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PRE 2010 DOCS0 City of Fridley, Minn. • BUILDING PERMIT N® 3.410 Date: ....�....../ . 0...4.. •'...... . Owner ....................................... Builder...................... Address...................................... Address .........9.. ...................... LQ�CAi� OF BUILDING /,, No. .`�.�.�.�. Street ...... ....... ........................ Part of Lot Lot .02.3.. ... Block ..... 3 ......... Addition or Sub -Division r 1 Corner Lot ............ Inside Lot .. ....... Setback. > i� I ` Sideyard ..1 �. .. .c. i ............ . DESCRIPTION OF BUILDING To Used as: .... .� ` � ,� /�,' ,,cs . ..... ... Front - Depth ! Height / 9-: PO Sq. Ft. Z". Y Cu. F't. .................... Front ........Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................• .Nfit. Cost. �.J� ......... 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 f% d in�eo3�npliance with all provisions of ordinances of the city of Fridley. /Ci j ..W ....... ..... W., ,o ...................... . In consideration of the payment of a fee of $ 2.l. �.., 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 violation of any of the provisions of said ordinances. 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 Item& i AVr,%cc6an i Vxw P F=f2ra- rr b'o 4o eyu�u ` CofAngo Ve1v&a .iiat�-:i b b"w aJi� �r'IY W-«��+� Wd A17 mMica'- g S T s MA Bowl= PARTIAL RATE SCH�D E GRAVM WARM AIM: Furnace Shell & Duet Work Replacement of Furnare Repairs & Altcrat,ons--up to MM.00 Repairs &,Alterations each add. 1500.00 KZCX WARE! AIR Furnace Shell & Duct Work to 120,000 BTU each add. 60,000 BTU Replacement of Furnace Repairs & Alterations—up to 1500.00 Repairs & Alterations each add. 1500.00 STEAM ox HOT WATER SYSTEM SLATE TOTAL $10.00 1 6.00 1 ' 600 S 300 S $1000 = 3.U0 8 6.00 a 6.00 $ 3.00 = Furnace Shell 4 Lines—to 400 sq. ft FMR Steah $10.00 S Furnace SheU & Line --to 640 sq. ft. EDR liot Fater 1000 1. Each add 200 sq. t1. EPR Steam 3M 1 Each add. 320 sq. ft. EDR Hot Water 3.00 1,_, _ OIL BUJINER—to 3 gal per hour 6.00 over 3 gal. per hour—See free ScheduL GAS BURNER (UP to 149.000 BTU) 6.00 1 over 199.000 RM See Fee Schedule GAS FITTING FTM: NO RATE TOTAL 1st 3 Fixtures a xE 200 1 Additional Fixtures �_ a 76 Gas Range to Ii1.9,COO X$ 6.00 i x:wN, •..'e MAI& � - A'_ State S.rcharge �= is" Foe ched a TOTAL �D X6pt. of Bldgm Phone M -34M LoccA 6? %a - 7..-;a L 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 Ordiaancer- and ruling of the Department of Buildings, and hereby declares that an the facts and representatiuns stated in this application are true and correcl C /U Fridley. Minn 27 /1B7.�G Owner Kind of Building —-.� Used as To be completed about Estimated Cost:, $ BIO'IJ , CO Old—New. Building Permit No. ___ Permit No. FG3i:h.:ry{�5 • �'�:i HEATING or POWER PLANTS—Sham, Hot Water, Warm Air—No Trade Name gin No— Capacity— -- oCapacity—__ — Sq. Ft. E.D.R BTU HP Total Connected Load Rind of lit BURNER = Thede No Size No Capacity 3q. rL Z.D � B'gV SUBURBAN AIR CONDffIONING CO. 5419 CENTER DRIVE 37 MINNEAPOLIS, MINNESOTA 55432 (RDalAatiS—OVHR1 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 RESIDENTIAL RATE TOTAL Furnace Shell and Duct Work, 1:50 Burner (Also replacement furnace) $ 20.00 $ Gas Piping $ 10.00 r $ (piping needed with new furnace) I Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ * Air Conditioning (all sizes) $ 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 TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00• PLUS $.50 STATE SURCHARGE $ .50 $ Attach stack verification form with replacement furnace permits *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Address bepartment 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 true and correct. OWNER KIND C USED A TO BE COMPLETED ABOUT ESTIMATED COST -49; - NEW BUILDING PERMIT NO. PERMIT NO. A0, A!� DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Wa er, Wa�A.. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel G� S BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Qj'-' yQ'ia AN Avg COKIDMGN" iib Co, D419 CEETE5 ONIVE STA 5 71 Company Signed By Tel. No. SUBJECT City of Fridley ` 2 8 015 AT THE TOP OF THE TWINS B U I L D I N P E R M I T r RECEIPT NO. � COMMUNITY DEVELOPMENT DIV. -----_ �may_ r PROTECTIVE INSPECTION SEC. V � l 1 � NUMBER REVI ATE PAGE OF APPROVED BY � /---1 - CITY HALL FRIDLEY 55432 I'J 612-571-3450 810-F15 )/29/98 JOB ADDRESS 6872 7th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 3 Rice Creek Terrace Plat17 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr.&Mrs. E. Gosselin 3 CO TRA T R MAIL ADD E S ZIP PHONE LICENSE NO �>xg� 5456 4 ARCHITE DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO Cif 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW 0 ADDITION 0 ALTERATION 5k REPAIR 0 MOVE 0 REMOVE S DESCRIBE WORK Reroof house and garage 26 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 S0. 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 OWLG. UNIT 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 2228 Z.II 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 OR THE P Rf RMANCE OF CONSTRUCTION $74.75 Fire SC $2.23 PLAN CHECK FEE TOT EE e 0 .09 S1 tUR C .RAC O u ORiZED ADEN= D Er tNRP VALIDA NIS IS Y P MIT Ar S-GNA LURE O1 R� D E� Rr PATE NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXESR-1 BUILDING PERMIT APPLIC TIC ConstructionAddress: Legal Description: Owner Name & Address: Contractor: Mpa Address: 12' 2 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: C] u3N M R-2 / Tel. # MN LICENSE # Tel.# Attach to this application, a Certificate ofurvey of the lot, with the proposed construction drawn tn it to scale. DESCRIPTION OF Length Width Reight Sq. Ft. Length Width eight Sq. Ft. Length Width :gt/Ground Sq. Ft. Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: 1 12j APPLICANT: Estimated C st: $ 20?A (Fee Sc edule 'on Back) Ft x $ = $ Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ Q . j .001 of Permit Valuation (1/10th%) State Surcharge $ 1/ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ ®(j $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 $ 93, Q STIPULATIONS: SUBJEtT PERMIT NO. City of Fridley 29813 AT THE TOP OF THE TWINS BUILDING PERMIT r � PT NO.EI RECEIPT COMMUNITY DEVELOPMENT DIV. �L r PROTECTIVE INSPECTION SEC. E � � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/2/99 JOB ADDRESS 6872 7th Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 3 Rice Creek Terrace Plat 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Emmett Gosselin571-4805 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 XX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 24' x 18' addition on home 9 CHANGEOFUSEFROM TO STIPULATIONS See stipulations on plan. WANING Belole digging call tat in utility lamtim 454.0002 REQUIRED BY LAIN WIRING, HEATING, PLUM81NG AND S' Gin 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 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 ISE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT n aQ92 $27,000 $13.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMA E OF CONSTRUCTION 411.45 9 Firm PLAN CHECK FEE TOTAL E SIGNATURE OFC 'AA AUTHORIZED AGENT DA EI ENP OP IS YO :PE7T « �ATEV7HIS S.GNATURE OF OWNEROF OWNER BUILDER, IDATEI BL NSA - DATE NEW[ ] ADDN [ ALTER [ ] 6� onstruction Address: Legal Description: � Effective 5/10/99 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION n F2.12''9 41-6x, Owner Name & Address: e. � I!PN Tel. #,A Contractor: MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. 4&3 ?/ GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: a Q Estimated Cost: $ 17,eet5> Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:APPLICANT: Tel. # —3"21— D CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side $ C2760 $ ,sv .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] I , Inc 47 CPvL 31471' L4-# C-. 12- 12Le , L Tr 5 /X Z_ C-cl j2I _S 4-ci -S t C', Im d e_ Dc ct 0 C- J 42C - y�2 - -\-cc lz� 0 r/mssA UU _L . . 10 CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2000 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES �7 REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date �o U written permission from adjoining property owner. JOB ADDRESS / / / e:�-_ . RATE SCHEDULE OWNE Residential Rate TOTAL EEDAS Furnace Shell and Duct Work, Burner - BUIL_DI Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO. - Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Vaal�lu%% of Ap liance or Work $ BTU HP EDR G'o z' Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE $ C S'4D representations stated in this application are true and correct. �'�D ' C)ZS DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 SigneTEL PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date �o U written permission from adjoining property owner. When replacing an existir a furance, the undersigned hereby verifies that the venting has been examinec and is free from rust, deterioration, obstructions, and is securely supported e nd firestopped where required. Yes () No ( ) The venting system is plaslc/PVC and meets all current codes and manufacturer specifications including sizi g, length, number of elbows and termination. Yes () No ( ) The undersigned also veri1pipliances. s that the replacement unit is a listed assembly and meets the current codand manufacturer's specifications. This doesinclude AGA-GAMA Categ I Central Furnace Venting Tables for fan assisted and natural draft Yes () No ( ) The existing -combustion lair is sized and installed to meet the current codes and manufacturer's specifi4ations. Yes () No ( ) When required to install a Inew combustion air, it will be sized and installed To meet the current codes land manufacturer's specifications. Yes () No When installing a new ve tina s stem, the undersigned hereby verifies that it is a listed assembly and eets the current codes and manufacturer's specifications. This does i clude AGA-GAMA Category I Central Furnace Venting Tables for fan assi ted and natural draft appliances. Yes () No ( ) Is the common vent and an appliance has been re separately as per current Appliance #1 Type _ Appliance #2 Type _ Appliance #3 Type _ Total Appliances Common Vent Type Appliance #1 Vent Appliance #2 Vent Appliance #3 Vent HEATING CO: connectors sized and installed correctly after .d from the common vent and vented BTU Input _ BTU Input _ BTU Input Total Btu Input Yes( )No( ) Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Vent Height Diameter inches Height ft Length ft Diameter in Type Height ft Length ft Diameter in Type Height ft Length ft Diameter in Type Signed By: I Date : CITY OF FRIDLEY INSPECTION DIViSION Effective On May 10, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, Q 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS �� - RATE SCHEDULE OWNER Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement; Furnace $ 30.00 (Side Vent - Fill Out Back) $ _ ESTIMATED COST PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ No. of Heatin Units Circle One (Steam) (Hot Water) (Warm Air) Trade NameSize No. BTUe -I—YO � HP EDR *Air Conditioning • All Sizes $ 25.00 $ 10D �J4 _CQ Fuel C� Q�� Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No._ 1% of Value of Appliance or Work r $_ BTU HP_ EDR Commercial/Industrial 1.25% of Value of: Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE representations stated in this application are'true and correct. MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO _ REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed DATE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date ®b written permission from adjoining property owner. CBF4NEY 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 O No ( ) 4. Is securely supported Yes(.) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: I" G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 August 9, 2000 Emmett Gosselin 6872 7 St NE Fridley, MN 55432 Re: Final Inspection at 6872 7 St NE Contractor: Royalton Heating & Cooling Dear Mr. Gosselin: A mechanical permit was issued on April 27, 2000 for the property located at 6872 7 St NE to install and an air conditioning unit. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical system. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAVE,49NSEN Buildid Inspector CITY OF FRIDLEY INSPECTION DIV. k 3431 University Ave NE Fridley, MN 55432 , 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTAL I Fn ON FACH FI OOP Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 M� $ 7.00 Catch Basin ky7m. Rain Water Leader M Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas" _j-- $10.00 Gas Range'* $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 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" _j-- $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 State Surcharge JOB ADDRESS 54NIE- t- dW010? 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 aoolication are true and correct. GOSSELIN, EMMETT/LORRAIN 6872 7TH STREET NORTHEAST FRIDLEY. MN 55432 Owner (763) 571-4805 Building Used As j;S-a\pc:AY C'z q 112. , 2001 Estimated Cost PERMIT NO. L PLUMBING COMPANY QN1�al Al SIGNED BY /� �' " TEL N0. Z` - O J Approved By �T Rough -In Date Final Date TOTAL FEE $20-50 PLUS THE 5.50 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 replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting:. system is plastic/PVC and meets all current codes and manufacturer specifications .including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to Install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance;has been removed from the common vent and vented separately as,per .current codes. Yes( )No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : I CfiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 77 2003 Mr. Emmett Gosselin 6872 7 Street NE Fridley, MN 55432 Re: Final Inspection at 6872 7 Street NE Contractor: Norblom Plumbing Co Dear Mr. Gosselin: A plumbing permit was issued on September 25, 2001 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh 7 I'fP7�'I Building Cy�,q'D .1ViEUBANILUAL ."....... - Inspections RESIDENTIAL APPLICATION Received By: 7.63-572-3604 CITY OF FRIDLEY Date Rec'd: 3 DATE J �- Lo " �' YOUR E-MAIL ADDRESS SITE ADDRESS - THIS APPLICANT IS: O OWNER 11CONTRACTOR PROPERTY NAME: " w. r► -x e �4- (10 *�S!ise \ V-1 ` ADDRESS: �0�5 —l�`-' Sk N� CITY r , d e-� + STATE 1 IPS X13 OWNER/ TENANT _'S - - PHONE:1 CONTRACTOR NAME: CENTER:POINT ENERGY COMPANY SUBMIT A COPY OF CONTACT PERSON: JOANN ZINKEN YOUR STATE LICENSE WITH STATE LICENSE # EXP DATE ADDRESS: 13562 cENTRAL AVE WE CITY ANOKA STATE ffiffZIP 55304 APPLICATION PHONE 763-757-6202 FA}{ 763-757-6701 �c q e INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE PERNM TYPE O NEW REPLACEMENT ❑ ALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK e e — °'f -r; e- T 5,6(2U C�' ) - 1-1 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) ,, t)OC) MFG: (� Y r i -e { MODEL: 5%C V A U1 O- Equipment Installed SIZE/BTU MFC,. MODEL: MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 =NES �TT HTR L 010.00 FURNACE $35.00 BOILER $35.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 VENTILATOR $15.00 _DUCT WORK $10.00 _GAS PIPING S10.00 5119 $ Number of fixtures @ $10.00 x $10.00 =$ Permit Fee Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ 15 _40 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 for 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 which requires review and approval of plans. SIGNATURE OF APPLICe�ik Q"., � ^ t PRINT NAME ROGER HOF—MIN DATE \ �- � -�( - _ = t �ri� n :yc a i xoa7rj a _. •.� .,..R.au� ..,..-mg,�-�- City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESlADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. TMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction TMC 1346.0312 S. Ventilation . a_ Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346. 0603.2 .a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building $ BUILDING Plan Review Permit No.*: S?bo`I—oly Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By 763-572-3604 $ e .0005 x Permit Valuation Minimum $.50 License Surcharge ' qb U $5.00 (State Licensed Residential Contractors) SAC Charge CITY OF FRIDLEY $2000 per SAC Unit (Plans to MWCC for determination) Date Rec'd: C - 763-502-4977 FAX ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee EFFECTIVE 8-19-09 Fee Determined by Engineering Sewer Main Charge DATE YOUR E-MAIL ADDRESS Total Due SITE ADDRESS 109. Make checks oavable to: Citv of Fridlev Attach Stiuulations THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: S�,$1 '�'�4. �} , �1 CITY Fr ; aft �t STATE M�_ZIP �l PHONE: CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # eg © I EXP DATE 3 "� AND CERTIFICATE OF ADDRESS:�.z A'_% 1A E . be-VW�\"4 CITY c C c�„r STATEJni ,ZIP INSURANCE PHONE \i•3-- _021,78_7 FAX 0 a71 PROPERTY TYPE fTSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES Q7 C¢ ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: IDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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) OCCUPANCY TY Permit Fee $ ' le 5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ e .0005 x Permit Valuation Minimum $.50 License Surcharge $ qb U $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 109. Make checks oavable to: Citv of Fridlev Attach Stiuulations 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 for rmit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of a wo wh'ch requir review and approval of plans. SIGNATURE OF APPLICANT a PRINT NAME DATE �"�