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BUILDING PERMIT Village of Fridley, Minn. No Date 7a:---�� P -`%1r1 -A1` V ................. Owner �: —7.44-V ................. g. Address ' ... e r. -- � . 2759 Builder.......................... Address......................................... LOCATION OF BUILDING No. �.��......... Street.. ��.%�.. ........... Part of Lot ................ ... . Lot ......43 ..... Block 7 ............. Addition or Sub -Division . �........ . Corner Lot ............ Inside Lot ............ Setback X -7 451W.. Sideyard .............. DESCRIPTION OF BUILDING To be Used as: .... Front ... Depth .... Height 14.,!.... Sq. Ft,40 .. Cu. Ft. ........ .................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft......... Ov Type of Construction-� ... Est. Cost . [.. PP .' ........ To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth apd in compliance with all provisions of ordinances of the village of Fridley. I o ideration of the payment of a fee of $./ICA... permit is hereby granted to . ..L� ........ to construct the building br addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ................................... Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. IW - City of Fridley, Minn. N° 7733 BUILDING PERMIT S S7 -1- i Date: June 4, 1965 Owner: Bill F. Haines Builder 7h9m S. Silvis Address 5?{. 63rd. Avenue N. E. Adams 6020 N=Mod Rd, LOCATION OF BUILDING No. 524 street 63rd Avei a N. E. part of Lot Lot 23 Block 9 Addition or Sub -Division Christie Addition Corner Lot _ Inside Lot — Setback ____ Sideyard Sewer Elevation _ ___ — Foundation Elevation To be Used as: Type of Construction DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Front Depth Height Sq. Ft. Fit. Cost X64166•©0 _ To be Completed • Storm Damage Repair C� Ca. Ft. Cu. Ft. 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 fo and in compliance with Zi provisions of ordinances of the city of Fridley. s In consideration of the payment of a fee of 7.0.0 , permit is hereby granted to `ham Siler to construct the building or addition as described above. This t is granted upon the express condition that the person to whom it is granted and his agents, employees workmen, in all work L , around and upon saidMtonesota ltecity limitso�. Allen Jensen Building Inspector NOTICE: 'tide pwmh don eot cava the cowmetten, huhMadw for rrhbM phmb1nB. Ba heathm awer or water. Be caro to ae the Buddtee Inspedw for apoww parmha for thea bmw 19-10 1 J b/ APPLICATION,FOR BUILDING PERMIT CITY OF MIX MINNESaTA - OWNER'S NAMEIL ADDRESS Y- ADDRESS �2'�`` LOCATION OF BU):bING ' No: Street � - � � � "Part of Lot ' LOT 3 BLOCK ADDITION OR SUBDIVISION Corner L6t�Uside LOTSetback 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. DESCRIPttbN OF'-AVILD tG To:be used Front Depth` 'Height Sq. Ft. Cu. Ft. :Front Depth Height` Sq. 'Ft. Cu. Ft. Type of Construction Estimated Cost�,� To be completed The undersigned hereby makes application for a permit for -the -work herein'specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of•the Department of Buildings,• and hereby declares that all the facts and represen ' tions tated in this 'application are` true and 'correct: " DATE SIGNATURE i (Schedule of Fee Costs can be found on the Reverse Side). FROM Thmas S. Silva s 6020 wynnvood RDad Mpls., Minn. 5;,x;22 Telephone Number Proposal 544-3919 Proposal No. Sheet No. Date Proposal Submitted To I Work To Be Performed At City State I Date of Plan: We hereby propose to furnish all the materials and perform all the labor necessary for the completion of renlaca th^rmopane- Plastor board: renall all loose., retapr rsdecorAtA Van ty Irirror: replace, Paint: entire exterior, All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of 91 .ey�� pellets wit aymen s to a made ai ollows: Tot -31 due on cOnr,.t,ion. Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by "ontraetrr Respectfully submitted Per Note —This proposal may be withdrawn by us if not accepted within ten days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. rI Date Signature rOPS FORM 9460 M City of Fridley, Minn. • BUILDING PERMIT Date: AUGUST 11, 1966 E 0 Owner: MERLYN D. ARENSON Builder Address 524-- 63rd Avenue N. E. Address Fridley, Minnesota 55421 SAME LOCATION OF BUILDING No. 524 street 63RD AVENUE N.E. Part of Lot Lot 23 _ Block 9 Addition or Sub -Division .— CHRISTIE Corner Lot _ Inside Lot R Setback —_ Sideyard Sewer Elevation — — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: N° J��-51je 8956 DET. GARAGE Front 20 Dept 22 Height 10 Sq. Ft. 44 0 Cu. Ft. 44 00 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction FRAME Est Cost _ $1,320 To be Completed In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in compliance with aJl provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 4.00 , permit is hereby granted to MERLYN D, ARENSON 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 paw thereof, shall conform in au respects to the ordinancdes�go�R Fridley, Minnesota regarding 1p otn, 4 eddl t an4y Um i adv vi cna said within the city limits and tlds ordinances. CLARENCE BELISLE NOTICE This parmH don not am the senvtn Hon, ladallatloe ler wOM plumbing, gn heating, sewer or water. Be von to ago the Wlhft Impactor for separate pernft Mr thea hemv. APPLICATION FOR BUILDING PERMIT CITY OF FRIDL'`Y, MINNESOTA OWNER'S NAME A& w 4O 4 d4p-& jd ,5 ,oA BUILDER 5 a ADDRESS �� / ;3jQ�� /��, ADDRESS fri LOCATION OF BUILDING NO. Sa STREET �J---4,4e N PART OF LOT LOT X 3 BLOCK ADDITION OR SUBDIVISION C A a t ��i e AcIG/e � ®� CORNER LOT INSIDE LOT t, -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. DESCRIPTION OF BUILDING To be used as-.,/ Front 0 Depth_.a ;L Height C Sq. Ft. / Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction_ C) ea C' C Estimated Cost 4 To be completed` a 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__ vol V -5-f V-5-fP I &i SIGNATURE A9. aM41.ao� (Schedule of Fee Costs can be found on the Reverse Side). FORM 7181-4l u.s i 1 C� Co it T 1 bib YS- 1% Co�, u nice P 'c /4PP,ro /Z "><;I �� Om SUBJECT PERMIT NO. City of Fridley NO 5526 AT THE TOP OF THE TWINS BUILDING PERMIT r REC 1 fr _ COMMUNITY DEVELOPMENT DIV. r PROTECTVE INSPECTION SEC. ' �,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 10/23/79 JOB ADDRESS 524 - 63 Rd. Ave. N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 9 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Nerlyn Arenson 524-63 Rd. Ave. N.E. Fridley 55432 571-7123 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW. C:k ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install a wood burning stove with stainless steel and asbestos chimney. 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Steel 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 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 $1,000.00 $.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 7.50 PLAN CHECK FEE TAL FEE NATURE CONTRACTOR OR AU O IZEDAGENT IDATEI 17 $8.00 ♦ WHE ERLY VA ED THIS IS YOUR PERMIT 4.19'NA BLD WSP DATE TUREO OW NER OF WNER UILDERI 10 EI Om LTJ 1 60 26, 0 r z Hearin e�rP s.y ; as i e ��nca c ;•ole St:tacmg applied to the floor aces benea�I ex tendlag Oxy n+t :_r -:':a a ::;Ic h_ G:ep T- ;los; as noted in It uies 1 6 Hzarthextmslan Shd$1 be c'' 3'C P; i --V,"" 'd Il section 370 1 l of It:e Uniform Bu:Idtng Code. Healon e•:e^iL^• ^..tern a a:z ac^i c! 16 Imes tteyond the side with the feed door and a Inchi s z;;uawr., ce;:•; "e s.ee t.:astie t"•e teed azr k ;.IDes:cs cmrre,, nus; ee installed stimog at the pullet of the und. Clea:ar„a:. are tram the outside of the rhlmTey Report No. 3500 SOUTHPORTSTOV2S J'+0• • M19OPl$L OVERALL SIZE .IN: NES• CLEARANCE TO COMBUSTIBLES (MINIMUM IN INCHESI 4' HEARTH EXTENSION MINIUUM DROJ EC T!OH BEYOND uNI t.INCHES• CHIPANEY �.,:MUrr DIAMEtER •INCHES RELIRaI iC$ w•�1TH DEPTH HEIGHT SIOEp eLL•BACx WALL INSTALLA i10N CORNER INSTALLATICN FRONT SIDES BACK SIDF:A• BACK'Bi DIMENS,_W "x" 1 IUm.n3 Hood 0:9 60 233 8 171 4 33 1.4 38 30 Mol Peraltted 16 See flat.- 3 3 8 See Flgwe I 203.8 hlDrw Aa24 27 3 a 2034 4 42 1 2 38 36 Not Permitted i6 8 0 8 Sae Figures : 8 3 3 Parso A180 1514 30318 331 4 42 33 Mo1Pe7,i Ved 16 8 8 5 See NM;te.t 4 &'also A:8 13 27 3'4 2a 7 9 30 30 Not Permitted 16: 8 8 See Figure 5 n55 Muco A;80 Mu so A. 0 13 1338 it 3 4 451:16 • 30 Not P�rrtdted 16 8 B 5 See Figwe 5 o•a. +o. sa+•s» I. Ctealan�es air ho -1111'.1e outside of the chinuley connector pipes. � ' 2' Heardt extension Is defined as the noncombustible stufacing applied to the sides of the Nom area ber 3011. eateromg beyond the front, back• and sides of the 6leplace stave as noted in figures 14. Hea•tri exteas'on shaft 5e of matei,als specified in section 37071) of the Uniform Building Code., 3 Herth extens•m'I to extend a mine um of 16 Inches beyond side with feed door aid 8 inches nlamun oeyo+:d side op�ds,te teed door. I — 1W A:'I bold I I Rcparl Fla. 35J0 IRED11CFD r_LFAR ANCFS IMIN+; Mr-TAI'F1FCT(TC rust rmmm i No. MODEL_ OVERALL SIZE ANCNES: CLEARANCE: TO COM313S.TI"3LES HEARTH EXTENSION IMINIMUM IN INCHES)N& !� (MINIMUM PROJECTION 41 SIDEaALL BACKWALL LOANER �4- BEYOhOUN1T•INCHESI CHI°.7UEY MINIMUM w _ REMARKS • s_ _" ra•DTH DEPTH HEIGHT INSTALLATION INSTALLATION ' DIAMETER )NCH ES! 3•r �. 1S FRONT SIDE& BACK i4) BACK(B) DIMENSION •'K•' - r 1 Kamm poo.-. 203.8 17 i'4 331:4 37 8 518 Not Pe(milted 18 See Note 8 8 — See Figure 1 3 See Note 4. i C FIGURE- I 1 + • � ' "� ���-Health Extenslc•I f 1„nr FIGURE 4 1 1 I I:cnt FIGURE 2 Z. I I�-HerLh EAtetslon •rT r . FIGURE S CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) Ti 1 OWNER; ADDRESS: TEL NO: h % / — -2./ ;Z _3 BUILDER: ADDRESS: TEL NO: Construction Location STREET NO: —3 STREET: ! 7') t4 /LV- LOT: Q3 BLOCK:` ADDITION: 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. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Squane.Feet: Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: V ' Type of Construction: Estimated Cost: $ ' To Be QDmpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct DATE: ��� c�6 ��/SIGNATURE: �� L�������� ���•�� Stipulations: sue�Ecr PE City of Fridley rT 1Z48 AT THE TOP OF THE TWINS BUILDING PERM rp ftPEIPT NO. ....... COMMUNITY DEVELOPMENT DIV. INSPECTION 0 r PROTECTIVE SEC. 1 � � CITY HALL FRIDLEY 55432 `_--• A "',,, NUMBER. REV. DATE PAGE OF APPROVED BY L J` 612-571-3450 910-F15 11/18/86 JOB ADDRESS 524 - 63rd Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marlys/Merlyn Arenson 524 - 63rd Avenue N.E. 571-7123 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 Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Finish Basement 9 CHANGEOFUSEFROM TO STIPULATIONS SEP TE PERIWrrS REQUIRED FOR YWRFIVG, HEATING, PLUMBING AND SIGNS. 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 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 $21000 $1.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $32.50 LAN CHECK FEE TOTAL FEE f $33.50 SIGNATURE OF ONTRA 0 OR(H.011ZED AGENT W(DATE) •yWHEN PROPERLY V I ATED THI IS YOUR PER IT SIGNATURE OFO ER tlF OWN RERi BLDG iNSP WATE NEW til ADDN. [ ] ALTER. [ ] Construction Address City of Fridley �R-1 AND R-2 Building Permit Application Effective 4/1/86 Legal Description: / Owner Name & Address: %�� s Tel. # Contractor: Tel. # Address LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Corner Lot [ ] 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 Sq. Ft. Length Width Height Sq. Ft. Le th` Width _-_ Hgt/Ground Sq. Ft. 1� 'n /'0 C {. SP A/VI PAA, i Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd. Setback Side Yar etbk Estimated Cost: 2ac©�G' �� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: APPLICANT: CITY USE ONLY Permit Fee $�� Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $475 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge ' �l Agreement Necessary [ ] Not Necessary [ ] TOTAL EJ v STIPULATIONS: 6. 1 CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT »moi tin m u d a o00 l N m " E 3 c' G C +� 41m c w W 3� u�i " w .4 N cei a"i y W ao 3 'ip, iS W m a 1 m" 64 O Water Heater 6amew J6 � 1" LIS-, MINNESOTA 5V -10B lec ROUGH INSP. Date FINAL INSP. ®� P Date APPROVAL FOR PERMIT 1st 2nd 3rd 4th (R) - Future Connection Opening (*) Q New Fixture, Old Opening Connected with Sewer Water M10191%19 PLUMBING FIXTURE RATES: New Fixtures Future Fixtures 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 I Back Flow Preventer Required. . . Yes ( ) Type RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 TOTAL No ( ) $ 5.00 $ ALL OTHI:.!S AND/OR REPAIRS AND ALTERATIONS la of Value of Fixture or Appliance State Surcharge Reinspection Fee $ ($15.00) TOTAL FEE I Job Address Department of Buil�ditl� City of Fridley Tel. #571-3450 Effective Date May 1, 1988 1"31-!E3\-a.l1'N, 1-IARI-Tq- -92-4 r_ --RD (a%0\per NMTHEAc-;T FFUDL_YI=Y. M y-r't-'%_;•nom. H 571-712-3- I„I 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 �`� 's �yFridley, Mn. / r 19 �y OWNER �C V- e- (/I KIND OF BUILDING USED AS l TO BE COLLETED ABOUT ESTIMATED COST ~ Iy(J , ✓V SAT OLD - NEW BUILDING PERMIT NO. / TT�� //QQ PERMIT NO. COIR Pant Signed BY AVENUE SOUTH 6amew J6 � 1" LIS-, MINNESOTA 5V -10B Tel. No. ROUGH INSP. Date FINAL INSP. ®� P Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE I SUBJECT PE City of Fridley 27660 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ,'� 612-571-3450 910415 9/9/98 JOB ADDRESS 524 63rd Ave ME NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 9 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marlys Arenson Same 571-7123 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Four Seasons Roofing & Remod 7930 Univ Ave NE Fridley - 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 IR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage 8Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2,399.00 $1.20 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 OTHER STATE OR LOCAL LAW REGULATING CON- @ $74.75 Fire SC$2.40 S UC N OR THE P RFORMANCE OF CONSTRUCTION. f� Q PLAN CHECK FEE TOTAL F Lic nSC $5. 0 $83.35 SIGNATURE FCONT A TOR OR THORIZEDAGENT IDATEI N P OPE ALIDAT IS I$ PERMIT I /fT-.A BLDG SP ♦/� r SIA TE SIGNATURE OF OWNER OF OWNER BUILDER1 IDATEI I NEW J Effective 1/1/98 ADDN [ ] C° 0-f MDLEY ALTER [ ] sjNols. FrAK. Lk( is DUPLEXES R-1 AND 1,L-2 VjU L®1N0 PERWr APPLICATION 0 ConstructionAddress:�f�/�- Legal Description: Owner Name & Address: Contractor: Address: RAN LACENSE # AA Tel. # At *o &•Cenificate of SurWj of AM - lot, Wj**".'apa56 for(xtxion drawn an 1o,, LIVING AREA: Lay* Sq. Ft. GARAGE AREA: 1"% W�dh _ Sq. Ft. DECK AREA: h._ V►Ih�rd Sq. Ft. OTIFIER:.d y'o _rsPn � Construction Type:&�ty—Btimated �1: �3c2q (Fee s L11E an Back) Driveway Curb Cut Width Needed: DATE: , APPLWAI XO! V014 -116W Tel. # Permit Fee $ 1741S Vez.cdWoke on Rmverse Sidp, Fire Surcharge $ �C27�cld ,G�1 P�Sttai}'�kt1U�►"yarn (l/ l0il State Surcharge $ 16661Wvaiiorn SAC Charge '%$-- 11000 m ACUnit License Surcharge $ (' $S,00G&VkLResidential CbpjV0QJa0 Driveway Escrow $ W "A" Or A'A,`"W" Above Erosion Control $ &450.00 C'msef"ermPlan $0.v Park Fee$ __ �-��t�►l \ W)04 Engineer�iig Sewer Main Charge [ J TOTAL $ &33 � STIPULATIONS: R, SUBJECT City of Fridley 3 155 AT THE TOP OF THE TWINS BUILDING PERMIT `IPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC.5 1 NUMBER REV DATE PAGE OF APPROVED BY .-I CITY HALL FRIDLEY 55432 1 763-571-3450 9t0-Ft5 10/10/02 JOB ADDRESS 524 63 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 9 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Carrie & German Hernandez 524 63 Avenue NE 763-571-8568 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 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW JD ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 26' x 6' Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNIN W" AMTE PWW Before digging call for all utility locations vwumm �5�-0002 PUPAW AND SIGNS LAW 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 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 1 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 @ $8,854 $4.43 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 OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $180.53 Ei SIGNATURE OFCON'RA CT�f70R AUTHORIZED AGENT DAT6011) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT $-GNATURE O� ER�,O OwNER BUILDER, I, SLOG IN$R GATE R, NEW ( J CITY OF FRIDLEY ADDN6431 University Ave NE, Fridley, MN 55432 rA ALTER SINGLE FAMILYND DUPLEXES R-1 AND R-2 ( J BUILDING PERMIT APPLICATION Construction Address: 5 24 & 5 fd ✓C Alf - Legal Description: X9 ZLo.9 Effective 1 (763) 5724 Owner Name & 'Address: G Xr-C e 'C- 5 " ®- �'m �a�e� ®� Tel. # '�'�� �1;- Contractor. M e 604e- V` MN LICENSE # Address: Tel. # 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. DESCRIPTION OF IMPROVEMENT Length �-� Width Height '00'. Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construction Type: S 1-r- c_ k r I- - Estimated 7 - Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ LJ LA DATE: APPLICANT: L;1a'h 2 Tel. # Call (763) 572.3604 for Permit Fees if mailing In application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ , o Fee Schedule on Reverse Side Fire Surcharge $_F� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by 'Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ) TOTAL $ ®,& STIPULATIONS: 0 N Job Sac Address: _52� 3 �� AW CATEGORY 19' ALTERNATE FOR ONE & TWO FAMILY DWELLINGS 1S'I'RUCTIONS: This alternative may be used for one- and two -fancily dwellings built to meet cite Category 1 requirements of +linnesota Rules, Chapter 7670. Complete parts A. D. and C. Clearly mark plans with: insulation R-%alaes:..InJow anJ sk.It_hi U_ size and type of equipment; equipment controls. and location of vapor retarder and windwasa harriers. 'lfure d.-nailc.t iformation can be found in the.1/fimesora Erte'XII-Cott,: summary sheets available from tlte.• Minnesota Depa.tm_nt of Commerce 'art A. BUILDING ENVELOPE htzk- proposed cnvclope joint sealing option 4 ❑ Prescriptive tceulking, gaskets. ete.) ❑ t'ertorntan.:c itca: per 7t►'u.u.t'U suhp '.C.) heed: themd ewrgy cm!.ulalion option used 4 X "Cookbook" (complete worksheet below) p &InCheck method !attach report) C3 Performanev (attach U -value calculations) 0 Systems Analysis methoJ !attach anal-.si;) Cookbook" Worksheet INSTRUCTIONS :p (.Check item(s) that design mects on .th uatum Regntreomn:i list t►► the right :Aust meet all items to use-Cuokhook" ap tiou :p 2. Indicate proposed wall ty pe on table helaw p 3. Indicate Window 1.1 -value and source. p 4. Verify total window (including arca ofall foundation %%inducts) anJ door area is equal or less than alluwahle percentage. TABLE FOR DETERIMINING 31AX131UM WINDOW AND DOOR AREA MINUNIUM REQUIRE.NIENTS (for "Cookbook" option only) 0 Ceiling Insulation: Minimum R-38 with 7':" energy heel; or Minimum R44 with luw truss heel. or Minimum R-38 with R-5 sheathing ►.hen no ace- 0- 1=utn Uuurs: Mas. U -value of 0.311 or I','solid wood %%t:h storm O Item Joist Insulation: Minimum 14-11) O Floors oer uneanditioned s arcs: Minimum R-24 O Foundation Insulation: Minimum R -lo 10 Foundation windows: ::'insulated -.lass, wood or vinyl t:an:: TABLE FOR DETERIMINING 31AX131UM WINDOW AND DOOR AREA wimum Allowable Total Window and Door Area as -ercentage of Exposed Wall 120/1 14% 1 16% 1 18% 20% 1 22% 1 24% 26% 28% d: Ty (Standard Framing): Maximum Average Window U -value (cm- t foundation windows): 2.%4. R-13 insulation. Z R-7 sheathing 0.55 0.47 0.41 0.36 0.33 0.30 0.27 0.25 0.23 . 2.N4. R:15 insulation. -5 !.heathing 0.52 0.45 0.39 0.35 0.31 0.23 0.26 0.24 0.22 2x6. R-19 insulation. < R-5 sheathing 0.48 41 0.36 0.32 0.29 0.26 0.24 0.22 0.21 2x6. R-19 insulation. Z R-5 sheathing 0.56-. OAS 0.42 0.37 0.34 0.31 0.28 0.26 0.24 2x6. It 21 insulation. < R-5 sheathing 0.31 0.43 0.38 0.34 0.30 0.23 0.25 0.23 0.22 20. R•.1 insulation. z R-5 sheathing 0.33 0.50 0.44 0.39 0.35 0.32 0.29 0.27 0.2S ll Type (Advanced Framing): Maximum Average Window U -value (exec t foundation windows): 2s6. R-19 insulation. < R-5 sheathing 0.52 0.45 0.39 0.35 0.31 1 0.23 0.26 0.24 0.22 2.�6. R-19 insulation. a R-5 sheathing 0.53 0.50 0.44 0.39 0.35 0.32 0.29 0.27 0.23 3x6. It -2I insulation. < R-5 sheathing 0.53 0.47 0.41 0.36 0.33 0.30 0.27 0.23 0.23 2%6. R-21 insulation. 2 R-5 sheathing 0.60 0.52 0.46 0.41 0.36 0.33 0.30 0.23 0.26 Window U -value: window 8 doorarea gross \eaS posed wall area Source: DESIGN O NERC O ASI•IRAE 1993 Handbook ALLOI,t'ABLE (from table above) INNESOT--1 ENERGY CODE - WHICH RULES MAY I USE ? TYPE OF RESIDENTIAL BUILDINC APPLICABLE RULES -cached R-3 occupancy 1- and 2 -family dwellings Chapter 7672; or &amoles: single family, twin homes. duplexes Chanter 7670 "Category I" with statutorti &.pressurization an.i vefflfti4i, requirements inched R-3 occupancy dwellings I C:haptrr 7674; or E%amplcs: triplex townhouses and row houss Cha; tar 7670 w ith cither'•Cateeory 1" or "Cutegon 2" 1 uccunancv buildiaes of 3 stories or less I ('h i -t --r 7674. -or Part .B. DEPRESSURIZATION PROTECTION •'heck option used: ❑ Fuel burning equipment (eOmplete schedules below) ❑ No fuel burning equipment. I��I RI't-tIAX1 EXHAUST/ 61AKE-UP AIR SCHEDULE* ti:ep I . Cuntplete the C'aarhu.crruu FWrr0an•0u SWhJ./uk below. Only equipment Exhaust devices over 300 cf n Flow with a Y (Yes) may he selected under the"Cate__ory I" alternate. cfm Step 2. Complete on the ri__ht if director pu�� cr cfm vented or solid fuel atmospheric vent space heating equipment is selected. I . efnt CO�ti1BUSTION EQUIPMENT SCHEDULE (check n11 types proposed) Space heating — nonsolid fuel 13 Sealed combustion Y 0 Hearth — nonsolid fuel O Sealed combustion Y O Direct or power vented 13 Direct or power vented Y Atmospherically vented Atmospherically vented N Pater heating — nonsolid fuel ❑ Sealed combustion Space heating — solid- fuel O Atmospherically vented Y• O Direct or potter vented Nater heating — solid fuel O Atmospherically vented Y Atmospherically vented NJ Hearth — solid fuel ❑ Atmospherically %ented Y If atmospherically vented solid fuel or direct or power vented nonsolid fuel space heating is installed, then make-up air to match flow is required for each individual exhaust device which exceeds 300 cubic feet per minute. 'art Ci. VENTILATION VErNT1L-MON QUANTITY (Mechanical ventilation must be provided per the larger quantity calculated below) cubic feet x 0.00583 /minute �� cfm x 15 cfm/bedroom) + 15 crm — crm ,fume of habitable rooms number of bedrooms VENTILATION FAN SCHEDULE eck method(s) proposed 3 1 O Exhaust only O Balanced (heat recovery ventilator. air exchanger, t description or location 4 1 TOTALS '.NTILATION Intake cfm cfm cfm cfm cfm DESIGNED Exhaust cfm cfm cfm cfm cfm ' cement of Compliance: The proposed builJin, design represented in these documents is consistent +pith the building plans: :..icatic•:. an I nthc::_:.::.aacions submitted with the permit application. The proposed building has been designed to meet the rirements of the Minnesota Energy Coda. dicant (print name) Signature Date _ Telephone number art C2. VENTILATION (Submit Part Ci upon completion of system verification+) ---------------------------------------------------------------------- iil;. Address: iescription or location I I TOTALS SURER Intake cfm cfm cfm cfr. cim =ORMANCEfi Exhaust ctin cfm cfm cfm cfm Ventilation rate must be measured and verified when the performance option is used in lieu of the prescriptive option for the sealing )f joints in the building conditioned envelope (from Part A). )liance �t.ttrnr��nt: _':;;±,:�I J venahuon a.a±em is to comp liance with MN Ejwm_-� Cute and is;irc.r. io'pro:_n a:r floe Aggregate Make -Up Air Alternative and Ventilation Documentation (Can be Used as a Supplement to Permit Application) Bldg Address: 1524 63rd ave ne Date: 9/24/2002 Ci fridley Zi Code: 55432 Completed By: terry schmolke Co. Name: Path 1, Aggregate Alternative Exhaust Devices CFM Space Heater: Power Vented Clothes Dryer 150 Water Heater: Direct Vented Kitchen Exhaust 0 Gas Hearth: None Solid Fuel Hearth: None CO Alarm: Not Required Make -Up Alr Central Vacuum None Exhaust Devices Dryer Kitchen Largest Other Total Exhaust Capacity 150 0 0 150 Distribution CFM Passive Infiltration 150 Passive Opening(s) Rigid Flex Direct 0 Powered Make -Up Ventilation Minimum Required Sq. Ft. Bedrms Total Ventilation People Ventilation Supplemental Ventilation 2118 3 106 60 46 ' People installed ventilation in excess of the required minimum people is deducted from the required minimum supplemental. This is based on the Energy Code definition of Supplemental = Total minus People. People Supplemental Other Balanced 106 cfm. Other Balanced 0 cfm. Central Exhaust 106 cfm. Central Exhaust 0 cfm. People: 212 cfm. Supplemental: 0 cfm. Total: 212 cfm. Ventilation Measurement Documentation Bldg Address: 1524 63rd ave ne I Date: Ci!y: I fridley Zip Code: 155432 Completed By: terry schmolke Co. Name: Path 1, Aggregate Alternative Ventilation: Measured Performance People Ventilation Supplemental Ventilation Total Ventilation Minimums ---a 60 46 106 Measured Measured People Designed Intake Exhaust Supplemental Designed Intake Exhaust Other Balanced 106 cfm. Other Balanced 0 cfm. Central Exhaust 106 cfm. Central Exhaust 0 cfm. People: 212 cfm. Supplemental: 0 cfm. Note: Air flow for balanced ventilation systems must be balanced within ten percent. Total Designed Ventilation: 212 cfm. Total Measured Ventilation (people + supplemental): Compliance Statement Installed ventilation system is in compliance with the MN Energy Code and sized to provide the design air flow. Applicant (print name) Signature Date Phone number 524 63rd ave ne fridley (1) If a closed controlled combustion solid -fuel burning appliance is installed in Path 1, then the clothes dryer and any central vacuum that exhausts to the outside must be provided with make-up air by passive opening to match flow, and a CO alarm must be installed. (2) Only one atmospherically vented appliance is allowed under Path 2. (3) Passive infiltration must not be used to provide make-up air for supplemental ventilation in excess of 0.05 cfm/sf. (4) Passive infiltration or passove openings must not be used to provide make-up air for supplemental ventilation in excess of 0.05 cfm/sf. (5) Check with local code officials. (6) If power vented combustion air will be required. If direct vented or selaed combustion, check with local code officials (7) A central vacuum that exhausts to the outside is not a mechanical exhausting device for Prescriptive Paths 0 and 1 but is in Paths 2 and 3. (8) Check with local code official concerning installation of power vented gas hearth in Path 3. SUBJECT R ITN City of Fridley 3329 AT THE TOP OF THE TWINS BUILDING PERMIT , RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ~ f PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APFROVED Br L 763-571-3450 910-F15 12/18/02 JOB ADDRESS 524 63rd Ave NE T LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE German & Carrie Hernandez 524 63rd Ave NE Fridley, 2 763-571-8568 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO German & Carrie Hernandez same as 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 �I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK New windows & siding 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. Per Section 1402, 1997 Uniform Building Code requires that a weather- resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions to this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in the application guidelines. Call for inspection of wrap before covering. 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 1 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 $7,300.00 $3.65 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 OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE T ' L FEE 7$164.20 SIGNATURE OF CON7RA/C1TOR OR AUTHORIZED AGENT H PR 4Y VALIDA ED THIS IS YYOUR PE IT �Jf 91DATEI �f ( (/ BLPG INS- S�GNA URE OF OWN R,IF OWNER BUIL OE Ri IDATEI NEW [ J CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 6 2,q Lo 3 re A V -e lV F_ Fri 'z) 1,e it M Al SS 3 Z_ Legal Description: Owner Name & Address: 6erme4►nt 0-arrn'e L)ern&ndPz Tel. #70 5-7I'SSlo8. Contractor i MN LICENSE # Address: Tel. # 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. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft z&O0 -S"dj°lz:,"of Construction Type: M l y6 ) WS y- S 0'_) J JV 6 . Estimated Cost: $ 11'70 o - W, nd o w s % CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2003 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas'" Gas Range" NO. RATE TOTAL Gas Dryer** . Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS 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. 20 03 Owner :11 Y'rl c' 9 e r maki d vo roa k9d e z Building Used As Estimated Cost PERMIT NO. 2 PLUMBING COMPANY SIGNEDBY�4tiih TEL NO. 5-7IS!Slo Lj Approved By Rough -In Date Final Date 50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 $ 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 When reIn acing an exictinrl prance, 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 pxic i g enmbistinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a now rnmhusfinn 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 cl 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 l:lyV ri,[eZoZ•3 Signed By: Date: Effective January 1, 2003 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 FAX (763) 571-1287 -� JOB ADDRESS` �✓✓� RATE SCHEDULE OWNER Residential Rate TOTAL ,"Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 $golco_ BUILDING USED AS ' a� - (Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of HeatingUnits r Circle One (Steam) Hot Water ) ( ) ( arm Air Gas Dryer $ 10.00 $ Trade Name Size No. BTU If_/6 HP EDR *Air Conditioning - All Sizes $ 25.00 $ ��lO Fuel Total Connected Load " All Others/Repairs & Alterations (LIST ON BACK) ""Burner Trade Name i3f�/�rr�Size No. -7e- 7 Ddb 1% of Value of Appliance or Work Cducfwc� $ BTU HP EDR .c Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and 6 representations stated in this application are true and correct. TOTAL FEE $ � DATE DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 /1 A, JJ �/^"'" -A 3 57l 5� /U/_`-� U L �2G:.�lCC - TEL PLUS THE $.50 STATE SURCHARGE Signed L # FAX # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By_� Rough -In Date Final Date written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When ren�.sn+ an exietin0 h trance, 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 Yes () No ( ) assisted and natural draft appliances. The ' is sized and installed to meet the current codes and manufacturer's specifications. Yes( No ( ) When required to inetaii a now comhuetion air_ it will be sized and installed Yes to meet the current codes and manufacturers specifications. () No ( ) When Yivstallonn a-na venting -r stern, 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 Yes( )No( ) separately as per current codes. T ,. anti ci7Picnmmnn Vent and Vent Coonpr-tor information Appliance #1 Type BTU Input __ BTU Input Fan Assisted or Nat Fan Assisted or Nat Appliance #2 Type 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 = Length ft Diameter in Type in Type Appliance #2 Vent Connector Height _ ft Length ft Length ft Diameter ft Diameter in Type Appliance #3 Vent Connector Height HEATING CO: Signed By: Date: 431 University Ave NE •ridley, MN 55432 763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTAI I Fn (71nI FAr.N FI nnR �PC�0(e 0a4�p�y .. . Urinal n . ..:::.. )3... S ower h Wash Tr a ' tfifG::::::::: ..................... F oor In Iw f= : `: =:<` Aut o.:.::..::.:. <::<::::. Gas I}A::::: Water Heater Range ;;?��� Gas Elec Stone s Basement or Flo 1 Floor 2 Floor - Floor 4 'LUMBING FIXTURE RATES: Jew Fixtures )Id Opening, New Fixture Seer Dispenser Slow Off Basin ;atch Basin lain Water Leader Sump/Receiving Tank Nater Treating Appliance Nater Heater -Electric Nater Heater - Gas** Sas Range** NO. RATE TOTAL Sas Dryer** Sack Flow Preventer Required ( )Yes () No Type $10.04 $10.00 $10.00 $10.00 $10.00. $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 $15.00 Reinspection Fee $50.00/Hr 4LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS Sow e QU1L/ IVA �e 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. nai-P- 041506 20 OWNER BUILDING USED AS - ESTIMATED COST HERNANDEZ, CARRIE 524 63RD AVENUE NORTHEAST FRIDLEY, MN 55432 (763)571-8578 `4 (V 00 PERMIT NO. NORBLOM PLUMBING CO. e (A17) R77-Annn 2905 GARFIELD AVE. SO. Rough -in Date 0 eu,(- e, — Final Date 1W11 1111,11 rLum-lin3ammJ r -r -m 1 la a is uu or 5%a ur t;u; $ OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE 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. E i 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 :