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PRE 2010 DOCSw BUILDING PERMIT Village of Fridley, Minn. No 2788 DateL ��.1. 7 ...................... Owner ................ Builder....................... . Addressf �.l o ��,,,--------- Address ......................................... LOCATION OF BUILDING No. \0 'A i ........ Street . Z J. `� . P.—'170- - - - ..... Part of Lot ....................... Lot ... Af4 ....... Block ...... ....... Addition or Sub -Division I.4�•rrafilrCal... ....... . Corner Lot ............ Inside Lot .,f�........ Setback J6' Side and ........... . DESCRIPTION OF BUILDING To be Used as: Front Q... Depth ... Height �r...... Sq. Ft.9W.... Cu. Ft. ........ .................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ......... d M Type of Construction .... Est. Co t l°3 a. ®�............... To be Completed In consideration of the issuance to me of a permit to construct the building desck e�abovc 'agree to do the proposed work in accordance with the description above set forth and in omplian wl ll provisions of ordinances of the village of Fridley. ................................................... In consideration of the payment of a fee of $13n.,m permit is hereby granted to .. . .c.,r ........ to construct the building or addition as described above. This permit Is granted upon t e 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 with- in the village limits and this permit may be revoked at any time uponviolation any of the provisions of said ordinances. •.......•......T.: i.• Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. City of Fridley, Minn. BUILDING PERMIT N® 3365 .- Date: .... ..C.. .. ........... Owner .. ......... ......... ......... Builder ...... .............................. - A . Address .rf �.. .:` ........ .. Address ............................................. LOCATION OF BUILDING No. � ... Street ..(O. J. .01 ........ Part Of Loot ................... Lot .... Block ...... .......... Addition or Sub -Division ..(�. ..... . ... Inside Lot ,�i eSideyard P e Comer Lot ......... .. ,%� ...... Setback .. . ��. � i�................ . DESCRIPTION OF BUILDING To be Used as: O leF�'.G'. .0C .... BY. ,��.... Depth .. Height /0... Sq. Ft. —Ca Ft. 4C4 .................... Front ........... Depth ..... Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................. • lift. cost... FJF.��....... To be Completed ................... In consideration of the issuance to me of a permit to construct a building desribed above, I agree to do the proposed work in accordance with the description above set f and in compliance with all provisions of cWdinances of the city of Fridley. In consideration of the payment of a fee of 4p. .., permit is 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, all conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteratio , maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any a upon violation of any of the provisions of said ordinances. lir :....... Building Inspector NOTICE. This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. City of Fridley, Minn. N° 8149 40 BUILDING PEI MIT Date: Jobe 7s_ 1965 owner: Hary X Longlois Builder T. S. Silvis Address 512 63rd. Avenue N. E. Address 6020 Wynnwood I'd. LOCATION OF BUILDING No. 53 Street 63rd Avenue N. E. _____ Part of Lot ,,at 24 _ Block 9 Addition or Sub.Divisin Christie Corner Lot — Inside Lot g . Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Att. Garage Front 21 Depth 22 Height 101 Sq, Ft. 462 c tL Ft 4620 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost = �5 -,4'6'("0To be Completed Att. Garage In consideration of the issuance to me of a permit to construct building described above I agree to do the proposed work in accordance with the description above sex fo and in complian with provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of , permit is hereby granted to Ts S. Silvis 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 ordinancesmoving of of Fridley, Minnesota �permit l location,construetioked ata time upon violationot any of the provisions of said within the city limits and ordinances. Allen Jensen Building Inspector NOTICE: rnb permit dose eat cause the construction, hufalldion for rdrh* phimbiog, ga hatted, sower or water. Be urs to am the Building Inspector for separate permits for thea Nano. r OWNER'S NAME, APPLICATION FOR'BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ADDRESS, ADDRESS i LOCATION OF BUILDING No./ - r+;�, Street Part of Lot LOT BLOCK ADDITION. OR SUBDIVISION -d4 Corner Lot x_ side LOT,_- Setback Side- fArd SEWER ELEVATION -- _ _ FOUNDATIOIU ELEVATION Applicant attach to this form Two Certifidates of Survey of Lot acid proposed building location drawn on these Certificates, bLSCRYPrt0N 'OF BuliftNG To be- used as Front. _Depth -2 Height Sq. Ft.-- �� �� Cu: Ft . %` 4v� a FrontDepth Height: Sq. Ft. Cu. Ft. Type of Construction Estimated Cost y� . To be completed t The undersigned hereby makes application fora 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 gf Buildings, and hereby declares that alL the facts and representations'.stated in this application are ue•and correct.' v, DAT$ (Schedule of Fee Costs can be found•on the Reverse Side). 6 49,ia 2 PB 126% nnm9T SAY IT WRITE IT c 41360nas S. Silvis 6MO Wyawood Hood Vay 210 1965 KPIS MIM. 55422 544-3919 Harvey 1mg-lois same 5.12 63rd Ave. Vii. E. Md1ey Ana. R00f: remVe south and west side 630.00 - repair sheathing atd rafteru 70.00 replace 7 so.. roofing 175.00 1 repair roofing on north and east Olde 75.00 SldljQgt remove south and west side 60.00 newer sbeathing and studdirAgs 80.00 replace 6 -sq. siding 260.00 repair siding on north and east side loo,00 Coridcot-replace face boards 150.00 repair and dleahsoffiLs .100.00 Ulm'"G. rePl&ce brOkeR Or aged window fraM01395.00 Continued on reverse side Five'.. thousand one hundred forty six and nq/100 - - - - - - - - - - 5,246.00 TOW amount due an completion. Contractor tM 0 i e �A ,t w • I i l I 'Windowas replace broken wmbinat3ons-or parts thereof 76.00 replace -aU broken window glass 80.00 replace ell damaged window scram 35.00 Repair sheetrock and decorate kitchen 110-.00 Repaint entire exterior 330.00 Repair brigs planter U 75.00 -Paaplace gWWe 1,-5w.00 replace approx. 200 lineal feet of redwood fenco 600.00 Check and repair'eleetriosl,system for Inspection. 125.00, a;eplaco damaged outside casings (5 sides) 60.00 Building Permit 10.00 PReplace dammed reef vents 60.00 Joh c1eaa-up and debris removal 200.00 Overhead and profit 15% { 1 f► w Appl eaftn for Power Ranh and Heafiag. Cooling. Ventifatton. Refefgerala and Air Conditioning System and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AYR: RATE TOTAL Furnace Shell & Duct Work .......................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................ 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECM WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60.000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 8.00 Repairs & Alterations—up to $500.00 ................ 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .$10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water . . . ........ .. 3.00 $ OIL BURNER—to 3 gal. per hour . ' ... ... .. 6.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to M,000 BTW ........................ 5.00 $ over 199,000 BTU See. Fee Schedule ; GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ................ x$ 2.00 $ Additional Fixtures ................ x .75 $ Gas Range to 19900 ........... SAO $ AIR CONDITIONING $ I0- 5-2 FAN HEATING SYSTEM See'Fee Schedule VENTILATING STST09 $ ALTERATIONS & REPAIRS TOTAL FE $ / ®1 r1NAI, 8 - 2, - 7 �/ Dept. of Bldgs. Phone 88Q -MM Locafiaa�s.[/� City of Fridley: The undersigned hereby makes application for a permit for the work hereic specified, agreeing to do all work in strict accordance with the City Ordinancef 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, Minn- Owner Kind of Building f Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit No. DESCRIPTION OF WORN team, Hot Water, Warm Air—No Trade Name �� Size No Capacity en. Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fue) BURNER — Trade Name Size No Capacity Sq. Ft. E.DR BTU H.P: (W"RKS-OYER) �` O"Z�4 Signed B Business Phone No- i rd —C �. _ WO SUBJECT PE City of Fridley 366i AT THE TOP OF THE TWINS PERMIT ' r BUILDING RECEIPT NO. Z L COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 9 1 � i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'•"� � ,'� 812-580-3450 910-F15 7/22/76 JOB ADDRESS 512 - 63rd Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 24 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kent Waterman 512 - 63rd Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Custom Pools 701 East Excelsior Blvd., Hopkins 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 X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK XKKXW= Construct a 16' x 32' Swimming n Pool 9 CHANGE OF USE FROM TO STIPULATIONS See letter dated July 21, 1976 from Environmental Officer with stipulations. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Alum. in 1 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $7,000 $3.50 DOES NOT PRESUME TO GIVE AbTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCT) R THE PERFORhRrNCVF CONSTRUCTION. $42.00 PLAN CHECK FEE TOTALFEE $45.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) PROPERLY VALIDATED THIS IS YOUR PERMIT ' /p�\�WHpEN j- BLDG INSP l J� o -A J / - -�2 9 - —/ W DATE SIGNATURE OF OWNER IIF OWNER BUILDER) 4DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NA14E:/i-e-'.'(VA- BUILDER: (?GW'S �n ADDRESS: ,�r /�/ l � ADDRESS: �Gn ���W/�t/ NO:. STREET: LOT: ` BLOCK: ADDITION :��% CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTIO "� BUILDING To De,.Used As: f Front: 3 �� Depth: Height: Square Feet: Front*: Depth: Cubic Feet: Height: Square Feet; Ll �j' Cubic Feet: Type of Construction: f ���( j �-ff�'z Estimated Cost: $ �,ccc, 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. DATE: .Zl -74 SIGNATURE. LL, . ZI, (See Reverse Side For Additional Information.) 560.3450 Cit r Of I Yr i allecy ANOKA COUNTY 6431 UNIVERSITY AVENUE NE July 21, 1976 FRIDLEY, MINNESOTA 55432 Mr. Tim Hanon Custom Pools Inc. 701 Excelsior Avenue South Hopkins, Mn. 55343 Re: Swimming Pool Construction at 512 -63rd Avenue N.E. Dear Mr. Hanon : This letter is to make clear this departments requirements for the swimming pool construction at the above address. 1. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, three (3) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6-8 hours. 5. A deck of at least three (3) feet wide, measured from the pool water's edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the city. .6. The diving area will be acceptable provided there is no overhead obstruction. 7. A fence or other suitable barrier, a minimum of six (6) feet high, that affords no external hand or foot holds and which is impenetrable by toddlers, must be provided around the entire perimeter of the pool. All gates and other accesses shall be equipped with self-closing and self -latching devices which are capable of being locked. 8. An automatic chlorinator should be provided with a suitable test kit. 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. All electrical lines must be 10-20 feet or more away from the pool surface. 11. The pool fill spout -must be air gapped -or protected by a vacumn breaker. Mr. Tim Hanon July 21, 1976 Page 2 12. Suitable safety equipment to, include but not limited' to a ring buoy and rope that is 1� times the pool diameter, and shepards crook pole • must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools: The building permit is approved contingent on final inspections and approval by the City. if any questions or problems arise from this letter, please feel free to contact me at 571-3450, ext. 170. Sincerely, S J.OLS .Envirome Officer SJO/mh CC: Kent Watexman 512 -63rd Avenue N.E. 4 • • l�ill�'11 .. . �,� �i I • ,GIO y . 5,3-8l1-8790001 ' - 1�rilC:iil�?1 b`C! PitiEr �•iJ ."+.'icy 1 1.1"ns Permit . .. . . • S , .•-- New Fixture Old openinY..•• • • •'• • • • •---- New x 51.50 Dop't. of BldQs. Phono S.NJ•3450 DESCBIPTION 0: VIOnr- $ Numb4T. xj&d a..%d Lecr:loa of Fixtures ' — S • New Ground Run Old B!dr.:..:....--.------ x :3.25 S w,ics Mrs. ,City of T7idley: . 0 1< S 3 : o l� ■ 3 t iThe u • ju im uadcrsigncd hereby rm kes appllcat!on for a permit ier the, work specified, a� oeing to do all work in strict acco:d�::cc with the Cita O:d� a� •td hereby declares that aA t?u Essr I . l:: I 3:d • FL'`.:•0 Cc•.:a::..cn t�:.cir.:s � � uc'woz s Raw Flurun. Old 01111 L':Cs 0=2col 0 PARTIAL RATE SCHEDULE L +I3IttC rIXTURF. RATES: KO. RATE , TOTAL X $2.013. s —. Number flxtures • • • • • • • • • • • • • • •'• Future ilxture Opening • • • • • ••• • • • • ------ x 51.50 S , .•-- New Fixture Old openinY..•• • • •'• • • • •---- New x 51.50 S—'-- — x $3.25 $ Dasin .................... Water I{ester 1110 to 99,000 BTUs • • • •------- S.3 x .3.00 S • New Ground Run Old B!dr.:..:....--.------ x :3.25 S $2.00 3 NO. RATr TOTAL ilS :IT;I1G FEES: E - • Ist3Fixtures •••••••••••••••'•'---�'x32.G0 x S .75 S 1�ddltJcnsl Fixtures ..:............ ..... -- . • ••••e to 199.000 BTU ------ C:s Rs..a ........... x $5.00 S a^d ruling of the �:pa::r^•ent of l:ull...aZ:t, a• • and r•epresentatlons stated is this appJcat!oa are true and co�etit' , • Fridley, MW 8-13-76 Owner "ent Water Kind of Building frame res, Used as • To be completed about 8-20-76 . Estimated Cast. S perail::a. 7 Old—lam Building Permit No. , Siznc ®; _ • By Businvu Ph-jre No ROUGH FINALlo .50 State Surcharge . '?-.r?.l:°S tt AL:EgJ►TIOMS'—P.efor to Code .Ik:cslyJon. ..............:....................... � 7.00 TOTAL F=5---- . t Ilk. n '4 1.�4'h �... pts-tf 1�; f}'S '. '.♦, M`. �'_'_z't + 'F� CY' 2 J.-. 4• 24p� .,.a.,.. .....F...-, p , yyi,��'L `yam ."vz��iF & .. .: a Ov FF 1 k `^ "� D' �' "F J, . .+ ;F ,-v dN f' �4 ¢� --yy��ry GAGj' - iklX 0 ! ti yFrS: n i 7p' ,yk 'iyTy w A „r*e{I t o r .„•f 5g7k'`'�'_ `$'kms Z.d•%1�” �'4 R t _i 1,' . . I 1NY� yf,�kYh`1+ �: •iy i 4 4 •,. 27W. 'V�OtIt.' Y , r h f k. * x LNITROL VALVE � r a R•. c i di 1 1/2" POOL RETURN-- �A.�11 DABS: y4' st L10 �m� a r r - y l'. I_. STRUCTURAL FOAM SKID r t", J SELECTIONCHART CATALOG MODEL FILTER ARCA PUMP 'rAA . FT. - t NUMBER NUMBER . FT: H.P. ; A. B C 24736-216 HRS-16 1.4 1�Z 16' 33• 13/4 2B 1d90 1d;AB0, lA 10,�QEf ' K 24730-221 HRS-20 2.2 3/4"" 2 44 '260,(11'. i 24731-224 4+6.A30 _ HRS-f4 3.1 24m 41° 21/2 24731-324 1 1/2 62 6E1(ERAL ROTESs - `t `` 2'., ,1ht ftlu taalts t�'� iw4tra� •kali �.- i. Plan rata show art basad an 13 wA 20 B.P.M. per 14. ft. "; ReoMrd' Rw Ratl 1; Baialtrtt4ro'Poan iltan. . of Hlttr ar+�a. Marear; rat" 1► "?Ifray l0 to ZQ S. 1. d Per q. ft. M deslrod. x 'Jim ,f�itarR oft IN t* *flaw" pafatss trill sae. ala; 275 A Canada. Pat,.lb. 7n.018;i t � pit, a0. '964 ; iiGitl� Pat. Ne. 19;791; .......�.. �r Pat.maims I* m w11a. 1J �w �� win.ii�i �a k �so& SWrnQ= VERTMAL i#i- (SKIO UNIT). HRS' SERI IES WWMA. VALVE` 000niwaw+wsatt�owr.oNnwaar�aaars�atrr�w ra 1�7JUNE; I 3 ""°' ? 502 SUBJECT R M I City of Fridley �PE 19221 AT THE TOP OF THE TWINS BUILDING PERMIT _ • COMMUNITY DEVELOPMENT DIV. 1 1 1 � PROTECTIVE INSPECTION SEC. 1 ; � CITY HALL FRIDLEY 55432 . DATE OF APPROVED BY 612-571-3450 INUMBERREv 910-F15 10/2/87 F;GE / JOB ADDRESS 512 - 63rd Avenue N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 24 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ken Waterman 512 - 63rd Avenue N.E. 571-4791 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 1j REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (25 Squares) 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. install ridged galvanized valleys. 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 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 } $1,250 $.63 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. $22.00 PLAN CHECK FEE TOTALFEE $2 2.63 SIGNA EOFCONTRACT OR AUTHORIZE AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT 1 �/ ' % ATU E F O IIF E 'B DER1 IDATEI BLDG AT NEW [ ) City of Fridley Effective 4/1/86 ADDN. [ ] i R-1 AND R-2 I ALTER.[ ] jild ng Permit Application 15 Construction Address: � Legal Description: 15 \� �� r Owner Name & Address: ����r Tel. # Contractor: Tel. # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Corner Lot [ ) Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction:Estimated Cost: $ �� �ZSb. 0 Approx. Completion Date: as SQU iP mgs . © Zi. a d z I LSV Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: 10-1-811 APPLICANT: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ '2100 $ o� $ .*3 $ $ $� zuo Tel. Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ) Not Necessary [ ) ss � dao Z'2.00 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT A ® water Heater �a1 al fa [S C H m 4 4 S O M W .941 O Q d 0�1 aO,O N atll w u o r o� to Bc o w m w U O s lec 1st 2nd 3rd 4th (R) a Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5_00 $ Rain water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 S water Treating Appliance $ 7.00 $ Hot water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer required. . . Yes ( ) No ( ) Type S 5.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $® Effective Date May 1, 1988 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 n� A /� /tel Fridley, Mn. 'v . 19 ?/ OWNER 1 `,. A r,i Y1 VI % , I A RIND OF BUILDING f USED AS TO BE COMPLETED ABOUT i - ESTIMATED COST iOO . 0 OLD - NEW BUILDING PERMIT N0. PERMIT N0, /0 .20 Company P Signed By Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT A_ 0 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE sueaEcr PERMIT _ City of Fridley 214 0 0 AT THE TOP OF THE TWINS P, BUILDING PERMIT Ir may_------ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r CITY HALL FRIDLEY 55432 NUMBER REVD ATE PAGE OF APPROVED By I'J 612-571-3450 910-F15 6/15/92 JOB ADDRESS 512 63rd Ave NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 24 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Neu 512 63rd Avenue NE 5714791 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jedi Deck 4354 Round Lake Rd, Arden Hills, Mn 55112 638-9460 3094 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 JJ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20t x 121 Deck 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WA RNIt -0 Before digging raj; far all Utility forEons 454-0002 REQUIRED BY LAW SEPARATE PERMITS REQUIRED FOR WINNG, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 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 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 $1,843 $.92 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $43.00 Fire SC $1,84. ST CTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ° License SC $5.00 $50.76 S ATURE OF CONTRA.C•F UTHORIZED AGENT IO TEI WHE PR ERLY �RALI ATED THIS IS/ YOUR f/ �PERMIT `� l CEJ �✓ -?C_ BLDG INSP GATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 3/1/92 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: J i �, 3 74 Lle /Vi Legal Description: LDT (",t(k l S i E 4,Q & ,770A-1 Owner Name & Address: D� v �4 L Tel. # Contractor: ,?C 1 t" n e c r< MN LICENSE # ©p d 3 o s �( Address: 43 ( k o u -J L, k c kc4 j4,jp Vk A115 Tel. # 6 '" 0 LIVING AREA: GARAGE AREA: DECK AREA: [11WI U� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width 1 Hgt/Ground o1To Corner Lot [ ] Inside Lot f ' Ft. Yd Setback _ Type of Construction: D z= c Approx. Completion Date: 0,�> Tu o e Driveway Curb Cut Width Needed: 4 APPLICANT: �/ Tei. # C TY USE ONLY DATE: 11 ')74 01 t Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee Ft. + b Ft = Sq. Ft. Sq. Ft. Sq. Ft. a q 0 Side Yard Setbacks 111 Estimated Cost: $ (Cost on Back) Ft x $ = $ Sewer Main Charge $ TOTAL STIPULATIONS: $ J--�O,Z6 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,00 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 9 01 SUBJECt P City of Fridley 32007 AT THE TOP OF THE TWINS BUILDING PERMIT 1. v __-__ COMMUNITY DEVELOPMENT DIY. PROTECTIVE INSPECTION SEC. 6?2-3604 r . � =�1 --11 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910415 7/17/01 JOB ADDRESS 512 63 Avenue NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 24 9 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave Neu 512 63 Avenue NE 763-571-4791 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Osborne Enterprises 5869 Hackmann Ave NE, Fridley, MN 55432 763-502-6765 e ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20169386 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 37 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (28 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 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 $1.43 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,863 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- $83.25 Fire SC $2.86 STRUCTION OR THE PERFORMANCE OF ONSTRUCTION PLAN CHECK FEE T;rAEE License C $5. SIVNATUREOFCON'RACTORORAUTHORIZEDAGENT IDATEI E PRO VALID TE THIS IS YOUR PERMIT S,GNATURE OF OWNERof OWNER BUILDERI IDATEi G 10 DATE 9 01 NEW [ l Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 13 Legal Description: Owner Name & Address: P %./ e- A/e Sfy3 6�"` ✓e �% Tel. # `� 3" _� %�- `l �� Contractor: Oslo ✓" e- C f'e�r �iS� S MN LICENSE # © % Address:SY6 % 90 L" -7y &1 t4--- -41-1 /lid X sS`-�I� -"el. # -A�FV-- 0, -IeV5 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: — / .,-)77- Construction () Construction Type:e- V-®® Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: �— I � APPLICANT`— Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ 83,oZ -Fee Schedule on Reverse Side Fire Surcharge $1� - Al 4� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ S-. 06 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ I.39IZ1IIFT'"Ce1►,1F3 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (7631571-1287 ADDRESS : 512 63RD AVE NE PIN : 143024420122 LEGAL DESC : CHRISTIE ADDITION : LOT 24 BLOCK 9 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PE ' IT NO�2004-00605 DATE ISSUED: 04/28/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A GAS INSERT # A/C UNITS # FURNACES # GAS RANGES APPLICANT RIVER CITY SHEET METAL INC 9928 BLUEBIRD ST NW COON RAPIDS, MN 55433 (763) 754-2199 OWNER NEU MARY ANN 512 63RD AVE NE FRIDLEY, MN 55432 0 VALUE OF APPL OR WORK 2300 0 # GAS DRYERS 0 0 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 co ction or the performance of construction. AD91i Date Bldg HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 23.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 23.50 PAID WITH CHECK # 13095 QRUAR ATF PRRMTTQ RFNITTTRRTI PnR WrIVY nTTJT:T? TWART nPQ('RTRRTI ARnVR 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 Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) m c4vak > QAN 5R.,-+ Gas Range ►-N,ccnv3oQi=� Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater iZ-f� O'��60 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS ':0 \ a — ion ^c4 We it �_ Fee Total Owner "_� AV@. N 2 v--- $35.00 $35.00 $ Building Used $10.00 $ �13. Ob $10.00 $ $10.00 $ $25.00 $ Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR I , -,C- ESTIMATED ,aESTIMATED COST a300 - c0 PERMIT NO # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP _ - EDR - Fuel (IUAi . GA, S Total Connected Load FO-e1c. Q'nS4L'* Burner Trade Name Size 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 $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ . $ cD 3s5 -b *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 HEATING CO River City Sh 9928 Bluebird St. N.W. Signed roon Rapids, MN A5433 Tel # %3- 754-2199 FAX # %a -a -Osq -�r��4.a 8 Date 4 - a(- —O Li 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 replacina 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 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 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 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 BUILDING Permit No.: a I Inspections RESIDENTIAL APPLICATION Received By: 763-572-4977 CITY OF FRIDLEY n ° 1. 763-502-4977 FAX . EFFECTIVE 1-1-09 DATE —0 YOUR E-MAIL ADDRESS SITE ADDRESS S% a\ el �� 3 l IQ d Ve- JE THIS APPLICANT IS: vK_OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: VSC` ED TENANT ADDRESS: _-37I D, (O 3 a cJe ✓U=� CITY ( STATE)�,I\ZIP. PHONE: �2 (2 – S % 1— 9 291 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE [ILSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER 4&SWIMMING POOL `Zem \ TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIRr\ ❑ REMODELING DESCRIBE WORK BEING DONE: �� r�kDy 2 �' �\ S ' �IDo� /; W Mme; M l.�` e\ti C�" !CN\7�5'cT SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE ORWINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: flJS SCHEDULE) TOTAL JOB VALUATION $ ��0 G THE 1997 U.B.0 FEE JOCCUPANCY TYPE Permit Fee $ c; See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary( ) Non Necessary ( ) Total Due $ &P R> Make checks payable to: City of Fridley Attach Stipulations 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 on site; that the work will be in accordance with the approved plan in the case ofaIl work icli re it s review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME L7 DATE — �� Building PLL BSG Permit No.: Inspections REE SIDE T APPLICATION Received By: 763-572-3604�A CI' OF FRIDLE �� ARI: 763-502-4977 FAX EFFECTIVE 2-19-Q9 DATE Q'30 YOUR E-MAIL ADDRESS SITE ADDRESS 5-12- /Qt: THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY NAME: UV ( OwNEB/ _ ADDRESS: 9p, (O CITY STATE ZIP_ '— TENANT PHONE: CONTRACTOR NAME: Q-Vlk4aj`44 STATE LICENSE# EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF STATE BOND# EXP DATE rl STATE ZIP s�Z ADDRESS: ® 11 CITY INSURANCEPHONE "- "1 �' ?� FAX 2s PERNIIT TYPE SINGLE FANMY O TWO FAMILY ❑ TOWNHOUSE TYPE OF wop 0 NEW �REPLACEAIENT DETAILEDESCRIPTION OF WORK K A 1 FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. SINK/LAV FLOORDRAINS _SHOWER _ WATERPIPING _BATH GAS PIPING (NEED GTTY LIC) SWE M NG, POOL _ WATER SOFTNER ($35) —BATHTUB _ _ _CLOTHES WASHER _KITCHEN SINK WATERCLOSET _BACKFLOWPREV.($15) TRAY WATER HEATER ($35) FORIRRIGATTON _DISHWASHER _LAUNDRY WATERMETER —OTHER •.�r, !. it � t ! � ut V-� 1� s � t'M1`,y�j �.. •� � i '3i �• ti2��x. � x t ��'ri i� `� �h f,� PI `�'iG jEl: t i tl. •: � ��P N 1 ` %�. t 4{:.�, 1 l � �! ,} t � "I '�'F N 1 r. , .�, , %f �� t t„ 1 �����a ! i,�1 (n !• � tN S �� �r vt t fi� �„ ! � '� t � ithj�„ F �t • t i � ' • 'ki �� -'. 1 �. �t ..yi k "i(• f �.,:T`1�ie y � i� 3 { I r��� °^h ��r�r .St22'--'' tl t ��,,.��LLa vi •,I � ,„t,��n ya �' ' � { a x, THIS IS AN APPLICATION FOR A PERMrf-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 case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT �/�� PRINTNAME IGS.. DATE qhM PL;EASENOTE SEPARATE:PERN[ITS. AREREQU RED FOR BTJ_ILDING;.ELE:CTRICAL.ANDMECI-IANICAL. WORK City of Fridley Building Inspections Department 6431 University Avenue NE. Fridley, NIN 55432 763-57''-3604 FAX 763-502-4977 08/20/2010 10:07 7637542908 RIVER CITY River City Plumbing Combustion Air Waiver PAGE 02/02 I understand that my existing combustion air may not be up to Cade per the city requirements. I hereby agree to pay River City Plumbing. _� $, To change, alter, replace, or add to existing combustion air to satisfy requirements as per the city Inspector's Instructions I represent that I am either the owner of this property or the owners's Agent, and have the authority to authorize said additionsto work or installations. (Required) 50 Cubic FT for 1000 BTUs ��� ,57'07 r� Cubic Feet BTUs ��� 0 00 CustomerNa Address Iv ery Customer Signature Date . --- 37 y a 0: '