PRE 2010 DOCSCity of Fridley
suaJEcr PE
o 17846
AT THE TOP OF THE TWINS
BUILDING PERM
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION
r PROTECTIVE SEC.
1 . ,
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
'/'11,
.-•-�
L 612-571-3450
910-F15
1/25/85
JOB ADDRESS 20 - 64th Way N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt. 2, 3
15
Fridley Park SHEET
2 PROPERTY OWNER MAIL ADDRESS_ ZIP PHONE
Herb Knutson Const. 11501 - 134 1/2 Avenue North, Dayton, MN 421-8257
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
JJ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ -REMOVE
8 DESCRIBE WORK
.MK Construct a 241 x 381 Dwelling and a 22' x 221 Garage
'SEPARATE PERMITS REQUIRED FOR
9 CHANGE OF USE FROM G .
s FLUMEN114 „l,)
MC''JIRINGTOHEAT
MvC'derifying
STIPULATIONS provide City with copy of survey before capping. Provide sod
in the front and side yards.. Provide a hard surface driveway. Builder agrees to
ensure that adequate drainage facilities will be maintained to prevent flood damage
to newly developed property and existing buildings in this area due to surface wate
runoff. Temporary facilities may be constructed due to winter conditions at time
of project start but a permanent solution must be approved and completed before
construction is completed and occupancy is established.
SEWER LOCATION: (Approx. 8' Deep in Street) 47' E. of M.H. (E. INV. ELEV. 832.93)
WYE ELEVATION: 833.02 TOP OF FOOTING: 836.52 Minimum AI
WATER LOCATION: 10' E. of Sewer Service.
THE CITY OF FRIDLEY DOES NOT GUARANTEE THE before digging calf (ora( utifri�
r£L£PiiOJ£
ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS, m CLQ CTr;I GAS Eto
THIS DATA IS FOR INFORMATION PURPOSES ONLY, REQUIRED ByLA �
AND PERSONS USING THIS INFORMATION SHOUL'2. /
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
I
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
$53,250
$26.63
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 COW
PERFORMANCE CONSTRUCTION.
$295.00
$425.00
STRUCTION OR THE OF
LAN CHECK FEE
TOTALFEE
\
$73.75
$820.38
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT 7(DATEI
WHEN PROPERLY LI DATED THIS IS YOUR P RMIT
BLDG INSBATE
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) •
NEW [� City of Fridley Effective 4/1/84
ADDN. [ ] �R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: v
Legal Description: -- n-•�
Owner Name & Address: Tel. °�=�1 Tel. #
Contractor: o ��- #�
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 QL
Width _
Height
Sq.
Ft.
Length
Width =
Height
Sq.
Ft.
Length
Width
Hgt/Ground
Sq.
Ft.
Inside Lot EN . Ft. Yd. Setback S-7 Side Yard Setback )CD -SL
Type of Construction: ���'� ��� - �� Estimated Cost: $
Nil
Approx. Completion Date:
Alt. A Alt B
,
Proposed Driveway Width If New Opening Is Desired: \(__ $ x $
See Back Page for Explanation
DATE: APPLICANTS Q� �= Tel.
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
CITY USE ONLY
$ ,66 Fee Schedule on Reverse Side
$ 91.70 25% of Building Permit Fee
$ Z4+` 3 $.50/$1,000 Valuation
$ y s,ew $425 per SAC Unit
$ �' Fee Determined by Engineering
$
TOTAL ` $ 2 20.35
LA
STIPULATIONS:e
�o
Agreement Necessary [ ] Not Necessary [ ]
ao
1
n
/10
All of Lot 3 and that part of Lot 2 lying West of the East 13.00 feet therec
FRIDLEY PARK, Anoka County, Minnesota,
ensionstogether
acrosswith
it ofthat
theaEastfandthe
Westtl:
vacated alley lying between the
above described property.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
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 Neater
Gas Range
Gas Dryer
NO.
s
I
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
Is of Value of Fixture or Appliance
Reinspection Fee $
($15.00)
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
State Surcharge
TOTAL FEE
Ettectrve Aug. 1, 19u1
Job Address 1 Z104-1-1
Department of Buildings
City of Fridley
Tel. 1571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Q� Fridley, Mn. , 1g�-,
OWNER �iiriL1� ,
KIND OF BUILDINGJZ�r-�
USED AS
TO BE COMPLETED ABOUT
ESTIMA/T-EDD COST l
TOTAL OLD F NEW yUILDING PERMIT NO. PERMIT NO. 9�
Company
$ Signed
$ Tel. No.
S
$
ROUGH INSP.
$
Date
:01
m
$
a
_
$
U
$
x
e
APPROVAL FOR PERMIT
Water
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a
H
.ci
w
e
A w
pa,
w
g�
Neater
w
m
w
a e
e 4
41 WuAga
'ggt
u
o
au
a'i
o�
ow
1.g
3
V
a
o
s
lec
lot
1
I
2nd
3rd
4th
(R) - Future Connection Opening
Connected with Sewer
(�) - New Fixture, Old Opening
Water
RATE SCHEDULE
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 Neater
Gas Range
Gas Dryer
NO.
s
I
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
Is of Value of Fixture or Appliance
Reinspection Fee $
($15.00)
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
State Surcharge
TOTAL FEE
Ettectrve Aug. 1, 19u1
Job Address 1 Z104-1-1
Department of Buildings
City of Fridley
Tel. 1571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Q� Fridley, Mn. , 1g�-,
OWNER �iiriL1� ,
KIND OF BUILDINGJZ�r-�
USED AS
TO BE COMPLETED ABOUT
ESTIMA/T-EDD COST l
TOTAL OLD F NEW yUILDING PERMIT NO. PERMIT NO. 9�
Company
$ Signed
$ Tel. No.
S
$
ROUGH INSP.
$
Date
$
$
FINAL INSP. 4,+�
_
$
Date
$
$
APPROVAL FOR PERMIT
S
S . So
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
`�� PLUS THE $.50 STATE SURCHARGE
y
3_
CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N E . FRIDLEY. MINNESOTA 55432 • PHONE 16121 571-3450
July 2, 1985
Herb Knutson Construction
11501 - 134 Avenue North
Dayton, MN 55327
Re: 20 - 64th Way N.E., Fridley, MN
Dear Sirs:
A reinspection was conducted on July 2, 1985 for the purpose of determining
if the items outlined in our letter of May 30, 1985 had been completed.
There are two items that still need to be supplied or corrected:
1. Submit a verifying survey to the City by July 15, 1985.
2. Regrade and resod the front yard along the wes-t property line. The
drainage swale must be located on the property line and drain either to
the front, over the street curb, or to the back, into the 'retention
pond/drainage outlet. The only other acceptable method would be to get
approval from the affected property owner to the west, to grade it
differently. This must also be completed by July 15, 1985.
Your cooperation in these matters will be appreciated. If you have any
questions, please contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
CC: Mark Burch, Asst. City Engineer
SUBJECT
City of Fridley
30076
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
f PROTECTIVE INSPECTION SEC.
9
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
L 612-571-3450
910415
8/18/99
JOB ADDRESS
20 64th Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt.2 & 3
15
Fridley Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert Smith
571-6124
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
American BldjZ. Contractors 12247 Nicollet Aate S- Bu3msville
55337 707-6959
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 X3 REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (20 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO 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
$1748
$.87
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-
STRUCTI OR PERFORMANCE OF CONSTRUCTION
$63.15
Fire SC $1.75
/�,
��'7
PLAN CHECK FEE
License
5.00
TOTAL FEE
1 $7V.477
SIGNsruREOFCON TRACTOR ORAUTMORIZEDAGENT (DATE.
NOP
ALIDATED IeR PER
SIGNATURE OF OWNERoF OWNER BUILDERI (DATE,
B G INSF'
T1ATE
. .. w L - J trlectrve 1111 98
ADDN[) CITY OF FRIDLEY
ALTER [ ] 444)ff"iGLE FANMY AND DUPLEXES R -I AND R-2
BUILDING PERNIIT APPLICATION ,A v a
� 5
ConstructionAddress. "?o
Legal Description:
Owner Name & Address: Tel. # I2- , 2
Contractor: -__j4-A4ej24 CAtJ 6 ct.l t.j)?CO6 GV�CrV/M .,. MN LICENSE #,2016 4 3 3
Address: ofd Allcm LL8-r-41/ S. &kAa✓lc-c-t-- Tel. # 612--7o 7 62Z
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.
DECD AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
,p
Construction Type: Estimated Cost: S �� / ��r6
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
(o[2— 707-0"er
DATE: / _ q i APPLICANT: ii� k�' Tel.
Permit Fee
Fire Surcharge $ - %S .001 of Permit Valuation (1/10th%)
State Surcharge
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY
$ Fee Schedule on Revcrse Side
$ C� � $.501$1,000 Valuation
SAC Charge
$ $1000 per SAC Unit
License Surcharge
$ U U $5.00 (State Licensed Residential C
Driveway Escrow ontractors)
$ Alt. "A" or Alt. "B" Above
$ , $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
r
f,
t
GI FY OF FRIDLEY IN61-E(; I ION DIV.
Effective On Jan 1, 2000
6431 University Ave NE
Fridley, MN 55432
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
I
Was
.........
Floor Gas
Auto. Water Heater
Stories . ... . ..... . ..
Urinal - - - - - - - - - - - - - - - - -----
Shower
Tra
.0.0N....'
Drain Dow Washer Range Gas jElec
Basement
----------------- . . . . .
. ..... . ......
... ..... . . ......
.. ......
Floor I
Floor 2
Omni
sm
...
. .
. ................ . . . . .. . . .... . . . . ...............
Floor 3
...........
.......... ...
. . . . . . . . . . . . . ......
. ........
Floor 4
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
JOB ADDRESS
New Fixtures
$7.00
j
The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture
$4.00
specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser
$5.00
and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin
$7.00
and representations stated in this application are true and correct.
Catch Basin
$7.00
Rain Water Leader
$7.00
Co 200e
Sump/Receiving Tank
$7.00
Water Treating Appliance
$10.00
Owner
Water Heater -Electric
$7.00
Water Heater - Gas**
$10.00
Building Used As
Gas Range"
$10.00
Gas Dryer**
$10.00
Estimated Cost PERMIT NO.
Back Flow Preventer Required )Yes No
Type
$15.00
PLUMBING COMPANY
Reinspection Fee $47.00/Hr
SIGNED BY TEL NO..e7,f
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
'o09
1009-
1.5% of Value of Fixture or Appliance
ApprovedBy Rough -in Date Final Date
4
State Surcharge
$ .50
TOTAL FEE
_51ZD
$=,
MINIMU ANY PLUMBING/GAS PERMIT IS $20.00
PI US THE S.50 TATE SURCHARG
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
t
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes ( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type _
Appliance #2 Type _
Appliance #3 Type _
Total Appliances
Common Vent Type
_ BTU Input
BTU Input
_ BTU Input
Total Btu Input
Fan Assisted or Nat
Fan Assisted or Nat
Fan Assisted or Nat
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 :
W2
SUBJECT
ePERMIT NO.
City of Fridley
31208
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
i COMMUNITY DEVELOPMENT DIV.�,f
try
PROTECTIVE INSPECTION SEC.
F �
CITY HALL FRIDLEY 55432
NUMBER
REVDATE
PAGE OF
APPROVED BY
l 612-571-3450
910-F15
___[7/17/00
JOB ADDRESS 20 -,64th Way NE
1 LEGAL
LOT NO,
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 2 & 3
15
Fridley Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Bob $ Janet Smith 20 - 64th Way NE
3 CONTRACTOR MAIL ADDRESS 2936 Quail Ave. NO. ZIP
PHONE LICENSE NO
JW Williams Const., Inc. Golden Valley, NN 55422 612-791-0397 20125107
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 t ALTERATION O REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Finish Basement
9 CHANGE OF USE FROM TO
STIPULATIONS
For stipulations, see attached plan.
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 ME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES OVERNING THIS TYPE OF WORK WILL BE COMPLIED
$25 OOO.00
$12.50
WITH WHETHER SPE FIED HEREIN OR NOT. THE GRANTING OF A PERMIT
f
DOES NOT PRESUME O GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PgOVISIONS Of NY O ER S ATE OR LOCAL LAW REGULATING CON-
SC $25.00
STRUCTION HE PERF RMA CE OF CONSTRUCTION
$391.25
re
PLAN CHECK F
TAL FEE
%7-
Lice e C 5 00
$433.75
SIGNATURE OF CON'RA OR ORA NORiZED AGENT tDATEi
HE RO R VA ID D THIS IS Y P �
_
7r
S-GNATURE OF OWNEROF OWNER BUILOERI iDATE.
8L G -NSP
0ATE
W2
NEW []
ADDIS! []
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: x b yr--#
Legal Description:
Owner Name & Address:
,-/ 3 P --
STIPULATIONS: /3a -
Effective 1/1/200
(763) 572-3604 Bldg I p
i
Tel. # ! Q -q
MN LICENSE # e?,01951tJ7
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:
W&4 00
Construction Type:a4v-lpEstimated Cast: $ D
OO
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $Z/
_ $
DATE: 1,0-00 APPLICANT: �. Tel.(61A 7f1" 0396
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ F wcc. Fee Schedule on Reverse Side
Fire Surcharge $ -'Z�,' ®® .001 of Permit Valuation (1/10th%)
State Surcharge $ /.2. S'® $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$ $1100 per SAC Unit
$ 64 $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
P
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary ( ]
TOTAL s-
STIPULATIONS:
Y r : t T ' ' L t yy ' E' ,7Y•Y?, '• � t r ° '9F .S l +i y� °: Y' s. L �p L
ld r u � ' • .v i � y°r 4 w n : da9 t FP„ . •� � it :w ,,,m:���` i�< 1 �`�3 .
L q tr � ;.'�' 1z. i t P ♦ .y 4'+�'C'� ♦}1 5..��',. ti r tir n ti p•-4,;�':..!4j ,7„�si a .:,•� �
^� t �y y� i�r � � s °j. �'�t .,�r'� �: ';•1!>� ti v r r - i!• Y .. s 7C.. D�
e',r. 4!� I. tCj• q}i, !i hµ+�� t, >� Shy �!% 1+� -.J' �'� >-t ?� y.. t t ,v
i4 AL •N Mkt P1 .�t r >• ,ice✓ 1 ' ! .r+ r y `'4 fy� c
r y + "+ TP,�,.�a •.jj �„ R 1'^,g t i,�rAA i ,* • f .y �htw L !
.1 A'' .rL:% 3Jv`�•: . 'k }yKi•` ..w ;t �'^4iR j' ,+. + 3ry .7'P" • > `• ••y
,i;..' .. ..''�.* :y? '� 'j '°j.t r, •.trkA1. b/d�/, •� � .+Y�..�. is
y„°sy,. ��I°. +'�wq '• p ' •'.'rte'+
e2w- el
Eli .. F �! % fir. r T Z ..��f ` ya M t-- r v1�sY°•, ^�
`%MW
.
sem►? i:R `•'
�•(�� � � �"^�Ya., r �,w.Is� t� a dIw ��•.� x"3 �,��ryU r '�°�� � a r'_1� o •i
I Apt
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CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 2000
JOB ADDRESS '
OWNERab�����
TOTAL �
BUILDING USED AS CCf:: .
ESTIMATED COST C� C _00PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name 'Size No.
BTU HP EDR
$ Fuel Total Connected Load
Burner Trade Name Size No.
so- BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$D VOGT HEATING & AIR cONwIONING
3260 GORHAM AVE DATE
ST. LOUIS PARK, MN 55426
HEATING 0
SALES 929-6767 SERVICE 529-4011
Signed c TEL # q�� J 766 77-
dr-�Cuq% �
Approved By Rough -In Date Final Date ®®
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
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 existina combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
It 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
VOGT HEATINGAIR CONDITIONING
3260 GOR"A
HEATING CO: ST. LOUIS PARK, MN 426
m. SAI.FC 09dA7R7 Qr-0 G nlift-emi
• • 1 ...� i��l��Date
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 t'AX: (763)571-IZ57
ADDRESS : 20 64 WAY NE
PIN : 153024410088
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-01806 pq 1
DATE ISSUED: 10/05/2004
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114 -
OWNER
SMITH ROBERT F & JANET S
20 64TH WAY
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of 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.
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 118132
SEFARNI E FEKMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By-
763-572-3604CITY
OF FRIDLEY
Date Rec'd:
DATE (o YOUR E-MAIL ADDRESS
SITE ADDRESS S M*64 c urs
THIS APPLICANT IS: ❑OWNER *0NTRACTO Janet Smith -Schroeder
PROPERTY NAME: 20 64TH WAY NORTHEAST
OWNER/ ADDRESS: STATE ZIP
TENANT Fridley, 55432
PHONE:
CONTRACTOR NAME:
SUBMIT A COPY OF STATE LICENSE # EXP DATE Z &
YOUR STATE ADDREs S CITY Dl1 STATE/GI�ZIP ssyoq
�20 �7&�ezr_ke
LICENSEOVITH pHONE�FAX
APPLICATION
PERMIT TYPE
KSINGLE FAMILY ❑ TWO FAMILY - ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW XREPLACEMENT
DETAILED DESCRIPTION OF WORK RgAL .c. "&111 160A. �
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500:00,: whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This.should_reflect. only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 =
0".ROJECTS WHERE LABOR EXCEEDS--S500—FEES ARE BASED ON $10.00 PER FI)(TURE, EXCEPYWHI;RSNUT:ED-:FIXNMESa-. INDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINK/LAV DRAINS _ SHOWER _ WATER PIPING
_ _FLOOR
_ GAS PIPING (NEED crj7ucEm)^ SWIMMING POOL WATER SOFTNER ($35)
—BATHTUB _
CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15)
_ _
_ LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION
_DISHWASHER
WATER METER OTHER
Permit Fee $ 35".00
Number of fixtures @ $10.00 x $10.00 = $�
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.60 = $
TOTAL DUE $ 1 .5-0
State Surcharge = $ .50
Total = $
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case I work hich requires review and approval of plans.`
SIGNATURE OF APPLIC PRINT NAME 'J* � IOC`j 10l ie" DATE
L 0_3 �R 6=,Si..1AwNL^�§.VW H A�L�Efi" 14 &.� III!§il 8' fY[�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-5024977
P-3
Building ��
MECHANICAL
Permit No.:
Inspections C�
RESIDENTIAL APPLICATION
a aived By:
763-572-3604RJAY
3 2�� %
CITY OF FRIDLEY
1 /
O O
DATE \ YOUR E-MAIL ADDRESS
SITE ADDRESS oao O
THIS APPLICANT IS: ❑ OWNER VC0 CTOR
PROPERTY
NAME: babe r S YV� i �1n
OWNER/
TENANT
ll
ADDRESS: d -�� STATE �1NLIP 5�3�
a� �°�— �� �� C11y r i
PHONE: -llo3`S-1 %' La kA�
CONTRACTOR
Co1vlPANY NAME: CENTERPOINT ENERGY
SUBMIT A COPY OF
CONTACT PERSON: JOANN Z INKEN
STATE LICENSE # EXP DATE
YOUR STATE
LICENSE WITH
ADDRESS: 9320 EVERGREEN BLVD STE BITY "COON"'RAPIDS sTATEMN zIP55433
APPLICATION
PHONE 763 - 757 -- 6202 FAX 763--757--6701
PERMIT TYPE
& """''E FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK l,. r 4e-
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG: ��i.�� MODEL: u P f4 -0-7 SIz>® s cC�O
MFG: MODEL: L• O SIZE/BTU t z S
MFG: MODEL: SIZE/BTU
A/C $25.00 _FIREPLACE (GAS) $15.00 _, GAS RANGE/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILER $35.00 1FURNACE $35.00 UNIT HTR $10.00
_GAS
CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENT LATOR $15.00
s
-Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50
Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $
Number of fixtures @ $25.00 1 x $25.00 = $
Number of fixtures @ $35.00 k x $35.00 = $ 2S.
State Surcharge = $ .50
Total = $ (e10.1SO
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and' accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
n
�\
SIGNATURE OF APPLICANT �• Lf '1' NAME ROGER HOFFHEIN DATE k ' O(o - 0%
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.