PRE 2010 DOCSW.
SUBJECT
P
City of Fridley
®12'759
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
EIPT N
COMMUNITY DEVELOPMENT DIV.
�� . /�,
PROTECTIVE INSPECTION SEC.
1 �
I CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED By
612-560-3450
910-F15
110/11/74
JOB ADDRESS 1260 - 52nd Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9
2
Marian Hills 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jim Vant (Apartment on 52nd Avenue)
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
W. A. Osborne Construction 7565 University Avenue N.E.
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 El ALTERATION ❑ REPAIR El MOVE ❑ REMOVE
R
8 DESCRIBE WORK
Construct a 26' x 4014" Dwelling and a 22' x 2714" Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Provide a verifying survey before capping. Provide a hard surface
driveway.
SEWER LOCATION: 78' East of Manhole (Inv. 936.41)
Wye Elev: 936.80
Top of Footing: 939.80 Minimum
WATER LOCATION: 10' East of Sewer Service
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST,
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
1619
32,794 Total
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 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
$30,753
15.38
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 PERFORMANCE OF CONSTRUCTION.
$61.00
$300.00
PLAN CHECK FEE
TOTALFEE
V
K
37 8 r
N T E F9 RACTORO UTHORIZEDAGENT (DATE)
ENP OPERLY VALIDATED TH Y R PERMIT
4
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)DG
INSP GATE
W.
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME. s /V T BUILDER: 4. am o R ly g: 7,
ADDRESS: Sa au�E .� E. ADDRESS: / c5 �/I'% f J 1��' /� �/ e ! �►
NO:. ,65 STREET: S a Owe. N 2.
LOT: BLOCK:. ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: 16 SIDEYARD : 1 Olt 3-0 1
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:
r
UJ2 1
Front., _Depth : Lfo' �Height
?Square Feet: Cubic Feet: , d
d Front • __Depth: — 7 Height:_
Square Feet; Cubic Feet:� -
Type of Construction: 1A) (n t3A, Estimated Cost: $ 3S
To Be Completed: � ® `�S•
The undersigned hereby makes applicatian 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: •J P SIGNATURE • JZ4
T
(See Reverse Side For Additional Information.) ,
I
•
Land Ala n1,,W
Lvjd Sa-wtj,nq
Sall lest h;
��, � o87S N�hn� fCS a�• .
ENGINEERING, INC.
Engineer's Survecyof 5A ab
—
ceptus, icate of sup few
Rhiet 4 b0uor
VAT'
-.q� •"1
nd
m 1
Mani� � w
' r a0
it
► �wa�,s�r • 4flr ��. o �' 14;a
w. sf
l
LCAT 9 , ������ 2 , ��� I��,rJ -����� 2"PADDITQN
........ .._�__.'�LCnv+ca v►.:r�..,vl.:''..►� _;'a•.�trt,�•.�t .6t•�Q./.A C4,INTY
G Tje.r-r..4Ps Ont• F Dr•pa��d �.iro-.i cv.�wv5� or'rG•$ _.- ' "'r_;
/ W14y' #W &.5 fs o /nm ar,d sarirei reprsenfofiunr a o +carrey bvmdari q('#x ebaff 'w ford diad
s{� aN&1do s , thorm . a risib/t oximbi Genf! , �`&y. �n or w sad l� As surveyed � w f��
of A.o SU5 URBAN ENCWNEE2lN6, INC. '
+ SGC�ie
1 40►
//� -7-27 02 ZOCP7-,1'010
l� ' E. OF Z� e r rr/ic- e
City of Fridley
for MurNng end Cr Vee g F+Y6—..!T Y .
Dept. of Bldg*. Phone 580-3450 '
DESCRIPTION OF WORK ® 6 ® __I;-�
Number, Kind emd LoeaBon of Fixtures Location
'o38=
O;
OOU
?_`
d
2
�n
<�
; r•
O r
a="
r O 5
o
7
7
I
N
WATER Mrs.
GAS
ELEC.
_—N
Base
•
A
B
1st
2nd
_
3rd
4th
. � waanveaues waau
ruturo Connection Openings Sower A
e
Now Fixture, Old Oyonings Ccaspool a
PARTIAL RATE SCHEDULE
PL171rf81NG FIXTURE RATES:• • • • • . • �� • x $2.00�$ TOTAL
�
Number Fixtures ..........
Future Fixture Opening ........... . .tel- x $1.50 $
New Fixture Old Opening .....:.... x $1.50 $
Catch Basin ...........:......... x $3.25 $
Water Heater (Up to 99,000 BTU) .... __..L_ x $3.00 $
New Ground Run Old Bldg......... x $3.25 $
Electric Water Boater, ..... ........ a $2.00 $
ZAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ............... x $2.00 $ "�
Additional Fixtures ................. x $ ,75 $
Gas Range to 195,000 BTU ... ,.......... x $5.00 6
City of Fridley:
The undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the Citi Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct'
Fridley, lllinn J� v2 197y
Owner Aft PS
Kind of Building�i � �/ i �n %,i
Used as P_C ; P"I—; a /
To be completed about e� /• 07�
Estimated Cost, $
Old—New. Building Permit No. I °? a 9 Permit No.
ROUGH
REPAIRS & ALTERATIONS--Rofer to Code .50 State Surcharge
. Description ................. ,............................$
TOTAL FEE '
_,Xi
Signed
By
Busin une No
Application for Peyer Phuft and HealhMh Cooling, Ventilation. Reft.,,..ulloe and�j
61
Air Coedltioe189 Sydan mid Devicu 1
'I /1.
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: BATE TOTAL
Furnace Shell & Duct Work ..... .. $10.00 $
Replacement of Furnace ..... ..... 6.00 f
Repairs & Alterations—up to =500.00 6.00
Repairs & Alterations each add. $500.00 300
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ... .. $10.00"
each add. 60,000 BTU .................... 3.00 i
Replacement of Furnace 6.00 $
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 .... .. 3.00 $
STEAM or HOT WATER SYSTEM
6,00
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
10.00 $_
Each add. 200 sq. ft. EDR Steam
A00
Each add. 320 sq. ft. EDR Hot Water
3,00 $_
OIL BURNER—to 3 gal. per hour
6,00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU)
8.00
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures
x$ 200
$ %D 0
Additional Fixtures
a .75
$
Gas Range to 199.000
s$ 5.00
$
AIR CONDITIONING Lennox HS8311FF
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
76o
ROUGH (SURCHARGE $_=53)
Dept. of BldvL Phone 560-3480
Lie 1260 - 52nd Ave. N.E.
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 an the facts
and representations stated in this application are true and correct.
Fridley, Minn—
Owner
inn Owner Osborne Const.
Kind of Building ._- Frame
Used as - --- - — Dw_!9_e —
To be completed about
Estimated Cost,
Old—NekK Building Permit No. Permit No. � 1
DESCRIPTION OF WORK
HEATING or POWER PLANTS --Steam, Hot Water, Warm AiK—No 1
Trade Name Lennox Size Na- G1203-110
Capacity Sq. Ft. E.D.R- 3 10. 0 0 0 BTUHp
Total Connected Load 60,907 Kind of Fuel Nat. Gas
BURNER — Trade Namp Size No
Capacity Sq. FL E.D.R BTU Blp
sty
(REMARKS -OYER)
Mill City Heating Co.
Business Phone No 544-1501
r
HEAT LOSS CALCULAnoms DEPARTMENT OF INSPECTION
Wem rstri conetrnestioaa No. � �I�ts�alsteeln fi -� ' ��•
Geeide
Ali®dlra4s Doors Refference Out. Wan Int. Wan cline Roof air I�i_md How Awl°� V A
Ye®-
CV;d¢h igaht1:1, lwra�ch r id¢h pari �dts`d
�iliatdovrfa aced ®oar rackage and Area Wm&ws and Doo--Cuckage, and Area � dd
th tf pane lig os of
Pt. Aron Width Helsht N:. 4,f Tdaneal ft. Arra Q f l
Na of of ®ane IIQAIo of craclt o4. it. N of Pane o fir ne Ilzboa oY crach e®. ft. ." +
9R m u
Btu
Qae5ltrat�®
Glass ® ��ee.. Itl0ration T
L '.
os�_tttj g�
. watt 2:42. �i
er>p, wall
Wet .oval! t� C 0 a�-
Net exwall
Int. wan
r �'Bs';
d lat. wall
Ceiling
Floor a ML T,
'TAM as. Flocr
sq.WDooac
ins. WA. Lfeader area aq. C .or . ias. e�1.A. G&r are��eight ngeh �i'idth Bath �/idth . I-Iu 2tAdenas kagge and Areas VIM.tnalows and &�oara rackage and Area
e'
width 'Refs–ht- Ne K LMeal Pt. irea s
tda of of pane lights of eraerk aQ. Pt. WidthHaight Pao. 02 nine'! ft. Ares
No. oP
Dana
of {sane 14gAts Vcreek sq, PE.
Ilt�ltrationbtu COO .
InfftltrationChm IM —7 t
4Glass
EqL wan � Exp. wan
Not ow. wall Net exp. wall
ImL `{'all Int. wall
Ceiling
Ceiling
Floor
TAtallute. Floor
JAMMOkmqd F..D.R, or Tota! RBar.
sag. iris. WA der areae �� 3, . o ate. ills. VIA. der area
QU I:l. oom length ®Jid¢h ®Height �. �, ! I.ertgth / idol, Ekight —f
WireW Ns and rs—Crmckag�e and Arca '!I/indowa acid R.- raekaga and Area
teeth tght No. of Llaoal ft. Area IdeA Height No of Inoal tt Area
gym. of o e lights of Brae aq. Nolo,.Q40afte ' of a lights, of raek on. Pt.
e
Vii'
HEAT LOSS Majuuws DEPARTMENT OF INSPECT"iON
Weatherstrips A.SS.H.V.
Construction No.
Cuid®
Reference Out. Wall Int. wall I Ceiling I Roof J Floor Kii-I Hmw
wa
m- I Length lt -4
Fl. oo tiv;IZ7
Vindo, d Doors—Crackage -and A ea Windows d Docm,--4Creckvg'� and Am
"o
c h
Win nd n
MtWid H*lghv of Lineal ft. Area Width
an to of ctgc)v,^ sq It Height No I Anma L� Arae
PTO. of Pan p of pane liffitta of -rock Sq. ft—l".
7
Coe
zz:v
Btu Coe Btu
Infiltration
Infiltration A
Glam b4q C433
Up. wall
&P. wall
Y
Net M[P. wall
Af >y Net exp. wall
let. wal Int. wall
Ceiling 7 Ceiling
Floor Floor
Total Btu.
sq. fL EDR or sq. ins. W.A. kader area Required,U). 4. fID.R. or sq. ins. W.A. lAader area
F1 AgjRROOM I Length // width ®,-Height
2L —7--m-, Room I Length //<,-Width..
Id Height
Windows an&Uklom—Crackage and ea 7AW . _ Height
Width Height NO.09 Linsalft. Area ---Win s and Doors—Crackage and Area
No. of of pane lights of crack sq. ft. Width Height No. of Lineal Area
No. of PV f I sq- f
V7 a- a Pape lights of crack t -
Btu
h0ration
G6w
Glass
Exp. wall---- 7r;P-N
Exp. wall
Not exp. wag Net exp. wall
lat. wan 'j Int. wall
Ceiling C Ceiling, ril. "I
Floor Floor _2�
Total Btu. Total Btu.
Requirtj_ orliq.ins. W.A. &ader area RequiMdsq, A.YAR r sq. ins. WA. kader area
is 40
ic-0 m I L e n -A i
:Wid,h F11 . '2 M
&*menath 0' Width
F1.1 & 2C R.
— Y_ t
Windows -1 D-- rzackage and Area Windows and Doom—Crackage and Area
width Height No. of LinealCCArea
of pane of pane lights of crack Width Height Na of Lineal ft. Area.
ft. No. of a of Pass lights of$g k sq 94 0-S
mme
Infiltration
CUSS
Exp-.�,wa4
—Nif pip. "wall Z 4M,
lat. wall
Ceiling
Floor
Total Btu.
Requ°" ft, F_DJL or !y: ifts.. JAk
Cn�,mecun_.
SOWf;f
WaIEr
PAk5
$Ir LCIS
w�a Ifll en an CC
MEMORANDUM
TO: William W. Burns, City Manager PW94-162
FROM: John G. Flora Public Works Director
DATE: May 10, 1994
SUBJECT: 52nd Avenue Floodway. Project
On Monday, May 9, 1994, 1 attended a meeting with the residents on the 52nd floodway project,
Jerry Sorenson at 1280 52nd Avenue and Jerry Johnson at 1298 52nd Avenue. Purpose of the
meeting was to outline the three proposals that have been established for this portion of the
project; i.e., a second pipe, a swale and berming around their patios.
Neither resident supported berming around their patio. They were strictly against that option.
While they supported the underground pipe as their first choice, they indicated they would be
willing to support a drainage swale as long as the abutting property at 1260 52nd Way did not
have any major objections to the swale being on their property.
The Sorenson's at 1280 have sold their home and indicated to the buyer the on-going problem
with the drainage system. The residents at 1260 52nd are in the process of building a gazebo
and a retaining wall on the back of their properties. Any drainage swale that would be
proposed would have to be discussed with them as easements would be required.
The Columbia Heights City Council is to meet on June 13, 1994 to discuss this issue. If the City
of Fridley was interested in installing a pipe on the Fridley side of the line, additional easements
would be necessary from 1240 and 1260 52nd Avenue in order to provide right-of-way for this
construction. I will present the residents position to Mark Winson, who will be making the
presentation to the Columbia Heights Council.
JGF:cz
ri
SUBJECT
City of Fridley
30014
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i •
►V �_____ COMMUNITY DEVELOPMENT DIV.
yq'7
r � � PROTECTIVE INSPECTION SEC.
1 1CITY HALL FRIDLEY 55432
%.4
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910415
8/6/99
108 ADDRESS
1260 52nd Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
2
iMarinn Hills 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jim Vant
571-22
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Wellinjzton Windows 3938 M
-
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
X99 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Window and patio door replacement
9 CHANGEOFUSEFROM TO
STIPULATIONS
Install smoke detectors to meet the State Building Code - in each sleeping
room and on each level of the house.
Permit inspection Cards
Will Be Mailed
To Homeowner 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 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 1 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$15,784
$7.89
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 PERFORMANCE OF CONSTRUCTION
$265.25
Fire ASC $15. 78
PLAN CHECK F
TOTXL92 E
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI
EN ROP I T D is I V PER .000
L
INS QAtE
S-GNATURE OF OWNERJF OWNER BUILDER, IDATEIBLD
PrdpaiT Plan Check $
Estimated Cost $
Receipt ' #
Effective 1/1/9y
CITY OF FRIDLEY
R-3, COMAORCIAL & INDUSTRIAL
BUILDING PERNM APPLICATION.
Construction Address l a '' �n►, I�j
Legal
Owner & Address J;
OM1IRACD0R,& ADDRESS
Architect
TYPE OF WORK []
Reg.# Engineer
Tel# J
Tel# b5 0e
Reg.#
BUILDING CONSTRUCTION ) �}
0 Addition A� teratian-DescribelnJ I'r ' *� ,' ( Uan c
OFC. AREA: Length Width Height Sq.
MM AREA: Length Width Height Sq.
OTfE R AREA: I g h Width .. Height
SI
4
APPLICANT Tel
• VALUATION
Ft.
Ft.
Ft.
Date [
Sq. Ft.
x $
Cost/Sq. Ft-.
_, Valuation
$
Sq. Ft.
x $
cost/sq,. Ft.
Valuation
$ )
Sq. Ft.
x $
Cost/sq. Ft.
Val tion
$ )
TOTAL VIALUE
g
Moo I fir'
Building Use Construction•Type Occupancy Group
Air Conditioning [] Yes [] No Fire Prot ion Provided [] Yes [] No
Perfo=ance Bond Amount $
See Reverse for Schedule Received [] Yes [] No
Permit
Fee d` $
.See Fee Schedule on Reverse Side
Plan Check n $
'• In Excess of Prepaid Amount - See Reverse Side
Fire SurcharN $
.001 X Permit Valuation (1/10th a)
1 State Surchaxge�• a5011�Q00
7
$
Valuation (See Sched. for > $1 Million) .
•$1050 `per SAC Unit (Plans to MKCC for detenniriatior�
Erosicn_Contml $
x$450.00 Conservation Plan Revie
Park. Fee. -`-.,s$
tFWpetermined By Engineering''
Spec. Assessments $ Agreetrtnt Necessary [] Not Necessaxy, []
Driveway. -Escraw $
feet x $13.50/foot ,• : [.
r ATTACK. STIPULATIONS
� 0�� •�
1
S s.
g
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
FAX (763) 571-1287
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
TOTAL
$�
III
Llrective January 1, LUUJ
JOB ADDRESS /d loci 5,Rn d A Uee 776
OWNE
BUILDING USED
ESTIMATED COS PERMIT N0.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating its Circle One (Steam) (Hot Wat arnAir
Trade N me Size No.
BTU HP EDI
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE
HEATING CO Sharp Htg & AC
Signed o fir`_ TEL # 763-572-0459
FAX # 763-5724164
n
Approved ByZt)�.A Rough -In Date Final Date
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
When .,a a ani a % axi�finp ftirane-is, 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 ( )
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-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes No
The @xicfinp e -n is sized and installed to meet the current codes
and manufacturer's specifications. �es No(
When required to inctail a new enmbimUnn ai - it will be sized and installed
s s ecifications. Yes () No
to meet the current codes and manufacturer' p
When inr&llinn nunspam.., 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 #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 It Diameter in Type
Appliance #3 Vent Connector Height _ft Length ft Diameter in Type
J
HEATING CO: Sha xt
Signed By:
e
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
r63) 572-3604 FAX: (763) 571-1287
ADDRESS : 1260 52ND AVE NE
PIN : 253024220042
LEGAL DESC : MARIAN HILLS 2ND ADD
: LOT 9 BLOCK 2
PERMIT TYPE : HEATING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-00187�00
DATE ISSUED: 02/10/2004
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 UNIT HEATER (WARM AIR, REZNOR, 45,000 BTU)
VALUE OF APPL OR WORK 0 # FURNACES
# GAS DRYERS
ENTER VALUATION
APPLICANT
SHARP HEATING & AC INC
7221 UNIVERSITY AVE
FRIDLEY, MN 55432-
(763) 572-0459
RTA s
VANT JAMES M & SANDRA J
1260 52ND AVE NE
FRIDLEY, MN 55421
0 # GAS RANGES
800
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 yoth state or local law
regulating construction or the pe rman e of construction.
Annlicant Date _ i
Bldg
HEATING PERMIT MINIMUM FEE
FURNACE SHELL/DUCT WORK
GAS RANGE FEE
GAS DRYER FEE
HEATING REPAIRS/ALTERATIONS
STATE SURCHARGE, MECH FLAT
TOTAL
PAID WITH CHECK # 14181
ARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
0
0.00
30.00
0.00
0.00
0.00
0.50
30.50
CITY OF FRIDLEY BUILDING INSPECTION
6431 University Ave NE
Fridley, MN 55432
763-572-3604 FAX 763-571-1287
RAIHEDUt.E
affiftaftl
Furnace Shell and Dint Work, Sumer &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
,;�v&s - OC23 11
Effective 4/1,/2004 `
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Al Othw Repairs or Alterations (List on Bads)
1% of Value of Appffarm or Work
Minimum Fee $15.00 for Residential or 5'% of cost of
Improvement whichever is greater
$10.00
$
$10.00
$
$25.00
$a�o
Cam mewJal IndusMal/1 nstitutional
1.25% of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 for Commercial/industrial/Institutional
State Surcharge
TOTAL FEE
REINSPECTION FEE $50.00/HOUR
$
i1 -.1 L, I el , - I Ill
Building Used As
ESnMATED COST PERMIT NO
p of Heating Untts__�__ Circle One (Steam) (Hot Water) Air)
Trade No Size No.
B1U Wl� HP EDR
Fuel Total Connected Load
Burner Trade Name Size Into.
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeingto 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.
*Air Conditioners can not be placed in side yard without written approval
from ac#dning property owner - copy to City
I
Vii. I'
AW
,-P I
a vT / I
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Approved by Rough4n Qate Final Date
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an exlstina 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 manufacture's specifications. This does
include AGA GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
The exisfina combustion air is sized and installed to meet the current odes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacture's specifications.
Yes Oi� No( )
z
a��
Yes (7 No( )
Yes (} Not )
Yes {) No( )
Yes( )
When Installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacture's
specifications. This does include AGA GAMA Category I Central Furnace Yes {
Venting Tables for fan assisted and natural draft appliances.
No( )
No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented Yes () No( )
separately as per current codes.
Appliance Type and Size/Common Vent and Vent Connector Information
2®
Appliance #1 Type
o iy % BTU Input ' Fan Assisted or Nat �"�
Appliance #2 Type pec --90,3 `O BTU Input :�� Fan Assisted or Nat
ApppI
ABTU Input Fan Assisted or Nat
pliance #3 Type
Total Appliances Total Btu input �;----
Vent Height Diameter inches
Common Vent Type 44-� a�d
Appliance #1 Vent Connector Height Length 1'� Diameter in Type
Appliance #2 Vent Connector Height O= ft Length rft Diameter �in Type
Appliance #3 Vent Connector Height _= Length ft Diameter in Type
ALTERATIONS: Describe E I 1n-- ^�
HEATING
Signed By.
NOV-16-2004
Ntvv
ADDN [j
ALTER { j
10:25 CITY OF FRIDLEY
IN ! 1 yr 1 I XLLJL_L- 1
6431 University Ave, NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION i
Construction Address:
Legal Description:
Owner Name & Ai
Contractor.
LPANG AREA:
GARAGE AREA:
DECK AREA:
e .n — \ {tee _ -4 ! "_//,V l �
P. Ci--,. ['I-'
(763) 572-3604 Bldg Insp
b0s, .0
Attach to this applications a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Driveway Curb Cut Width Needed:Ft. + 6 Ft= Ft x $ = $
LO3 l3
DATE: APPLICANT: Tel. # ?, 3–& .
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut 'Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
$ q7, o�f Fee Schedule on Reverse Side
$
65% of Permit Fee
$ ` . jO
.001 of Permit Valuation (1110th%)
$ /, 61 Q
$.501$11000 Valuation
$
$1350 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 [ ]
$
STIPULATIONS; \f
/6,2' �S—
oltoa-j
Building
PLUMBING
Permit No.:
inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FIt DLEY
Date Reed: � IS
DATE !124 " YOUR &MAIL ADDRESS
SITE ADDRESS 11 V o S 2."-` A J E A/ E
THIS APPLICANT IS: 0 OWNER 060NTRACTOR
PROPERTY
NAME: E S VA14
OWNER/ -
--T-44%
ADDRESS: / G, a 5,2 "-a' A•J6, CITY f12 6+E y STATE ZIP `�''z
TENANT
PHONE: "7
CONTRACTOR
NAME: 6 R. p_y 4 V a Aex E e P L u M 6, 6 .je.
$rATELICENSB# 61,4,f PM E (PDATE 1'Lhi I0 6 - - y 3 L
CT H SPR J G LAk 6 PK STATE�-<rZIP
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
ADDR�-._ Ile a 8 y u: y 16 ary l
PHONE it 3 5 y Z 88 0 _FAX
APPLICATION
PERNUT• TYPE
WSINGLE FAM1LY D TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
0 NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK
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 Exturw, (This should reflect only the cost of labor)
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x A5 =
FOR PROJECT'S WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE„ EXCEPT WHERE NOTED. FI)ntT S: ([DEDICATE TOTAL
NUMBER OF EACH BELOW)
S1NKAAV FLOOR DRAWS —SHOWER WATER PIPING
—BATH
BATHTUB OAS PIPING azw carricEnO _ SWRAMI +TG POOL _ WATER SOFTNER ($35)
'- CLOTHES WASHER—KTCCHEN SINK WATER CLOSET ^ BACKFLOW PREY. ($M
.._
DISHWASHER LAUNDRY TRAY WATER HEATER (S35) FOR IRRIGATION
'—" - WATER METER —OTHER
Number of fixtures @ $10.00 x 510.00 = $
Permit Fee $
Surcharge .50
Number of Sxwres @ $15-00 x $I5.00 - $
Number of fixtures @ $35.00 x$35.00 = $
TOTAL DUE $
State Surcharge = $ So
Total = $
TAS 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
the and codes of the City of Fridley and with the Miamesota Construction Codes; that I understand this is
conformance with ordinances
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 witb the
approved plan in the case of all work which requires review and approval of plans. l
�! P / a 6
SIGNATURE OF APPLICANT 4A Z K 4 9 k kO J -0 PRINT NAME DATE
oz,��,tTFY::R+ARkTF?,:P�^sI2Ml`iR=�iRTiEC�ilIREDF(3RBLIlI1Tlci _ r'm"W",
City of Fridley
]Building Inspections Department
6431 University Avenue NE, Fridley, NN 55432
763-572-3604
FAX: 763-502-4977
... r ..-.. INV 66 V94: 90OZ/6Z/8 :BIaO vz :a'6'0d-- 6'888 ZL5 S9L :uioJd ..^... � � .... ..� a....