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PRE 2010 DOCSr - City of Fridley 4T TNR TOP OF THE TWINY ------- COMMUNITY DEVELOPMENT DIV. t i PIIOTECTIV[ 0209CY OM DIK, CITY "LL FJUOLRY YMY j 418-600-3460 s 53 -8l' -s-915.51 iwileT PLUMBING, PERMIT APPLICATION 1 406/ 200 N. E. 53rd. Ave. ner Address P one games R. Fegely 566-2495 Contractorress Phone 7G11NNEGASCt3 M IOG4RQUETTp AVENUE Kind of Building Frame Res. omp etion Date Estimated Cost 11-29-7b .10.00 .i 'j + W 1 W W W n I acNral eve •,evo � I •eaa, I 'MNIra m .. eNteVe H�1V� i �Crj... PNtvao '0 0 9: aoo,d i3 �O VI SUMMONS z� 010 1Nnod II�•d HNlaal a��f/1 , fiArall 8)A N19I Ntve i7YNwn M71VM ev'a L.I wba ffi 1 1 1 I• 1 .11 11 �1 it /,z _//_ 7 6 — Plumbing Fixture Rates: NO. RATE TOTAL I1 ! Number Fixtures x $2.00 II Future Fixtures x $1.50 New Fixture -Old Open. x $1.50 I Catch Bastn x $3.25 Water Heater -99,000 BTU x $3.00 I Ground Run Old Bldg. x $3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: 1st 3 Fixtures x $2.00 Additional Fixtures x $ .75 I Gas Range -199,000 BTU 1 x $5.00 5.00 Repairs & Alterations See Description: Code State Surcharge .50 - 101asS ®A® �aCcfiarge ..509 TOTAL FEE $ 5.50 !The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and rulinj of the Department of Buildings, and hereby declare that all'the facts and representations stated in this appl ation re true d rrect. dswArir � � 'Signature Date City of Fridley SUBJECT PERMIT ®1299'7 AT THE TOP OF THE TWINS PERMIT t BUILDING RECEIPT NO. COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION r SEC. /'--1 CITY HALL FRIDLEY 55432 i �----� 'J NUMBER REV. DATE PAGE OF APPROVED BY 812-580-3450 910-F15 6-4-75 JOB ADDRESS d Avenuq 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 8 Carlson"R Summit Manor. North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR AIL ADDRESS IP PHONE LICENSE NO. Lifetime 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS I ZIP PHONE LICENSE NO. 6 USE OF BUILDING Attached Garage 7 CLASS OF WORK CA NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct Attached Garage 24 x,24 x 9 9 CHANGE OF USE FROM TO STIPULATIONS Demolish Existing Garage Provide Hard Surface Driveway local Elides call gla�a dim ELECTRIC GAS Etc. PERMITS REQUIRED F08 WIRING, - SEFMTE I TELEPHONE Dy 'AW PLUMBING AND SIGNS. 0V 1,ReD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Frame 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 R-1 576 5,185 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING '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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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. LAN CHECK FEE TOTAL FEE $1 5.33 SIGNATURE OF CONTRACTOR OR HORIZ? GENT I 1WHEN PROPERL ALI�HIS IS YOUR PERMIT u€�A7S SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) � �Z— BLDG INSP .,, APPLICATION FOR RESIDENTIAL., ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER : y� ADDRESS: �,�'f� �c���/�=� . /� 4!5,- ADDRES S : �: �✓ d��� o NO:. STREET • LOT: BLOCK: d' ADDITION: C�G��`�� V��i%/�®lam•®, CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach :o -this form Two Certificates of Survey.of Lot and.proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: ♦j ont• Depth: 025P-" Height: Square Feet: Cubic.Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of : Construction: Estimated Cost: $ _,g To Be Completed: LY0 L7--/ 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: �(�GCdd' SIGNATURE: (See Reverse Side For Additional Information.)' Q�eYWtluglu,v o? / 1(jc% < 0-9Y S01 u 01$ 4O .7 z Miocer Z. x z 53rd AVE. N.E. 100 24.. 00 . Ul 200 O. 0.i ld - 40 Ln w i 125 24 LnCA •j r W 30.5Is— °,: 125 24 N cn J a. 125 is -s A a Jl V ,pk N I` to I 2f '25 ^3 J I � �I 24 N F r L y V 30 7- a, 125 a a 43.4 n N L N l Ul 2f 125 1 r T C; " U Cr Y c • sr CD N t K _ i 7 ji t ^ a vC L+ b N ti T - ► _ 9 1 i e ty. >..� � • U r r3 a x z 53rd AVE. N.E. 100 24.. 00 . Ul 200 O. 0.i ld - 40 Ln w i 125 24 LnCA •j r W 30.5Is— °,: 125 24 N cn J a. 125 is -s A a Jl V ,pk N I` to I 2f '25 ^3 J I � �I 24 N F r L y V 30 7- a, 125 a a 43.4 n N L N l Ul 2f 125 1 SUBJECT City of Fridley 2 6 5 2 8 AT THE TOP OF THE TWINS BUILDING PERMIT � � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r ~ PROTECTIVE INSPECTION SEC. �•(/ NUMBER REv DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 7/10/98 JOB ADDRESS 200 53 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 8 Carlson's Summit Manor North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Virginia Felegy 200 53 Avenue NE 572-9585 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Viking Home Improvement Co 4832 2 1/2 Street NE, XM Mpls, MN 55421 572-1821 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 4772 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION lJ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 Sq) Tear-off; Reside House & Garage 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for inspectio of building wrap before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 1 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 $6,885 $3.44 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVIS NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $124.75 Fire SC $6.88 STR ON OR THE PERFORMANCE OF CONSTRUCTION. P PLAN CHECK FEE TOML FEE - 6 /17 7-16- 1)i�a�la-eaz/(� d Licens C $5. IZ140.07 SIG/ ATURE OFC NTRACTOR OR AU HORIZED AGENT IDATEI E P ._ G INSP Y VALID T T�IIS IS YOUR PERMIT ale (( hA TE SIGNATURE OF OWNER IIF OWNER BU4DERI IDATEI NEW [ ] ADDN [ ] AL -TER [ ] a CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUELDING PERMIT APPLICATION ConstructionAddress: _j A_ Legal Description:, Owner Name & Address: A Contractor: 016 N Address:. Lf 9_ 3 2 * E 44, -e .:Y-,44 p/ z ('0 r �y Effective 1/1/98 Tel. # J�� 77- -W ' MN LICENSE # Z 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 Sq. Ft. OTHER: 04L� j V s 0at" U fS. .10.1 Construction Type: Estimated Cost: $ 'Back). (Fee Schedule, Zli Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ?-/02-APPLICANT:Tel. # &��- 3r 3T CITY USE ONLY Permit Fee $ `76 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1 / 10th %) State Surcharge $ -3. L/-/ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ d0 $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 $ NO. 0/7 STIPULATIONS: SUBJFCT City of Fridley 3245 AT THE TOP OF THE TWINS BUILDING PERMIT R C �COMMUNITY DEVELOPMENT DIV. v______ r - PROTECTIVE INSPECTION SEC. � �.9� l/(�•� 1 ; r J 1 1 ----I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 3/12/02 JOB ADDRESS 200 53rd Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 8 Carlson's Summit Manor, North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Virginia Felegy, 200 53rd Ave NE, Fridley, MN 55421 763-572-9585 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ber Con Inc, 3450 153rd Ave NW, Andover, MN 55304 763-427-0207 3193 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwelling 7 CLASS OF WORK �f ] NEW ❑ ADDITION ❑ ALTERATION 7� REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replacement windows and one exterior door 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. 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 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 $7,520.00 $3.76 DOES N91PRESUME TO GIVE THORITY TF VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE ON PROVISI S OF ANY OTHER TA E OR L AL LAW REGULATING CON- ST UC 10 OR T PERFOR OFC STRUCTION VT $153.25 $7.52 Fire SC PLAN CHECK FEE TOTE $5.00 a se $V9.53 1 TURF OF CON'aA TOR Oq AU DACE iDATEi N PR PERL DATE/DTIS IS OUR PERMIT BLDG ASP - pATE S,GNATU AE OF OWNERoF OWNER BUILOERI iOATE, NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 31 Construction Address: S Ve /UC Legal Description: Owner Name & Address: b1l i / t Tel. # "lod•' 7� �� Contractor C MN LICENSE # Address: — Tel. # Attach totis a plication, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: �Wiok)�sti ated Cost: Driveway Curb Cut Width Needed: FO 6 Ft = Ft x $V DATE: 1c;? ®APPLICANT: Tel. # _ �® Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 7 3-5714287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ 1-53.c,?S—Fee Schedule on Reverse Side Fire Surcharge $ 2, Q .001 of Permit Valuation (1/10th%) State Surcharge $_____3 2� $.50/$1,000 Valuation SAC Charge $ _ $1200 per SAC Unit License Surcharge $- UC� $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 $ , STIPULATIONS: CITY OF FRIDLEY INSPECTION 643" University Ave NE Fridley, MN 55432 (763) 572.3604 RATE SCHEDULE DIViSION APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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 1; $ .50 $ It: OWN BUILDING USED AS L0 L"l 5e— ESTIMATED t ESTIMATED COST Effective On January 1, 2002 ICA 42, PERMIT NO. ZS' DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units._ Circle One (Steam) (Hot Water)IVarm ', Trade Name: t_tl Size No. t BTU Cly-TG'v��', HP �j EDR 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. HEATING Signed FAX # DATE TEL # ?, :3)4-�\Ijx? 5`l Approved By `rte Rough -In Date Final Date Al—I _0 -)- FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE V THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON V NTS VENT .ONN TOR AND COMMUSTION AIR V RIFT CATION When _re In acing an_xis ing 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 WNo ( ) 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 existing comb is inn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No (l When required to install a new r-nmht ,s+ion air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When installing a new ventingsyc m, 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 M No( ) Appliance #1 Type '?- ._�,P .yAc 4P BTU Input l a CCC Fan Assisted or Nat Appliance #2 Type ��. BTU InputFan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height � e Diameter _ f inches Appliance #1 Vent Connector Height -_ft Length -2- ft Diameter _ in Type Appliance #2 Vent Connector Height __I_ft Length __�ft Diameter in Type C Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: y. -&j ox, �A Signed By: Date: 12 •.