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PRE 2010 DOCSBUILDING PERMIT V . N° 227(1 Village, of Fridley, Minn.,- � Y Date• • .. ...... Owner�.�.��. r...... _ '!��.'�.. .......... Builder ............................ Address /,FIA' . Address ...... .... ........ . LOCATION OF BUILDING NO... i! %w...... Street...................:.... Part of Lot ....................... Lot ...... �131ock . Addition or Sub -Division. B ... .. ! 40 • ........ . Corner Lot .1l+".`.. Inside Lot ....... Setback . Sideyard .. ... ....... . t -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. Coat .:I: t�.. .. To be Completed . u' ................ i In consideration othe issuance to me. of a permit to construct the building described above, I agree to do the proposed work h t ccordance with the description above set forth and in compliance with all provisions.of ordinances of the villof Fridley. .h.....•. .,.............. .. n c s oration the payment of a fee of $..41% . , permit is hereby. granted to . to construct the buildingor addition as described above. This permit is granted upon the express condition t the person to whom -it is granted and his agents, employees and workmen, in all work done in, around and, ul on said building, or any part thereof, shall conform In all respects to the ordinances of Fridley, Minnesota r g location, construction, alteration, maintenance; repair and moving of buildings with - In tl q village limits an I this permit may be revoked at any, time upo;v violation .of any of the provisions of said ordinahces.. Building Inspector NOTICE: This permit d° i not cover the construction, Installation or alteration' for wiring, plumbing, gas heating, sewer or water. Be inure to seethe Building Inspector for separate permits for these Items. I BUILDING PERMIT Village of Fridley, Minn. N° 2335 Date.............................. Owner /....... Builder ............................................ { Address......... ............................. Address ......................................... � CATION y�O, F BUILDING No. .. .. Street "'''�"j- '. `....*04;. .............. Part of Lot ...... ............. l�Lot ... I�'Block ... ............ ........ .... Addition or Sub-Division�E�Z..... ................. Corner Lot ..... .. Inside Lot ............ Setback ........ ~� ��� Sideyard ��i!....��............. 11 DESCRIPTION OF BUILDING To be Use as: ..... .... Front . T .. Depth 4 # ... Height /14!... I, ................... Front ........ Depth /�...... Height ......... Type of Construction: ... t ! 46!11rd ............. Est. Cost Sq. Ft......... Cu. Ft. ........ Sq. Ft. ........ /�, Cu. yFt......... To be Completed "'lay 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. ..............................A*................... id��era 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 rearding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon }nolat�on of any of the provisions of said ordinances. .� 1 / ,/_ % ,n fir ... V.... f -'': Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Bq. sure to see the Building Inspector for separate permits for these Items. , i City of Fridley, Minn. N° .8 519 BUILDING PERMIT Date: October UP 1265 Owner: John L. Jensen Builder J. J. Nagengart Address - 6070 - 6th Street, N --W- Address 5712 Greek V l l evs Edina_ LOCATION OF BUILDING No. 6Q7i1_ _ Street 6th ftreet R.E. Para of Lot Lot _.3 _ Block p Addition or Sub.Division . Bonny Addition Corner Lot _ Inside Lot Setback _ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: D glli8g Front Depth Height — Sq. Ft. Cu. Ft. Front Depth Height _ _ Sq. Ft. Cu. Ft. Type of Construction & Est. Cost _ 1 s 000.00 _ _ To be Completed Storm Damage 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 sett forth and in compliance with ons of ord moss of the city of Fridley. A // In consideration of the payment of a fee of .�?�.CC �`J , permit is hereby granted to .J.,7.1laganoart to construct the building or addition as described above. This permit is granted upon the express condition that the peon to whom it is granted and his agents, employs and workmen, in aII work done in, around and upon said building, or any thereof, shall conform in all respects to the ordinances of Fridley, Mirmesota rega�n� location, construction, alteration, maintenance, repair and moving of buildings within the dty limits and tb�a permit may be revoked at aqy time upon violation of say of the Provisions of said ordinances. NOTICE: Me permit den net emu the eenstraetien, Irma m for wirl& ph=bW9, on hsdW& sewer or water. Be son to sso do Bufldh* hmpedw for apm to permits for thea it=s. OWNER'S ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING Street Part of Lot LOT, OCR ADDITION OR SUBDIVISION ff Corner Lot_L_Inside LOT 10 Setback Side—Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant -attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth,_ Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Coastruction,�_�� Estimated Cott si O To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this,application are true and correct. SIGNATURE I� (Schedule of Fee Costs can be found o e Revers Side) 0 Date: Sept. 13, 1967 0 City of Fridley, Minn. N9 9446 BUILDING PERMIT Owner. John L. Jenson Builder ____Sup s e 1 Co. Address 6070 6th S t . N. E. Address 1850 Como Ave, LOCATION OF BUILDING No. 6 07 0 Street 6th S t . N. E. __ pmt of Lot Lot — I ___ Block 2 Addition or Sub -Division _— B nnIM A d do Corner Lot Inside Lot _ Setback --_ Sideyard Sewer Elevation __ _ _ Foundation Elevation To be Used as: Finish Basement Front Front Type of Construction DESCRIPTION OF BUILDING Depth Height Sq. Ft. Cu. Ft Depth Height Sq. Ft. Cu. Ft. r Est. Cost _ �a _2...QQ4 �To be Completed 7 %1 S �h R 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. j 'g ® " In consideration of the payment of a fee of $ 12.00 , permit is hereby granted to Sussel Co. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of withinythed e8lota imitsregardingnthislocation, construction, alteration, maintenance, repair and moving of building city 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 whdng, plumbing, gas heating, ewer or water. Be sun to ase the Building Inspector for separate permits for these Mena. AMLIC.M.Cli FOR B711ILDIPIG ??E r- IT CIT OF Fk�i;J:,E?, MINNESOTA OWNER'S NAME e/®1l �y ®l @ � Ru,.F•DER C� .SSE co ADDRESS f) 7 lJ ' S f- �9 ADDRESS gs, o LOCATION OF BUILDING N0. STREET f ILI /- PART OF LOT LOTBLOCK ADDITION OR SUBDIVISION 11 o a CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING - To Be Used Ad: jd,4,,� Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost �G d To Be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 3 - SIGNATURE Uo- yy (Schedule of Fee Costs can be found on the Revetse Side). t► City of Fridley, Minn. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT ate; July 16, 1971 per; _ John Jenson Builder Russel Company MIR Address - _6070-6tb Street N.E. Address 1850 Como Avenue, St. Paul LOCATION OF BUILDING No. - 6070 Street 6th Street N.E. Part of Lot Lot 1 Block 2 Addition or Sub -Division M Bonny Addition Corner Lot inside Lot X Setback __ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Gnrage Front 24' Depth 22' Height 10' Sq. Ft. 528' Cu. Ft. 5280' Front Depth Height Sq. Ft. __ Cu. Ft. Type of Construction Frame Est. Cost _ $2,100.00 To be Completed 90 days Provide a hard surface drive. Set Garage slab elevation 4" above grade at house on West side. 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. ---- $1 -15 -State Surcharge .. In consideration of the payment of a fee of - 10.00 , permit is hereby granted to Sussel Company 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 buildup V.Itblnnthe city limits and this permit may be revoked at any time upon violation of any of the provisions of said l �: /1 �n�.e' �✓ ►. L�-� A ay Spector CLARENCE BELISLE NOTICE This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sun to we the Building Inspector for separate permits for these items. 1e',V .:;I. f nec« SALES M AN ,` 'i,%k �'�s" - •- CONTRACT DATE JOB. ADD-.—�--SS BLGD. CODE AREA -' d OR GrY 10E Us. bALYy CONTRACTOR:' JOB E7" ` SUSSEL UOB r CONTRACT # 300 - INDICATE THE ITEMS BELOW ON LAYOUT Cord4iz 'F-- r Kear Z-5-carzings mint:: wiry �.n. Dr. Offset Alley S.P.L. house S.L. Location meets y S.S.P.L. --locks "W?,—L]-BF- Property Lines R.P.L. Gtiaer indows 1SEasement p -ley �sare With Soa Reem. -BY5 `�_ - -Eaz Mix . RG•iilJ .�LiG Permit By Legal Description Lot Blk b Add' Value Type Const. " f' CONTRACT # 1 j fi 0 _ ., j /-RC�c�hrj� hf(t�i J� . IL',50 CONwO AVE. ST. PAUL CALL: 645-0331 SALESMAN CONTRACT DATE JOB ADDRESS FOR OFF/CEUSE ONLY CONTRACTOR JOB# '^— - ' |ND|CATETHE ITEMS 8ELQWDi\jLAYOUT _ �Pormitby / [] Legal Description —_---_--_� � �uo � �� 8|l( | :1Add'n [-7 Value E: Type Consx. | / �Square With / — Rods |� *asn �Sod Rmn.'By___________ Mix — 3,3ug K0.x ompirig _ [,�oTamping 2-6zaninyoPoints Only S.P.L. S.S]P.L. R.P.L. Alley House F. Street Other CJNDU|T Dr. Offset � S.D.Lumtion — "';ocks �vVindowo ' ' . ?A��7 OF CONTRACT # ns�� ~ / � ` APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAM: -fc k-, -Ae -L.T'0/U BUILDER: '=�d6 Sj e ADDRESS: foo iQ 6 "', 1511 kl� ADDRESS: 145-6 bin a A-V_ - --51' NO:. STREET: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: & 4d Lk ._;1 I/ Front • �7 �?_ Depth: /o o Height Square Feet:__ Cubic Feet: ' vz S Front: —Depth: Height: Square Feet; Cubic Feet: Type of Construction: krO.W� Estimated Cost: $ .71es =` To Be Completed: ?0 4z I The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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: dcc /0 - 1 ?W SIGNATURE: Cd - (See Reverse Side For Additional Information.) f.? los l//"v A., 60000 VIOGUNNoto so-ladvilmm" Hinom mnNHAV HIVE - 6909 MOASAmns QNV U33NION2 11AID A3-lC3VU8 'H 'S io IV t) f.? los l//"v A., 60000 VIOGUNNoto so-ladvilmm" Hinom mnNHAV HIVE - 6909 MOASAmns QNV U33NION2 11AID A3-lC3VU8 'H 'S CITY OF FRIDLEY Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE / RESIDEaTIAL RATE TOTAL Job Address L 070'9 / /J Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 Gas Piping $ 10.08 $T_ (piping needed with now furnace) Gas Range $ 10.00 $_� 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 Ga or $ 10.00 $ ' and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. w •Air Conditionin -.(all sizes) $ 10.00 S a, 19�L All .Others/Repairs and Alterations '' owtasR 11 of Value of Appliance or Work S :_ KIND of BUILDING COMMERCIAL/INDUSTRIAL USED AS It of Value of Appliance or Work $ Ta BE COMPLETED ABOUT nOLDIM ATEDCOSTState Surcharge $ .50 . 10(p)NEW BUILDING PERMIT NO. PERMIT NO. a� TOTAL !SE $ REINSPECTION FEE $30.00: $ �� DESCRIPTION OF FURNACE BUHAFERDAi,/l - Rough Insp. Date HEATINGAr POWER PLANTS, Steam, Not Water,Wallo. Final Insp. �D r Trade Name�� 11 E9 1 K . Size No. TZO 0 3 ® 5 Date ( capacity Sq. Ft. EDR BTU MD UP -13 Approval for Permit Total Connected load kind of Fuel BURNER - Trade Name size No. Capacity Sq. Ft. EDR BTU NP MINIMUM FEE FOR ANY BEATING/COOLING/VENTING PERMIT IS $15.00 PLUS TBE $.50 STATE SURCHARGE 'Aix - Conditioners- can not be placed in side yard wi.thagt;_ written pesmiasion from adjoining neighbor. company Richmond & Sons Eir, ft ft Signori By 5182 West Broadway GrYSK MN 55429 Tel. Phon rye Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes No ( ) 2. Is free from rust or deterioration YesNo ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes X 1 No ( ) 5. Meets all current Code requirements for size and to-tal_.BTU connected Yes No ( ) 6. Has Total heating BTU's of All other BTU's —7 TOTAL / U Rema rk s RI�HMtI��SONS dbal. Company GOLD0I VALLEY HSG & A1R Signed By SEP 5 Date 1 J J J e -f suarecr PE City of Fridley 2720-_ 7 2 0.�-1 AT THE TOP OF THE TWINS P,NO. BUILDING P E R M I T 1 COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r ; 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/17198 JOB ADDRESS 6070 6th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Bonn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jenson 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Darr Brent Construction 12601 Able Circle NE Blaine MN 55434 862-3574 20134193 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 Rk REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 20 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING MOT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1668 $.83 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION O�R�THE OF CONSTRUCTION. 54.00 Fire SC $1.67 PERFORMANCE 1�i �/I/�- � f 7—C� � PLAN CHECK FEE TOTAL F E �✓'V \ License 5.00 6 0 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N P OPER[ IOAT I$ IS V UR PERMIT i BLD INSP PATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW' [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY 1 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 070 6A 54 fU E Legal Description: Owner Name & Address: J e h 5 o h Tel. # Contractor: B J - f "t b a V' Ca 1,15 fl- U CMN LICENSE # Address: W01 Able 6, c % IrE Cy j q Tel. #- j�j � r64 35 7� Attach to this application, a Certificate of Surve of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width GARAGE AREA: Length Width DECK AREA: Length Width OTHER: Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type: A e ' Q oo F Estimated Cost: $ / 6 8 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �-17- 1g' APPLICANT: &-evf bOrr Tel. # bJ W 357y Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 5^ 14• 00 Fee Schedule on Reverse Side $ (-, 7 .001 of Permit Valuation (1/10th%) $ 3 $.50/$1,000 Valuation $ $1000 per SAC Unit $ 5`, OO $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 [ ] g /S SUBJECT - PE -. City of Fridley 31734 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. �1 -------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 572-3604 /71171/r PROTECTIVE i "'�•� CITY HALL FRIDLEY 55432 NUMBED pEv DATE PAGE OF APPROVED By ---•� l 612-571-3450 910-F15 4/9/01 JOB ADDRESS 6070 6 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barry/Eleanor Jensen 6070 6 Street NE 763-571-6211 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55416 952-933-6300 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 J REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Permit inspection Cards Will Be (Nailed To Homomer To Post, SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $3.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,502 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- $139.25 Fir,r SC $6.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TO L FEE City i ense 49.00 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT MATE( EN O VALID THIS IS R P OR IT S-GNATURE OF OWNER.IF OWNER BUILDER. IDATEI g p (NSF' FIAfE NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name, & Address: E IUD r Tel. # 26? -S7/ -6Q Contractor.G w MN LICENSE # G2 2 Address: Tel. # q .� 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: Rep cCte-cmc , -" "C:, � C> -&.Construction Type:UJ'G/S Estimated Cost: $ <;50a Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$ DATE: �` S , Ol APPLICANT: / �� Tel. # CITY USE ONLY.: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Call (763) 572-3604 for Permit Fees if mailing in application $ 21 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ M $1100 per SAC Unit $ i 'Licensed -Residential Contractors) $ Alt. "A" or Alt. T" Above $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] (((( ov TOTAL $ �I i STIPULATIONS:r% j"jl�' 47--�o /7`17 l-! c • �G/c,�•�s�--- CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK N11MRFR ()F FIXTI IPPR Trl RF INICTeI I PrI nni Genu r1 nnc Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE New Fixtures �7 $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas"*_ $10.00 Gas Range"* $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes ( ) No Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance TOTAL JOB ADDRESS_ 3417£- +S dWL)SF_ ®l D State Surcharge 5_50 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. 5/0 102' , 20 Owner C-16ndi \Jef [ — &070 &'-- (9'.. �jf Building Used As �;S611)sm Cz Estimated Cost PERMIT NO. 1 PLUMBING COMPANY SIGNED BY TEL NO. 6I0" 8Z7 '1(9 Approved By Rough -in Date Final Date TOTAL FEE $141550 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When reviacing 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 O No ( ) The venting"system is plastic/PVC and meets all current codes and manufacturer specifications :including sizing, length, number of elbows and termination. 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. The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. 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(. ) Yes ( ) No ( ) Yes ( ) No ( ) 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 It Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date :