PRE 2010 DOCSCity of Fridley, Minn. •
BUILDING PERMIT No 4126
Date: ........... E... ........ _._.. ------••----•
Owner: ................... Builder ....-.��
Address
rrr=
C/ATION OF BUILDING
No.......... Street .....LY. Lam. -----T l .Ls6�G?f..._..y:/ _......._.. Part of Lot ............................................... ......._...._....._._.. ._
Lot........... .......-. Block ..... _........ ............................. Addition or Sub -Division 5...:.�....................... .............
�
Corner Lot .................................... Inside Lot%C............................... Setback ,3.t -..'O................ Sideyard.. .�. .�........ --........_
Sewer Elevation ...... ........................................... _............ ......................................... Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
. . ........... -------..... Front-v!....`J. -.1! Depth ..-? '+9 Height ./. .... Sq. Ft. 1.d.JA Cu. Ft..
-....._ Front L... .'cdr Depth ..-a2-- C t.
;�.//Height .._ .. Sq. Ft... ®1.... Cu. F.�
Type of Const ction............................................................ Est. Cost .... /,,,rJ . ...%0 P—`... To be Completed ... ................. _............. ........
In consideration of the issuance to me of a permit to construct e g described above, I agree to do
the proposed work in accordance with the description above set fo d jornpliance with all pro ions of
ordinances of the city of Fridley. �o
In consideration of the payment of a fee of $ 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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to as
the Building Inspector for separate permits for these hems.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
b,
$
Water
x
$2.00
$
Catch Basin
x
$5.00
$
•
x
❑
$
°
x
W
C
Water Softener
Heater
Q
u
.4
x
N
$
H
-.01 C
b4 JJ
$4
W
W
U1
r
#V $4
B d
W
Q
1st 3 fixtures
�
$3.00
$
Additional Fixtures
M
54
W
r:
G
Gas Range to 199,000 BTU
C
•�
N
$
r. C
3
O
U ••i
O
U
N
N
each add. $100.00 or fraction
$2.00
•.�
s+
iJ
ro
Vi
ro
•�
W
ro
••i ?
$+ o
O
x
0
a
1J U!
ro ro
4J N
a ro
M
ro
ro
.0
"
O
as
lec
vJ
,oi
U
❑
m
m
vi
3❑
w
En
w
U m
Q 3
U
U
1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Rin Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$
REINSPECTIQN FEE
($10.00)
Job Address / \6' 1 __
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. / — / / , 197 411-11,
OWNER
KIND OF BUILDING /G
USED AS
AS
TO BE COMPLETED ABOUT
014 �
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By
Tel. No. 7 sp
ROUGH INSP.
Date
FINAL INSP. /40
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
CITY OF FRIDLEY Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
'RESIDENTIAL RATE TOTAL Job Address %� �r
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1• of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
$ 20.00
$ 10.00 $
$ 10.00 $
$ 10.00 $
$ 10.00 $
$
State Surcharge
TOTAL FEE
keinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.-a—'09
Date
Approval for Permit i
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00'
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
V
$ .50
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley,
Minn.
OWNER
KIND OF BUILDING
USED AS 4Z4,
TO BE COMPLETED ABOUT --
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name Size No.
Capacity Sq. Ft. EDR BTU ?-S o J&— HP
Total Connected Load Kind of Fuel Lv G_1
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company : 'MR mv.
ca
Signed By y� -13 J .
Tel. No. �// /- �/ f1 O
Fill out back side for stack verification on replacement furnaces
CHIMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney
r
or stack;
1.
Has been carefully examined
Yes (,)
No ( )
2.
Is, free from rust or deterioration
Yes O
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 connected
Yes ( )
No ( )
6.
Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Company
Signed By
Da to
CITY OF, F,RIpLEY
APPLICATION FOR HEATING REPLACEMENT
CHIMNEY AND STACK VERIFICATION
THIS FOP14 MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM.
LOCATION DATE i/3
OWNER .� �.z, r,, / - —7---- -. ,� ADDRESS -r 3 --;-
The
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
2. Is free from rust or deterioration
3. No foreign objects are lodged within ✓
4. That it is securely supported
5. That it meets all current Code requirements
for size and total BTU connected
6. Total Heating BTU % S; 06
All Other BTU o'p, no D 00eol&
TOTAL
REMARKS
SIGNED e
Licensee
by
Address
Telephone Jy v
HEATING PERMIT #
Fridley City License
CINOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
January 7, 1992
John Vanderhoof
Field Adjuster I
ANPAC
Corporate Centre
1949 East Sunshine
Springfield, Missouri 65899-0001
Subject: Claim #22-H-427-534
Dear Mr. Vanderhoof:
Barbara Dacy requested that I respond to the attached letter
regarding 830 - 66th Avenue N.E., Fridley. The City of Fridley has
50 feet of right-of-way over 66th Avenue. The pavement width is
30 feet; therefore, two 10 foot boulevards exist on either side of
the pavement. This would be the property ten feet from the curb
toward the residence. The City does not own this property; it only
has easement rights over it.
If you have any further questions or concerns regarding this area,
please refer them to the City's legal counsel, Gregg Herrick,
Assistant City Attorney, at:
Barna, Guzy, and Steffen, Ltd.
Gregg Herrick
400 Northtown Financial Plaza
200 Coon Rapids Boulevard
Minneapolis, MN 55433
(612) 780-8500
Sincerely,
Michele McPherson, BLA
Planning Assistant
MM/dn
C-92-07
cc: Gregg Herrick
AN PAC°
AMERICAN NATIONAL PROPERTY AND CASUALTY CO.
AMERICAN NATIONAL GENERAL INSURANCE CO.
ANPAC GENERAL INSURANCE CO.
CORPORATE CENTRE
1949 E. SUNSHINE
SPRINGFIELD, MISSOURI 65899-0001
FAX # (417) 887-1801
(417) 887-0220
December 31, 1991
Barbara Daisy
City of Fridley
6431 University Avenue Northeast
Fridley, MN 55432
Re: Claim #22-H-427-534
Dear Ms. Daisy:
I represent American National Property And Casualty Company
located in Springfield, Missouri. American National Property And
Casualty Company insures Mr. and Mrs. Pertinem. They reside at
830 66th Avenue Northeast in Fridley.
At this time, we are involved in a minor insurance claim that
occurred at the Pertinem residence. I have been in contact with
individuals at your office and was notified that the munici ality
of Fridley owns approximately ten feet from the curb area o the
street toward this residence.
We are at this time asking if you could possibly send us
documentation as to how much yard and driveway area the
municipality of Fridley owns at the above residence.
Also, if possible, we would like to obtain any statute or
something similar that would stipulate who is responsible for any
liability problems that take place on this property owned by the
municipality.
Please note, the insurance claim at this time shows no liability
on our insured or the municipality of Fridley.
If the above -requested information could be returned to me in the
enclosed envelope, it would be greatly appreciated. Thank you in
advance for your cooperation and help in this matter.
If you have
Sincerer
Joh%V d:
Fie dj t I
Central ivision
1-800-333-2860
Contact #9277
Enclosure
A,►k
AMERICAN
NATIONAL
stions, please do not hesitate to call me.
MEMBERS OF THE AMERICAN NATIONAL FAMILY OF COMPANIES
06/07/89 PAGE 7
om SI06FR STREET SEGMENT AND HISTORY REPORT
ED STREETS: ALL REPORT YEARS: ALL
ROAD ROW SOW SUR CURB BASE BIND WEAR OVER SEAL
STREET NAME SEGMENT FROM SEGMENT TO CL TYPE WID LNOTH WID TY MAT YR TYPE CRS CRS LAY COAT
65-05 65-1/2 WAY
65-05 65-1/2 WAY
i
66AM 66 AVENUE
66A05 66 AVENUE
66A05 66 AVENUE
66A10 66 AMM
66A10 66 AVENUE
66A15 66 AMU
66A15 66 AVE?iUE
66A20 66 AVENUE
66A25 66 AVENUE
66A30 66 AVENUE
66A30 66 AVENUE
HICKORY ST
-ASHTON AVE
L
MCS
UlNIV E SVC RD
-CIA.-DE-SAC
L
MCS
ARTHUR STREET
-609' WEST
L
MCS
ARTHUR ST
-STINSOI BLVD
L
63 AVENUE
7TH STREET
-MONROE STREET
L
MSAS
50
0.249
40
8
CON
75
55
1.5
1.5
0.0
63 AMU
MONROE STREET
-QUINCY STREET
L
MCS
60
0.061
35
8
CON
79
30
0.0
0.0
0.0
T
63 AVENUE
0.0
0.0 P
62
45
75
25
1.5
1.5
0.0
30
63 AVENUE
QUINCY STREET
-JACKSON STREET
L
MICS.
60
0.064
30
6
BIT
82
0.0
0.0
0.0
P
63 AVENUE
66
0.169
36
8
CON
83
45
2.0
1.5
58
25
1.5
0.0
0.0
CON
63 AVENUE
HWY 65 E SVC RD
-RIC: CREEK ROAD
L
MCS
66
0.157
35
8
CON
80
0.0
0.0
0.0
P
63 AVENUE
66
46
0.0
1.5
0.0
50
77
25
1.5
1.5
0.0
63 WAY
RIVERVIEW TERRk-E-EAST RIVER ROAD
L
MCS
50
0.150
30
6
BIT
84
0.0
0.0
0.0
P
63 WAY
67
0.0
0.0
0.0
P
63 WAY
61
45
0.0
1.5
0.0
63 WAY
EAST RIVER ROAD
-ASHTON AVENUE
L
MCS
60
0.094
35
8
CON
79
25
1.5
1.5
0.0
63-1/2 WAY
RIVERVIEW TERRACE -EAST RIVER ROAD
L
MCS
50
0.151
30
6
BIT
82
0.0
0.0
0.0
P
63-1/2 WAY
67
0.0
0.0
0.0
P
63-1/2 WAY
61
45
0.0
1.5
0.0
63-1/2 WAY
ASHTON AVENUE
-EAST RIVER ROAD
L
MCS
60
0.109
35
8
CON
86
0.0
0.0
0.0
P
63-1/2 WAY
82
0.0
0.0
0.0
P
63-1/2 WAY
79
25
1.5
1.5
0.0
64 AVENUE
UNIVERSITY E SVC -5TH
L
MCS
60
0.000
40
8
CON
74
0.0
0.0
0.0
T
64 AVENUE
67
65
1.5
1.5
0.0
64 AVENUE
JACKSON STREET
-VAN NO STREET
L
MCS
60
0.063
22
6
BIT
82
0.0
0.0
0.0
P
64 AVENUE
66
0.0
0.0
0.0
P
64 AVENUE
58
25
0.0
1.5
0.0
64 AVENUE
VAN BUiREN ST
-ABLE STREET
L
MCS
60
0.062
35
8
CON
75
25
1.5
1.5
0.0
64 AVENUE
BAKER STREET
-HWY 65 SVC RD W
L
MCS
66
0.149
35
8
CON
75
25
1.5
1.5
0.0
64 AVENUE
CENTRAL AVENUE
-ARTHUR STREET
L
MCS
60
0.242
28
6
BIT
73
0.0
0.0
0.0
P
64 AVENUE
68
25
0.0
1.5
0.0
64 WAY
EAST RIVER ROAD
-ASHTON AVE
L
MCS
60
0.125
30
6
BIT
88
0.0
0.0
0.0
P
64 WAY
87
0.0
0.0
0.0
P
64 WAY
68
0.0
0.0
0.0
P
64 WAY
62
45
0.0
1.5
0.0
64-1/2 WAY
EAST RIVER ROAD
-RIVERVIEW TERR
L
MCS
0.113
30
M
CON
87
0.0
0.0
0.0
P
64-1/2 WAY
66
46
0.0
1.5
0.0
65-05 65-1/2 WAY
65-05 65-1/2 WAY
i
66AM 66 AVENUE
66A05 66 AVENUE
66A05 66 AVENUE
66A10 66 AMM
66A10 66 AVENUE
66A15 66 AMU
66A15 66 AVE?iUE
66A20 66 AVENUE
66A25 66 AVENUE
66A30 66 AVENUE
66A30 66 AVENUE
HICKORY ST
-ASHTON AVE
L
MCS
UlNIV E SVC RD
-CIA.-DE-SAC
L
MCS
JACKSON STREET -ABLE STREET L MCS
PIERCE ST
-t Nta RD
L
MCS
C09RAL AVENUE `
-609'W.ARTHUR ST
L
MCS
ARTHUR STREET
-609' WEST
L
MCS
ARTHUR ST
-STINSOI BLVD
L
MCS
66W05 66 WAY ASHTON AVENUE -HICKORY DRIVE L MICS
50 0.147 30 6 BIT 82 0.0 0.0 0.0 P
61
45
0.0
1.5
0.0
66
0.305
35
8
CON
86
0.0
0.0
0.0 P
73
0.0
0.0
0.0 P
69
45
0.0
1.5
0.0
50
0.129
30
6
BIT
84
0.0
0.0
0.0 P
62
45
0.0
1.5
0.0
50
0.061
30
8
CON
77
0.0
0.0
0.0 P
73
25
2.0
1.5
0.0
66
0.169
36
8
CON
83
45
2.0
1.5
0.0 R
50
0.115
36
8
CON
84
45
2.0
1.5
0.0
60
0.246
30
8
CON
83
0.0
0.0
0.0 P
66
46
0.0
1.5
0.0
50
0.173
30
6
BIT
82
0.0
0.0
0.0 P
SUBJECT
PERMIT NO. ,
City of Fridley
26241
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r 1 v PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
,•j CITY HALL FRIDLEY 55432
L „ 612-571-3450
910-F15
6/15/98
JOB ADDRESS 830 66 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
2
Meadowlands
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Tom/Sheri Schmoll 830 66 Avenue NE
574-2183
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (22 Sq) 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
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
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
$.92
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,834
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-
Fire SC $1.84
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$59.50
PLAN CHECK FEE
TOTAL FEE
$62.26
SIGN TUREOFCONNTPACTORORAUTHORIZEDAGENT IDATEI
WHEN PROPER VALIDATED THIS IS YOUR PERMIT
36IGNATURE
'11,91t, INSP
GATE
OF OWNERI F OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FANDLY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: - <3 -�)D �0 & t, cv� n L
Legal Description:
Owner Name & Address: �V m c ����� �i)%�(7 1 Tel. # �/Z S79�1f-3
Contractor: 1,' Yee r MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA:
Length
Width
Height
Sq. Ft.
GARAGE AREA:
Length
Width
Height
Sq. Ft.
DECK AREA:
Length
Width
Hgt/Ground
Sq. Ft.
OTHER:
$
hDIA5e
/�► 5Q,-,
$
Construction Type:
Erosion Control
$
Estimated Cost: $
l (`�• `f
$
Fee Determined by Engineering
Sewer Main Charge
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft =
Ft x $
= $
DATE: (c - I S- APPLICANT: o� . Tel. # ���d-/ffJ
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ r
Fee Schedule on Reverse Side
Fire Surcharge
$ `
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit -
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
STIPULATIONS:
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY PERMIT NO.: 2004-00774
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 05/25/2004
571-36U4 t'AX: (763) 571-1287
830 66TH AVE NE
143024140075
MEADOWLANDS ADD
LOT 5 BLOCK 2
ELECTRICAL
RESIDENTIAL
ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE AIR CONDITIONER
AND GFGI.
# INSPECTIONS I
APPLICANT
ROBINSON J M ELECTRIC INC
5015 FERN DR
INDEPENDENCE, MN 55357-
1111: /►1 Di ;7
ERIN & JOSE, RAMIREZ
830 66TH AVE NE
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.
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 6830
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-3604 FAX: (763) 571-1287
ADDRESS : 830 66TH AVE NE
PIN : 143024140075
LEGAL DESC : MEADOWLANDS ADD
: LOT 5 BLOCK 2
PERMIT TYPE : HEATING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMITO.: 2004-00554
DATE ISSUED: 04/21/2004 ,
VALUATION : $ 3,166.00
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.
INSTALL AN AIR CONDITIONER
# A/C UNITS 1 # FURNACES 0
# GAS DRYERS 0 # GAS RANGES 0
APPLICANT
KNIGHT HEATING & AIR CONDITIONING
13535 89 ST NE
OTSEGO, MN 55330 -
OWNER
ERIN & JOSE, RAMIREZ
830 66TH AVE NE
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 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.
Annlicaut— - A Date
HEATING PERMIT NUNIMUM FEE
0.00
FURNACE SHELL/DUCT WORK
0.00
GAS RANGE FEE
0.00
GAS DRYER FEE
0.00
AIR CONDITIONING FEE
25.00
STATE SURCHARGE, MECH FLAT
0.50
TOTAL
25.50
PAID WITH CHECK # 5266
SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
-CITY OF FRIDLEY BUILDING INSPECTION
3431 University Ave NE
=rldley, MN 55432
r63-572-3604 FAX 763-571-1287
3esidential
=umace Shell and Duct Work, Burner &
3Iso Replacement Furnace
Sas Piping (New Furnace, Fireplace, Insert)
aas Range
Sas Dryer
'Air Conditioning - All Sizes
klI Other Repairs or Alterations (List on Back)
1961 of Value of Appliance or Work
Minimum Fee $15.00 for Residential or 5% of cost of
mprovement whichever is greater
Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Ind s1=_1
$35.00
$
$10.00
$
$10.00
$
$10.00
$
$25.00
$ C' u' 12-02
L,
;ommercia I/industrial/lnstitutiional
L25% of Value of Appliance or Work (List on Back) $
Minimum Fee $35.00 for Commercial/Industrial/Institutional
State Surcharge $ /5D
TOTAL FEE $_��
3EINSPECTION FEE $50.00/HOUR
kAir Conditioners can not be placed in side yard without written approval
°rom adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
JOB ADDRESS �O — &62M AJC
Building Used As
ESTIMATED COST . -A �� P • PERMIT NO 6RZ' l `0®,Sr7
# of Heating Units Circle One (Steam) (Hot Water) (Warm Alr)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
SizeN .
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Building Division, and hereby declares that all the facts
stated In this application are true and correct.
Date *_16P_L1
V5
Approved by Rough -in Date Final Date _ a7 G%
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 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 Installina a new venting systemthe undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes ( ) No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
PLUMBING
RESIDENTIAL APPLICATION
City of Fridley
0 oos 0JB6/
Permit Number
Received By
Date Received
NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT.
DATE — YOUR E-MAIL ADDRESS
SITE ADDRESS q,JG
THE APPLICANT IS: (CIRCLE ONE) CONTRACTOR
�OWNER
A
NAME c -P Z -
PROPERTY OWNER/
ADDRESS SA7'n e C l RQ,.19__
TENANT
_06
CITYSTATE ZIP
PHONE # �(g d Z2' 2 9
NAME.�/� HJT LICENSE #— U Q
/'rl/z�-t/
ADDRESS3
CONTRACTOR
CITY STATE ZIP 5?c -1c- �
PHONE # FAX#
PERMIT TYPE
SINGLE FAMILY TWO FAMILY TOWNHOUSE
TYPE OF WORK
❑ NEW
PREPLACEMENT
DETAILED DESCRIPTION OF WORK :1;j 5±1642 C _ � 5a &_ -U4
-U
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FIXTURES: (INDICATE TOTAL NUMBER OF EACH)
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15)
DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION
WATER METER OTHER
Permit Fee $ MINIMUM: $15.00 or 5% of cost of the improvement -whichever Is
Plan Review $ greater on work less than $300
Surcharge $ .50
TOTAL DUE $ Make checks payable to: City of Fridley
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 odes 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 approvalof fans.
NAME OF APPLICANT DATE — °-
lease e t
SIGNATURE OF APPLICANT
PLEASE` 1�iOTE �EPAR�ITE PERM �� E�IUfREQ FC1I2 BUILiSING, >i.f1CiR)CAL,,A�D N[EC}�ANI�ALV�Qt�iK� � � `` �
t�
CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT
6431 UNNESITY AVENUE NE, FRIDLEY, MN 55432
/ �/ cE/6 A)l AJ 6 (763) 572-3604
Building
PLUMBING Permit No.:—
Inspections
RESIDENTIAL APPLICATION Received By:
763-572-3604
CITY OF FRIDLEY
763-502-4977 FAX
EFFECTIVE 2-19-09
DATE ZO I v % YOUR E-�IA1L ADDRESS
ro i. G1.s.r+L� Y1
SITE ADDRESS
THIS APPLICANT IS: O OWNER WON-rRACTOR
PROPERTY
NAME:
ADDRESS: .730 (0 " t' CITY STATF ZII$ty
WNI*b
NT
PHONE: ea 1 2-
NAME:— Terry Overacker Plumbing Inc
CONTRACTOR
COPY OF
SUBMIT A
STATE LIC EXP DATE
YOUR STATE
502 E Main St
LICENSE, BOND AND
STATE HOl Anoka, MN 55303 EXP DATE
CERTIFICATE OF
ADDRESS: 3TATE Z[P
INSURANCE
(763) 572-8880
PHONE X
�%INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
PERMIT TYPE
TYPE OF WORK:
O NEW REPLACEMENT
IP
DETAILED DESCRIPTION OF WORK M
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINK/LAY FLOOR DRAINS _ WATER PIPING
—SHOWER
BATHTUB —GAS PIPING (NEED C ITY LIC) SWIMMING POOL _ WATER SOF INER ($35)
CLOTHES WASHER —KITCHEN SINK — WATER CLOSET _BACKFLOW PREV. ($15)
_DISHWASHER _LAUNDRY TRAY —WATER HEATER
METER ($35) FOR RRIGATION
OTHE
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•.r. ,'!� �3,:s a -+. - 1-n x r rj.,. + ! 4 kdLFrs �_. ay. • ,'&y'`r,�1�••aw'q'�'ct' .y'+,.y`f$'1" s9 ''1 ..,
e
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_ . ti .:+< b."k'�.''v'SP
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED ,
1 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 understated 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. j
f
N K t 'DATE 9
SIGNATURE OF APPLICANT C - PRINT NAME
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
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