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PRE 2010 DOCS/• Date: Owner: Address fAityof Fridley, Minn. BUILDING PERMIT Address 0 N° 6614 1; 7-- ;?�'3 LO I FWILDING No. Street . _ Part of Lot Block _ Addition or Sub -Division Corner Lot — Inside Lot _ �� Setback ^�J - Sideyard — `-lam Sewer Elevation — _ _ , Foundation Elevation DESCRIPTION OF BUILDING To Used as. l Front VV Depth 7Height" Sq. Ft. Cu. Ft _ t Depth H ght — Sq. Ft Cu. Ft Type of Construction `' ____ Fit To be Completed In consideration of the issuance to me of a permit to cons et g described be, I agree do the proposed work in accordance with the description above fo compli, ce all p of ordinances of the city of Fridley. 01 1 In consideration of the payment of a fee of $� , t is hereby granted to_ to construct the building or addition as described above. This permit is granted upon the Fess condition thdne around anduFridlMinnesota reg location, construction, alteration, maintenance, repair and moving of buildings ordinaa : dty limits and permit may be revoked at any upon violation of any of the Provisions of said Building Inspector NOTICE: Ude pertnB does not corer the construction, hatallatien for wmh& plumbing, on heaHno, sewer or wafer. as sure to we the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING FROM CITY OF FRIDLEY, KaMSOTA Owner's Name Builder AddressAddress - LOCATION OF BUILDING // No. i� Street=✓%���� Part of Tit Lot Block Addition or Subdivision .��-` Corner Lot __Inside Lot Setback S"r Side -Yard /_e SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Sq. Ft. We V -L. Front_ Depth Height Sq. Ft. Cu. Ft. Type of Construction �-':r'� Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in /this application are true and correct. �• SIGNATTJR.B ,&,-- (A Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley Application for Plumbing and Gas Fitting Pennit DESCRIPTION OF WORK Number, Kind and Location of Fixtures % NO. RATE TOTAL Number Fixtures ...................... 7 x $1.50 $ 10850 Future Fixture Opening ................ x 1.20 $---9.40 New Fixture Old Opening .............. WATER HTR. x 1.00 $ ; (S 2 x 3.25 $ o 2 Water Heater (Up to 200,000 BTU) ...... 8� LL � S < �U' •d �U' 4n f�y 0 F N GAS ELEG GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ 1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. Base x 2.00 $ 10 11 1 lst 1 1 1 1 1Dislaosol 2nd _ 3rd H4 - 4th • Future Connection Openings Connected with I Sewer � New .Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... 7 x $1.50 $ 10850 Future Fixture Opening ................ x 1.20 $---9.40 New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... 1 x 2.00 $ 2.00 New Ground Run Old Bldg. ............ x 325 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ 1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $_I§. 40 Dept. of Bldgs. Phone SII 4-7470 * —.M__ 122 — 63xd Way City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn July 24 i9 63 Owner Paul J. Schwartz Const. CO/ Kind of Building Frame Used as .Dwelling To be completed about Hov. 1 r63 Estimated Cost, $ 800.00 Old—New. BL' ding Permit No / Permit No. signed STM*0 Flumomo By Busiii ss Phone No We 8 3589 ROUGH FINAL C Application for Power Plants and Healing, Coding, Ventilation, Re#rigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ................. ...... 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 5.00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ 1.50 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ 1Q • 50 ROUGH Placa. R-1 On file 'FINAL Dept. of Bldgs. Phone SU 4-7470 Location 122 --63rd- ay N. ;� City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn- 87, 196 -3 - Owner Paul Schwartz Construction Co. Kind of Building r'r • Used as Residence To be completed about 9-7-63 Estimated Cost, $ 400.00 Old ew Building Permit No. `r1 Permit No. �! DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No_ 1 Trade Name Westinghouse Size No- GDS -100 Capacity Sq. Ft. E.D.R BTU LOOM H.P. Total Connected Load 451631 Kind of FueL Gag BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) FRED VOGT A CO. Signed HEATING & AIR J By 6%30 West I ake St -* W6.-°r6W St. Louis Park, Minnesota . a; -42 iM 7-59 Business Phone No 0 • City of Fridley, Minn.. BUILDING PERMIT 02': .rM 7- *i Owner; Richard A. Morrow Builder Sussel Lumber Co. N° 8489 ��0 Po 6 Address 12 - 63rd Way N.E. Address 1850 Como Ave., St. Paul LOCATION OF BUILDING No. 1_ Street - 63rd Way X.R. Part of Lot Lot 2 _ Block 3 Addition or Sub -Division .Eva Erickson River Manor Corner Lot _ Inside Lot _ Setback — Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Det. Garage Front 20t Depth _ 221 . Height 10 t Sq. Ft.. 4140 Cu. Ft. 1'n Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Era= Est. Cost To be Completed 2Q She 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 a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $-j4AO$-.O ,permit is hereby granted to �S'79RRAl _ . mb _r Co. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and tl& permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTIM. This permit dos not emer the construction, testaltation for fi& plumbing, on banns, sewer er water. Be son to as the W"Ing Ws"ftr for separate permits for these Nems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY$ MINNESOTA OWNER'S NAME i�f®r�- BUILDER d6v ADDRESS ,;` , — (® lam- ADDRESS1't�d C'o„e m 9'/ LOCATION OF BUILDING NO. STREET PART OF LOT LOT BLOCK -3 ADDITION OR SUBDIVISION etAzX_ �dL CORNER LOT INSIDE LOT SETBACK SIDE YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; �@ t4 _� a ® Front Depth �- Height / Sq. Ft.�_� Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost c 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_ SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). i�5� GI G' r r ti /_r1 - Z7 n a, LOT NAME SIZE l?CRA,M0 201 x -.2.+ BLOCK ADDRESS VALUEO. IZ2 - (.,3 o. 300` ADD'N. AREA TYPE r-7aIOLC'4 1zo►M 3 201 1 M es" -ca `orJov N I (or ©oo m, 18 rj o o'r's ��r 1 'O r v SQve.rzE tt1rn4 WouSE Q mEs" £ C,oIL3ou1T r 1 J o 53-84-s-915.51 CH -1 of scriGloy - ApplivnTlan fQ7 P1U7nb3r1 9 gi Dogt. of Bld7s. Phone M-3450 DESCRIPTION 0: W011 122. N. E. 63rd. Way _ Nuinbar, Kind and J ocrlicn of Fixtures T'O�ti�- :lJ 13 � � �s . a N I3 ► o . � . o � $-- _New New Fixture Old Opening .....:.... IYN $ WATtR N7R• x $3.25 $ Bair Fater Beater 'Up to 99.000 BTU) • • • • x $3.00 $ New Ground Run Old Bldg. ....•.... x $3.25 $ El.ctric Water Haatar...... ........ a $2.00 $ all$ FITTING FEES: NO. RATE TOTAL Ist 3 Fixtures ............ • • • • • • 1st $ . Additional Fixtures .............. x $ .75 $ In to 1 I tanf 5.00 Gas Range to 199.000 B: U ........... 1 x $5.00 $ 3:d 4 t,1h • Futuro Co=ac•.'.:a 0porinrjs e Xsw Fl: -t :re. Old Openings PARTIAL RATE SCHEDULE Saxrar � Ccaapc of 0 PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $__— Future Fixture Opening .. • .. • • • • • • x $1.50 $-- _New New Fixture Old Opening .....:.... x $1.50 $ C3tc1h Basin ................... . x $3.25 $ Fater Beater 'Up to 99.000 BTU) • • • • x $3.00 $ New Ground Run Old Bldg. ....•.... x $3.25 $ El.ctric Water Haatar...... ........ a $2.00 $ all$ FITTING FEES: NO. RATE TOTAL Ist 3 Fixtures ............ • • • • • • x $2.00 $ . Additional Fixtures .............. x $ .75 $ 5.00 Gas Range to 199.000 B: U ........... 1 x $5.00 $ City of Fridley: X The undersigned hereby makes application for a permit for the• work herei specified, a„recing to do all work in strict accordance with the City Ordinance and ruling of the Department of Bulld,'ngs, and hereby declares that all tate fact and representations stated in this applca,"on are true =d correct Fridley, Minn 10-15-75 1g� Owner Richard A. Morrow Kind of Building Frame Res. Used as -- To be completed about 10-22-75 Estimated Cost, $ 10.00 Old—building Permit N P. it N Signe ' " BY MINNEGASM _ ' Business P•hune 'No ROUGH FIN.r,L1 s -! s - s �� P.EPAIBS k ALTERATIONS—Rafor to Code .50 State Surcharge Description........................................5 5.50 TOTAL FEE •— aass �V Surcharge :50¢ Cit of Fridle y y PEI SUBJECT ro 14101 AT THE TOP OF THE TWINS BUILDING P E R M I T CEIPT NO. *r ______ COMMUNITY DEVELOPMENT DIV. r I PROTECTIVE INSPECTION SEC. f "1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 5/23/77 JOB ADDRESS 122 - 63rd Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 3 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Morrow 122 - 63rd Way N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Fetz Construction 321 W. 1st Avenue, Shakopee 445-3300 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 14' x 16' Addition to Dwelling 9 CHANGE QF USE FROM TO STIPULATIONS roams Odors ft' ft Cy to�1 utifittes SEP M -M PERMITS REQUIRED � WIRING, TElLrgo 1E • ELECMC 40 Etc, HEATINCI, PLUMBING AND SIGNS.. REQUIRED BY LAIN TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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. $6,070 $3.04 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- $22.40 STRUCTION OR THE PERFO MANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE yr 79 $25.44 SIGNATUr OMTAYbRORAUTHORIZEDAGENT IDATEI WHENOPERLLY,VA,LI�ATED THIS IS YOUR PERMIT LP 464)(1,Jim BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) I - CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: Ztc�aj aM p e,-' BUILDER: F eoL/S Address: _ 1,3 (, ace //1,'k_ Address: ���/ 44,1 Id �. Tel . No ,3 3 OU No.: /cfof- Street: LOT: BLOCK: 3 ADDITION: �OA &10 -Mk) ')W M6�,_ CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: 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: Z"'&'/74-Loodl Front: Depth: Height: / Square Feet: ��— Cubic Feet: /.41419 } _ C Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ p, To Be Completed: 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. See reverse side for additi-onal information. DATE: �j`''��- %� SIGNATURE: Stipulations: C;.R?. . vo r '11 n q MIL EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: /fie"� �l �A l�C� �Or� l�r� cam DATE SITE ADDRESS: J.�,� j62�,,/% � Z PHONE: CONTRACTOR:�l7n_ Determine working square footage of each, 1. Total exposed wall area...... sq. ft. x .17 = 2. Toal roof/ceiling area ...... �. sq. ft. x .05 = /�• �S Total exposed wall area above floor = ;;?,?, a. Total wall window area ................................. b. Total door area ....................................... w_ C. Total sliding glass door area dotal fireplace wall area ............................. . Total- wall framing area (average 10%) .................. 3 7,6 otal rim joist area .................................. 3 8 go wall area above floor .......................... h. wall area above floor .......................... 3 i. wall area above floor .......................... J. wall area above floor .......................... Total exposed foundation area = k. Total foundation window area.: ......................... 1. Total net foundation area above grade ................. Determine "U" value of each wall segment (e.g. window, door, each separate wall section) a. X uuSt o b _ b. X "U" C. 4( J X "v" d. X e. X f. X g- t/ull = Stull Stull • X "U" _ h. 3,3 X null i 49 7 = 1 X "U" _ • �3 J. X "u" r _ k. X "U" _ 1 X "U" _ . _10 Z. 0;-3.GG 4a If item #3 is the same as, or less than item #1, you have met the intent of SBC 6006 (c) 2. 3. Total " �1" Total exposed roof/ceiling area = m. Total skylight area ............................ n. Total roof/ceiling framing area (average 10%)... o. Total net insulated roof/ceiling area........... Determine "U" value for each roof/ceiling segment M. X "U" = n X "U" _ o X "U" 4......... ............... Total = If total of #4 is the same as, or less than #2, you have met the intent of SBC 6006 (c) 1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2. 1. + 2. _ 3. + 4. _ wvrA: use lUt of opaque wall area for frame construction WALL FIG.1 FRWM WALL 0... ,' ` V ./ pp•. ti E. f' � UG. #3 Cb FIG. #f4 '"" /` � �' /i( p • rc(� X x lit • /� 1 .:_ �t (= lir NOW'..: Indicate type, "R" 'value, depth and placement of insulation. .Construction R -Value 1. Interior air film 0.68 —Q 2. --�3. 4. 6. Exter3or air film 0.17 Total 1. Interior air film 0.68 • 2. 3. S. _� ice• 6. Exterior air film 0.17 Total a0 R 1, Interior air film 0.68 3. 4. 5. •`-"� 6. Exterior air film 0.17 Total S 1. Interior air film 0.68 o • 2. 3. 4. S. 6. Exterior air film 0.17 0... ,' ` V ./ pp•. ti E. f' � UG. #3 Cb FIG. #f4 '"" /` � �' /i( p • rc(� X x lit • /� 1 .:_ �t (= lir NOW'..: Indicate type, "R" 'value, depth and placement of insulation. ft ROOF/CEILING �.\ � �--•---tom . /ice ��� `--LJ • Vented Heat flow up FIG. I5 Feat floe up ;-vented � ..FTG. #6'.. . FO' Heat f low up - • ' . . PXG- 417 Construction R -Value 1. Interior air film 0.61 2. 3. 4. Exterior air film (still) 0.61 Total 1. Interior air film` 0.61 2. 3. 4. Exterior air film (still) 0.61 Total 1. Inside air film 0.61 2. 3. 4. 5. Outside air film 0.17 Total Note: Use additional sheets if more space is needed for details and calculations - CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND $ .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $ Boiler only up to 100,000 BTU GRAVITY WARM AIR: RATE TOTAL —' Job Address 1,-2 a— 6 " ^ Furnace Shell & Duct Work $12.00 $ gal. per hour Replacement of Furnace Repairs & Alterations -up to $500.00 7.00 7.00 $ $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 4.00 $�� Repairs & Alterations each add. $500.00 STEAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 _ gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 • $ AIR CONDITIONING $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ State Surcharge $ .50 TOTAL FEE $ 8,00 ROUGH INSP. IMI -0 FINAL INSP. Date APPROVAL FOR PERMIT REINSPECTION FEE ($10.00) 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. OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT / 3_ o — 7 �S� "—% ESTIMATED COST OLD NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER or POWER PLANTS, Steam, Bot Water, Warm Air- No. Trade Name Capacity 35�, nnected Load BURNER - Trade Name Size No. EDR BTU HP Size No. Capacity Sq. Ft. EDR BTU 's7-7 HP Company. Signed By Tel. No. _!� '2 ,-O 7` / Q MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE �/ — V OL Q"'L e 01 SUBJECT PNO. E City of Fridley 18739 AT THE TOP OF THE TWINS BUILDING PERMIT RE COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. J/p 1 ; I NUMBER REV. DATE PAGE OF APPROVED BY i 1� /"'1 CITY HALL FRIDLEY 55432 ---. •j L 612-571-3450 910-F15 11/5/86 JOB ADDRESS 122 - 63rd Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 3 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Morrow 122 - 63rd Way N.E. 574-9602 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. AM RE 3700 Annapolis Lane, Mpls. MN 55441 553-0030 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5. ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install soffit & fascia 9 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4,323 $2.16 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- $50.50 TRUCT�THERMA E OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $52.66 SIGNAGTj /o(CONTRACTOR R AUTHORIZED AGENT (DATE) ^ ,• WHEN PROPE RL ALI DATED THIS IS YOUR PERMIT 4 BLDG INSP SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI 01 NEW [ ] City of Fridley Effective 4/1/86 ADDN. I ] �R-1 AND R-2 ALTER. L ] Building Permit Application Construction Address Legal Description: Owner Name & Address: Contractor Address Tel. # `fie/ 9 Co 0 _ten 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: S Estimated Cost: $ -Y3 c;;L Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: �` S— APPLICANT: Tel. CITY USE ONLY Permit Fee $ CS• 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 $ Agreement Necessary [ ] Not Necessary TOTAL $ [ ] STIPULATIONS: SUBJECT I City of Fridley o 199490 AT THE TOP OF THE TWINS BUILDING PERMIT _ r CEIPT NO. -------- COMMUNITY DEVELOPMENT DIV. i r PROTECTIVE INSPECTION SEC. 1 � Q t 1 � NUMBER REV, DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 l .... ilk,,� L 612-571-3450 910-F15 6/13/89 JOB ADDRESS 122 - 63rd Way N.E. 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 3 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Morrow 122 - 63rd Way N.E. 574-9602 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 CJA NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 101 x 121.x 91 Shed in Rear Yard 9 CHANGE OF USE FROM TO STIPULATIONS Shed must be securely anchored to ground with slab or alternate method. 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 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 $5Q0 $. 50 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- $15-00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. P AN CHECK FEE TOTAL FEE $15.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHENPROPERLY V IDATED T S IS YOUR PERMIT BI DG INSP GATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 5/1/88 ADEN [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: a Legal Description: 14w rL t,9 r, g. 4j QINUA V / i !�l • Owner Name & Address: /�� w� �P ��°`G'%�®�' Tel. # Contractor: Attach to this application, a, Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVM AREA: Length Width Height Sq. Ft. GNU= AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Grownd a Sq. Ft. f OTHER: HER: � J► r' 1'` a / .tl W'� w4 R..esi ®e-", ; //) ^N V D .,� %" Q --1.3 A l� Corner Lot [ ] Inside Lit [ ] Ft. Yd Setback Side Yal Setbacks Type of Construction: W :,r3.Q Estimated Cost: Approx. Completion Date: ?ten '?,Z� Proposed Driveway Width If New Opening Is Desired: - Ft. $ $ Width + 61 See Back Page APPLICANT: �� Tel. # Permit Fee $ 6 CO State Surcharge $ -60 SAC Charge $ Driveway Escrow $ Park Fee ` $ Sewer Main Charge $ STIPUTATIONS: CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "Atl or Alt. "B11 Above Fee Determined by Engineering Agreement Necessary L ] Not Necessary L ] Surveyor's Certi'fi'cate Ste, 90t: Pa40 co. HARRY S. JOHNSON ROBERT R MEPrnrr/e LANO SURVEYORS Harm ' . hhnsom ss o iaes 10 621 FRANCE AVE. SOUTH I MILAN 2AF0 LIS 20. .MINNESOTA E TUi00 6.21001111111P or L.11,11,111, 1 A Orv�osPo' Zoe. IMAINA6E �9ND urn /Ty EASE A a 9 het*.by eettqy that thin 4A a t"e &" c4*t et 4"edeAt4tion of a AmAm y o f tlw- bmsow64 " o f .Cot 2,9tock ?, F U A FjZ 9 C K 5 D N R 9 V F R M A N D R, Anoka. Co unty, MimwAota. Ad "we yul by we fi/�.i s. 9 7A day 'of `I (%L f p 196 3. ` ° -0q SO BS'U.T.cP JOT h � - A Orv�osPo' Zoe. IMAINA6E �9ND urn /Ty EASE A a 9 het*.by eettqy that thin 4A a t"e &" c4*t et 4"edeAt4tion of a AmAm y o f tlw- bmsow64 " o f .Cot 2,9tock ?, F U A FjZ 9 C K 5 D N R 9 V F R M A N D R, Anoka. Co unty, MimwAota. Ad "we yul by we fi/�.i s. 9 7A day 'of `I (%L f p 196 3. ` ° -0q SO BS'U.T.cP JOT I SUBJECT PERM City of Fridley 213 71 AT THE TOP OF THE TWINS BUILDING PERMIT f ' , RECEIPT N COMMUNITY DEVELOPMENT DIV. j `% r PROTECTIVE INSPECTION SEC. (O I I , 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By �'"""� � ,'� 612-571-3450 910415 6/3/92 JOB ADDRESS 122 63rd Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 3 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Morrow 122 63rd Way NE 574-9602 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling 3700 Annapolis Ln, Plymouth, MN 55447 553-0020 2406 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dvel li ng 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED 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 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $9,600 $4.80 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- $117.00 Fire SC $9.60 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $136.40 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEIENP OP LY ALI AT THIS IS YOUR PERMIT OG IN P 6 ATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI I NEW [ ] ADDN [ ] ALTER[ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 6� " Legal Description: Owner Name Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 3/1/92 Tel. MN LICENSE # Tel. 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 Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ J Inside[ ] Ft. Yd k Side Yard Soacks Type T of Construction: i iEstimated Cost: $ ®D Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: "� `roti APPLIC Tel. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee $ Sewer Main Charge $ TOTAL $/ `V STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ I Not Necessary [ ] SUBJECT IT NO. City of Fridley 21725 21_� 2 5 AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ��� r i 1 NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 2/1/93 JOB ADDRESS 122 632 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 1 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ms. Lyga 122 632 Way NE 574-9661 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Shaw Chamberlin Roofing 999 E 4th St, St Paul 55106 224-2864 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Res i den tial 7 CLASS OF WORK O NEW. ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (18 Squares) Tear-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 1 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 $954 $.50 WITH WHETHER SPECIFI EREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME T G E AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O ANY TH STATE OR LOCAL LAW REGULATING CON- $25.00 Fire S�.' $.95 STRUCTIO THE ERF MANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC N/A $26.45 OF CONTRACTOR OR AUTHORIZED AG IDATEI WH4 P ERLYNVALIPjATED THIS IS YOUR /NATURE /PERMIT � A! + / -' BLD )NSP DATE SIGNATURE OF OWNER 0F OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/93 ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: / C=) / kD4/.'4 /. n'1►� � `/3� Legal Description: ' Owner Name & Address: 3 Tel. # T Contractor: G, MN LICENSE # ©® O -S I O� 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: L;� ��idth r ` Hgt/Ground Sq. Ft. OTHER: - 8 _— 1 S z /� S 1 i2 o r -)c Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: ��, �., ' � Estimated Cost: $ _ Approx. Completion Date: 27,5-- q3 oC (Cost on. Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ Or - DATE: - APPLICANT: 0-5X*0 Lwj, Tel. # 4141 ITY L ����� Permit Fee $ CO Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ ,� �� - Agreement Necessary [ ] Not Necessary TOTAL STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On March 1, 1996 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT y U 1 d, MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL 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** 1 $10.00 10-00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ Z0.5,0 JOB ADDRESS SW 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 codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. MORROW R I CHARD Ow r /2� jX 6 -33RD WAY FRIDLEY Building Used h.. H 174-9602 cw tj� Estimated Cost 00 PLUMBING COMP SIGNED BY v 61! 32 57q- 1&02 PERMIT NO. ll�q V7L4NAjAj4 �. Approved By/V-7— Rough -In Date MINIMUM FEE FOR ANY PLUMBING/ PLUS THE $.50 STATE SURCHARGE TEL N0. Final Date J ) it go PERMIT IS $20.00 **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES. suejECT T NO. City of Fridley 29550 AT THE TOP OF THE TWINS BUILDING PERMIT r R O . � `L ______ COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION +�`,s� j CITY HALL FRIDLEY 55432 I'' ce/ r NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-FlS 5/25/99 JOB ADDRESS 122 63 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 3 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Morrow 122 63 Way NE 574-9602 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Suburban Exteriors 9701 Penn Ave S STE 107, Bloomington MN 55431 881-8232 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 4289 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (34 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,913 $1.46 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 $2.91 ST UCTION OR THE PERFORMANC OF CONSTRUCTION PLAN CHECK FEE TOTAL EE o�� Lice $5.00 92.62 I ATURE OF CONTA A&eFrOR AUTHORIZED AGENT ATE - EN ROP ALIDAT D HIS IS /F7 S.GNATURE OF OWNEROF OWNER BUILDER$ IDATEI fkat.Nsp �IAtE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ SINGLE FAMHLY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: l oZ Legal Description: rd U j «�� I -tu3�6 Owner Name & Address: kt�a% f �1 OIA-A.Ktr- Tel. # i q 'moi Contractor: az ru MN LICENSE # e-1 02 Address: q O PAry\- . aNj-p- -. -s--ta. ,-/ o 2 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: $ / Driveway Curb Cut Width Needed: Ft. + 6 Ft = _ _Ft x $ DATE: � -, - 9 G APPLICANT: / Tel. # g 1 a STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ C) 0 $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: 4� CITY OF FMLEY PERM NO.: 2004-00813 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/02/2004 572-3604 k'A2L: (763) 571-1287 ADDRESS 122 63RD WAY NE PIN 153024430018 LEGAL DESC EVA ERICKSON RIVER MANOR LOT 2 BLOCK 3 PERMIT TYPE HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 6,200.00 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. REPLACE FURNACE (WARM AIR, CARRIER, 70,000 BTU'S) AND AN AIR CONDITIONER # A/C UNITS 1 # FURNACES # GAS DRYERS APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304 - OWNER MORROW RICHARD A 122 63RD WAY NE FRIDLEY, MN 55432 0 # GAS RANGES AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. I:. _ ;, 10 HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 5663 RR.PARATF PFRMTTR RPOTTTRFT)FOR WC)RK CITTTFR TWANTIFRCRTRF.n AROVF. 1 0 0.00 35.00 0.00 0.00 25.00 0.50 60.50 CITYC�FR31DLEY BUILDING INSPECTION 9 ;431 University Ave NE 9=ridley, MN 55432 L 763-5723604 FAX 763-571-1287 9 D RATE SCHEDULE Residential Furnace Shell and Duct Work, Surner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) ZI Gas Range Gas Dryer *Air Conditioning -All Sizes �o r� Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS `� oZ Cn r 'y� S Fee Total Owner $35.00 $ 3!S Building Used $10.00 $ ESTIMATED COSTACOi� Do • OCA PERMIT NO � r � $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ $25.00 $ All Other Repairs or Alterations (List on Back) r 1% of Value of Appliance or Work $ a Minimum Fee $15.00 for Residential or 5% of cast of Y Improvement whichever is greater on work less than $300.00 i 5 Commercial lindustrial/Institutional } 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/industriaVirtsi.itutional 50 Y State Surcharge $ ' 1 TOTAL FEE $ ` S0 v v REINSPECTION FEE $50.00/HOUR IT *Air Conditioners can not be placed in side yard without written approval N from adjoining property owner - copy to City N FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE EL cc # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name (► facer r .4'Ff MVP Size No. BTU I ®r a o HP EDR Fuel _ /%B �. (_Total Connected Load- 3V-7Y-4 oad3V-7Y-4 030 49 XX � v1 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 aocordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations s$1ed �` ' 1� 1e and correct. CFr,ier o►n -i562 Central Ave fJE HEATING CO -1- Signed Tel #�lr3 _ �TS7- (�v� FAX # Date - 24 -®Y L Approved Rough -in Date Final Date �S EO * d Idlol 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 >Cr No( } The venting system is plastic/PVC Ond meets all current codes and manufacturer termination. Yes No( ) specifications including sizing, length, number of elbows and Sn e r'2N q The undersigned also verifies that the replacement unit is a listed assembly W!� -o C, and meets the current codes ar d -manufacturer's specifications. This does include AGA-GAMA Category I CQntral Furnace Venting Tables for fan draft Yes > No( ) assisted and natural appliances. The existing combustion air is sized and installed to meet the current codes and manufacturer's spec cations. 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 *J, 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 -LAMA Category I Central Furnace Yes X No ( ) Venting Tables for fan assisted and natural draft appliances. 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. Yeses[ No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance 01 Type 4-144e 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 614 l-3 Vent Height _/�' Diameter inches Appliance #1 Vent Connector Height2 L ft Length 3 ft Diameter• V ^ in Type G� C Appliance #2 Vent Connector Height ft Length ft Diameter' in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type a HEATING CO: Po' --k k Sn e r'2N q Orli 0 C W!� -o C, Signed By: Date: FA/Fn I A tGl A. AJ ' Ol A 1791 NA A0 J.1 r a wnH-I qP : T T b®0Z—LZ—Nc4b AGh C'i00ftifit- • , M/ rld HEAT LOSS Yes DATE HTG. INST.( —�—a SOLD BY CenterPoint Energy Minnegasco Electrical Work By _ TYPE OF HEAT X77 SPACE HTR. GAS DESIGN MAKE Ca ry 0P -e -A Model K - t3 J Serial f9 (J NPUT 421. ao 62 12 CONTROLS Pressure Percent CO2 IT Za nput CFH Percent 02 If A Stack Temp. �/� Percent CO /0j2M APT. _ OWNER FLOOR CITY J Le 4— INSTALLED BY CenterPoint Energy Minnegasco Gas Line By --f UNIT HTR. OTHER CONVERSION Vent Size _ y4�- KIND OF LINER /8'/i�ti0�'� SIZE NONE Draft Hood jxCeiJ Regulator Filters Size F L Number 1 Chimney Location Inside d/ Outside Chimney Construction 61d" 13 Wiring Test Tag l/ Lighting Inst. (/ Date Tested 1/0 — Company Testing CenterPoint Energy Minnegasco Name of Tester CITY OF FRIDLEY PERMIT NO.: 2004-00814 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/02/2004 572-36U4 FAX: (763)571-1287 ADDRESS : 122 63RD WAY NE PIN : 153024430018 LEGAL DESC : EVA ERICKSON RIVER MANOR : LOT 2 BLOCK 3 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. REPLACE FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT CENTERPOINT ENERGY/NIINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304 - OWNER MORROW RICHARD A 122 63RD WAY NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 5663 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp. Date SEPARATE: FI RMITS REQUIRED FOR WORK OT1-iER THAN DESUKIBED ABOVE. :ITY OF FRIDLEY INSPECTION DIV. ®Og D5 Effective April 1, 2004 431 University Ave NE Adley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLEn nN FACH FI nnR ILUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 6&4-A& - 0.S a -LJ Nw- lew Fixtures $10.00 I T MW 1W!1A1=�ffl0=M The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes Seer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Ilow Off Basin $1.0.00 and representations stated in this application are true and correct. :atch Basin $10.00 $10.00 MORROW, RICHARDq� /�� Iain Water Leader 2005 122 63RD WAY NORTHEAST ;ump/Receiving Tank $10.00 FRIDLEY, MN 55432 Vater Treating Appliance $35.00 OWNER (763) 574-9602 Vater Heater -Electric $35.00 Vater Heater - Gas** 1 $35.00 11 BUILDING USED AS �SI d ey1C� Sas Range"* $10.00 Sas Dryer** $10.00 ESTIMATED COST` �� PERMIT NO. lack Flow Preventer Required ( )Yes () No ILUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 6&4-A& - 0.S a -LJ Nw- lew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes Seer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Ilow Off Basin $1.0.00 and representations stated in this application are true and correct. :atch Basin $10.00 $10.00 MORROW, RICHARDq� /�� Iain Water Leader 2005 122 63RD WAY NORTHEAST ;ump/Receiving Tank $10.00 FRIDLEY, MN 55432 Vater Treating Appliance $35.00 OWNER (763) 574-9602 Vater Heater -Electric $35.00 Vater Heater - Gas** 1 $35.00 11 BUILDING USED AS �SI d ey1C� Sas Range"* $10.00 Sas Dryer** $10.00 ESTIMATED COST` �� PERMIT NO. lack Flow Preventer Required ( )Yes () No `` Type $15.00 PLUMBING COMPANY O (-�` a% -A l�nM t Zeinspection Fee $50.00/Hr SIGNED BY TEL N0.%ol2) 92%— 033 kLL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ - MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ �S•� OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. ,;OMBUSTION 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 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 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( ) Avollance 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 :