The URL can be used to link to this page

PRE 2010 DOCS!p ! City oFridley, FY, Minn e BUILDING PERMIT N® 4182 Date:.. -.._August 31,_1y59 Owner: ............................. Builder ....--._Lyndele -Builders .._._. Address ........................... .... ......... ... _...... __.._..._.._..............._.... _............... Address ......... LyAdale venue South Minneapolis., Minnesota LOCATION OF BUILDING No. ..... 553 ----------------- street -----------------54th . A-enue-N.-..._E t........_ ............._.............. Part of Lot ................................ _................... ...... Lot l�-TIOB.......... Block ..... . ................1......................... Addition or Sub-Division....._...Tamdale.._Bu3ldei'Sa.._4th _Add It. Corner Lot .................................... Inside Lot..................X....---........ Setback XOR.......................... Sideyard........... PAP ...................... ............... .._....... SewerElevation ................................... ........ _.... .............. ....................................... Foundation Elevation -------------------- -------------- _.._-------- -............. _.................... ........ DESCRIPTION OF BUILDING To be Used as: PR4ling.... ........................ Front ....40 t...._.. Depth ..27.'10" Height .19............ Sq. Ft. 1.:_063_.. Cu. Ft... nJT ...._.............._...................................... Front ..... _................. Depth .............. _.. Height ...................... Sq. Ft. ..... _................. Cu. Ft. of Construction M ..........FrAIS Type ................................. Est. Cost..........3..9.....0 75......................... To be Completed ......................... 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. "-)„ „ I I d In consideration of the payment of a fee of $.......2.0.aQQ.......... 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 Application for Power Plants and: Heating, Cooling, Ventilation, ,Refrigeratian End Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations --up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ................ 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 . _06 _ y each add. 60,000 BTU ... _, .................. 2.00 ; Replacement of Furnace ............................. .§.00 $ Repairs & Alterations—up to $500.00 ... ` ............ 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $—� GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 /- $��) Additional Fixtures ................ x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING — FAN DATING SYSTEM See Fee Schedule VENTILATING SYSTEM $1 ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SII, 4-7470 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 all the facts and representations stated in this application are true and correct. Fridley, 'nn ^ `�/ , 19 Owner Kind of Building Used as 4,� _��Xc_�._ To be completed about / Estimated Cost, $ G) AMd--New. Building Permit No. Permit No. f c� DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, �armAir--No ^� Trade Name >---�� Size No_ Capacity Sq. Ft. E.D.R °� c�—BTUH.P. Total Connected Load C, t)— �> Kind of Fuel BURNER —Trade Name Size No Capacity. (REMARKS—OVER) 4 z 2M 7-59 Sq. Ft. E.D.R BTU H P. c—. Signe �- By Business Phone No City of Fridley, Minn. BUILDING PERMIT N° (:5:4:3 3 Date: .. `– Owner: f Sunder _ _ Address Address A.00AT N I. BUILDING No. Street! e Part of Lot Adc]ition or Sub 710, - CorneILBt _ Inside Lot aback 1deyard Sewer Elevation _ __ Fo tion Elevation DESCRIPTION OF BUILDING To as: Front Depth Height Sq. Ft `'u. Ft Front Depth Height Sq. Ft. - Cu. Ft ✓`. Type of Construction F:st AIrl To be Completed 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 $–t2— , 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 within the city limits and this permit may be revoked at any time upon violation any of the provisions of said 9rdinancm s,, .01 i ,, Building Inspector NOTICE: This permit does not cover the construction, Imstallation for wiring, plumbing, gas heating, sewer or water. Be acre to see the Building Inspector for separate permits for these Items. • 1 RM el,18 BLOCK - - ADDRESS S7 4/ VALUATION 2120�_,* TYPE _S /C 7- � ,g e- 7- -Z < -4 4. /c a dL Ap,P-oAj Is 44L 3e r c- Z,6 V A� 07 7- A* 0 W E:,.L L OoU 0y r 7-- H Cm S, 14 i3 #2,L r 5 OP cpoz 15b L 'A PR x is r *AJ G. rs f, APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEXIER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. FrontDepth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost 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 representations stated in this application are true and correct. DAVE SIGNATURE 1l (A Schedule of Fee Costa can be found on the Reverse Side.) Clay of Fridley Application for Pltnnbing and C�u F'ithing Permit SQ11- Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 4 Number, Kind and Location of Fixtures Location 5 5 A� e • +� ;d Number Fixtures ...................... �1 y 2 ilii 3� G� �a2r�i ui Z �� , z tU' O < J (9 gI (�4§ 0 a• z �O12 R • N WATER HTR. GA5 ELEC Base 2 x $2.00 $ 2. 00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 2 3.00 .00 1st con dl lite 8c c,r 111 2nd 3rd 4th • Future Connection Openings I Connected with New Fixture, Old Openings PARTIAL RATE SCHEDULE 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 City 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, Afinn ?q Oct 67 19_ Owner Clarence D ah 1 fr Kind of Building Sewer [] Used as Cesspool E] PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2,00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 2 x $2.00 $ 2. 00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 2 3.00 .00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 8 - 00 res To be completed about 30 0 C t Estimated Cost, Old—l*xi. Building Permit No Permit No By 140 GA Business Phone No ROUGH FINAL 42 53.84.915.51 City of Fridley Applicallm for Pring mid Cm Fktkg Dank Dept. of Bldgs. Phone 9®0-34.90 DESCRIPTION OF *0111 553 N E 54th Ave Number, Kind and Location of Fixtures r_w" I waaw.�aw wean -— suture COnneetba Openings Sewer + Ness Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 $ _ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater '.Up to 99,000 BTU) . • . • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............ • • • • • • x $2.00 $ Additional Flztures ................. x $ .75 $ Gas Range to 199,000 BTU ............. x $5.00 $ Gas Dryer 1 5.00 REPAIRS & ALTERATIONS—Refer to Code Description ....................-....................... TOTAL FzE $ 5. nn MEN EMEMEMEMEMONIN I waaw.�aw wean -— suture COnneetba Openings Sewer + Ness Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 $ _ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater '.Up to 99,000 BTU) . • . • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............ • • • • • • x $2.00 $ Additional Flztures ................. x $ .75 $ Gas Range to 199,000 BTU ............. x $5.00 $ Gas Dryer 1 5.00 REPAIRS & ALTERATIONS—Refer to Code Description ....................-....................... TOTAL FzE $ 5. nn 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 City Ordinance and ruling of the Department of Buildings, and hereby declares that alt the fact and representations stated in this application are true and correct Fridley, Minn 10-30-70 19, Owner C Dahl Kind of Building fram res Used as To be completed about 11-4-70 Estimated Cost. S 10.00 Old—New. Building Permit ROUGH SUBJECT P City of Fridley2 67 73 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. • _____ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBERREV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/22/98 JOB ADDRESS 553 54th Ave Ne 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 18A &18B 1 Lyndale Builders 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tainmy Topp 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Reith Meyers - Meyers Construction - 11430 Jonquil St NW Coon Ra ids 55434 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 422-8921 20093588 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION M REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (22 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 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 $1834 $.92 DOES NOT P SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION O HE PERFO NCE OF CONSTRUCTION. 59.50 Fire SC $1.83 / PLAN CHECK FEE TOTAL FEE License SC $5.00 67.25 SI NAT E OF CONT fACTbR OR AUT (ZED AGENT IDATEI WHEN PROPERLY V (DATED THIS IS, YY UR PERMIT��/-///j� 13LO96LNSP DATE SIGNATURE OF OWNER 0F OWNER BUILDERI IDATEI NEW [ l ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contract Address: F�I_ kt Effective 1/1/98 —Tel. # LICENSE # 2� 9 35?" Tel. # Z12-2 —�'9Z Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height GARAGEAREA: Length Width Height DECK AREA: Le gth Width Hgt/Ground OTHER: Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: �� Estimated Cost: $ , o l a� 4 1. (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 7- 22 --9 9 APPLICANT: Tel. # %/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / 10th %) $.50/$1,000 Valuation $1000 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 [ ] �� SUBJECT City of Fridley C 34 0 0 5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. �- _ COMMUNITY DEVELOPMENT DIV. r � -____ � PROTECTIVE INSPECTION SEC. 1 /"'1 CITY HALL FRIDLEY 55432 ti11.' NUMBER REV DATE PAGE OF APPROVED BY .... 11.� 763-571-3450 910-F15 10/30/03 JOB ADDRESS 553 54 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 18A & 18 1 Lyndale Builders 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Christiansen 553 54 Avenue NE 763-502-7972 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 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 Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 10 windows - new openings; Reside house 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering or take pictures. Caulk and flash all exterior openings. Headers for new window openings must meet the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING 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 ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @@ @ WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT $5,000 $2.50 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 PLAN CHECK FEE TOTAL FEE $118.75 S NATURCO .�TORORAUTORIZEDAGENT iDATE, �(�AATURrOV PROPERLY VALIDATED THIS IS O R PERMIT O NER,IF OWNER BUiLDERi iDATE. B OG ,NSP FjATE �� NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 5's3 6--LoA Ayt /Ve�,� Legal Description: // Owner Name & Address: 2 �—� 1P � S�` cvi'1 � Tel. # 17� �� Sa � -7`T `7 Z Contractor. �1 MN LICENSE # Address: 5-n Ttf A Awc, Tel. #C�3 gc 2 -717 2- 1— ' Attach 7`i72- 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 C> Width S P Height �` Sq. Ft. �O GARAGE AREA: Length o2�f Width 2 If ? Height g Sq. Ft. DECK AREA: LengWidth Hgt/Ground Sq. F OTHER: �JCk) ^ � �S uf f Construction Type: Estimated Cost: $��.0 �D Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: APPLICANT: J)Ni r t !>4 i A11 29-� Tel. # && 3 7 T2 Call (763) 572-3604'for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ .S -L D d $ S $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 553 54TH AVE NE PIN : 233024430020 LEGAL DESC : LYNDALE BUILDERS 4TH ADD : LOT 18A BLOCK 1 PERMIT NO.: 2004-00127�430�3 DATE ISSUED: 01/27/2004 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES APPLICANT CHRISTIANSEN, DALE R & JOYCE E 553 54TH AVE NE FRIDLEY, MN 55421 /L CHRISTIANSEN, DALE R & JOYCE E 553 54TH AVE NE FRIDLEY, MN 55421 0 # GAS WATER HEATERS 0 # GAS RANGES 4 # WATER TRMT APPLIANCES AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Annlisant- /1 Date Bldg PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 6991 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0 0 0.00 28.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 28.50 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective On Jan 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT_D MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FI OOR PLUMBING FIXTURE RATES NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas"` Gas Range" Gas Dryer`" Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance JOB ADDRESS -5 5- DDRESS5S :3 OV F 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 application are true and correct. Building Used As Estimated Cost PERMIT NO. � L' ` 0L J � PLUMBING COMPANY SIGNED BY ^ TEL N . ��35_02-7T75 Approved By Rough -In Date Final Date State Surcharge .50 'n Ir MINIMUM FEE /OR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ 604-0. � PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED (`nMMnN VFNT. VENT CnNNFCTnR AND MMMIISTInN AIR VFRIFICATIm When replacing an existingf urs ante, 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 plasticlPVC 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing e!nmhi istinn air is sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When required to install a new comhustion air. it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When inc alling-a npw venting nye 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( )No( ) A pnlian Typt- and SI7P/Common Vent and Vent onnector 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 HEATING CO: Signed By: Date : 0 LO O Building MECHANICAL Permit No.: _ Inspections RESIDENTIAL. APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 1413A, DATE YOUR &MAII, ADDRESS SrrE ADDREss a5:3 -e. 1V L THIS APPLICANT IS: ❑ OWNER WONTRACTOR PROPERTY NAME: C1 \_ C1h r � s;� % cn Sen ADDRESS: rJ-J 0500 twit, CrrY Fri cI `e.+► STATEMN ZIP��.1 OWNER/ TENANT PHONE: LDS - SO'a - COG a I CONTRACTOR COMPANYNAME: C,}-r-011ec� w-7�r CONTACT PERSON: C� r r �" SUBMIT A COPY OF STATE LICENSE # _00-7/o-7 EXP DATE , - - YOUR STATE LICENSE WITH ADDRESS: aa l ® G Cw_ � 55; - CITY �=Cjrrrlt na,+Vn STATE N1l-�Zip i APPLICATION PHONE (a 1-14 t,5n1 Q-ja FAX PERMIT TYPE 0 INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW 01EPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPHON OF WORK Pvmo \r r & i::7 l)mn�)r c 1c. b- Ps (_ 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) Equipment Installed MFG: T; -r, E. MODEL: O sizEmTU Pfa� COO MFG: �p� r.T� MODEL: 13ra GCS 07 kl-I SIZE/BTU 7_ -eon 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 NEW GAS GRILL $10.00 BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 —POOL HEATER $35.00 _DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ t.0 - 70 Number of fixtures @ $10.00 Ix $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ -(on_.s Number of fixtures @ $35.00 x $35.00 = $ 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. PRINT NAMFi' I_, DATE 1 o I c' I (o SIGNATURE OF APPLICAN'( t n L, 1 zAatj� jj PLEASE NOTE: SEPARATE P RMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MADE-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 Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC 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 IMC 1346.0312 5. 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 Inspections 763-572-3604 763-502-4977 FAX SITE ADDRESS _ THIS APPLICANT IS: From: 7637840503 Page: 212 Date: 12/7/2009 3:14:53 PM PLUMBING permit No� RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY Amcok EFFECTIVE 2-19-09 YOUR E-MAIL ADDRESS O OWNER CONTRACTOR OWNER/ ADDRESS: /O `a S7'"-1U+� CITY TENANT PHONE. '7&3 5UBiVIIT A COPY OFSTATE LICENSE #�,-�Ll C� EXP DATE YOUR STATE LICENSE, BONA AND STATE BOND # .�y3 �7 EXP DATE —�-�. CERTIFICATE OF ADDRESS: ru l w - 1054-1, /-P yg CITY N�:vC STATE/174/ ZIPyS INSURANCE PHONE % FAX 7&3-- '7B'lI`" 4503 PERAW TYPE I P(SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW WUM ACEMENT DETAILED DESCRIPTION OF WORK 2s2.9;& W AAA.MMIC£- Lykw FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV ,FLOOR DRAINS i SHOWER WATER PIPING —BATHTUB —GAS PIPING (NEED CITY LIC) — SWIMMING POOL WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($IS) DISHWASHER _.._ LAUNDRY TRAY ,WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved plan in the ail y/ork is bquires review and approval of plans. SIGNATUREOF APPLICANT c PRINT NAME /.fjZ_ �e ��' /A DATE -142-2-471 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977