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COS (2)SUBJECT RM1TR0: ", City of Fridley •3 2 2 3 5 AT THE TOP OF THE TWINS BUILDING PERMIT r �• RECEIPT NO. � _____ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. m 7� S®4 j PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV DATE vAGE OF AOPROVED BY 612-571-3450 910-F/5 10/10/01 JOB ADDRESS 23 62 Way NE T LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 L & L Builders Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tim Sylvester Builders Inc 27875 Hwy 65 NE, Isanti, MN 55040 763-444-6855 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 20029187 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 p NEW O ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE B DESCRIBE WORK Construct a 38' x 26' Dwelling and a 22' x 25' Garage 9 CHANGE OF USE FROM TO STIPULATIONS See rotations on plan. Submit a verifying survey to &e City before capping. Provide a hard surface driveway. Provide sod in the fornt and side yards. Grade swale on west property line to keep water off adjacent property. Verify that the drainage at back of iot stays on property line and goes out to curb. Paid park fee of $1,500.00. WATER & SEWER LOCATIONS: See City Engineering Dept. SEPARATE PERMITS REQUIRED FOR: WIRING, WARNINN ,SPLMBINA GNS Before digging call for SII utiljU location SEPARATE PERMITS ARE AYOMR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VEN THIS THIS PERMLATIN NPXIU RK 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 $82,165 SAC $41.08 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHERSATOR LOCAL LAW REGULATING CON- $874.75 F e SC $82.17 STRUCTION OR THE PERFORMANC OFC STRUCTION PLAN CHECK FEE T AL FEE ®^/1J^k Licen C $5. 0 $2,153 + PF SIGNATURE ONTRACTOR OR AuTMORIZkj AGENT tOATE, HE FPROVMY VA O ED THIS IS YOUR PERMIT 00, SIGNATURE OF OWNERi60WNER BU4DERi $DATE, B G 14$ qa TE NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: (-oa,,nc� w 1u 1 Ldk L 9,,, 1 Effective 1/1/2001 (763) 572-3604 Bldg Insp Dlbwner Name & AddTM TLV=TXK1111111,11� lM'M. Tet. # LlulQ Contractor: I nal -_MN as= MN LICENSE # Address: Tet. # 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:► Estimated Cost: $ ncxWr Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: "'APPLICANT: I Sal~ I v�sr ��� 'Qcs Tel# ,,� -S/ CITY USE ONLY - Permit Fee - Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control 4( Park Fee Sewer Main Charge TOTAL Call (763) 572-3604 for Permit Fees if mailing in application $ EP 71,76 1, % Fee Schedule on Reverse Side $ B,;? 17 .001 of Permit Valuation (1/10th%) $ L// , 023 $.50/$1,000 Valuation $_/ / ,SO , 00 $1150 per SAC Unit $ ®® $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ 65,00, 00 Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ 3(v -s-3, eco ",' lylfi�l©,a-/ STIPULATIONS: ���j(��/�✓�r L�,�/�f.1� 1, 30 .2y y� 00q 41 /5 Ail ao L4di- /Wz /-,ek d/ofs 446, e FROM : Deck P1b9 FROM : FAX NO. : +320 679 1254 FAX NO. : Apr. 04 2001 10:57AM P1 May. 10 2000 09:19W P1 PLUMBING PERMIT APPLICATION. Propao owner mac' ^— Building c Rotor i w, �4*x_,e yy - �—� address - __( ��. r\ A u_; o_w-i � -% �— T4wnSh1» Bf%cdve August 1,1999 aM penon contracting to do plumbing work in Minnesota will be required by law ro obtaili a 35,000 "code compliance" bond. The law requires a bond that can be used to reimburse consumers for up to 25,000 in cost, in owe where the eorsumcr ends up paying to correct work that don not Greet code. License d art a^i+, a% pint .�.._ or fi onci N_ p # -- 3�.0 - 6'74 - 1 aL Property owners planning on performing plumbing work on there property must sign below and are responsible for code compliance Pro owner mint)_= '" Proptrty owner signature - --....�_ ._....�.-. Building Official approval _ Date Site address address a Y,C; �_&j r� zip Please identify all General Contractors and Sub -Contractors to be performing work on this permit: General: T*� Su��,Qa Y ��rs-xNe, "163- 44`i -6855 aaoagl In - kme phone # • license # Roofing: C4V a"""" t,: i,1\ .I ( -A -40(ti -396 name phone # Plumbing: V�-P� V lino\ n4 I -3a0- G-1 9 - i a5y name phone # Septic: W Q1,Sk; d Scy-, 163-3ss4-3oSio name phone # Well: `` tvo_CUsm �b3-1S3- Puz name phone # Electrical: fAalkoz .I 63-434- b9?o phone # Masonry: -name V..B �Q '163 - y 3q- B8 b name phone # Carpentry:(xuil t �s2 y. I -'3aD- b'z01 name phone # Sheetrock: 5%`w`rwvv� Uso x� 763-3a3'' 4°l'7'7 name phone # Heating: Insulation: Qtr ►' \a�` C b-sz name Db V,•S�wSu name -163 -434 - _n L0 phone # -163 - -) phone # license # �aa9 a license # license # license # license # C1ty, The undersigned agrees to do all work in conformance with ownshi Ordinances and herewith declares that all facts and representations on this application are true and correct. THE UNDERSIGNED AGREES TO NOTIFY THE INSPECTIONS DEPT. WHEN READY FOR INSPECTIONS. Signature of Applic n : ,=z-=� � - <— Date: -2 ******************************************************************************* OFFICE USE ONLY Permit # pATH=C1My DOCUMENTSkBUILDINSPTERMIT APPSWEW HOME APPWPPLICATION.DOC revised 01/26/00 City of Fridley 6431 University Ave. NE Fridley, MN 554324383 763-571-3450 20 -Sep -01 Special Assessment Search And Statement of Charges TO: On all that tract or parcel of land lying and being in Anoka County, Minnesota described as follows to wit: Parcel No: 15-30-24-44-0094 Lot: 1, Block: 1, L & L BUILDERS ADD LEVIED SPECIAL ASSESSMENTS This is to certify that I have examined the records in the office of the Clerk, City of Fridley, Anoka County, Minnesota, and for such search, certify that the following special assessments appear unpaid with respect to the above described tract or parcel of land: Term Certified Initial Interest Remaining Current Current Proiect Number Project Description Type (Yrs) Date Amount _Rate Balance Principal Interest 3000-0015-00 00 W/S 3230 20 12/31/1959 $764.59 6.00% $0.00 $0.00 $0.00 9100-0000-00 00 REG SA(Water/Sewer 3100 15 12/31/1960 6000-1960-10 00 ST 6400 10 10/03/1961 6000-1979-01 00 ST 6000-1979-04 00 ST 6400 10 05/19/1980 4400 10 06/07/1982 $93.61 5.00% $0.00 $0.00 $0.00 $399.52 6.00% $0.00 $0.00 $0.00 $960.88 9.00% $0.00 $0.00 $0.00 $714.58 10.00% $0.00 $0.00 $0.00 Amount Certified to Anoka County Auditor for Current Year Taxes Is. $0.00 PENDING SPECIAL ASSESSMENTS For the purposes of this document, the City of Fridley has determined that an assessment is considered pending after the City Council passes a resolution ordering the improvement, the approval of plans and the advertising for bids. This is prior to the City Council adopting the final assessment roll. If you seek further information, you should do so upon your own independent inquiry. Any amount given as to pending assessments is informational only and may or may not be the amount ultimately assessed. Term Initial Interest Estimated Proiect Number Proiect Description (Yrs) Year Rate Pending Amt. NONE MISCELLANEOUS FEES Description Status Date Fee Amt. Park Fees Unpaid 3/28/01 $1,500.00 UTILITY CHARGES You shall be responsible to verify the status of any outstanding utility charges. To check utility charges ( water and sewer) contact Fridley Utility Billing Department at 763-572-3529. The records referred to above are public and may be inspected by anyone during regular business hours. The search of these records was made by the undersigned as a public service on request. The undersigned certifies that the above indicated searches were made and are believed to be accurate, however, the undersigned or the City of Fridley does not insure the accuracy of the above statements and does not assume liability for errors and/or omissions. The above figures are good through November 15, 20 Date Prepared: Thursday, September 20, 2001 By Page 1 of 1 CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ 0"0 $10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 $ 5� JOB ADDRESS :�?3 -/00 4-g� Effective On January 1, 2001 OWNER BUILDING USED AS'SIl . . ESTIMATED COST � O ' PERMITNO. LI 'j l DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units I Circle One (Steam) (Hot Water)(Warm Air Trade Name Arm 5inn n Q, Size No. M bg3/+L 01o`i L1 a BTU 9,3. D(h 0 H EDR Fuel A4 , Total Connected Load Burner Trade Name Size No. BTU HP EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 16 -ag- 0 HEATING COC'�d�C Signe < TEL # '7&-3 Approved By/L!� Rough -In Date Final BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONN CTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer termination. Yes No ( ) specifications including sizing, length, number of elbows and 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 combustion air is sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturers specifications. Yes No( ) When installing a new venting system, the undersigned hereby verifies that it 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( ) 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 Gj rn a a.— BTU Input ,Dai an Assiste 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 2© ft Length ft Diameter A" 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 : CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2002 PLUMBING FIXTURE RATES: NO. -RATE TOTAL �� L 60 New Fixtures $ 7.00 _ Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas** �_ $10.00 !U• (,�o Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 'WD JOB ADDRESS (7 It 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.Y13 / 1 , 20a Owner W -0217:M Building Used As PIP 'Estimated Cost .3& ,9,19, 00 PERMIT NO. PLUMBING COMPANY', aMeSQtrSon.� FILAM,t& Reinspection Fee $47.00/Hr SIGNED BA UmL1;GJ� TEL NO. f!�� ! � 2-7,3Y ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX# r�63 3 1.5% of Value of Fixture or Appliance y/`�/D� Approved By Rough -In Date Final Dat State Surcharge .50 /-7 -R FEE OR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ /� 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 SC{)MMON VFNT, VFNT CONN CTOR ANn COMBUSTION AIR VFRIFICATION When renla ingan pxictina hiranng, 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( 1 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 verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The eyonHnp cnmht mien air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to ann+all a now _emhns inn airy it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When iinstalling a new yentinag evetem, 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 O No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type N HEATING CO: Signed By: Date SUBJECT City of Fridley 33521 AT THE TOP OF THE TWINS BUILDING P E R M I T RECEIPT NO. COMMUNITY DEVELOPMENT DIV.® PROTECTIVE INSPECTION SEC. r 1 . � 1 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 763-571-3450 910-F15 5/16/03 JOB ADDRESS 23 62 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 L & L Builders Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Star City Builders Inc 474 Manor Dr, Spring Lake Park, MN 55432 763-286-5533 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same e 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 O NEW O ADDITION ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Complete construction of new house; tape walls, spray ceilings, flooring, millwork, hang garage; final HVAC, plumbing, electrical,sewer and water; final grade an landscape 9 CHANGE OF USE FROM TO STIPULATIONS Original building permit #32235, issued 10/10/01, stipulations apply to this permit. Submit a verifying survey to the City. Provide a hard surface driveway Provide sod in the front and side yards. Grade swale on west property line to keep water off from adjacent property. Verify that the drainage at back of lot stays on property line and goes out to curb. SEPARATE PERMITS REQUIRED FOR: IM13IN6 PLU AND $1115 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 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 $2.50 WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT $5,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON - Fire SC $5.00 LT N P ORMA E OF CONSTRUCTION $111.25 PLAN CHECK FEE TOTALFEE ce se SC $5.00 $123.75 . �GNATURE OF ONTRACTOR OR AUTHORIZE D AGENT tDATE, HEN PROPERLY VALIDATED THIS IS YOUI FERMI 5 l D3 INS qAM _ S -GN A TU RE OF OWNER�iF OWNER BU4DERi DATE, 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 �d l Construction Address: Legal Description: '�" � -3 Owner Name & Address: >2 �SS �� �-�"C . Tel. # ?�3 - ��" Contractor: kt"- 4yr�. -Lin e �L Ac/r2 "sr-42MN LICENSE # off+ � 1 S o? LE Address: 1-/ -N tU/q Vlw 0,1z, S'L® NEU S 5L(_3_z- Tel. #.7(,, 3 - R 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 'Ah v4-✓Icr � ✓'C.cJ E: � ( � �� � � F' �f Inc , Construction Type: Estimated Cost: $ .:�--Ooo Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ��_ 0 3 APPLICANT: _ Tel. # 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. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 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 [ ] A INN •r�� . W 110.09 �' f ti S 89 03 23,. , 10 r— jVF .F- yj LU ,t Asa c W w _ 1 �, Sri S� �� • � .'� �- � ,d z4• h� ,� � p) Ile i� 4 � yy ;89903118s;E 1034- .+I1 ,/1,1,, MW, 62ND WAY €603 in int X rNvR-r1F1 J6 C)0 I hereby certify that the numbers as shown in red ink above is as shown as located by us this 12th day of March, 2004, and that I am a duly Licensed Professional Land Survey under the laws of the State of. Minnesota. By e;� , Minnesota License No. 12267 NOTE: Due'to ice and frozen ground conditions no iron monuments were located P CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective On Jan 1, (20/0/3 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT` l•` MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS a Q �A (,-A WCC/ New Fixtures "1 $ 7.00 69-W The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 , 20— Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner Ct' Water Heater -Electric $ 7.00 Water Heater -Gas** $10.00 it). OD Building Used As / c'►PY!/ 9 Gas Range"* $10.00 PERMIT NO. / ° Gas Dryer" $10.00 Estimated Cost- Back Flow Preventer Required ( )Yes () No L Type $15.00 PLUMBING C Reinspection Fee $47.00/Hr SIGNED BY / TEL NO. 76 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By. Rough -In Date Final Date State Surcharge $ .50 JOR MINIMUM FEE ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ so Sb 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 r.nM nN VENT VFNT CONNFCTOR AND COMBLISTION AIR VERIFICATION When rapla i an P-Astinnf uri anap, 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 verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The nxistin0 nnmht ,Minn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to rnatall a naw rnmhusfinn air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When *nstallonn a now venting gyspm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date : CfiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 March 9, 2004 Star City Builders Inc 474 Manor Drive Spring Lake Park, MN 55432 Re: Final Inspection at 23 62 Way NE, Fridley Dear Sirs: A final inspection was conducted on March 9, 2004 for the completion of the dwelling at the above address. The inspection noted that the construction was completed according to the approved plan but the following items need to be completed before the building permit can be finaled out; 1. Provide sod in the front and side yards by June 15, 2004. 2. Provide copy of verifying survey to City by March 15, 2004. We will expect the above items to be completed by the scheduled dates and a reinspection called for. The dwelling is approved for occupancy. If you have any questions concerning this matter, please feel free to contact me at 763- 572-3602. DJ/mh CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 OF -60 S J i5 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK Nt IMRFR nF FIXTURES TO BE INSTALLED ON EACH FLOOR Stories .���!>~'I�C>< Urinal '�I::::>::: Shower �fG:;<:>:: Wash Tray :»::::: .t??4t1:::::::::: Floor(1:::::: Dram ��= �I't:::.�:.�: Auto. Wash :'::;::;.:;:: ��� ��.�..�.::::. Gas Ran 1?(r:::: Water Heater .::.I......... Gas Elec Basement $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas** $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Floor 1 $15.00 Floor r Floo 3 I F o0 r4 PLUMBING FIXTURE RATES: NO. RATE TOTAL J New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas** $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance JOB AD 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. DATE: �P 0? , 20 OWNER �+ uL 1 " 0 J1't� BUILDING USED AS ESTIMATED COST I PERMIT NO PLUMBING SIGNED Approved By Rough -In Date TEL N0. 4<7^ -75T—;6q5-- Final Date State Surcharge $ .50 o MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ �ib15 OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE 't FILL IN COMPLETELY FOR REPLACEMENT FUEL BUANING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the BTU Input venting has been examined and is free from rust, deterioration, obstructions, Appliance #2 Type and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer BTU Input specifications including sizing, length, number of elbows and terminatidn. Yes () No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does Vent Height include AGA-GAMA Category I Central Furnace Venting Tables for fan Appliance #1 Vent Connector Height assisted and natural draft appliances. Yes ( ) No ( ) Tfie existing combustion air is sized and installed to meet the current codes ft Length and manufacturer's specifications. Yes ( ) No( ) When required to install a new combustion air, it will be sized and installed ft Diameter in Type to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When installing 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 I Central Fumice Vinting 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 : CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and uct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Fireplace insert Gas Range Gas Dryer Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee $35.00 $ $10.00 $ $15.00 $ $10.00 $ $10.00 $ *Air Conditioning - AllSizes $25.00 $ All Other Repairs or Alterations (List on Back) 1°/a of Value of Appliance or Work $ Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater on work less than $500.00 JOB ADDRESS 0 62�- Total Owner t 2cc.� d` l �. Vc v�tS f f C" Building Used As ESTIMATED COST '300 ° � PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No. EDR __ _ The undersigned hereby makes application for a permit for the work herein Commerciall/lndustrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/Industrial/institutional and representations stated in this application are true and correct. State Surcharge $ 0.50 HEATING CO (if permit fee is over $1,000 multiply by .0005)6-,- vl' _ TOTAL FEE $ Signed Tel # FAX # Date *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date 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 verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) The existing combustion air is sized and installed to meet the current codes and manufacturers specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No( ) When installing a new venting system, the undersigned hereby verifies that it 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( ) 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 Appliance #2 Vent Connector Height ft Length ft Appliance #3 Vent Connector Height ft Length ft ALTERATIONS: (Describe) Diameter. in Diameter in Diameter in HEATING CO: Signed By: Date Type Type Type 19 LO NEW [ ] CI-TjY OF FRIDLEY � X09 r� ADDN [ 6431 University Ave NP, Fridley, MN 55432 (763) 572-3604 Bldg I p ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571- 28 Fax BUILDING PERMIT APPLICATION Constriction Address: Legal. Description: Owner Name & Address: 0- e- o cog J i v� < Tel. # 65-7, Contractor: MN LICENSE # Address: 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: Estimated Cost: $ 11' 6bo , Driveway Curb Cut Width Needed: Ft + 6 R = Ft.x DATE: r-0171 657 APPLICANT: J�" Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-6714287 if using credit card and we will call you for card number. CRY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 per SAC Unit $5.00 (State Licensed Residential Contractors) Alf. "A" or Alt. "B" Above $450:00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ 1 Not Necessary [ TOTAL $ i -Z/ " I/ STIPULATIONS: Building Inspections 7.63-572-3604 DATE 4/–/& e SITE ADDRESS THIS APPLICANT IS: PROPERTY NANS OWN♦1� OWNER/ ADDR] TENANT MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY 0 OWNER YOUR E-MAIL ADDRESS Permit No. Received By: Date Rec'd: ATEA, CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF STATE LICENSE # EXP DATE P YOUR STATE fi �.vf CH y c' -n� L4kc w TATE LICENSE WPTH ADDRESS: �` APPLICATION PHONE FAX i SINGLE FAMILY O TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE - NEW C REPLACEMENT ❑ ALTERATION/RENIODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK e� PERMS 1613.665 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) X.05 Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor KATE TOTAL FOR PROJECTS WHERE LABOR EXCEEDS $5D0, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERENOTED. FIXTURES: (IIID NUMBER OF EACH BELOW) MODEL: SIZE/BTU Equipment Installed MFG: MODEL: SIZFJBTU MFG: MODEL: SIZE/BTU MFG: FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 $– A/C $25.00 —FIREPLACE (WOOD) $35.00 GAS GAS GRILL $10.00 _AIR TO AIR EXCHANGEER $ IS—F�yACE $35.00 _GAO UNIT HTR $10.00 BOILER $35.00 _GAS DRYER $10.00 _POOL HEATER 15.$35 00 —BEY LINER $10.00 GAS PIPING $10.00 _VENTILATOR $1500 —DUCT WORK $10.00 T •x.: y Number of fixtures @ $10.00 x $10. _ Permit Fee $ S ex Number of fixtures @ $15.00 x $15.00 = $ Surcharge $ 50 TOTAL DUE $oa Number of fixtures @ $25.00 x$25.00 = $ — Number of fixtures @ $35.Ostate Surcharge = $ .50 Total = 5-260 THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED that the work will be in I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; th is nstructi conformance with the ordinances and codes of the City f Fridley s not a d with rt without Minnesota permit; o the work will be in acro dance with the not a permit but only an application for a permit and w approved plan in the case of all w irk which requires review and approval of plans. PRINT NAME]IJ SIGNATURE OF APPLICANT _ - — City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropandNGC 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 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 u$ed for combustion and make up awl- calculations