PRE 2010 DOCS11 A
This permit 4088 not cover the construction, instail�tlon or aiteration for wiring, piumbing,' gas •heating,
sewer or water. e.sure to See jWulfdIng inspector lor separate Permits for' 0 Items. ,
U v ,
Application for Power Plants and H '
�►p'� eaMng, Cooling, Ventilation, Refrtgercction and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
RATE
TOTAL
8.00
$
5.00
$
5.00
$
2.50
$
8.00
$
2.00
¢
5.00
$
5.00
$
2.50
$
Furnace Shell & Lines—to 400 sq. ft. IDR 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
Do
GAS BURNER (up to 400,000 BTU) 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ..... x $1.50 $ T
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $$�
D
ALTERATIONS & REPAIRS TOTAL FEE
REMARKS:
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- __w -',"e . / % 19"
Owner---i%/l� >�� ,/���� 195_
Kind of Building 195—
Used as
To be completed about
O�
Estimated Cost,
Old -11m -Building Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. Ft. E.D.R. BTU H.P.
Total Cpnnected Load ,/Kind of Fue
BURNER — Trad Name ���� �Gsze No- 6z/P-0
Capacity Sq. Ft. E.D.R BTU H.P.
Ap cal0.0n. for Power Pknft and Nang. Cooiing, Yel1fi9A�oB0 Re%igecolon and
Air Conditioning System and Devices
PARTIAL RATE SCHEDULE Dept. of Ridge. Phone sea -3490
GRAVITY WARM AIR: RATE TOTAL LocNlm a
Furnace Shell &Duct Work ...........................
$10.00 =
Replacement of Furnace .............................
6.00 :
Repairs & Alterations—up to $800.00 ..................
6.00 $
Repairs & Alterations each add. $800.00 ...............
3.00 $
MECH. WARM AIS
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.W ..............
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. IDR Hot Water
.. 1000 $
Each add. 200 sq. ft. EDR Steam ............... :......
3.00 $
Each add. 320 sq. ft. IDR 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) ........................ &00 $
over 199,000 BTU See. Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures a$ 2.00 $
Additional Fixtures x .75 $
Gas Range to 199,006 ........... s$ 800 $
AIS COPDiI'IONIIlG�
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAID TOTAL FEE �S1�
ROUGH
FINAL
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 Ordinance:
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- 4 ` ;I,. 14��
Kind of Building
Used as
To be completed about 7/
Estimated
7%
Estimated Cost, $ o
Ol New. Building Permit No. Permit No. `� 7
DESCSIPTION OF WORK
BEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. Ft. E.D.R BTU . H.P.
Total Connected Load Kind of Fuc
BURNER — e Name �Gb�-�,® Size No
Capacity �- �i s fl BTU 200 o mop .
(29wRus-01va)
City of Fridley
Pl°caAbn for Phmbbiq and Sm Mug Pwmit
Debt. of Bldgs. Phone 580-3345D
DESCRIPTION OF WORK r �..,. /.3 16
Plumber, Kind and L®c@Aou @4 Fixtu?"
1
i i i M I I I a I� i, 111 Tis 1 11 ; Is I I
Base
PARTIAL RATE SCHEDULE
wr, City of Fridley:
o M cis me The undersigned hereby makes application for a permit for the work herei,
specified, agreeing to do an work in strict accordance with the City Ordinance
and nsling of the Department of Buildings, and hereby declares that all the fact
and vapresentations stated in this application are true and correct
Fridley. Minn
Owner
Kind of Building
sever0 Used as
CMNPod
PLUMBING FIXTURE BATES: NO. RATE TOTAL
Number Fixtures ................ x 32.00 S U 0
Future Fixture Opening .... :...... 71$1.50
5
New Fixture Old Opening .......... x $1.50 S
Catch Basin .................... x $3.25 $
Water Heater Wp to 99,000 BTU) • • • • x $3.00 S
New Ground Run Old Bldg......... x $3.25 S
El ctrtc Water heater . ............. s $2.00 $
GAS FITTING FEES. NO. RATE TOTAL
lot 3 Fixtures z3100 $
Additional Fixtures ............... , -z$.75 $
Gas Range to 199,000 BTU ............ x $5.00 $
State Surcharge $ .50
REPAIRS & ALTERATIONS—Refer to C®d® _
Descriptian 0 O . O . . . O O . .. O B .. . ... . A.. . . . ..... . O. O . F . I.. .
TOTAL FEE o 1%
To be a
Estimated Cost, $
Old --N Permit No. J Permit No.
Signed ;`%/
Business Phune No 2'Y y R ti z
ROUGH
97-84-416051
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Job Address 1131..._•5 .� 66 A6E. _ NE
Department of Buildings
City of Fridley I
Tel. 1571-3450
The undersigned hereby makes application for .a permit for the work
specified agraoing•to do all work in strict accordance with the City
and rulings of the Departnont of Buildings, and hereby declares that
the facts and representations stated in this application are true and
Fridley, M.'t. . 8-10-77 , 19-
PARTIAL RATE SCHEDULE
M
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
h%= -her Fixtures
i
$3.00
U
Future F-fx ture Opening
�
$2.00
S
waterq
x
$2.00
S
Catch Basin
x
$5.00
$
4a
u
$5.00
$
m w
a
w
$
Water Softener
Heater
$7.90
• u
nn
C
M
Electric Water Heater
iC� ar
U
N
,C C
E 0 U
U
1st 3 fixtures
X
$3.00
an
lac
4
:l JI
• G'
.Cas Range to 199,000 BTU
.•q
'�
YI
C
A
8
l rl
.0
O
65.00
$
o
o
r u
a
p
a
x
ca W.
vci
w
3 M
a
1st
replac
- r
ge
E2ud
3 rd
< th
'
(R) - Future Connection Opening
Connected with Sewor
(•) - liev Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
h%= -her Fixtures
X
$3.00
$
Future F-fx ture Opening
x
$2.00
S
New Fixture, Old Opening
x
$2.00
S
Catch Basin
x
$5.00
$
i Nater Heater - to 99,000 BTU,
x
$5.00
$
100;000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.90
$
New Ground Run Old Building -X
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
X
$3.00
$
additional Fix turas
X
$1.00
$
.Cas Range to 199,000 BTU
x
$10.00
$
REPAIRS & ALTERATIONS
First $100.00
65.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 8.00
• RELNSP�CTT�N PFR
OWNER MID MECH
KIND OF BUILDING frage
USED AS res.
TO BE COMPLETED ABOUT 0-17-77
ESTIMATED COST 10.0Q
OLD - NEW BUILDING PERMIT NO. f�PE %IST N0. i
4J die�L�/'
Company
Signed By'
1 Tel. No.
ROUGH INSP.
Date
FINIAL INSP.
Data '
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
SUBJECT
PER IT
City of Fridley
m '� 16 81 1
AT THE TOP OF THE TWINS
BUILDING PERMIT
!
RECEIP
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
/®
CITY HALL FRIDLEY 55432
'.j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/7/82
JOB ADDRESS 1315 - 66th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8
Dennis Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Mech 1315 - 66th Avenue N.E. 574-1197
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Hank Dueval Construction 9307 - 5th Street N.E. 784-7859
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
X
8 DESCRIBE WORK
Construct aporch/greenhouse addition to dwelling (40110" x 12'4")
9 CHANGE OF USE FROM TO
STIPULATIONS Variance approved by XX= the ¢3pp
A eats Commission on
August 24, 1982.
SEPERATE PERMMS A00140' 'F
WARMWG
HFATING, PLUMPINn ANN g1rNis.
Before digging cat! IOcal
utilities
TELEPHONE
- ELECTRIC - GAS Etc.
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Frame
VENTILATING OR AIR CONDITIONING.
wood
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
503
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
$8,300
$4.15
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$74.50
NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$18.63
$97.28
S16f4ATUREOFC RACTOR OR AUTHORIZED AGENT IDATEIWHEN
PROPERLY VALIDATED THIS IS YOUR PERMIT
�
wv %
f j6y
BLDG r OVATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIM FOR RESIDENTIAL BUILDING PCRi4ITS
(Nett, Alterations, Additions, or Repairs)
OWNER: ,Dav i d Ayth m e= BUILDER: 14a-tA do 0 0
ADDRESS: , f3 /S (� 6 i9�J2 ADDRESS:� P r � h �, c e /— Va 1, k -
TEL 110: _ E 7 V TEL 110:
1 Construction Location
- STR W NO.- I I STREET: A V 2,
LOT: BLOM : ADDITION: D e h h TS AA -Z ,J
Corner Lot: Inside Lot: Setback: - Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
E� DESCRIPTION OF CONSTRUCTION
A D Front: Y� p't2i s ��Height:
Square Poets Cubic Feet: y 1800
Front: Depth: Height:
Square Feet: Cubic Feet:
gcd ''` € 76i moo
Type of Construction: 5 U h �OUc-� Estimated Costs
Rb Be Wrapleted: t(60 I
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired:
SEE REVERSE SIDE OF SHEET ,
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do -all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE: � C5"& T - SIGNATUIM:
Stipulations: �.
Pic.
1
CITY OF FRIDLEY INSPECTION DIV. ),46 Effective On August 1, 1995
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
�p 1��
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES / / Ale
JOB ADDRESS;-//'������
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00 x $ 3Q% representations stated in this application are true and correct.
(Side Vent — Fill Out Back) 02 a2o2. ,190 6
Gas Piping (Needed with new furnace) $10.00 $
OWNER X' Sd" 1,
Gas Range $10.00 $
BUILDING USED AS (/U✓tiJ �o S 7 2 - $ 176
Gas Dryer $ 10.00 $ d o
ESTIMATED COST lei/ pPERMIT NO. E
*Air Conditioning — All Sizes $ 25.00 $
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water arm Air
Trade Name 4 e n h ®x Size No.
Commercial/Industrial BTU Q 0 0 HP EDR
1.25% of Value of Appliance or Work $ Fuel Total Connected Load
State Surcharge $ .50 Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE .$ Su
HEATING COMPANY
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION /�
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No.
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr Approved Byid Rough—In Date Final D
*Air Conditioners can not be placed in a side yard without/
FILL OUT BACK SIDE OR STACK VERIFICATION ON
adjoining O��l�i�®
written permission from oinin property G
p 1 9p pe�Y owner. REPLACEMENT FURNACE
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
CHIMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney, or stack:
1.
Has been carefully examined
Yes (X)
No ( )
2.
Is free from rust or deterioration
Yes
No ( )
3.
Has no foreign objects lodged within
Yes yf)
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 75 ® 0 0
All other BTU's 1( U d
TOTAL BTU's �/,� Q Q (�
7.
Has a liner been provided for water heater
Yes ()
No (1C)
8.
Has combustion air been provided for water heater
YesA)
No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
From: City of Fridley To: 7844694 Page: 2/2 Date: 8/17/200611:16:13 AM
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
DateSite Address: 1315 6.co4" Ave
The applicant is: cirlce one
Owner Contractor
Property Owner: Tpg`�q -4y.,
Address:
�.
City:
State: Zip:
Phone:
Cell: Fax:
Contractor Information
Company Name: cWo'u�
-P4' C ,
Contact Person: Kim t vee xJ,
Address: I2�qc-r3
City:
State: Inti Zip: 5543z
Phone: 763 ee4 -(, t
Cell: Fax: 't &3 -7e4-4M
Email:
MN Bond# & Exp Date
Type of Work circle one):
New Re lacement Alteration/Remodel
Detailed Description of work: I o r y -n c-�e 0—CE L2o -t .s •
ruko hA4 , t-4BL,4a
4 6, e ,
Equipment Installed: MFG:
cu Model: i24ANr\o24 Size/BTU: 2 • D `row
MFG:
Model: Size/BTU:
MFG:
Model: SizeBTU:
Please check all that apply:
_Fireplace (gas) $15.00 New Gas Grill $10.00
ZC A/C $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 $
25. CO Minimum fee $15 or 5% of cost of improvement
Surcharge
0.50 whichever is greater + surcharge
Total Due $
25. 5v Make check payable to City of Fridley
This Is an application for a permit- not valid until processed
I hereby appy 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: �Date:
Approval Inspector Signatur . -2r, — Date:
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
Revised 6/1412005