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PRE 2010 DOCSkity of Fridley, Minn. 0 BUILDING PERMIT N° 4038 ._%- � - �i Date: ... ...................... s Owner:............................................................. ........... ........ _............ ..................... Builder // - _.._J _........ Address ........................ __.... ................ _......... _..._._._.._...._...................... Address ........ _............. _............. _............ _............... _..................................... _._._.._ // - LOCATION OF BUILDING No....i..,( ..(Ca_-- Street----------.--1�... ........... .............. Part of Lot ..... _....... ---- _............. Lot ............ .............. Block ............. ../.............................. Addition or Sub -Division 'G� --- -- ............._............................_............_..... $ o Corner Lot ................................... Inside Lot X ........................... Setback ` ...®........... Sideyard .. f,&.`.._.. ....._............_.. ..................... SewerElevation ....................... Q.....1....._�...------........--------......................... Foundation Elevation .................... ............... _............. ............................. DESCRIPTION OF BUILDING To be Used as: 1.V.e .......... Front ..:I_.... ._O Depth ._.. Height / ....o Sq. Ft .... --4 Cu. Ft. /.....r'�.. .1 ................................. -....... .............. Front ---................... Depth .................... _.. //Height .... ..- ... Sq. Ft......................... Cu. Ft. .................... ... D�A VO -110 Type of Construction ...................... ........................ Est. Cost..../..Z.. .. ... .. To be Completed ....._............. ............................... In consideration of the issuance to me of a permit to construct the buoding described above, I agree to do the proposed work in accordance with the description above set forth an complian th all prov�si� of ordinances of the city of Fridley. A In consideration of the payment of a fee of $./....f1....__... permit is hereby granted to ...... __........ .................................. .............. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. I Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. h 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA �1. Owners Name Builders w, �._ Address l`a Address LOCATIO '::OF BUILDING Y . No. &Street Part of Lot Lot Block flddition or Sub.Div. Corner Lot Inside Lot. Set Back`' Si a-Xard SEWER ELEVATION7'Yi% FOiTNDATION ELEVATION / Applicant,:attach to this fora► Certificate•of Survey of Lot and proposed builA ng location: DESCRIPTION OF BUILDING To be u as: .4 Front . Depth Height Sq. Ft. �Lll e1511 Cu„ Ft. .. - Front Depth Height Sq. Ft. Cu. Ft.,: . imated Cost' Type of To be compl.e 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 oi' Buildings, and hereby declares that the facts and representa- tions stated this "pplcation are true•and corre DATE �S ;_:SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) d, P ;1XXCity of Fridley Application for Plumbing and Gas Ming Permit � Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK 0y-/ Number, Kind and Location of Fixtures Location I ® /—(� I O. RATE TOTAL Number Fixtures ...................... X vl Y Future Fixture Opening ................ K Z N $ New Fixture Old Opening .............. x 1.00 F N WATER HTR. GAS ELEC. Base Z x 2.00 $ ° Od New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 $ , A Additional Fixtures .................... 1st $ Gas Range to 200,000 BTU .............. x 2.00 $ 2nd 3rd 4th — Future Connection Openings I New Fixture, Old Openings Connected with Sewer Cesspool 0 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE TOTAL Number Fixtures ...................... X x $1.50 $ M9, S 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) ...... Z x 2.00 $ ° Od New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 $ , A Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code 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. /•FriffiRley, Minn__ Y- a'q9 19_ 5 Owner /0721, 19— Kind of Building 19 a Usedas To be completed about ®J Estimated Cost, $ & Old �eBullding Permit No ©0 sign By _. Business Phone No JUL 14 1959 ROugn Description ............................. TOTAL FEE11 POST 1M-19-58 City of Fridley, Minn. BUILDING PERMIT • Date: July 30, 1968 • • Owners David L. Wahlgren Builder Address 6161 6th St. N. E. Address Same Same LOCATION OF BUILDING No. _ 6161 Street 6th S t . N. E. _____ part of Lot Lot 13 Block 1 Addition or Sub -Division __ Aland 2nd Corner Lot . Inside Lot _ _ Setback _ _ _ Sideyard _.._ Sewer Elevation Foundation Elevation -.Xrl,46 g'_3 N9 9854 DESCRIPTION OF BUILDING To be Used as: Garage Front 24' Depth _2AL Height __ Q! Sq. Ft. 576_ Cu. Ft __57120 Front Depth _ _ Height — Sq. Ft. Cu. Ft Type of construction Frame Est Cost ,^�1500� 00 �..__ 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 orth and in compliance with 21 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to David L. Wahlgren to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Official Building ZnViDIM NOTICE: This permit does not cover the construction, Installadon for wiring, plumbing, gas heating, sewer or crater. Be sun to see the Building Inspector for separate permits for these hems. 1W APPLICATI(X FOR.BUILDT,.NU.PE T CXV OF .RPIDLEY, MT.P;NESOTA - OWNER'S Wk f\y i DI�BUILDER _ ADDRESs__&I % 1 l�T 717- ADDRESS _ - - WCATibi OF BUILDING WO.- I 1 STREET % 7t± STS �C LOT $LQCR _ '–ADDITION - DR, SUBDiVIS101t CORIZR LOT INSIDE LOT: $ETAACK SIDEYARD_� SEWER ELEVATION T4, • OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front Depth Height:_ Square feet Cubic Feet Front Z4 Depth Zq Height /Q Square feet S (_ Cubic Feet 5– -7 (go Type of Construction 7$?4w G7 Estimated Cost TSO® -L 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 _% 30 - C. 8� SIGNATURE e — (Schedule of Fee Costs can be found on the Reverse Side). CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDEkiTIAL ` RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $®� Gas Piping $ 10.00 $ (piping needed with new furnace) Gas Range $ 10.00 $ Gas Dryer S 10.00 $ • Air Conditioning (all sizes) S 10.00 $� All Others/Repairs and Alterations 1% of Value of Appliance or Work $ COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work $ State Surcharge $ .50 TOTAL FEE $ Reinspection Fee `($15.00) $ d S V Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission Frog adjoining neighbor. Job Address Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 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 a and correct. h /� Fridley, Minn. U , 19 -)Z 7 ��L KIND OF BUILDING USED AS TO BE CC ESTIMATED COST �CJUC-- • ��� OLD - NEW BUILDING PERMIT,NO. PERMIT NO. No to DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name) -4 Size No. --e-7s ®�) Capacity Sq. Ft. BDR BTU + / HP / /q Total Connected Load Kind of Fuel /1L C��S BURNER - Trade Name Size No. Capacity Sq. Ft. EDR _ Compan Signed Tel. N Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes No ( ) 2. Is free from rust or deterioration Yes (✓� No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes ( No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes (-V)l No ( ) 6. Has Total heating BTU's of Z_ O00 a' All other BTU's TOTAL Rema rk s Company ---)y Signed By Date SUBJECT l O.24694 City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. COMMUNITY DEVELOPMENT DIV r • PROTECTIVE INSPECTION SEC i 57 1 • • /'--1 CITY HALL FRIDLEV 55432 NUMBER DATE PAGE OF APPROVED BY 1'j 612-571-3450 7F7 910-F15 10/16/96 JOB ADDRESS 6161 6 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 13 1 I Upland 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Walhgren 6161 6 Street NE 571-2053 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118 Snelling Ave S M ls. MN 55406 721-6628 2179 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 O ALTERATION U REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House; soffit & fascia; storm doors, patio door 9 CHANGE OF USE FROM TO STIPULATIONS Provide ventilation to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $11,280 $5.64 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 $11.28 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $187.25 PLAN CHECK FEE TOTAL FEE License SC $5.00 $209.17 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERL ALI DATED THIS IS YOUR PERMIT 4 BL INSP 1 - BATE SIGNATURE OFOWNER IIFOWNER BUILDERI (DATE) NEW (� ADDN (( CITY OF FRIDLEY ALTER (j SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: 4�1141- l _'L Legal Description: Owner Name & Address: Cont actor:_� %2Q/, -*- Address: 9//0 ' / L /), L I /Tel. # MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # Effective 1 / 1 /94 .7/-3453 LIVING AREA: Length Width _ Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft.- DECK t.DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ I Inside Lot [ I Ft. Yd Setback Side Yard Setbacks Type of Construction: 51DIAj67/ STDkA-e' Z)61C l Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 F = Ft x = $ DATE: -c - �O APPLICANT: Tel. # ID/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL '$ STIPULATIONS: _CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $800 per SAC Unit $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 ( j SUBJECT City of Fraley =2�83 THE TWINS BUILDING ILDING PERMIT Irp, 57- T NO. ` `� _____ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 � NUMBER REV DATE PAGE OF APPROVED By i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/22/98 JOB ADDRESS 6161 6th Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 1 1 Upland, 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Wahl ren 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118 Snelling - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION RX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside; Soffit and fascia 9 CHANGEOFUSEFROM TO STIPULATIONS covering. Call for building wrap inspection before arla rix . Install soffit ventillation to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIREO 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 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 $2100 $1.05 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 PERFORMANCE OF CONSTRUCTION $74.75 Fire SC $2.10 PLAN CHECK FEE TOTAL FEE LIcen a SC $5.00 $82.90 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY IDATED THIS ISY UR PERMIT A6 -2z f -19 SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI BLD I- rJATE NEW [ ] ADDN [ ] ALTER [ ] • ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 Owner Name & Address:Tel. # Contractor: MN LICENSE # Z179 Address: Jvryej Tel. # 721-4�a(,,vZP Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:Estimated Cost: $ ':-212W -600 • �'1�.,_�� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: � - d APPLICANT: f Tel. # Permit Fee $'�.' Fire Surcharge $ �® State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ DOTAL $ a STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/ 10th%) $.50/$1,000 Valuation $1000 per SAC Unit $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 [ ] 01 SUBJECT P2 City of Fridley 8 6 66 AT THE TOP OF THE TWINS BUILDING P E R M I T,' ..572-36 NITY DEVELOPMENT DIV. o. PROTECTIVE INSPECTION SEC. C goo I� 1 I � CITY HALL FRIDLEY $5432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/30/98 10B ADDRESS 6161 6th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 1 lUpland, 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Wahlgren 571-3053 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Westphal Roofing 686 141st Ln NW Andover MN 55304 754-3294 3937 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential I CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION IIS REPAIR 0 MOVE 0 REMOVE B DESCRIBE WORK Reroof house (12 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the 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 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 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 $1028 .51 DOES NOT PRESUME Tq GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS N HER STATE OR LOCAL LAW REGULATING CON- ST UCTI R P�ANCE OF CONSTRU ION 37.50 Fire SC $1.03 PLAN CHECK FEE TOTALFEE License SC 5. 44.04 S.INATUBEOFCON'RACTOROR NORiZEDAGENT iDATE, WHENPROP;Er VALIDATED THIS IS YOUR PE�ORM.IITT/T 84G NSP - "Alt S-GNATURE OF OWNER. -F OWNER BUILDER, iDATE, 01 NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: 1 I Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 Owner Name & Address: , J h (L(2VU Tel. # Contractor: h--+— MN LICENSE # Address: d 6 tel/ /—, t,) Tel. # 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 SqFt. OTHER: ,'%r)c)SC r�L/,� /Z c� /n .at✓' ;K/vF Construction Type: Estimated Cost: $ T I'D,? 8 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: G ,APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ .32. S 6 $ .� Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $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 [ ] CITY OF FRIDLEY INSPECTION DIV. 3431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BF INSTAL I Fn ON FACH Fi MR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric NO. RATE Water Heater - Gas" Gas Range" Gas Dryer" Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 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 ADDRESS540E I"s 61401E State Surcharge $ .50 TOTAL FEE $M-� 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. WAHLGREN, DAVID -7/ , 2001 6161 6TH STREET NORTHEAST FRIDLEY, MN 55432 Owner _ (763) 571-3053 Building Used As T)S610424 C.R Lif _�' Estimated Cost PERMIT NO. PLUMBING COMPANY©�00I� Z.tJ#?,&A) SIGNED BYTEL N0.1d' Z-827-1/0 .�L3 Approved By Rough -In Date Final Date 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 replaclna 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. 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 Installina 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 Nate, 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) — 7 HEATING CO: Signed By: Date : IJ�eu Building $ BUILDING Plan Review Permit No.: Inspections Surcharge RESIDENTIAL APPLICATION (.0005) times the total job valuation — Minimum $.50 Received By: 763-572-3604 .001 x Permit Valuation (1/10%) CITY OF FRIDLEY $ Err Date Rec'd: DATE 17,0 b YOUR E-MAIL ADDRESS {�I/1SCs i�I �' )Q /Vl SITE ADDRESS $ ft + 6 ft = ft x $20 = $ THIS APPLICANT IS: ❑ OWNER ONTRA –R $450 Conservation Plan Review PROPERTY OWNER/ NA,A,M: Fee Determined by Engineering TENANT CIT' ADDRESS: �91 tol t-� S� til , C - --Y STATE ZIP a� Total Due PHONE: �IO?i7 011— f?20 195. gOdake checks payable to: City of Fridley Attach Stipulations CONTRACTOR N,s,ME:_ RENEWAL BY ANDERSEN SUBMIT A COPY OF STATE LICE 1920 COUNTY RD. "C" WEST YOUR STATE LICENSE ADDRESS:— ROSEVILLE, MN 55113 CITY STATE ZIP WITH APPLICATION PHONE 651-264-4777 LICENSE #20130983 PROPERTY TYPE❑o -)RIES PERMIT TYPE CIADDITION ❑ GARAGEISHED 19WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION SAN ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF HVIPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROO G ❑HOUSE ONLY NUMB OF SQU ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAG ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSE SIZE ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Alumin ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS $Yes ❑No A ON OF WS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF�]a} OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION _$ LI, —7 —7 0 ` OCCUPANCYL TYPE— ,Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $?? (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $r--® .001 x Permit Valuation (1/10%) ,License Surcharge $ Err $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ ( 195. gOdake checks payable to: City of Fridley Attach Stipulations 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 f r 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 all work wl requires r i and. approval of plans. �1�1 SIGNATURE OF APPLICANT /� PRINT NAME Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE 1�G :�10 YOUR E-MAIL ADDRESS U:1� SITE ADDRESS �' �1 1 — o ST, T THIS APPLICANT IS: ❑ OWNER WCONTRACTOR PROPERTY OWNER/ NAMEM0�A�` TENANT ADDRESS:T CITY STATE_ZIP PHONE: NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 t STATE—ZIP— TATEZIPWITH WITHAPPLICATION PHONE License #20130983 ❑ SINGLE FAMILY/N0 PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4777 _ — ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING 0 OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION C3MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: YY1 r ' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHTr . Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ Vinyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminum ❑ Other ❑ Trim ADDITIONS. 1. & PORCHES SUBMrr: Site Plan/Survey showing the existing structur ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ Co. (Don OrClIPANC-V TVPR Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ tD.lo $ 3. O $ —M-) 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) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit but only an applicati n for a permit and work is not to start without a permit; that the work will be in accordance with the approve plan in the case of all work hick requ' review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME ��n (jY1,DATE N r