PRE 2010 DOCS!0 �'.* i
BUILDING PERMIT
Village of Fridley, Minn. N° 2 Q 3 8
Date...�f�.sl.l...r.�......................
Owner ...I l J �rM'�.`....� �.�.i�. Builder ..... . .
Address .....6. 8. ....... '-,>..13 -13 . i ............ Address ....Jr� ��..�.... .
LOCATION OF BUILDING
No. ....�....... Street .....;g3 /. `............................ Part of Lot .......................
Lot ....671 ....... Block ...... ,........ Addition or Sub-Division�.. .................
Corner Lot ............ Inside Lot .....f ! Setback ............ Sideyard ..........................
DESCRIPTION OF BUILDING
To be Used as:
PR
, Y
.. J.: ® �: A-:� .... Front . -I Depth .RO-11. Height . /d;
Sq. Ft../®.0 - Cu. Ft. ........
.................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ........
Type of Construction ..L MMU E:.. Est. Cost J . , ® .......... To be Completed ........
a
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
.... .;: .......... ..................
J
consideration of the payment of a fee of $?. ®, permit is hereby granted to ...6.. A cin . �........
..16J.(W.��....... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, m ' ce, repair and moving of buildings with-
in the village limits and this permit may be revoked at anyupon olation oany�f the provisions of said
ordinances. „ , I,. A
f.M. Building Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
J
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MINDMENGWIP. G CO.JNCa�'
ENGINEERS AND SURVEYORS
LAND GuRVEY1ND SOILS TESTING
CIVIL A. MUNICIPAL ENGINEERING LANO PLANNING'
641$ -:56TH AVENUE N. "
MINNEAPOL13 M. MINN.
KE T- 3637
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WE HEREBY CERTIFY THAT THIS 15 A TRUE ANO CORRECT REPRESENTATION OF A SuRYEY of THE BOUNDARIES of THE
LAND ABOVE,'OF.3CR18ED AND OF THE LOCATION OF ALL BUILDINGS, IF MY, THEREON, AND ALL VISIBLE ENCRON04MENTS1,
IF ANY, FROM Ott^ON SAID lANO. MINDER ENGINEERING. CO.x INC
V
ONTED TII►s MiloF
z EWW1I.I�ERS AND suRVEYocz.s .. i
3201
City of Fridley, Minn.
WELDING PERMIT N°
Date: .. ... rl �..........................
Owner....................................... Builder .... .. I.........
Address ...................................... Address .............................................
LO,CAT N OF BUILDING
�y
No. .... !!'/. Street ......... ...
. ............ Part f Lot
! ... ... .. .
Lot ..... . l .. Block ..... /........... Additiol Sub-Divisi n ...... .. .. ... ..... !�� ��.
..... . �.
Corner Lot ............ Inside Lot ... .... Setback ... Sid and ./ L9 .0 (! 1!. , .:C e
DESCRIPTION OF BUILDING
o be Used as: /
..... Front ........ Depth ... y.vHeight ....8 p'.. Sq. Ft. ..4f lamA
.06L Ft. ........
. Front ........ Depth ....... ei t ...b.b Sq. Ft. ........ Cu. Ft. ........
Type of Construction,! f.+Pla.� ..... Est. Cost.. �. T.`. Q .�" . • 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.
....................................................
w '
In consideration of thea T D
p yment of a fee of $. ,. 9......, permit is hereby granted.
......................... 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, alter ~tion, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at aay time upon violation of any of the provisions of said
ordinances.
...:. 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 Inspector for separate permits for these items.
City of Fridley, Minn.
BUILDING PERMIT
l
Date:
{
Owner: '�gy�pN..--.ir Builder
Address ...Y. !"" ,,__ Address
L9CATION OF BUILDING
J...... Part oP t
Lot -......-..-_...... ! :. .................--•----.. A tion or Sub-D'visi n,.,.,..
Block •--. ._
Corner Lot ..-.-........... Inside Lot .-- �':?._..-.._�1flFtback SideAd .......... _
SewerElevation....._:................................................ _...._......................_..--_.._.._ F dation Elevation . ....................... ..................................... ..............
DESCRIPTION OF BUILDING
To Us
- :._
% Front _. DepthHeight Sq. F't. 'j_- Ft. r
................... .:....................... ::.... Fron .................... Depth .... _-. Heigh Sq. Ft. _... ................. Cu. Ft. ............ ----.-..
Type of Construction .y� be Completed .-..._.
Est. Co r�', .::. ""'""" To
CA(JTION
THIS PEW,41T DOE S NOT AUTHORIZE VIOLAT-
ION OF ANY PRIVAI•E LAND COVENANTS AND
BUILDING RESTRICTIONS.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.---• . •---.'"" permit is hereby gratilted to. .... ..... -........ - ...... -...........................
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of by of the provisions of said
ordinances.
Building Inspector
NOTICE: y
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits, for these hems.
APPLICATION FOR BUILDING MW
CITY OF FRIDLEY, MINNESO
Owners Name L' `�".2 �°a p� Builder - - -
Address �- ���A1` -f Address _
LO TION OF BUILDING
No. Street XPert of Lot
Lot i Block ,�' Add tion or Sub.Div. .& ,--e-
Corner Lot Inside Lot Back Side -Yard _-
SIM ELEVATION
TION ELEVATION_„_,^_
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To
Front Depth � � HeS.ght
l r
Sq. Ft.!�2LCu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft. ��
Type of Construction f Estimated Gost ,
To be completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and cojcz,_
rrect.DATE `SIGNATURE /�� Y��� C
4- &LL
(A Schedule of Fee costs can be found on the Reverse Side.)
SUBJECT
PER .
City of Fridley
15267
AT THE TOP OF THE TWINS
BUILDING PERMIT
�10' _
r
f,
I
q ZQE_l PT
COMMUNITY DEVELOPMENT DIV.
/ ��
r PROTECTIVE INSPECTION SEC.
1 i
1 1 CITY HALL FRIDLEY 55432
%.j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/18/79
JOB ADDRESS 5.581 - 5A Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
T RACT OR ADDITION SEE ATTACHED
DESCR.
21
1
Temple Terrace 2nd SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Vernon Schuldt 581 -.63h Avenue N.E. 560-5449
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Aquarius Swimming Pool Co. 16900 Cedar Avenue South 432-1130
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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct an inground pool (14-19 x 31.51) 18,500 gallon capacity
9 CHANGE OF USE FROM TO
STIPULATIONS
See stipulations on letter dated 6/15/79 from Environmental
Officer.
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATINGs PLUMBING AND SIGNS. WARNiNe,
dining call local UtUrd
7EREP140hE - ELECTRIC. &a E
REQUIRED BY LA
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Vinyl/Steel
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$6,300
$3.15
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
UME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
pERM1T FEE
SAC CHARGE
ANY OT R STATE OR LOCAL LAW REGULATING CON-
$39.00
aTSPRE
HE P FO ANOF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$42.15
SIGNATURE OF NT CTUR ON AUTHORIZED AGENT (DA11E)
WHAENA PROPERLY VALIDATED THIS IS YO�1R PERMIT
l/p
BLDG INSP E
SIGNATUREOF OWNER I IF OWNER BUILDERI IDATEI
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS: 6 M
TEL NO:Gj
STREET NO: �� STREE
LOT: I BLOCK:
B U I L D E a" &
ADDRESS: f (oylloo
Construction Location
Corner Lot: Inside Lot:K Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: /A/— Depth: �/ •Jr Height:
Squane.Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: 6 Cubic Feet:
Type of Construction: �'CV `' Estim ted Cost: $ la®�
7b Be Completed: 1p p
j7q,
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
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 applica
DATE: (. t /-? SIGNATURE:
Stipulations:
J 9• U o
r
�1 Ufa
June 15,
1978
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Paul Duea
Aquarius Swimming Pool Company
16900 Cedar Avenue South.
Rosemount, MN 55068
TELEPHONE ( 812)571-3450
Re: Swimming Pool Construction at 581-5311 Avenue N.E.
Dear Mr. Duea:
This letter is to make clear this departments requirements for the swimming
pool construction at the above address.
1. As indicated, two (2) skimmers approved by the National Sanitation
Foundation will be provided.
2. As indicated, two (2)..inlets of approved design for fresh and/or
repurified water will be provided.
3. As indicated, a main drain of approved construction will be provided.
4. The filter and pump shall be approved by the N.S.F. and be of
sufficient capacity to provide a minimum turnover of at least two (2)
times in 24 hours. This department recommends a turnover rate of
6-8 hours.
S. A deck of at least three (3) feet wide, measured from the pool waters.
edge, shall be provided which extends completely around all private
residential pools. Above ground private residential pools maybe
provided with decking of a minimum size of 4 feet by 4 feet at pool
entry points and provided that such decking has the approval of the
City.
6. The diving area will be acceptable provided there is no overhead
obstruction.
7. Fencing or other effective means including but not limited to walls
or buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
(a) The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self -latching gates capable of
being locked.
(c) Self-closing and self -latching devices shall be placed at the•top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
B. An automatic chlorinator should be provided with a suitable test kit.
9. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
Mr. Paul Duea
Aquarius Swimming Pool Company
June 15, 1979
Re: 581 - 53� Avenue N.E.
Page 2
10. All electrical lines must be greater than 15 feet away from the pool
surface. An alternative is to bury said lines.
11. The pool fill spout must be air gapped or protected by a vacuum breaker.
12. Suitable safety equipment to include but not limited to a ring buoy
and rope that is 142 times the pool diameter, and shepherds crook pole
must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is approved contingent on final inspections and approval by the City.
If any questions or problems arise from this letter, please feel free to
contact me at 571-3450.
Sincerely,
,e� "_1 . - 11 -
STEV J. OTS01
Environmental fficer
SJO/mh
CC: Mr. Vernon Schuldt
581-5A Avenue N.E.
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SUBJECT
P
City of Fridley
2 7 3 82
AT THE TOP OF THE TWINS
BUILDING
PERMIT
4WeMPT NO.
i • _ COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.��
NUMBER
REV
DATE
PAGE OF
APPROVED BY
/---1 CITY HALL FRIDLEY 55432
ti.__..11•' '-j 612-571-3450
910-F15
18/25/98
JOB ADDRESS 2
581 53 Avenue NE
T LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
21
1
ITemple Terrace 2nd
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Vernon Schuldt572-9226
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Northern Crest Inc. 8797-9164
20098415
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 ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (24 Sq.) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$2001
$1.00
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.
$74.75
Fir SC $2.00
PLAN CHECK FEETOT
EE
Licen
5.
.75
SIGNATURE OF CONTRACTOR OR AUTHORIZEDAGENT (DATEi
N RO
VALI T THIS I R P RMIT
D
BL iNSP
E
S,GNATUREOFOWNER0FOWNER BUILDERi iDATEi
01
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: 5 e /y
Legal Description:
Owner Name & Address: S(e�1.ul L j Tel. # �5 � - 7 a D. G
Contractor: No it T�,em &L6< xric MN LICENSE # �2 00119/ 5 -
Address: 4 ;� q 55 p o jjSt, , 1V6 P,,L SW.Jel. # 211- Er 6 q
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: �����1,C '& �'` (=2C/Sa -
Comer Lot [ ] Inside Lot P4 Ft. Yd Setback
Type of Construction: TO, k Pv� A&A -se k G.agz
Approx. Completion Date: / j Aj
(Cos t: on
Side Yard Setbacks
Estimated Cost: $—
Back)
Driveway Curb Cut Width Needed:
Ft. ++ = Ft x $ _ $
DATE: g �5'� APPLICANT:
16;,Ftt
_ Tel. #
CITY USE ONLY
Permit Fee
$ S
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ / . UCS
$.501$1,000 Valuation
SAC Charge
$
$900 per SAC Unit
License Surcharge
$ (�`� (�
$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:
;ITY OF FRIDLEY INSPECTION D1ViSION
Effective On January 1, 2000
1431 University Ave NE
=ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOIJNG, VENTILATION,
763) 572-3604 REFRIGERATION
AND AIR CONDITIONING SYSTEMS AND DEVICES
z
2
JOB ADDRESS,5 F) I
RATE SCHEDULE
OWNER tC b k I r �
o-
iesidential Rate
TOTAL
Furnace Shelf and Duct Work, Burner .
BUILDING USED AS
N
Also Replacement Furnace $ 30.00
$
(Side Vent • Fill Out Back)
ESTIMATED COST _ PERMIT NOJ
Gas Piping; (Needed with new furnace, $ 10.00
1�
but not replacement)
DD S�CR1P_TION 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
O
-n
'Air Conditioning - All Sizes $ 25.00
$-__
Fuel Total Connected Load
e
All Others/Repairs & Alterations (LIST ON BACK
Burner Trade Name Size No.-
1% of Value of Appliance or Work
$�
BTU _ Hp— EDR
:ommercial/Indusirial
1.25% of Value of Appliance or Work
$
The undersigned heroby :Hakes application for a pert-nit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
State Surcharge
$_ _ _.� Q
rulings of the Building Division, and hereby declares that all the facts and
�----��
representations stated in this application are true and correct.
o
TOTAL. FEED
6INIMUM EEE FOR ANY H THING/COALING/VENTILATION
HtATIN '1
IKERLGERATLWAIR fQNDITION 16 G PERMIT 15 $25.00
FLUS
�t
a-�
THE S,aU STATE SURCHARGE
Signed TEL tfal UI
1INSPECTION FEE $47.00/Hr
CD2
T ��
Air Conditioners can not be placed in a side yard without
Approved By Rough-In Date Final Date
mitten permission from adjoining property owner.
FILLOUT
BACK TA K f TJ ON REPLACEMENT NAC
m
a
Z8 ' d `1tii01
COMMON VENT. VENT CONNECTOR AND COMBI1STtON AIR VERIF1CATlON
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and Is Free frern rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes( ) No( )
The venting system is plasUcJPVC 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 fisted assembly
and meets the current codes and manufacturer's specifications.* This does
include AOA -LAMA Category 1 Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes( ) No( )
The exlsona combustion air is sized and installed to meet ft current codes
and manufacturers specifications. Yes( ) No( )
When required to Installa now combustion air it will be sized and installed
To meet the current codes and manufacturers specifications. Yes( ) No( )
When InOt—allIng a new ventlp_pLsystem, 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 t 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 ( )
AraafianceTxRg and Size/Common Venjand Vent Con dor lnfbrmad
Appliance #1 Type �, r_i i v_ BTU Input _ Fan Assisted or Not
Appliance #2 Type BTU input � Fan Assisted or Nat
Appliance 93 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance 01 Vent Connector Height __ it Length ,_...,fi Diameter in Type
Appliance *2 Vent Connector Height f1 Length ft Diameter in Type
Appliance #3 Vent Connector Height ft length ft Diameter in 'type
ALTERATIONS: iO criM---
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V� `r `��� �` `� v From: unknown Page: 1/2 Date: 10/25/2010 3:10:52 PM .
Building
MECHANICAL
PermitNo.• v
Inspections
RESIDENTIAL APPLICATION
Received �*�47
763-572-3604
CITY OF FRIDLEY
Date Rec
763-502-4977 FAX
EFFECTIVE 2-19-09
DATE 10/25/10 YOUR E-MAIL ADDRESS dave®dovesheatingendalr.com
SITE ADDRESS 58153 1/2 AVE NE
THIS APPLICANT 1S: 0 OWNER OCONTRACTOR
PROPERTY
NAME: ARLENE BCHULDT
ADDRESS. 58153 112 AVE NE CITY FRIDLEY STATE MN ZIP 55421
OWNER/
TENANT
PHONE: 763.572.9226
CONTRACTOR
COMPANY NAME. DAVES HEATING, AIR a ELECTRIC
CONTACT PERSON: AMY MADVIG
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: 1801 37TH AVE NE CrrY COLUMBIA HEIGHTS STATE MN Zip 59421
APPLICATION
PHONE 763-781-6801 FAX 783489-8805
PERMIT TYPE
�NGLE FAMILY Ia TWO FAMII.Y 0 TOWNHOUSE
TYPE OF WORK:
O NEW ZMPLACEMENT O ALTERATIONIREMODEL
DETAILED DESCRIPTION OF WORK{ REPLACE CENTyl'l,
FEES ARE BASED ON $1000 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL. " S1ZE/BTU�^��
MFO: MODEL: SIZENITU
MFG: MODEL: SIZEJBTU
$25.00 FIREPLACE (GAS) $15.00 _OAS RANGEJOVEN $10.00
IR TO AIR EXCHANGEER $15 PLACE (WOOD) $35.00 NEW GAS GRILL. $10.00
11
`901LER $35.00 1 Z111KNACES35.00 GAS UNIT HTR $10.00
LINER $10.00 AS DRYER $10.00 _POOL HEATER $35.00
_CHIMNEY
DUCT WORK $10.00 GAS PIPING $10,00 VENTILATOR $15.00
Number of fixtures Q $10.00 . _. _. x $10.00 = $
Number of fixtures @ $15.00 _ _ x $15.00 = $
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures c@ $35.00 ? x $35.00 = $ 35.Ob
State Surcharge = $ .50
MINIMUM FEE S.35.50 Total = $40-100
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 o I ances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
glut a permit but only ap lication for a permit and work is not to start without a permit; that the work will be in accordance with the
approval o
approved plan in the e 0 o kr1TmtTPRINTNAM7;1V11
SIGNATURE OF APPLIC T
PLE SB :SBP TE PE TS RE REQUIR5115 FOR BUILDINO, ELECTRICAL AND WMCHANICAL WORD
/6 �`6 City of Fridley
uilding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977