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• City of Fridley, Minn.. MU DING PERMIT Date: June 16, 1965 --27�--27 N° '7909 Owner: James Leoon Builder Charles J. Beggs Address 631 58th Ite. N.E. Adm 569 W. Orange St. Penal 17. LOCATION OF BUILDING No. 631 Street 58th Ave. N.E. Part of Lot Lot — 6 _ Block 8 Addition or Sub -Division Donnays Lakeview Manor Corner Lot Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft Front Depth Height Sq. Ft Cu. Ft Type of Construction Est, Cast — 15-0-0-00 __ To be Completed • Storm damage repair C� 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 rth and in compliance with provisions of ordinanctza of the city of Fridley. In consideration of the payment of a fee of $10*OO , permit is hereby granted to Charles J. Beggs 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�g location, construction, alteration, maintenance, repair and moving of buildings within the city 11—i and � his permit may be revoked at any time upon violation of any of the provisiona of said ordinances. Allen. Jensen Building Inspector NOTICE: 761: permit don not ecru the eandmdbe, tedalhilm far wkb& phmblng, gn he&&& sewn or wder. Be Cure to ae the Building hopedor for sepm" permits for thea he w. s APPLICATION ICOR ,BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME .`-z�.•� _ --�_ BiiILDIM ADDRESS DR&iS LOCATION OF BUILDING Na. Street part of Lot LOTK ADDITION OR SUBDIVISIONXz. t.� Corner Lot -Inside LOT Setback Side -;Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed ,building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth _Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost fld� 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 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. %ocneuuie or Yee uoszs can oe round on the Reverse Side). 53-84-s-915.51 City of Fridley Applicalfoe for PMmbbg and G�n R Pemb Dept. of Bldgs Phone 960-3490 DESCRIPTION OF WORK 631 N. E. 58th. Ave. Number. Kind and Location of Fixtures � p,tt 7 Qg SF► K j¢� F % V< 5 V r N WA MTA. GA5 ELK. Base 1st 1 2nd 3rd 4th • Future Canmeetloa Opeaiaga t Naas Fixture. Old Openings Connected with Sewn Cesspool E] 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 Fixtures ..... — .......... x $ .75 $ Gas Range to 199,000 BTU......_..... 1 x $5.00 $ 5.00 REPAIRS & ALTERATIONS—Refer to Code Description .............................................. _ TOTAL FEE S 5.00 (SURCHARGE $_.50) City of Fridley: The .undersigned hereby makes application for a permit for the- work herei specified, agreeing to do 411 work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that alit the fact and representations stated in this application are true and correct Fridley, Itllinn 2-7-72 19, owner James A. Le Aone - Kind of Building Frame Used as Re s. To be completed about 2-14-72 Estimated Cost, $ 10.00 ORPLNew. Building Permit No - —permit No. Signe o By DAINNFGAS00. Business Phune No ROUGH FINAL 9 ` 7- 3 — 7 1/- Class VA" Sorcharge $.50 Rec. # 62210 Cify of Fridley Applicc*Wn for MmIlabig and Gas R"hiq t Dart. of Bldge Phone 560-3450 DESCRIPTION OF WORK L„��..s 631 58th Avenue N.E. Rumber. Kind and Location of 7Ixtures PARTIAL PLATE SCHEDULE PLUMBING FIXTURE FRATES: NO. RATE TOTAL Number Fixtures ................ x 8200 $ Future Fixture Opening ........... x $1.60 $ New Fixture Old Opening .......... x $1.80 $ Catch Basin .................... x $3.28 =- Water Heater ,'Up to 99,000 BTU) • • • • x $3.00 t New Ground Rasta Old Bldg. ........ x $3.28 $ Electrk Water Beater .............. a 82.00 8 GAS FITTING PEES. NO. RATE TOTAL lat 3 Fixtures . • ............. x $2.00 $ Addltlonal Irixtures ............... x $ .78 $ Gas Mange to 199.000 BTU ............ x $8.00 i State Surcharge $ .50 REPAIRS t ALTERATIONS—Rotor to Cade _ cription © o . o . . DesDescription 5.50 TOTAL TEE 8 City of FWdley: The undersigned hereby makes application for a permit for the work herei, specified, agreeing to do all work in strict accordance with the Qty Ordinance and nding of the Department of Buildings, and hereby declares that all the fact and Tepresentations stated in this application are true and correct Fridley. Mina _ July 27, IV I9.72 Owner James Leaon Kind of Building Frame Used as Dwelling To be completed about August 1, 1972 Estimated Cost, $ 429.00 Old—New. Building Permit No. Permit No. 5661 Signed Culligan ROUGH By Business Phune No City of Fridley SUBJECT PrIaml O. X?33 9 AT THE TOP OF THE TWINS BUILDING PERMIT r I ; COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 J 612-560-3450 RECEIP NUMBER 910-F15 REV. DATE 3/3/76 PAGE OF APPROVED BY JOB ADDRESS 631 - 58th Avenue N.E. 1 LEGAL DESCR. LOT NO. 6 BLOCK 8 TRACT OR ADDITION SEE ATTACHED Donnay's Lakeview SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE J. A. Leaon 631 - 58th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Home Modernizers Inc. 1339 North Pascal St. Paul 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 Ek REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install aluminum siding on house 9 CHANGE OF USE FROM TO STIPULATIONS �EPERATF., PERMITS 1;aFt )1jJ1R//yy FOR RHFATING, Pl—t#"ING AND SIC SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Alum. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION 2 880 $2r8801 SURTAX $1.44 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. $18.00 PLAN CHECK FEE TOTALFEE $19.44 IGNATURE OF CMONTRACTOR Au oR12ED AGENT (DATE( WHEN PROPrERLY V (DPA TOED THIS IS YOUR PERMIT - -BLDG (NSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) V •APPLICATION FOR RESI'DL'NTIAL., ALTERATION, OR ADDITION•BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER IS NM : $UILDER: C E, -ADDRESS: 3 1 - �` d" d P AZ v z /� ADDRESS : l 3 3 /� v 77i Y' h-� c dr s 1. lr• 1 -- STREET: - LOT: CL BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK:_ SIDE -YARD: Applicant attach to this form Txao Certificates..�f Survey .ofLot and .proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: �1CQ� ��?L�_%�-Ci Front: Depth: Height: Square Feet: Cubic.Feet• • Front Depth: Height: Square Feet; Cubic Feet': Type of Construction: c�� -- = 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 of Fridley Ordinances and rulings of the Department of Buildings, and herjeby declares that all the facts and representations stated in this application are true and correct. • DATE: 9 7 6 SIGNATURE • CCS-,�-� �� '� ```�"`� (See Reverse Side For Additional Info on.)' v I T ur rRiu"r 91-8L:879001 APPLICATION FOR PLUMBING AND GAS FITTING PEI441T PARTIAL RATE SCHEDULE . •� n PLUMBING FIXTURE RATES: NO. RATE ''� p. x $3.00 water Heater Future Fixture Opening • x $2.00 Now Fixture, Old Opening x $2.00 $ Catch Basin �_ x $5.00 $ Water Heater - to 99,000 BTU, x o o m q qq N 3 a b yp W x W N ,J x 19O $ �- Now Ground Run Old Building ^_ as ler N % U O W Q 41 $5.00 $ GAS FITTING FEES: 1st 3 fixtures _ x $3.00 $_- Additional Fixtures �_ x $1.00 $ .Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 1st $ each add. $100.00 or fraction $2.00 $ State Surcharge $ _ •50 TOTAL FEE tad 3rd . 4 th (R) - Future Connection Opening Connected with Sewer (+) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL leer Fixtures x $3.00 $ Future Fixture Opening • x $2.00 Now Fixture, Old Opening x $2.00 $ Catch Basin �_ x $5.00 $ Water Heater - to 99,000 BTU, x $5.00 $ 100;000 BTU to 199,000 BTU x $10.00 $ water Softener x $7.90 $ �- Now Ground Run Old Building ^_ x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures _ x $3.00 $_- Additional Fixtures �_ x $1.00 $ .Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ _ •50 TOTAL FEE REINSPECTION FEE 010.00) Job Address 631- 58 AVE. NE - Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application lora permit for the work hen specified agreeing -to do all work in strict accordance with the City Cod and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and co. Fridley, Mn. 5-10-77 , 19� OWNER JAMES LEAOIV - - KIND OF BUILDING fame - USED AS res. TO BE COMPLETED ABOUT ESTIMATED COST .10.00 OLD - NEW BUILDING PERMIT N0. PEWT N0. - CD ,,, / /.' if>�� - • Company - LONWAM00 Signed By Tole No, J%OUGH INSP. Date FIN4 INSP. Data APPROVAL FOR PERMIT _ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 'lass "A Surcharge .505 CITY OF FRtLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: $ 4.00 $ RATE TOTAL Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ MECHANICAL WARM AIR: a jzJ1 mace Shell & Duct Work to 100,000 BTU $12.00 $ a BTU 4.00 $ Re lac a of Furnace 7.00 $�® lrs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ STEAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3 gal. per hour each add. 3 gal. per hour $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 10.00 GAS BURNER- from 100,000 BTU to 1990999 BTU $10.00 (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 Additional Fixtures x $ 1.00 Gas Range to 199,000 BTU x $10.00 AIR CONDITIONING FAN HEATING. SYSTEMS VENTILATING SYSTEMS ALTERATIONS &, REPAIRS S ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT See Fee Schedule State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) 4 REFRIGERATION AND /MJ� �NF,4 1*M101/ NOW Dep—L"""lt of .Buildings w City of Fridley Tel. #571-3450 .The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes.-. and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. �[_(„�/, 19rltq OWNER 0/ i Yl�l / I , ( P nv /rn KIND OF BUILDING USED AS TO BE COMPLETED ABOUT 1A 7 % 1 $ ESTIMATED COST $ DLDNEW BUILDING PERMIT NO. PERMIT NO. $ S S c/ MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm AiY No. 0 Trade Name Size No. Capacity d�TC_ Sq. Ft. EDR BHP Total Connected Load Kind of BURNER - Trade Name' Size No. Capacity Sq. Ft. EDR RR,J a �, � HP, , I ,,/ Company . �K�7 �% Ila i "i CU',A, Signed B Tel. No. 535 YM1 l� A SUBJECT PER City of Fridley 1617 AT THE TOP OF THE TWINS BUILDING PERMIT _ r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. 2e r PROTECTIVE INSPECTION SEC. � i 1 -'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED By ,.j 612-571-3450 910-F15 5/13/81 JOB ADDRESS 631 - 58th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 $ Donnayls Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Leone 631 - 58th.Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 161 x 121 Deck 9 CHANGE OF USE FROM TO STIPULATIONS tkAl,1, pt WARW�IG 04181A ' &C Before digging tall local utilities SIONS TELEPHONE - ELECTRIC - GAS Etc. � REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Treated Pine 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 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 ��SSOO SO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $8.00 SIG ATUREOFCONTRACT RAUTHORIZEDAGENT (DATE) TOW WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT _ k' s cl_ V BLDG INSP ATE SI URE OF OW NER IIF NE BUILDS 1 IDATEI l� A CITY OF FRIDLEY APPLICA7Io'4 FOR Rf:SIUI711TIAL BUILDING PE_P14ITS (Nevi, Alterations, Additions, or Repairs) OWNER:C_� � � . J �- BUILDER: ADDRESS: ✓ c ADDRESS: TEL NO: TEL NO: Construction Location STRMT -NO: STREET: A11ttC.0v LOT: Lz BLOCK: 45) ADDITION: 0am-ovdV Corner Lot: Inside Lot: %� Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIO14 OF CONSTRUCTION GFront: : Square. Feet: Depth: If eight: r Cubic Feet: Front: Depth: Height: Square -Feet: Cubic feet: Type of Construction: 40 AM -)w To Be Oor.�pleted: � 3-01 Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ Alt. A Alt. B fi $ SEE REVERSE SIDE OF SHEET the undersigned )lereby makes application for a permit for the vnrk'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 represenUiti.ons stated in this application are true and cor ect. DATE: J aft I7> � SIGNATUM. I rt- 1-12 v Stipulations: V %L -IQ 9 LO d'7 X A/ 4w% c1 Lft s rbo au 1s�r sv���.� MAxd : SUBJECT P IT NO. City of Fridley 16 5.2 4 AT THE TOP OF THE TWINS BUILDING PERMIT r RE � • _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. � I � CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY L J \ 612-571-3450 910-F15 4/15/82 JOB ADDRESS 631 - 58th Avenue N.E. I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 g Donnay's Lakeview Manor Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE James Leaon 631 - 58th Avenue N.E. 571-6573 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Franzen Construction Co. 4250 - 5th Street N.E. 788-4071 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 Kitchen del(remove window, replace window, remove wall, add new sheetrock, install patio door) 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS HEATIN RE ® FOR1►�1 1 + .G. PLUMB'NG ANDvSIG a. 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 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 $10,000 $5.00 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. $80.50 NONE PLAN CHECK FEE TOTALFEE CA& �� rynti.�r 7 IS- F-2— NONE $85.50 SIGNATURE OF CONTRACTOR OR AUIrd&RIZEDAGENT IDATEI N PROPERLY D IS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) ULUG iNSP DATE CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDtNTIAL BUILDING PEFU4ITS (Well, Alterations, Additions, or Repairs) OWNER: ADDRESS: e TEL NO: -S s 7 3 BUILDER: r a ADDRESS: TEL 140:. -) e F 4/07/ Construction Location ---'4 • STRICT NO: STREET: e LOT: BLOCK: O ADDITION: -4�>o tz 4 /� 4► �"p ��cc� O �• Corner Lot: Insii3e Lot: X Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. Front: DESCRIPTION OF CONSTP.UCTION Depth: Height: Square.Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction: �o 0,0 f Py y� p� J Estimated Cost: $ Off/ '!b Be Cbmpleted: `y�°( k e Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the tvrk'herein specified, agreeing to co.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: '�' �y � SIGNATUM: Stipulations: gS.so i -' i-- - - - --t i --- _ F11, i i I , I I i A I I I I I I I I I I rA - - -r r I CO I � rboin, j - - - ---- F11, i i I , I I i A I I I I I I I I I I I � V�� t'► I I I ; � � I I I I i GD-' - - �1► -r - I CO I I j I I - T i FA MY OF - -- - -- 1 1- - -- l -- - - t_� - - -- - j Al -- { 4a I i I ► W a ti t4'NZ — - - -- - -T +- - - - I i v® p,• � �- n b M� ao uw • a D a CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT PLUMBING FIXTURE RATES: New Fixtures Future Fixtures RATE SCHEDULE NO. Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance RATE $ 5.00 g 3.50 S 1.50 S 4.00 $ 5.00 $ 5.00 S 5.00 S 5.00 $ 5.00 $ 7.00 $ 5.00 S 10.00 $ 10.00 Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE TOTAL $ � (0-0 bttective Aug. 1, 1981 Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, INn. OWNER eO A,LJ RIND OF BUILDING J USED AS -k--p S TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. B?qI Company d'E 6 y�J Signed By Tel. No. 5 -7 GJ ROUGH INSP. Date FINAL rNSP. =/ 7- f �� Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE m m F?rr E m .ci g m ro M W W Water Heater �lec Ran. I lst 1 l 2nd 3rd 4th L FF (R) - Future Connection Opening (*) o New Fixture, Old Opening Connected with Sewer Water PLUMBING FIXTURE RATES: New Fixtures Future Fixtures RATE SCHEDULE NO. Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance RATE $ 5.00 g 3.50 S 1.50 S 4.00 $ 5.00 $ 5.00 S 5.00 S 5.00 $ 5.00 $ 7.00 $ 5.00 S 10.00 $ 10.00 Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE TOTAL $ � (0-0 bttective Aug. 1, 1981 Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, INn. OWNER eO A,LJ RIND OF BUILDING J USED AS -k--p S TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. B?qI Company d'E 6 y�J Signed By Tel. No. 5 -7 GJ ROUGH INSP. Date FINAL rNSP. =/ 7- f �� Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE City of Fridley SUBJECT PERM.I_k1=== o 19823 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ~ r PROTECTIVE INSPECTION SEC. � i1 i A/"';•� CITY HALL FRIDLEY 55432 NUMBER PAGE OF APPROVED BY .-_. 612-571-3450 910-F15 REVDATE 4/11/89 JOB ADDRESS 631 - 58th Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 8 Donnay 1 s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Leaon 631 - 58th Avenue N.E. 571-6573 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Franzen Construction 4250 - 5th Street N.E. 788-4071 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 f ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace existing windows 9 CHANGE OF USE FROM TO STIPULATIONS 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 S0. FT, CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. 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 $1.65 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,300 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- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $63.00 PL N CHECK FEE TO$tl FE655 SIGNATURE OF CON RACTOR OR AUTHOPVED AGENT (DATE) HEN PROPERLY VALID • BLDG INSP D THIS IIS, YOUR PERMIT *1T SiGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ ] Effective 5/1/88 ADCN [ ] R-1 AND R-2 ALTER [ ] Build, uq Permit Application Construction Address: 6,'73/ ' ke, llJ.zf Legal Description: Owner Name & Address: d) -,-,Ce') VA Tel. # X77/-Cr7� Contractor: t� _ p .� �-,,� Tel. Address: '7' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVIM AREA: Iength Width Height Sq. Ft. GRP -VM AREA: Length Width Height Sq. Ft. DDCK AREA: Length Width 07HER: Hgt/Gmund Sq. Ft. Cornier Int [ ] Inside Lot [ ] Ft. Yd Setback Side Yawl Setbacks Type of Construction: re- e.. (.c) L, Estimated Cost: $ 33r)0190 Apprrox. C mPletion Date: Proposed Driveway Width If New opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: jqKj APPLIC AW: Teel. # 71K ti 712 y QTY USE ONLY Permit Fee $ aj 40 State Surcharge $Maim SAC Qharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TEAL $ STIP[TI.ATZ(�1S Fee Schedule on Reverse Side $.50/$1,000 valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 376 Zit `f 4 I= 47.04 sue.recr PE City of Fridley 20989 AT THE TOP OF THE TWINS BUILDING PERMIT r REE � • COMMUNITY DEVELOPMENT DIV. _ ____ r v PROTECTIVE INSPECTION SEC. 1 CITY HALL FRIDLEY 55432 ER REV DATE PAGE OF APPROVED BY 612-571-345.0 14110-F15 8/6/91 JOB ADDRESS 631 - 58th. Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 8 Donnay 's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leone 631 - 58th Avenue NE 571-6573 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Crandall Construction Inc. 9730 - 29th. Ave N, Mpls., MN 55441 537-0375 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 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (20 Squares) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Ice and water shield must meet the State. Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,040 $.52 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON - $27.06 Fire SC $1.04. TR N OR THE PERFW.ANCE O CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ('-NM$20156 SIGNATUR CONTRACTOR OR AUTHORIZED AGENT IDATEI W PPER L V TTHI S YOUR PERNTj7II SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI INSP r)ATE NW [ ] Effective 1/1/91 ADM [ ] R-1 AND R-2 AMM [ ] Huilding Permit Application // J Construction Address: r,. _ 3 / s "' 6 Legal Description: Owner Natme & Address: C- 0 O Tel. # .5''�/ %" S"% 3 COtitSBG'tor•��vaeC T - � -7�P Attach to Tthi s appf l ti ; C S Witte og Survey of the lot, with the proposed cots xuction drawn on it to scale. LB9C3tzPFIQJ CIF IICpli0O8ffi�TT UVM ARS: Length Width Height Sq. Ft. MUM AM: Length Width Height sq. Ft. AICA: length Width Hgt/GYouarl Sq. Ft. On=: Corner Lot [ ] Inside [ ] Ft. Yd Setback Side Yard Setbacks Zype of Clmwtnic�tian: roc4 �� �STA� 2 Estimated Dost: $ _z�®e-y"' Approx. C®pletion Date: l �P q 1 �``' C, �- lt>R Proposed Driveway Width If New Opening Is Desired: Ft. $ $ �� Width + 6' See Back Page DATE: APpucARr: i CITX D6S CEII,Y Permit Fee $ '7 <' Fee Schedule an Reverse Side Fire merge $ /.0�/ .001 x Permit Valuation (1/10th $) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $650 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Detenei ned by : i Sewer Main 0 arge Agreement Necessary [ ] Not Necessary [ ] slz UUMCNS: 1. 10 SuB.,ECT PE City of Fridley 28766 AT THE TOP OF THE TWINS PERMIT 1,57.2_-3604 BUILDING COMMUNITY DEVELOPMENT DIV. O /V r PROTECTIVE INSPECTION SEC Y3 1 � � 1 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE O: APPROVED By 612-571-3450 910-F15 12/16/98 JOB ADDRESS 631 58th Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 6 8 Donna 's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr & Mrs Leone 571-6573 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Roofing Specialist 3800 48th Ave - 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 gi REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (16 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1371 .69 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULAT G CON• STRUCTI N OR THE P FOR ANCE OF CONSTRUCTION 45.75 Fire SC 1.37 I0 �� �� PLAN CHECK FEE TOTAL FEE Lice se SC $5.00 1$52.81 SIGNATURE OF CON' ACTOR OR AUTHORIZED AGENT ID EI WHEN PROPERLY LIDAA/TED THIS IS YOUR PERMIT S-GNATURE -,DATE, I/' �✓ //ff// OF OWNEROF OWNER BUILDER) BLD INSo OAT 10 NEW [ J Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ^b� ConstructionAddress: �a�/ ���'Tbt��, A3, eel Legal Description: Owner Name & Address: , /1C 2,111(5 LCON Tel. # 57/-6673 Contractor: 6U� �JC��-C; r� L�S��MN LICENSE#b� Address: �800 y8rh hUj, Spa qC5I Alid !S'G64 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: Construction Type: fMC-dFF k&Kr`L(' Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: I9 1 V 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 [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 F63) 572-3604 FAX: (7631571-1287 ADDRESS : 631 58TH AVE NE PIN : 233024130063 LEGAL DESC : DONNAYS LAKEVIEW MANOR ADD : LOT 6 BLOCK 8 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL PERMN0.:200400738 DATE ISSUED: 05/19/2004 VALUATION : $ 6,445.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE FIVE WINDOWS WITHIN EXISTING OPENINGS. STATE LICENSED CONTRACTOR 1 APPLICANT RENEWAL BY ANDERSEN (20130983) 1920 W CO RD C ROSEVILLE, MN 55113- (763)502-4777 OWNER LEAON JAMES A JR & FRANCES 631 58TH AVE NE FRIDLEY, MN 55432 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 any other state or local law regal construction or the performance of constructio Applicant Date Bldg Insp LAWDSU An Da BUILDING PERMIT FEE 139.25 FIRE SURCHARGE 6.45 STATE SURCHARGE, VALUE 3.22 LICENSE SURCHARGE 5.00 TOTAL 153.92 PAID WITH CHECK # 35116 / SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 04/02/2004 FRI 13:21 FAX, ELDER JONES (:;Or- M 1@001/001 NEIN i ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ 2 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: _031 -�� -- ��� . � •� , Legal Description: Owner Name & Address:7:52 Tel. #3 -» ��' �•��` J Contractor. MN LICENSE#�0IW9Q3 Address: RENEWAL BY ANDERSEN Tel. it (.05 t' 0R(o4 - q Tj—+ 1920 COUNTY ROAD C WEST ROSEVILLE, MN 55113 icate of Survey of the i drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width _ Height Sq. Ft DECK AREA: ength Width HgUGmund Sq. Ft. OTHER: (�A_Y;a C43 ^D Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: APPLICA Tel. # 9.✓F' Z' 3 S CQ� Call (763) 672-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 If using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $_ ��(, Z s Fee Schedule on Reverse Side Pian Review $ 65% of Permit Fee Fire Surcharge $ .� S .001 of Permit Valuation (1/10th%) State Surcharge $ 3.22. $.50/$1,000 Valuation SAC Charge $ $1350 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ Alt. "A" or Aft. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necess TOTAL $ S STIPULATION CITY OF FRIDLEY r, 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-1287 PERMIT NO.: 2005-00036 DATE ISSUED: 01/07/2005 ADDRESS 63159 AVE NE PIN 233024130063 LEGAL DESC DONNAYS LAKEVIEW MANOR ADD LOT 6 BLOCK 8 PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A PH:612-8274033 # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS # GAS DRYERS 0 # GAS RANGES 0 0 # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) 400 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) 0.00 0.00 NORBLOM PLUMBING CO 2905 GARFIELD AVE S PLBG FIXTURES (EXIST OPENINGS) 0.00 MINNEAPOLIS, MN 55408-2173 WATER TREATMENT APPLIANCE 0.00 (612) 827-4033 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS 0.00 0.00 0.00 OWNER LEAON JAMES A JR & FRANCES 631 58TH AVE NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 35.50 PAID WITH CHECK # 29829 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 y oth r state or local law regulating construction or the tm:n of construction. Applicant Date Bldg SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. :ITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 431 University Ave NE 'ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 'LUMBING FIXTURE RATES: NO. RATE mum JOB ADDRESS_ tI�.e. - &S, 0-W AA"r Jew Fixtures 4 ffl�IREMOM The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes leer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the fads Ilow Off Basin $1.0.00 and represer rid correct. :atch Basin $10.00 LEAON, JAMES 631 58TH AVENUE NORTHEAST 7� vl J' Iain Water Leader $10.00 FRIDLEY, MN 55432 20 ;ump/Receiving Tank $10.00 (763) 571-6573 Vater Treating Appliance $35.00 OWNER Vater Heater -Electric $35.00 Vater Heater - Gas** _ $35.00 �5, 1 BUILDING USED AS �SI d e v►c-e- las Range** $10.00 �� Sas Dryer** $10.00 'LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS_ tI�.e. - &S, 0-W AA"r Jew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes leer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the fads Ilow Off Basin $1.0.00 and represer rid correct. :atch Basin $10.00 LEAON, JAMES 631 58TH AVENUE NORTHEAST 7� vl J' Iain Water Leader $10.00 FRIDLEY, MN 55432 20 ;ump/Receiving Tank $10.00 (763) 571-6573 Vater Treating Appliance $35.00 OWNER Vater Heater -Electric $35.00 Vater Heater - Gas** _ $35.00 �5, 1 BUILDING USED AS �SI d e v►c-e- las Range** $10.00 �� Sas Dryer** $10.00 ESTIMATED COST y6 oo PERMIT NO. e lack Flow Preventer Required ( )Yes () No 1 Type $15.00 PLUMBING COMPANY O i FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verges 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 exlatina combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to Install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When Installina a new.venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This, does include AGA-GAMA Category 1 Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : Building MECHANICAL Permit No.: ��' A Received By: Inspections RESIDENTIAL APPLICATION Date Rec'd: �� 763-572-3604 CITY OF FRIDLEY DATE 0 ' I ' O YOUR E-MAIL ADDRESS SITE THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: -Te rv-% -e s OWNER/ �V CITYSTATE"ZIP 5 _'kU ADDRESS: 1031 TENANT PHONE: –1 S --I l °- 6S –7 3 CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN ZIP YOUR STATE LICENSE WITH STATE LICENSE # EXP DATE ADDRESS: 13562 CENTRAL AVE NE CITY ANORA STATE MNf ZIP 55304 APPLICATION PHONE 763-757-6202 FAX 763-757-6701 PERMIT TYPE 9 SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW WREPLACEMENT ❑ ALTERAnON/REMODEL TYPE OF WORK: 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 fixtures. (This should reflect only the cost of labor ) improvement, installation or replacement of a residential fixture, excluding the 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) MFG: �1 q r r e r MODEL: o��t rtt� SIZEBTU 2 �1 1`� �r Equipment Installed MODEL: SIZEBTU MFG: SIZE/BTU MFG: MODEL: _GAS RANGE/OVEN $10.00 &A/C $25.00 _FIREPLACE (GAS) $15.00 NEW GAS GRILL $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 GAS UNIT HTR $10.00 $35.00 BOILER $35.00 _FURNACE CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 VENTILATOR DUCT WORK $10.00 PIPING $1000 — �,y] j %�pyGAS U .. yr' K -: ...�Yi!SU`.'' W,`Y. Y r ikya3��Yk Number of fixtures @ $10.00 x $10.00 _ $ $ Permit Fee Surcharge 50 Number of fixtures @ $15.00 x $15.00 = $ $ Number of fixtures @ $25.00 x $25.00 = $� TOTAL DUE 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 with the ordinances and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is conformance 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. 1� SIGNATURE OF APPLIC PRINT NAME ROGER HOFFHEIN DATE 5' _1-4016 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ZEXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas 1MC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction TMC 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