ft. 9DR Steam .... .$10.00 $ Furnace Shell & Line—to 640 sq. ft. IDA Hot Water .. 10.00 $ Each add. 200 sq. f% EDR Steam ...................... 3.00 ' $ Each add. 320 sq. ft. EDR Hot Water . ........ ... 3.00 $ OIL BURNER—to 3 gal. per hour .....:... ... .. ..... 6.00 $ over 3 gal. per hour -See Fee Schedule le Name Size Sq. Ft. E.D.R BTU H.P. GAS BURNER (up to 199,000 BTU) .......:................ 510 $ over 199,000 BTU See. Fee Schedule 691 Size No GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ................ x$ 100 $ Additional Fixtures :................ x .75 $ Gas Range to 199,000 ........... xa B 00 $ AIR CONDITIONIIlG $ FAN HEATING SYSTEM See Fee Sehsdab VENTILATING SYSTEM[ $ ALTERATIONS is REPAIRS TOTAL FEE $ ROUGH Dept. of Bldgs. Phone 880.3480 .ocattesL 7590 1 � VA. 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 applicationare true and correct. _ Fridley, Minn- ) /] r Kind of Building Used as To be completed about''�'� % X5.7 C> 61 ao Estimated Cost, $ Ol ew. Building Permit No. Permit No.4a� Capacity Sq. Ft. E.D.R- BTU H.P. FINAL (REMARKS -OYER) DESCRIPTION OF WORE HEATING or POWER Hot Wa WaFAiro— le Name Size Sq. Ft. E.D.R BTU H.P. Total ConnectedLoader �y Rind of BURNER — Trade Name 691 Size No Capacity Sq. Ft. E.D.R- BTU H.P. FINAL (REMARKS -OYER) City of Fridley, Minn. 15 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: X August 2, 1972 Owner: — Thomas M. Gronlund Builder Same Address __.__Z51.0 5th Street Nom,_ _ Address Same LOCATION OF BUILDING No. _._155_0._ Street_ 5th Street. N.E. Part of Lot Lot —A - Block 1 ­­ Addition or Sub -Division .__ Osborne Manor Corner Lot inside Lot — $ Setback — Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front ..._ 22' Depth 22' Height 10' Sq. Ft, 484 Cu. Ft 4,840 Front . _ Depth — Height Sq. Ft. Cu. Ft. Type of Construction Wood Frame Est. Cost .._..2. 192..0 To be Completed 811173 Provide Hard Surface Driveway 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. 3.30 State Su rrharga In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to Thomas Groulund to construct the building or addition as described above. This permit 4s 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 buildfno Within the city limits and this permit may be revoked at any time upon violation of any of the provisions of Said Ordinances. Building Inspeetw NOTICE: This permit does not cover the construction, installation for whing, plumbing, gas heating, sewer or water. Be sure to sae the Building Inspector for separate permits for these items. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PPRMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: , f / ,W S' Al ArO1,14MW BUILDER: _5,4',41A ADDRESS: `73 ✓'. v�'?�'i 57 X. —4- ADDRESS: NO :. 7.53'0 STREET: S"7W 57- /U . AE LOT; � BLOCK: —ADDITION: CORNER LOT: INSIDE LOT: � SETBACK: SIDEXARD: 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: -ZR FT Depth: X07 F7- Height: /0 Square Feet: - !z I �( Cubic Feet: Y f YO Ib .� Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: 1A906V f 4d i9 .F Estimated Cost: $ o7% "o'Z � a �eataq To Be Completed: The undersigned hereby makes application for a permit for tbe.work herein specified, agreeing to do all work in sttict accordance with the City Qf Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applig4tiotl are true and correct. lh TF, : % 2 SIGNATURE: (See Reverse Side For Additionai Information.) i HARVEY A. CARTWRIGHT F' I �"(� r 1. � �'�'�'�'°°�� COMBINING THE RECORDS OF wlmoxw COUNTY cluRvers ,, 4' ��'j leg J. E. HILL, Cim ENCINeen NiNNB.PIN COUNTY SURVEYS�J LAND D SUR V E YO R S [5TA6W5NBD 16" MINNEAPOLIS SURVEYS • C. F. SANAi'9i3.' R '8410 PALM STREET N. W. REGISTERED UNDER LAWS OF STATE OF MINNESOTA CIVIL ENGimarm SUNmET 4.7855 LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS ESTASL15NE0 1603 OWNER 902 UPPER MIDWEST BUILDING -� ..338-8721 JAMES NELSON SURVEYOR INDUSTRIAL - JUDICIAL HENNEPIN AT FIFTH — MINNEAPOLIS. MINN. 55401 ESTABLISHED 1924 •UGINESS - TOPOGRAPHICAL OT�!'� �eTtigieAteMETROPOLITAN LAND CITY LOTS - PLATTING R� SURVEYORS, [STABLIGNEO 1651 v TOM GRC14LUND 358-222 111? 6 N s� I 0 S1 tv?Q'tk C e e _ 3S .610 P , I Al— i i R� I i I 1 111? 6 N s� I C e e _ 3S �9. 1 SEI .�_._..___.__._._....._..__. _.._ _ _..._.._...._......•_a ._.._ _._...._.�._� __.. .___..._i ROS a I hereby certify that this is a true and correct repre santation of a survey made by me of let 4, Block 1, of Osborna Mano a Anoka County, Minneaoataa, as nade by >ms April 23rd 1972. SIGNED , —�.,r4,n1 �i'e y • ,{.�.•1 CAR'I'WRIGHT AUD OLLON V ' Y .610 P , �9. 1 SEI .�_._..___.__._._....._..__. _.._ _ _..._.._...._......•_a ._.._ _._...._.�._� __.. .___..._i ROS a I hereby certify that this is a true and correct repre santation of a survey made by me of let 4, Block 1, of Osborna Mano a Anoka County, Minneaoataa, as nade by >ms April 23rd 1972. SIGNED , —�.,r4,n1 �i'e y • ,{.�.•1 CAR'I'WRIGHT AUD OLLON V ' Y TYPICAL SLAB DETAIL . c G 2"� 66 x I OM v 'o wire mesh Grade .•. 2-r 4 Re—Bars C to CD 45" 12Min, 8Min. f e The above is a substitute design for frost footings, ho*aever, it is not yet accepted by the State as an amendment to the Uniform Building Code, Section 2905,a. TI)erefore upon using this method of construction, I agree to hold the City of Fridley harmless of any possible claim for foundation failure or structural damage caused by foundation failure. Witness �i Property Owner b %a/7 2 '7:5 ,,' '!57-1 s7- ILI. /F. D tee Address of Priperty /Legal Desc. CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Nu=ber Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction NO. RATE TOTAL r. $3.00 $ x $2.00 $ x $2.00 $ x X d x Water $ L $10.00 $ x $7.00 E a $5.00 O (A J 14 W x $3.00 $ Heater $1.00 $ .Ni E N d 41 $N4 v $4 A C E 01 a $4 0 •rA N •N N N 0 a +Cf 0 O O O .8 'd -'d7 40.1 ro N ro tll .0i w' (a rd W -4 TA ro 3 $+ O in W .0 V1 W U W Q 3 C7 z. � � p aS leC v1 U D W 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Nu=ber Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction NO. RATE TOTAL r. $3.00 $ x $2.00 $ x $2.00 $ x $5.00 $ x $5.00 $ x $10.00 $ x $7.00 $ x $5.00 $ x $5.00 $ x $3.00 $ x $1.00 $ X $10.00 $ $5.00 $ $2.00 $ State Surcharge $ .50 TOTAL FEE REINSPECTION FEE ($10.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct OWNER KIND C Fridley, Mn. 9'. - --� / _ , 19;76 USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. ---�G� Company Signed By Tel. No.z— ROUGH INSP. Date FINAL INSP. V-1 7 - Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PE IT IS $7.50 SUBJECT PE City of Fridley 154 7w- AT THE TOP OF THE TWINS BUILDING PERMIT rp IIIE CEIPT N0. • _____ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r S r PROTECTIVE 1 � � CITY HALL FRIDLEY 55432 ,.j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/27/79 JOB ADDRESS 7550 - 5t1i Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 1 Osborne Manor SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Mark Alfredson 7550 - 5t1i Street N.E. 784-3667 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Viking Home Improvement Co. 4832 - 21 Street N.E. 560-3794 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 X 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be second but not third roof. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DV/LG. 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 $64Q.00 $•50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFO MANCE OF CONST CTION. PLAN CHECK FEE TOTAL FEE y$8.00 SIGNA URE F CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT BLDG INSP 0A TIE SIGNATURE OF OWNER 0F OWNER BUILDERI (DATE) OWNER:/ ADDRESS: CITY OF FRIDLEY -APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) TEL NO: T � BUILDER: d ADDRESS: - TEL NO: Slo a —3 7Y7 Construction Location • STREET NO: 75S -C7 STREET: 5 a'H- • /(/,e - LOT: BLOCK: ADDITION: dj1'se- Corner Lot: Inside Lot: ,% Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square.Feet: Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: it CQ , 4b Be Completed: Proposed Driveway Width If New Opening Is Desired: dU Estimated Cost: $ �J Alt. A Alt. B SEE REVERSE SIDE OF SHEET 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.- ? �i SIGNATURE: Stipulations: �a0 SUBJECT MIT NO. City of Fridley 7n6 228 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. v �� I PROTECTIVE INSPECTION SEC. r NUMBERREV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/12198 JOB ADDRESS 7550 5 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Osborne Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark/Holly Waznik 7550 5 Street NE 780-9321 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (18 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 L ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,501 $.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 51.25 Fire SC $1.50 STRUCTION OR THE PERFOR%ANCE OF CONSTRUCTION. � PLAN CHECK FEE TO�T5LFEED SIGNATURE OF CONTRACTOR AUTHORIZED AGENT IDATEI p PER LI DATED TW IS YOU PERMIT 'ffLDG ASP • aI r GATE SIGNATURE OF OWNER,IF OWNER BUILDER) NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: '75-50 9-'t- St. Legal Description: Owner Name & Address: f U i IL(- t' 1-4 `w AZA' i k Tel. Contractor: MN LICENSE # Address: --) S Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width _ Hgt/Ground Sq. Ft. OTHER: G S E' Z CPA" / Construction Type: '4t- 12-tj �C FS Estimated Cost: $ 18V (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 12 q APPLICANT: � "�-�— �- Tel. # 7 �/O 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 $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: x w x U Q TY OF FWDLEY INSPECTION DIVISION Effective 3sauary 1, 2003 131 University Ave NE idiey, MN 55432 APPUCATiON FOR DOWER PLANTS AND NEATIN12, OOOUW% YENTILATIOH, m 63) 572.3606 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEUX= u. &K (763) 571-1287 RATE SCIIEDOLE L A asidential =ornate Shelf and Duct Work, Burner %D %Iso Replacement Furnace (Side dent • Fill Out flack) gas Piping (Needed with new furnace, but not replacement) Sas Range 0 ~ mas Dryer %ir Conditioning. All Sizes ill Others/Repairs & Aiterations (LIST ON BACK) 1 % of Value of Appliance or Work r .Q rmrarercial/Industrial Z2 25w, of Val f JOB ADDRESS 75 so 5-,3' Sr LL •• ue © Appliance or Wool $_ The undersigned hereb makes a y application for a permit for tem warlc herein Siete Surcharge specified agreeing to do all work in strict accordance with the City Codes an $. rulings of the Building Division. and Hereby declares that all the facts and I. - co `3 TOTAL FEE $- �.�presaMatiares stated in this appHcat;on are true and correct. LCD� rl- a oarl: OCA �1 c 9103 °D `` mifflltm FEE FOR ANY HEATING/ fATI0� HEATING CO �rrrecT�ttAyN / x / Lo .US THE 3 5D STATE WICKARGf r - Signed T£l # /z- PIP -423 if m :INSPECTION FEE $47.00/Hr FAX # (C5/� r� rr) it Conditioners can not be ptaced in a skis yard without Approved Rough -in Date_ _._i 7 'Ater perrnission from adjoining property owner. Final Date co C� m FILL OUT BACK SIDE FOR S VERIFICATION ON RF CE�utE+�T FURNACE W 63 OWNE p Rata TOTAL $30.00 $ BUILDING USED AS J!r5 B U .30' $10.00 ESTIMATED COST YDD� PERMIT 110. $ 10.00 $ DESCRIIaTION OF FURNACE uue OR BURNER $ 10.00 $ No. of Heating Units_ 1' Circle One (Steam) (Hot Water) arm Air Trade NameTA�t roCOL Size No. $25-00 ; BTU /an K Fuel n/.Er. G�4S HP £DIR Total Connected Load /oDK Burner Trade Name Sue ft, S._. BTU HP EDR LL •• ue © Appliance or Wool $_ The undersigned hereb makes a y application for a permit for tem warlc herein Siete Surcharge specified agreeing to do all work in strict accordance with the City Codes an $. rulings of the Building Division. and Hereby declares that all the facts and I. - co `3 TOTAL FEE $- �.�presaMatiares stated in this appHcat;on are true and correct. LCD� rl- a oarl: OCA �1 c 9103 °D `` mifflltm FEE FOR ANY HEATING/ fATI0� HEATING CO �rrrecT�ttAyN / x / Lo .US THE 3 5D STATE WICKARGf r - Signed T£l # /z- PIP -423 if m :INSPECTION FEE $47.00/Hr FAX # (C5/� r� rr) it Conditioners can not be ptaced in a skis yard without Approved Rough -in Date_ _._i 7 'Ater perrnission from adjoining property owner. Final Date co C� m FILL OUT BACK SIDE FOR S VERIFICATION ON RF CE�utE+�T FURNACE W 63 06/09/2003 07:03 6127887860 JUN -03-2003 15:59 FROM CITY OF FRIDLEY ARCH MECH PAGE 02 TO 6516367491 P.05/eS TM BELOW MUST BE FKAJM IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When , the undersigned hereby verifies that the venft has been examined and is free from rust, deterioration. obstructions, and is securely supported and Arestopped where required. Yes p( No( ) The venting system Is plastic VPVC and meets all current codes and manufacturer specifications including sizing, length, nuftw of elbows and termination. Yes( ) No The undersigned also veriflos that the replacement unit is a listed assembly and meats the current codes and manufacturers specftications. This does incl ufe AGA -r~ Category 1 Central Furnace Venting Tables for fan asbted and nattual draft appliance& Yes p<No ( ) The W" - . - %n -'-r is sized and installed to meet the current codes and marudac turees spvcIlcations. Yes( ) No( ) Wlwtt required b K will be sized and installed to moot the warrent codes and manufacxurt S specification. Yes pQ No( ) When • the undersigned hereby venfros that it is a d assembly and meets the cumnt codes and manufacturer's moans. This does include AGA-GAMA Category I Central Furnace `� Venting Tables for fan assisted and nawral drain appliances. Yes W No( is the common vent and vent connectors sketl and installed correctly after an appliance has been removed from the common vent and vented separst0y as per curnent codes. Yes-O<No ( ? Apr—' a J^ and Sbya'-nmmon Vent and V rAt Connee r.Infnrmatien Applio= #1 'Type 40 M A ce- BTU input 100 Fan Assisted or Nat Apptience #22 Type • � BTU input Fan Assisted or Net Appliance 03 Type BTU Input Fan Assisted or Not Toad Appliances Total Btu Input �. Common Vent TypeA(Vta1 ZOO Vent Height Diameter inches Appliance #1 Vent Connector Height ft Leq$h­ft Diameter in Type Appliance #2 Vent Connector Heraht R Length it Diameter In Type Appliance #3 Vent Connector Height -ft Length -ft Diameter in Type _,.. At TEReTIVINN. 1 Lel"CV.F( A�rO XN,St�t//fM& oF.�IJ,Fr HEATING CO: IffalfrEET /%EcN1f1V 1'C L .tHG Signed By: Date: ch/o TOTAL, P.05 Building PLUMBING Permit No.: ' Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE ` �f- YOUR E-MAIL ADDRESS SITE ADDRESS(�I�C� S THIS APPLICANT IS: ❑ OWNER (WCONTRACTOR PROPERTY NAME: -,5:)e_L f Zz-r_,o_ ADDRESS: `j O - 4> St _ L . � _ CITY �- t0_ STATE � ZIP_M� OWNER/TENANT �7�V- PHONE: / "- ()7ErZ CONTRACTOR NAME;-Ld,4,k - STATE LICENSE # EXP DATE �/ � l CITY STATE9�ZIP� �) SUBMIT A COPY OF YOUR STATE ADDRESSI'3 % (�!� LICENSE WITH PHONE !? FAX APPLICATION - PERMIT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE 24PLACEMENT TYPE OF WORK: ❑ NEW DETAILED DESCRIPTION OF WORK T[ PW M PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) _ BATH SINK/LAV _FLOOR DRAINS _ SHOWER WATER PIPING POOL WATER SOFTNER ($35) _ BATHTUB _ GAS PIPING (nom cm'uCEnrA _ SWIMMING CLOTHES WASHER KITCHEN SINK —WATER CLOSET _ BACKFLOW PREV. ($15) _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER 0811° F ? 00' Permit Fee $ Number o fixtures @ $10.00 x $10.00 = $ f Surcharge Number of fixtures @ $15.00 x $15.00 = $ .50 Number of fixtures @ $35.00 J_ x $35.00 = $— TOTAL DUE $ State Surcharge = $50 Total = $ -_� THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of a otk which u' s review and approval of plans. SIGNATURE OF APPLICANT AME �CX l� ✓ 1 DATE�� ��� ___ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977