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PRE 2010 DOCS0 • City of Fridley, Minn. BUILDING PERMIT N® 3630 Date: .. Owner ........... Builder ........ Address ...................................... Address .......................... 1�t41. . .. �� ...�ATI.BUILDING .. ... ........ . No. Street 4 i ........ Part Lot ... a Lot..... ..... Block .. �. ........... Addition or Sub-Divisip .. .. ...... .. . Corner Lot • ............ Inside Lot .... ./` ......... Setback . Sideyard .............. DESCRIPTION OF BUILDING To bA Used as: r t ,r �, /^ Front ��.. 6� Depth �'T— ® eight A� 6 -1 Sq. Ft./ �1 tJ. -0Cu. Ft. 4P .. .... ......� . . . ....... Front V . � Depth A7 .� . 7 Hgight .. M Sq. F . � Cu. 00 Type o Construction ................... Est. Cost. I ....rk.. -7.7- To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed 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 o $.. ., 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 city limits and this permit may be revoked at any time upon violationof any of the provisions of said = ordinances. K!,ij....... 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 InspectoNfor separate permits for these Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEYO MINNESOTA Owners -Name Builder 01, Address ss 7_7: LOCATION "OF BUILDING No.�K. Street Part of Lot Lot Block*. —Addition or Sub. Div. Corner Lot __'inside Lot Set Back "2 Applicant attach to this fork Certificate of Survey of Lot and proposed ' building location. DESCRIPTION OF BUILDING To be used as Front Depth Height Sq. Ft!'Af)j,�-_ cu.. Ft. "Oe t, I e, Front /,:L Depth .2 57eight Sq. Ft. 33.Cu. Ft. '7- Estimated Type of Construction cost To be completed The undersigned hereby makes application for a permit for. the work herein specified, agrgelini,to do all work-in stridtaccordance 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. Date Signature (A Schedule of'Fee 'Costs' can"be found on the -Reverse Side) City of Fridley, Minn. BUILDING PERMIT • Date: July 9, 1965 • • Dan Powers Address 6820 7th Street N. E. N° 8163 Builder D. M. Noyes Constr. Co., Inc. Address 100 West Franklin LOCATION OF BUILDING No. 6820 Street 7th Street N. 3. Part of Lot Lot 4 Block Addition or Sub -Division Rice Creek Terrace, Plat 4 Corner Lot Inside Lot % Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Add'n to Garage Front ? Depth 24 Height 81 Sq. Ft. 168 cu, Ft, 134_ Front Depth }}�� Height Sq. Ft. Cu. Ma OO Type of Construction - Fr -8M ]Lo.a 55QJQC----_ To be Completed New Addition to Garage, also Storm damage In consideration of the issuance to me of a permit to c the proposed work In accordance with the description above ordinances oY the city of Fridley. above, I agree to do with all provisions of In consideration of the payment of a fee of $ 10.00 , t is hjre,4-,- nted to D. M. Noyes Constr. Co., to construct the building or addition as crlbed above. This permit is granted upon Inc. the express condition that the person to whom it is granted and his agents, employees and workmen, in all work da a in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regardiig location, constructtoa, alteration, maintenance, repair and moving of buil�n� wio city ]units and this permit may be revoked at any time ups violation of any of the provialons of eatd Allen Jensen Building Inspector NOTICE: Ibis permit don not cover the condmcdw, hmblbdon for whbi , phmblee, en hedine, sewer or water. Be sun to we the WUdb m lespntor for separate permits for then Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER ,1� ./ . �I�® �� c'& / VC. ADDRESS ADDRESSu 1 d OF BUILDING N0. 0 STREET 'V PART OF LOT LOT____4, BLOCK ADDITION OR SUBDIVISION fl - 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, ; c� evH Front Depth iP �— Height Sq. Ft. / Cu. Ft.�� Front Depth Height Sq. Ft. Cu. Ft. `iy „ �!l jCd v Type of Construction—Estimated Cost To be completed r-_ �" 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 v _ SIGNATURE�a (Schedule of Fee Costs can be found on _the Re 6 r r verse 3 e). . as • • • City of Fridley, Minn. BUILDING PERMIT Date: _ _ ov mb®%! -300 1966 N9 Owner: Mr • Powers Builder Iso 0. Sanders Address 6820.— 7th Street N.E. _ Address 2418 California Street No& 'j e, ®-If 9110 LOCATION OF BUILDING No. 6820 ___,. Street — 7th Street N.E. _ _ _ Part of Lot Lot — 4 __ Block 3 Addition or Sub -Division .___ Rice CreAk Terrace – 7th Add, Corner Lot Inside Lot Setback --- Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Basement under Front _ _ 1 Depth ._._..24._. Height _ ._ Sq. Ft X20__ cu. Ft -4.v2= existing house) Front Depth Height — Sq. Ft. Cu. Ft Type of Construction B83®lltent Est cost 1 .100.00 _ To be Completed 1220-66 In consideration of the issuance to me of a permit to cons et the building described above, I agree to do the proposed work in accordance with the description above forth and in complia a with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ , permit is hereby granted to lea n_ Sanders 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 ordinance=s. NOTICE: lhis permit does not cover the construction, Installation for wiring, plumbing, gas headng, sewer or water. Be sora to see the Building Inspector for separate permits for these boors. " •1 4 ry y N11- , APPLICATION FOR BUMMING PERMIT CITY OF Fi':CMEY, WIVNESOTA1. : .OWNER'S- NAMF,, VOILDER ADDRESS ® �, ADDRESS LOCATION OF BUILDING N0. STREET J/ PART (jF ,LOT.. T r ,U � ZtOCX ��_ ADDITIbN' OR SUBD� VISIdN J� /C. f � CORNEA LOT INSIDE LOT BETBACK SIDE-leARD , .- - SEWER ELEVATIOIQ Applicant attachT to tM-' form Two Cer6tficates .Qf Suirvey of Lai and proposed. �bu3 W rte .a q,..: diawn OA the" -Certificates. d DESCRIPTION -OF "BUIi.DINiG= ,To be used as; 0 .-� Sq. Ft. ® Cu. Ft. a a Front Depth,,_ fight, Sq. Ft., Cu. Ft. Type of Construction .�li EVti ted Cost. 41 ®e ®_ o,-2 To be completed The undersigned 6reby 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. �6 /�� S {Schedule o� Fee Costs can be 5 -0-111 • found on the Reverse Side). /7 City of Fridley Application for Plumbing and Gas fitting Permit 5915.51 Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK682 Q N 7 St • Number, Kind and Location of Fixtures I'oca - y $ x 1.20 $ x 1.00 $ N i Z s Z w Z J w z 0p • P • N WATER HTR. GAS ELEC. Base 1st cc nn i 1 2nd 3rd 4th • Future Connection Openings Connected with I Sewer � e New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin .... . ..................... Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ X $1.50 $ x 1.20 $ x 1.00 $ x 3.25 $ x 2.00 $ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU..............3 x 2.00 $v5-00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $5,uo City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do an work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are are true and correct. Fridley, Minn 14 Au g 67 , 19— Owner Kind of Building fr res Used as To be completed about 18 A -ug Estimated Cost, $ 5.00 Old—New. Building Permit No Permit No. MINNEAPOLIS GAS C Signed 2 By G Business Phone No ROUGH FINAL City of Fridley02r- SUBJECT P NO. 9 7 0 41 AT THE TOP OF THE TWINS BUILDING PERMIT i � • _____ COMMUNITY DEVELOPMENT DIV. IL - r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 612-571-3450 R O. i 9 7� NUMBER 910-F15/ REV. DATE 7/12/83 PAGE OF / APPROVED BY 10B ADDRESS C820 - 7th Street N.E. 1 LEGAL DESCR. LOT NO. 4 BLOCK 3 TRACT OR ADDITION SEE ATTACHED Rice Creek Terrace SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Jim Jachymovski 6820 - 7th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Kloster Madsen Co. 9425 Syndicate 881-9425 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 1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install bay window - remove siding, insulate, add brick front 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBMIS, AND SIGNS 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,500 $] • 75 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF I NY OTHER STATE OR LOCAL LAW REGULATING CON- TRUqTIO THE PERFORMANC OF ONST C $44.50 PLAN CHECK FEE TOTAL FEE P $46.25 TORE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOURP RMIT�j 1 GJ BLDG )NSP TEf SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI CITY OF FItIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDtNTIAL BUILDIiIG PERilITS (New, Alterations, Additions, or Repairs) OW14ER• jz�ri o S�fIO• ADDRESS: TEL n0: ADDRESS: �'�/a S J 1//�4��C F, --A TEL 110: // Construction Location STRICT NO: (9 �� STREET:/rJ // wp I— `U/�� E LOT: _ q _ BLOCK: 3 ADDITION: )Z/ CO)F 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 9F CONSTRUCTION rte''- �j �,/ Fron A 1 w��0� Depth: Height: Square Feet: Cubic Feet: ��gjj(- jL) (. Front: Depth: Height: /A)Zu LA -i v-- - A -U U-X,'�s'quare Feet: Cubic Feet: _ Type of Construction: Estimated Cost: $ 3, QD-� To Be Mripleted: Proposed Driveway Width If New Opening Is Desired: Alt. A Alt. B SEE FZVFI SE SIDE OF SHEET • 9iie undersigned hereby makes application for a permit for the %:,ork 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 applica DATE: Stimulations: 44 S.-6 SIGNATURE: V City of Fridley SUBJECT P O - 17560 AT THE TOP OF THE TWINS PERMIT r BUILDING CEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. j7 /.7 1 , ; 1 , = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 6/18/84 / 10B ADDRESS 6820 - 7th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jachymowski 6820 - 7th Street N.E. 3 CONTRACTOR I MAIL ADDRESS ZIP PHONE LICENSE NO. Kloster-Madsen Co. - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑: ADDITION ❑ ALTERATION ElREPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14' x 12' Deck and a 438A Addn. to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED POR WIRIN HEATING, PLUMBING ANO SIGNS. *39 WS' DIS13313 - 3NOW3131 seivion le3ol Ilea oupip aiolag JNINHVM 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 1 'HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $18� 7OO $9.35 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS O ANY OTHER STATE OR LOCAL LAW REGULATING CON- $134.50 None STRUCTIO THE PE F MANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $33.63 $177.48 IG TUREOFC ACTOR OR AUTHORIZED AGENT (DATE)WHEN PROPERLY ALIDATED THIS IS YOURPERMIT BLDG INSP �i O E SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI ha," 1 ,�. _ a fey, r->..�_"".aY.�ia`n r,;,-x' .=�t�.4 t ..' a �'.- �. -5• - -:� ` .° i�' ''�- '�'. � i . � b. -,� ,s ,t s ','{C.' .rr:'.5a � _ .+ � r G .. ' ... a {�3 Y s i •�„ • F - •e -_ .� a � � `�- �� e �� • ' 1 11 9� 4 y"�r cf V 9 3 • - far. ' � .•l. 1 i .c -Y't %rte -v , JUL NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: .w Legal Description: Owner Name & Address: C S Tel. # Contractor: b S - C )) ,(� I Tel . # c t^ loci! /kt N / / Qz O Address: 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 766 Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: LengthWidth -� Imollg— Hgt/Ground Z4L Sq. Ft. OTHERy q0S q�(A q: q [/W ®, 1 1-6 ( q� ,J " I ' / OX Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback � Type of Construction: Estimated Cost: $ 9 (F '?06 Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge STIPULATIONS: 1 APPLICANT: Tel. #J CITY USE ONLY $ 3 Sd Fee Schedule on Reverse Side $ . G�3 25$ of Building Permit Fee $ ,3� $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering .� �e,P� Agreement Necessary [ ] Not Necessary [ ] if r USURBAN 0 NOINEERINO �1:1:"- IHC a5? ®M❑ . Location "A 00 _ �o I 890('510 Survey for RLOSTER MADSEN CO. t I it Cc 59 Scale: ilnch_ 30" `o LOT 4, BLOCK .3 , RICE CREEK TERRACE, PLAT 4. ARO V0. COURT Y M1Nt�E S OTi4 . SUMECT TO EASEMENT , IF auy I hereby certify that this is a true and correct representation of a urvay of the b undaries of the above described land, and of the location o�J1 buildings] ►hereon, and all v sikfle encroach ents, if any, from or on said land. As surveyed by me this_do of i s o. 1 ,}+ y � —A �( SUSUK AN INFER) , INC. L`1Cy =[ag+nrs y Surveyors b)e Not Published All R,ght, Heswvwl CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 x631572-3604 FAX: (763) 571-1287 ADDRESS 6820 7 ST NE PIN 143024120024 LEGAL DESC RICE CREEK TERRACE PLAT 4 LOT 4 BLOCK 3 PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMITO.12004-00984 DATE ISSUED: 06/24/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, RHEEM, 100,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 VALUE OF APPL OR WORK 1500 # FURNACES # GAS RANGES APPLICANT PROGRESSIVE HEATING & COOLING 9675 HAMILTON RD STE 500 EDEN PRAIRIE, MN 55344 OWNER JACHYMOWSKI JAMES & DIANE 6820 7TH ST NE FRIDLEY, MN 55432 1 # GAS DRYERS 0 0 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 c truction r the performance of construction. Anulicant , Date Bldg Insp. HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 15.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 75.50 PAID WITH CHECK # 010415 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. r m m IL T ti T n T J a L D 5 L, L e) n V i CITY OF FRIDLEY BUILDING INSPECTION 0431 -University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential .Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer .*Air Conditioning - Alt Sizes Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Thi JOB ADDRESS l0 Owner�I $35.00 T,�' $ Building Used As r 1 ifn tf, etsi Cl; enc c ,)o $10.00 $ ESTIMATED COSTSLI • CC) 96 C, `�dj PERMIT NO $10.00 $--� DESCRIPTION OFF RNACEAND BURN a $10.00 $25.00 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 on work less than $300.00 Commo rcia l/ In d ustria Vinstitutiona 1, 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/industrial/institutional State Surcharge $ # of Heating Units --L— Circle One (Steam) (Hot wate (Warm Air) Trade NameZ C.W% 2 1SACA -P— Size No. $a� _ BTU _6 ov, , ®®r--) HP rqEDR Fuel �7ns Total Connected Load Burner Trade Name Size No. BTU HP EOR $--15D - TOTAL FEE $ REINSPECTION FEE $50-UO/HOUR ed ``cc AC *Air Conditioners can not be placed in side yard without written approval l t from adjoining property owner - copy to City The undersigned hereby makes application fora permit for the work herein specified agreeing to do all work In strict accordance with the City Codes and rulings of the Building Mvislon, and hereby declares that all the facts and representations stated in this application are true and correct. Date_ FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -M Date Final Date lk 40 F �enLD m work, E1e.c- "Air Ce(.ner &vnnt6; �i e.r JUN -17-2004 12:53 FROM CITY OF FRIDLEY TO 9529425791 P.03/07 FiLL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT''CONNECTOR AND COMBUSTION AiR VERIFICATION When replaging replacingan 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. 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( ) Yes ( ) When installing a new venting, system, the undersigned hereby verifies that it is a listed assembly and meets the current odes and manufacturer's specifications. This does include AGA GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) Is the common vent and vent connectors sized and iinstalled correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ( ) Appliance Type and Size/Common Vent and Vent Connector information Appliance #1 Type _ BTU Input 1WpoD Fan Assisted or Nat Appliance #Z Type BTU Input _^RC2 Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input /cQ, 41y) Common Vent Type Vent Height --n2 Diameter �fj — inches i 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) J A_ Signed ,/1', No( ) No ( ) No( ) CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 PERMIT NO.: 2004-01014 DATE ISSUED: 06/29/2004 �(�✓ ADDRESS 6820 7 ST NE PIN 143024120024 LEGAL DESC RICE CREEK TERRACE PLAT 4 LOT 4 BLOCK 3 PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT WRIGHT ELECTRIC 2010 EAST CENTER CIRCLE PLYMOUTH, MN 55441 - OWNER JACHYMOWSKI JAMES & DIANE 6820 7TH ST NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 047593 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. Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. I ]' Building $ BUILDING Permit No. Inspections $ RESIDENTIAL APPLICATI ` Received By: 763-572-3604 $ CITY OF FRIDLEY t1 Date Rec'd: DATE Dsp� E-MAIL ADDRESS �E�iaLrL�//✓%�C�S/C �/�%Si7%� cc>/01 AYOUR SITE ADDRESS F42 D LEI THIS APPLICANT IS: XPWNER ❑CONTRACTOR PROPERTY OWNER/ NAME:Me-S c7 -40i vmo w --% // ADDRESS: Lt &p C) --:ZA St 4) C CITY F-ttz D L& STATF�'%IP SSy3 Z TENANT $ PHONE: 763— 5-21— 757a— '" Ce -11 PhDhe rot 2.— Ql ct — k0%=i CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE Y/NEW CONSTRUCTION SIZE $ ❑ TWO FAMILY/NEW CONSTRUCTION STORIES MZ- Lev PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WS =TILE $ ❑ BASEMENT FINISH ❑ ROOF Agreement necessary ( ) Non Necessary ( ) ❑ DECK ❑ SIDING ❑ OTHER $ ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR MODELING 'p DESCRIBE WORK BEING DONE: 12e,o LAu � ) /gon-f C' C`Eu2e 1d1>6 3 Gyhdaw 1314V SIZE OF IMPROVEMENT T LENGTH -30 WIDTH/ HEIGHT o� Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGST*es []No LOCATION OF WS 3. Energy Calculations l OR FOR NEW OPENINGS -DESCRIBE SIZE OIC o� �S JC od'� C / 6 X G OPENING CHANGES & 3':�,Vfcr-, 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 $ .5'000-00 OCCUPANCY TYPE Permit Fee $ HI '31Y See Back Page for Fee Schedule Plan Review $ i6`1 ,31 65% of Building Permit Fee Surcharge $ 01.5® (.0005) times the total job valuation - Minimum $.50 Fire Surcharge $ S, OO .001 x Permit Valuation (1/10%) License Surcharge $ $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 $ I • Ufa Make 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 permit is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work ch quir rev' d approv f plans. -�� I SIGNATURE OF APPLIC PRINT NAME JkM E S- J4G Q2 �cQiC9