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PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PERMIT • -,I®A 4 �o Date: ................................ Owner %../.. Builder .... ...... Address...... .... Address ..... ....... `� ezltrON OF BUILDINGrNo. G. "...... Street �`�...�.!�...................... Part of Lot . 1✓�. A� //............ . Lot .... /........ Block ...................Addition or Sub -Division .......... ... ......... Corner Lot ........... Inside Lot ........... Setback ........... Sideyard.............. .. DESCRIPTION OF BUILDING To be tis das: amu, Front J ..... Depth ! .... Height Sq. Ft./PO Cu. Ft. ........ ..................... Front ........ Depth .. Height . Sq. Ft. ........ Cu. Ft. ........ Type of Construction �Q !�..... Est. st ..�.� �........ 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 all provisions of ordinances of the village of Fridley. J 6 In consideration of the payment of a fee of $. 1/ ......, permit is hereby granted to ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, 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 violatio f any of the provisions of said ordinances. ....... .. � ding Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. • • • City of Fridley, Minn.. BUILDING PERMIT Date: RM July 28, 1967 owner: Duane E. Haason Builder dame Address _365 66th Ave. N. E. Address Same No. 365_ Street Lot --1-0--- Block LOCATION OF BUILDING 66th Ave. N. E. part of Lot Corner Lot --- Inside Lot Sewer Elevation 5 N9 9378 Addition or Sub -Division Rive Creek Terrace — Setback —_ Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Breezeway Front 12t Depth ._._..101 Height 101 Sq. Ft. Ca. Ft Front Depth Height Sq. Ft. _ _ Cu. Ft. Type of Construction _Frame Est. Cost ,^_._500.00 __ To be Completed NRV: 1. 1967 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 afl provisions of ordinances of the city of Fridley. Al , In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to Duane Hanson to construct the building or addition as described above. This permit is granted upon the express condition that thele to whom it is granted and his agents, employees and workmen, in eII work. done in, around and upon said building, or any part thereof, shall conform in allrespects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions asdd ordinance. CLARENCE BELISLE Building motor NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas hosting, sower or water. Be aro to ago the Building I gmftr for separate permits for these innuw I.... IN AMLI.".�'G:i 3jIIi,D.,,r..G Ci sY OF. i :i+_O:�ti i, MINNESOTA OWNER'S NAI -19 BU'',1-DER ` 1p e ADDRESS �6 5 6 LOCATION OF BUILDING 170. STREET � -- _ - PART OF LOT LOT L.' BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SET -BACK SIDE -YARD SMMM ELEVATION FOUMATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To fie Used M: ,-- Front ! Depth Height ` D Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construct'io A P-701 �� 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 representations stated in this application are true and correct. DATE J_/ SIGNATURE ` (Schede a of ee Costs can be found on the Reverse Side}.* ' i Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. ``Phone 560.3480 6 GRAVITY WARM AIR: RATE TOTAL Locatlo 2 5:� " 6 C s �- Furnace Shell & Duct Work ........................... $10.00 Replacement of Furnace ............................. 6.00 Repairs & Alterations—up to $500.00 .................. 6.00 Repairs & Alterations each add. $500.00 ............... 3.00 MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 each add. 60,000 BTU ....................... 3.00 Replacement of Furnace ............................. 6.00 Repairs & Alterations—up to $500.00 ................. 6.00 Repairs & Alterations each add. $500.00 .............. 3.00 STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 Each add. 200 sq. ft. EDR Steam ...................... 3.00 Each add. 320 sq. ft. EDR Hot Water .................. 3.00 OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM It ALTERATIONS & REPAIRS TOTAL FEE $� ROUGH FINAL A0 IV- City of Fridley: The undersigned hereby makes application for a permit for the work hereit 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- R y 19 LL Owner Kind of Building Q Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name �".e 234� Size No-i"� � Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Bind of Fuel.�o BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. V 4E (REMARKS—OVER$ Signe ftLf By --Z IAI-= �P Business Phone No -7 `� Cify of Fridley Appka*m for Numbbq and Cat Rnk9 Femb 52_84-915.51 Dept. of Bldgs. Phone 980-3490 DESCRIPTION OF WORK Number, Kind and Location of Fixtures I 365 NE. 66 Ave. �a• ` • 3` irA � � O t V �Qj < • -� • N WATER MTR. GAS C. Base 1st 2nd 3rd 44th • Future Connection Opening's * New Fixture, Old Openings Coanecled with sower ❑ spool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 $ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater :Up to 99.000 BTU) .... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water heater .............. : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL lst 3 Fixtures .................. 1 x $200 $ 2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 198.000 BTU ............. x $5.00 $ install (1) gas grill 3.00 REPAIRS A ALTERATIONS—Refer to Code Description ..............................................$ T,oTAL FEE s 5.00 City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the Cita Ordinance and ruling of the Department of Buildings, and hereby declares that aR the fact and representations stated in this application are true and correct Fridley, Minn Aug • 3, 1971 „ 19_ owner _ Duane Hanson Kind of Building - .frame Used as residence To be completed about Aug. 6., 1971 Estimated Cost, $ 10.00 Old XNew. Building Pe ' No. Pe `/ By - Business Phune No ROUGH FINAL !J' til. . CAa$s -pr Surcharge .50% SUBJECT PERMIT N,. City of Fridley 2 O31 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. 16 L ______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 9/5/73 JOB ADDRESS 365 66th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 & W 20 a LOT 9, B ock 2, Rice Creek Terrace Plat 2 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Duane Hanson 365 66th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central N.E. 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 ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside, gutter, aluminum trim 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. Aluminum 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 $2,000 1.00 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 PERFO MANCE OF CONSTRU TION. PLAN CHECK FEE TOTAL FEE $13.00 SIGNATURE OF CONTR OR OR AUTHORIZED AGENT- (DATE) N PROPERLY VALIDAZED THIS IS, YOUR PERMIT 18tDkTj SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME • 1 u A- P L -s`` -(— (i N S c� n) BUILDER:_ r � ADDRESS: 3 �-� - �v� A u&- N Le ADDRESS: Le :V r NO • . 3 Co S STREET: A,) cs A% LOT:— --BLOCK: ADDITION• CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING -Front:- Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction; ° G ti*v Estimated Cost: o� d ®O, n .............. f To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stfict 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: S, ` � `�`. SIGNATURE: (See Reverse Side For Additional Information.) /a. SUBJECT PE City of Fridley18045 AT THE TOP OF THE TWINS BUILDING PERMIT R • COMMUNITY DEVELOPMENT DIV. ' Lu ------ r 1 PROTECTIVE INSPECTION SEC. / t7 1 � = CITY HALL FRIDLEY 55432 NUMBERR EV. DATE PAGE OF APPROVED BY 612-571-3450 I 910415 [ 1 6/6/85 / / -- -- JOB ADDRESS 365 - 66th. Avenue N.E. 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Pt. 9,10 2 Rice. Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Duane Hanson Al 365 - 66th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Trnprovement Inc. 7401 Central Avenue N.E. 784-7543 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 Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be the 2nd layer but not the 3rd. Install ridged galvanized valleys. 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $li 410 $.7o 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 PROVISI S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $25.00 ST O OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE y dS s) $25.70 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DA TEI WHEN PROPERLY V I ATE T IS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATEI BLDG INSP DATE NEW [ ] City of Fridley Effective 4/1/84 ADDN. L R-1 AND R-2 I ALTER. [ ] Building Permit Application Construction Address: .5- 1/0 f ��e_ lie - Legal Description: -- Owner Name & Addre��s��s^^: /����e NSO Tel. # s71 3�S�S Contractor: � /J #ho %e /� ,_ G�� Tel. # Address:— �Z�IO/ 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 Type of Construction: We- [ ] Ft. Yd. Setback D � Estimated Side Yard Setback � /J � d // 1 Cost: $ 1a Approx. Completion Date: 6 �® g� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT: Tel. CITY USE ONLY Permit Fee $ D C) Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ 176 $•50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ TOTAL $ C) Agreement Necessary [ ] Not Necessary [ ] � . % STIPULATIONS: LIQ L3 7`18'91 HEREOF I sons WELL DRILLING FOR FOUR GENERATIONS 15650 Jarvis Street NX, Elk Rinr, MN 55330 INCORPORATED (692) 427-61Q0 Fax: (612) 427-0533 Date: JULY 11, 1991 MINNESOTA DEPARTMENT OF HEALTH 717 SE DELAWARE STREET DIVISION OF ENVIRONMENTAL HEALTH MINNEAPOLIS, MINNESOTA 55440 ATTN: Mr Jim Nye (612) 623-5339 SUBJECT: WELL ABANDONMENT RE: NOTIFICATION Dear Mr Nye, NORTH SITE DIAGRAM This letter is to notify you of a water well in your district that should be sealed according to the Water Well Construction Code MCAR §4725.2500-2900. E.H. RENNER & SONS, INC has been notified by the owner of this property or an interested party and have subsequently submitted to them an estimate for the sealing of this well under our LICENSE #71015. We have also included a copy of the current code with our estimate. In submitting our estimate, the owner may also receive additional estimates and hire any number of Minnesota licensed water well contractors in the area to seal this well. However, there is a possibility that this well may not be properly sealed and thus jeopardize the ground water and Public Health. E.H. RENNER & SONS, INC. wishes to provide you this information for future reference with the=baridonment report when submitted. PROPERTY OWNf: ADDRESS: 365 LOCATION: Sincerely Submitted, Raymond T. Renner, V -President ",- E.H. RENNER & SONS, INCORPORATED STATE LICENSE #71015 cc: CITY OF FRIDLEY 6531 UNIVERSITY AVE_ N_E_ FRIDLEY. MN. 55432 ATTN: DARRIL CLARK Equal Opportunity Employer PHONE # 571-3158 DATE -1-31-91 WELL DIA. 3n DEPTH: 251 air less r, (-, (r-- CIN OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING -SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer Rate $ 30.00 $ 10.00 $10.00 $10.00 *Air Conditioning — All Sizes $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE Effective On January 1, 1997 • : ADDRESS La6 Edi' 1 The undersigned hereby makes application for a permit for the work herein TOTAL 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. J 1 ,1997 $ LI $ BUILDING USED AS ESTIMATED COST / PERMIT N0. 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 50 Burner Trade Name Q ,QFcr e1u MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HP Size No. EDR . BLAINE HTG. AIC ELECT., INC. 135M CENTRAL AVE. NS HEATING COM ANY h ANOKA, MN 55304 Signed ByLAOilk o. Approved By ' I Rough—In Date Final Date FILL OUT BACK SIDE F R STACK VERIFICATION ON . REPLACEMENT FURNACE CE[IM NEY AND STACK VERIFICATION The undersigned hereby verifies that the. existing chimney or stack_ Has a liner been provided for water heater Yes( 1. . Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes( ) No (. ) 8. Has combustion air been provided for water heater Yes( ) No . ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: SUBJECT City of Fridley 26303 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. a. r 1 PROTECTIVE INSPECTION SEC. � CITY HALL FRIDLEY 55432 NUMBER T7DATE PAGE OF APPROVED Br 612-571-3450 9104156/22/98 JOB ADDRESS 365 66 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 f 10 2 Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Duane Hanson 365 66 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Jayson Lindsay Roofing 2638 Clearview Ave, Mounds View MN 55112 792-1857 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20098263 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residenital 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 Sq) -Tear -off; 6 Sq of Siding 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Install building wrap and call for inspection before covering. 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 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,168 $2.08 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF"— FTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR HE PER MANCE OF CONSTRUCTION. $99.75 Fire SC $4.16 k CHECK FEE TOTAL FEE Jo—1XPLAN - License SC $5.00 $110.99 SI NATUREOFCONTR CTOR AUTHORIZED AGENT ID TEI WHEN PROPERL ALIDATED THIS IS YOUR PERMIT E SIGNATURE OF OWNEROF OWNER BUILDER) IDATEI r• • BLD INS JUN -12-1998 NEW [ ] ADDN [ ] ALTER [ ] 12:16 FROM CITY OF FRIDLEY TO CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R -ll AND R-2 BUILDINGr PERMIT APPLICATION 7860893 P.01i01 Effective 1/1/98 3 ConsttuctionAddress: 3(0's - Legal (o's-Legal Description: Owner Name & Address: J44, -e- MA-rJSdrJ Tel. # Contractor: -, &)nJ ,s MN LICENSE!! i Fp() i'i F,3 Address: Oq--� 58 C. CA1v '.0'-; A, -e-- Tel. Attach to this application, a Certificate of Survey of the,..-- lot, he=lot, with the proposed construction drawn on it to sca15"- r,- DESCRIPTION OF EWPROVEMENT � LIVING AREA: Length Width HeightSq:-Ft: " GARAGE AREA: Length Width Height 1 Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:_ 12c,466 f dr 6 Srcirtilq Estimated Cost: $ - (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: -q&' APPLICANT: Tel. # 7942 IW5--7 Permit Fee $ Q %S Fire Surcharge $ / State Surcharge $ , o SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS: MY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] k TOTAL P.01 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit # Residential Application City of Fridley See Back Side For Required Information Date &31-6S Site Address: 34g,,,� &�� sL%iir" Ik' The applicant is: (cirlce one) Owner ntracto Property Owner: 5461�7 04 Address: 31� ��/0 6`�✓L City: 122 /'✓E State: AN/ zip: 53/32- Phone:.,533 - - 3oj Cell: Fax: Contractor Information 17 Company Name: r� Contact Person: Address: City: / i//% - - -State: eo4+/ Zip: 555i�Y Phone: Cell: Fax: Email: MN Bond# & Exp Date Type of Work (circle one): New Replacement r Alterati Remodel Detailed Description of work:l Equipment Installed: MFG: Model: Size/BTU: MFG: Model: Size/BTU.- MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 _AIC $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 _Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.00) Surcharge $ 0.50 Total Due $ !L,U Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical 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 case of all work which requires review and approval of plans. Signature of Applicant: � 4 Date: g 3� Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropaneliFGC 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. RCCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building PLUMBING Permit NO.:2Q�S'� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY % ej DATE YO1J,R E-MAIL ADDRESS �y SITE ADDRESS �� J �CD*W THIS APPLICANT IS: 0 OWNER *ONTRACTOR PROPERTYNAME: V1 ®� CITY STATI C ZIP OWNER/ADDRESS: TENANT �� PHONE: --A (Q,?) 5�� ) , CONTRACTOR NAME: STATE LICENSE # C�-7EXP DATE `off^I 1 " ADDRESS: bL CITY1( 3L�C�� STATIZIPI L(1 SUBMIT A COPY OF YOUR STATE LICENSE WITH PHONE � `1 FAX__W� �%moi APPLICATION PERMIT TYPE 0 SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) 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) _ BATH SINK/LAV _FLOOR DRAMS _ SHOWER WATER PIPING BATHTUB GAS PIPING (xrrnc�rrucF_mvE) SWIMMING POOL WATER SOFTNER ($35) _ _ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) _ _ _ DISHWASHER LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _ _WATER WATER METER —OTHER �1�4i 77,s s ...'. ...� ..:P.. i �. 'i. Y., ;: § si�3.':F.'.,. . 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 cr $35.00 _L x $35.00 = $ State Surcharge = $ .50 _ Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED 1 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 equires review and approval of plans. M}� I IIqR", SIGNATURE OF APPLICANTS RMT NAA�I 1 is 1C�ATE •fia ��' :� S�;N .... ' :..... ' .. _ ��» : ;:5 . >;7"IR�D!a1���;�fJI:�7�IN�� 1��E+�,'�`Ri.:i4L AiVD. ` ` . G�:L; ,.' =�i3 �'•� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICALrG`ilu� 1�"..i Inspections RESIDENTIAL APPLICATION Received By: W 7.63-572-3604Date ' JAN 0 8 2 CITY ®�' �' LEY _ DATE /- 9- O 9 YOUR E-MAIL ADDRESS SITE ADDRESS 3 (6 S* 4, 6 °`- A v g N 1_ TEAS APPLICANT IS: ❑ OWNER -.2000NTRACTOR PROPERTY NAME; A 01A n s OWNER/ ADDRESS: 3 G$- GG ut- N G CITY �/L# STATEI�N_ZIPSS 3a TENANT PHONE: i G3— 5'I% — !9-101 CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: COMPANY NAME: Kull✓ 1-14, CONTACT PERSON: r-'--"4 0- k-- Mq_�.l STATE LICENSE # EXP DATE ADDRESS: oppa9 0 Heti Sk t" 0 -CITY Ff2l .oi rL_ STATd1N ZIP SS`�3Z PHONE 7` b 'i S `f I rl ti FAX I�SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK XnS�A 1 (2�.,r� f! �.�•- �wA- ^ a `� 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)SIZEIBTU Equipment Installed p u o MFG: UV o MODEL: jfr�R L06 � MFG: MODEL: SIZEIBTlJ MFG: - MODEL: S1ZE�BTU A/C 525.OD 0.00 FIREPLACE (GAS) $15.00 . —GAS RANG $100..00 L $ NEW GAS GRILL —_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 UNIT HTR $10.00 BOILER $35.00 —_CHIMNEY LINER $10.00 Y FURNACE $35.00 _GAS _GAS DRYER $10.00 _POOL HEATER $35.00 V TOR S15.00 _DUCT WORK $10 00 GAS PIPING $10.00 _ENTILA .. � '`r ' ' .. L .. ...... _. •..... .. Permit Fee _��L��AY ... ...... � _S.: M ,.. ,. ., PSA ....,. ..::..� Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 3 J Sb Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 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 of all work which requires review and approval of plans. SIGNATURE OF APPLICANT olta= _PRINT NAME l rc J Q,P 12 DATE I City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-772-3604 FAX: 763-502-4977 Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received B)PW 763-572-3604 CITY OF LEY D'Ao 763-502-4977 FAX EFFECTIVE 1-1-08 DATE I - 5'- del YOUR E-MAIL ADDRESS SITEADDRESS 2 E Pali -%(S6 THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME:S so H A d Arts OWNER/ ADDRESS: 3� .1GLEE- >Q V�. N� CITY -roLl o(� STATE HN ZIP TENANT PHONE: '7 (s 3 - S33- $ 3 0 ( CONTRACTOR NAME: ie W I / Cc 1 P (k ✓► SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE y LICENSE, BOND AND STATE BOND # EXP DATE"r CERTIFICATE OF I ADDRESS: Slot 9 O A r. IV r CITY �i21p(t . 1- N ZIP J S 311 INSURANCE,, _____STATE 7 63 7 S U --A9 9' FAX �PH/ONE �'SiNGLE 13TWO PERNIIT TYPE FAMILY FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW 64EPLACEMENT DETAILED DESCRIPTION OF WORK _Tn.S4A L1 W,a C .. Wa"f-6111 PER MS 1613.665 the per,, 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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINK/I.AV FLOOR DRAINS _ WATER PIPING _ —SHOWER —BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL —WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINKWATER CLOSET _ BACKFLOW PREV. ($15) _ _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION DISHWASH_ER _ _ WATER METER OTHER - }tl r!J1S'7:1Lthi. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $ J TOTAL DUE $ State Surcharge = $ .50 (MINIMUM $15.50) (MINIMUM $15.50) Total = $ 3S• S <' THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE F APP ANT l r �PRINT NAME, h 1 J 60 DATE APPROVED BY DATE �- V PLEASE' NO ARATE: PERMITS ARE REQUIRED FOR BUiL'DING,.ELE..CrRICAL. AND `MECHAC 4L: WORK City of Fridley 3uilding Inspections Department 6431 University Avenue NE. Fridlev. ivlN X432 763-572-3604 FA;�: 763-502-4977