PRE 2010 DOCSCity of Fridley17
SUBJECT
7 2 6
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
REC O.
r ;------; COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1 = 1
1--'S CITY HALL FRIDLEY 55432
%j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/19/84
JOB ADDRESS 1472 - 66th- Avenue N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
2
Creekridge SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Chris Luwther
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Rodney Billman, Inc. 151 Silver Lake Road, New Brighton, MN 55112 633-0536
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 55R6111 x 38' Dwelling and Garage
SEPERATE PERMITS REQUIRED FOR WIRINS.
9 CHANGEOFUSEFROM HFATINGTOPLUMBIW% ANn OIGNS.
STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side
yards. Provide City with copy of verifying survey before capping. $1500.00
Park Fee paid by Brickner Builders-
uildersSEWER
SEWERLOCATION: "Y" 50" South of Manhole
"Y" Elevation: 884.91
Minimum Footing Elev: 887.91 W
������
WATER IN SAME TRENCH @��
call local utilitfo
Before digging
- GAS E
TELEPHONE -ELECTRIC
0.3 CITY OF FRIDLEY ODES NOT GUARANTEE e N& i' 1t p L � �� L�
--,1:OF UTILITY LOCATIONS AND ELEVAtlotw � r �
4HIS OAIA IS FOR INFORMATION PURPOSES ONLY AND
mR3C-,N.) USING r Swmw VERIFY THi wokJ11A iow
to THE 51h
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
.THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 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
10
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
$114,450
$57,23
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-
$470.50
Credit From SCh001
TR CTIO R THE PERFORMANCE OF CONSTRUCTION.
LAN CHECK FEE
TOTAL FEE
$117.63
$645.36
IGNATUREOFF—CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY LI DATED THIS IS YOUR PERMIT
i
v �✓�-r��� '
i ��' l;✓4e
BLDG )NSP DA
S NATUR F OWNER IIF OWNER BUI ERI IDATEI
ri
1
d
NEW [�JJ City of Fridley Effective 4/1/84
ADDN. [ ] R-1 MR R-2
ALTER. [ ] Building Permit Application
Construction Address: I ? 2_ 660 1"0'`� ~
Legal Description: " ;1- j- z&<e_-k "-7
--
Owner Name & Address: e w':t Tel. #
Contractor: r��7 /`,'��/y�22� a(/;� Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
A, 3 >.3
LIVING AREA: Length -Q--4. Width VMW Height � Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot] Ft. Yd. Setback Side Yard Setback A0�"'�'
Type of Construction: ? shy Estimated Cost: $�
Approx. Completion Date: 9 5;-J
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: _- $ $
See Back Page for Explanation
DATE: — APPLICANT: P Tel. 0_6 3 —_XeZ
CITY USE ONLY
Permit Fee
$ e""p'5o
Fee Schedule on Reverse Side
Plan Check
$ 17.(A
25$ of Building Permit Fee
State Surcharge
$ :5-0.23
$.50/$1,000 Valuation
�p 6`'
/��d�
D
SAC Charge
$ Onrzo, t Fum R.�.
$425 Per SAC U `d
Park Fee
$
ee Determined by Engineering
Sewer Main Charge
$ .—
Agreement Necessary [ ]Not Necessary [ J
TOTAL
$
STIPULATIONS:
y
Effective Aug. 1. 1981
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
Furnace Shell and Duct York,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Can Range
Gas Dryer
RATE TOTAL
$ 20.00 S•O'D
$ 10.00 S 16.
S10.00 $
$ 10.00 $
e Air Conditioning (all sisesi $ 10.00 $ le, av
All Others/Repair• and Alterations,
It of Value of Appliance or Mork / S
CONNERCIAL/INDUSTRIAL
It of Value of Appliance or pork
State Surcharge
TOTAL SEE
Reinspection Fee (515.00)
Rough Inap.
Date
Final Inep. e--
ate
Approval for Permit
MINIMUM FEE ron ANY HEATING PERMIT IS $10.00
PLUS $.SO STATE SURCHARGE
Job Address / / /2, '—ZL2 � a�
Departmnt of Buildingsb 6411 University Ave. N.E.. Fridley. MN SS432
City of Fridley
Tel. 1571-3450
The undersigned hereby naked 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 or BUILDING
USED AS �v
$ TO BE COMPLETED AM" / 2
y r�
ESTIMATED COST
OLD .UILDIMG PERMIT MD. PSI841T 00.
S �/
S
DESCRIPTION OF FUMACE/BUIINER
Attach stack verification fors with replacment furnace permits
*Air Conditioners can not km- placed in side yard without
written permission frac adjoining neighbor.
HEATING or POWEERPLA,NT-S& Steen. Mot Nater.t• Air No. —/
Trade Name 1�v Ywd { Size No. Allye A
Capacity V Sq. Ft. EDR STU 16 CaL�7 H*
Total Connected toad Kind of Mel `
BURNER - Trade Name Site No.
Capacity Sq. Ft. EDR BTU HP
Company
Signed By
Tel. No. ��
D-rs
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION IVIINNFAPOLIS.
Weatherstrips A.S.KVZConstruction No. Insulation
GuideWindows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
if ea= Imo Yeo 19
Is Fl.1 X= Room I Length / U Width b Height Fl.) Room I Length I I Width Height X
Windows and Doors—Crackage and Area
W
Height No. of Lineal f - Area or
No. or pane of pane lights of crack sq. ft.
%
I
Infiltration p
Glass re
Exp. wall
Net e --p. wall D
Iut. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Fl.1 A Fd 11 . Room I Length Width
Wm ws and Doors--Crackage and Area
Width Height No. of Lineal ft. Ares
No. of pane of pane lights of crack q. ft.
IC"Ll Btu
Infiltration
I L
Btu
Btu
Glass
Exp. wall
Net exp. wall /
lat. wall
Ceiling i
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I
7-FLI 7M; Rnetn Illnath f-. Widtl—HHeiah�
Windows and Doors—Crackage and Area
�-
-
Width Height No. of Lineal IL Area
No. of pane of pane lights of crack sq. ft.
14
Coef. Btu
IC"Ll Btu
Infiltration
I L
Glass
p
Glass
Exp. wall
/
0 /
Exp. wall
JIL
lesf
Int. wall
Net exp. wan 17(o ' I u / (r
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. urs. WA. Leader area
Windows and Doors—Crackage and Area
�-
-
Width Height No. of Lineal IL Area
No. - of pane of pane lights of crack q. it.
2 ,6
Coef. Btu
Coef. Btu
Infiltration
I L
Glass
p
Glass
Exp. wall
/
0
Exp. wall
JIL
lesf
Int. wall
Net exp. wall
44,
1-0 �
Int. wall
Ceiling
Q
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Z FU Mac411 ARoom I Length *11-I Width HeiaLt 7
Windows and Doors—Crackage and Area
�-
-
Width Height- No*o Lineal ft. Area
No. of pane of pane lights of crack q. ft.
2 ,6
Coef. Btu
Coef. to
Infiltration
L/ Y
Glass
& 0
Glass
Exp. wall
-A
/fee
Exp. wall
JIL
PH
Int. wall
Net exp. wallD
Ceiling
Floor
Int. wall
Ceiling
0
Floor
Total Btu. �Ln
Required sq. ft. E.D.R. or sq. itis. W.A. Leader area
Fl_ Rmtn I Ilnath I 'ice• Width o V Height
Windows and Doom—Crackage and Area
Width Height No. of Linin it. Area
No. of pane of pane lights of crack q. tt.
71 (41
Coef. Btu
Infiltration
3.
Glass
171
5(Y � is
Exp. wall
-A
Net exp. wall
JIL
10 1 lip
Int. wall
Ceiling
Floor
f
Total Btu.
Required sq. ft. ED.R. or sq. ins. WA. Leader area
9, 11om#0
Ddb
a
HEAT LOSS CALCULATIONS
Weatherstrips,
A.SJLV.L
Guide
WindowsI
Doon
Reference
es— o
YY—moo—Il
19—
i M1 A2dWj i➢6 Rnnrn
lanath
DEPARTMENT OF INSPECTION NvM
Construction No. Insulation
Out. Wap I lat. Wall I Ceding I Roof I Floor Kind How
0 Width I& Height
Windows and rs—Crackage and Area
a
No.
W1111% Height No. of Lineal t Area
of pane of pane Ilgbte of crack,.sq. ft.
Pg
(v(aQ
/L
Coef. Btu
Infiltration
Glass /
Exp. wall to
0
Net exp. wall C
Coef. Btu _
Infiltration
Glass b
Glass
13 e
Exp. wall 14
I
Net a :p. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
Ceiling
Floor O
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area 7 w tv v_.
F1.1 w i--6tRnom lsnath A Width 110 Height T
Windows and Doors—Crackage an Area
f -I- Height
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of enck cep. It.
Width Height No. of ,Lineal M Ana
No. off pane of pane lights of crack Ga. ft.
Width Height No. of Lineal ft. Area
No. of pa{n/e of pane lights of crack W. fl.
y
Coef. Btu
Infiltration
Glass /
Exp. wall to
0
Net exp. wall C
10 -2015
Int. wall
Glass b
Ceiling
33ac
Floor 03(010
I
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.1 kite, h Room I Length ya Width
f -I- Height
Windows and Doors--Crackage and Ana
Width Height No. of ,Lineal M Ana
No. off pane of pane lights of crack Ga. ft.
Width Height No. of Lineal ft. Area
No. of pa{n/e of pane lights of crack W. fl.
y
M 0, 3 ti
Coef.
Btu
Infiltration
1)
11 bo
Glass b
B
33ac
Exp. wall A001
I
Exp. wall
Net exp. wall
�'?,�
Int. wall
Net exp. wall
Ceiling
/D
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
I Fl.I f jo1-PV Room i Length sl Width V Height
Windows and Doors—Crackage and Area
�+► _ s
Width Height No. of ,Lineal M Ana
No. off pane of pane lights of crack Ga. ft.
/ .3' 0" G� r if—or
Coef.1
Btu
Infiltration
1p
% 0
Glass
Q
/000
Exp. wall
Z,qo
�'?,�
,Lv 6 0
Net exp. wall
'!
/D
`ZQ o
Int. wall
Ceiling
Floor
C 6
41 1
Z 2
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I Fl.I / r if rmos Room I Lenath 14 Width It Heialit 4
Windows and rs--Crackage and Area
�+► _ s
Width Height • No. or Lineal ft. Area
No. of pane ofpanelights of crack cep. tG
V 0
Coef.1
&a
Infiltration/
&
Coef. Btu
Class
Q
1 y .
Exp. wall
Z,qo
�'?,�
,Lv 6 0
Net ev. wall
'!
/D
`ZQ o
Int. wall
Ceiling
Floor
aC/
=�
I1 4
Total Btu.
Required sq. ft. E.D.R. or sq. ins. YA Leader area
177_I Ara i V R..l lrnath /lav Width It/Height
Windows and Doon—Crackage and Area
N
width Height No. of Lineal ft. Area
of paceo! ns lights of crack sp. tt
Coef. Btu
Infiltration
Q
1
Glace
�'?,�
,Lv 6 0
Exp. wall
Net exp. wall
Z
10 1-106
Int. wall
Ceiling
_
Floor
JU 0
I1 4
ITotal Btu.
Required sq. ft. E.D.R. or sq. ius.. WA. Leader area
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixtures
Future Fixtures
Old Opening, New Fixture
Hear Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Hydraulic valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Heater
Gas Range
Gas Dryer
NO.
_ (P
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
RATE
$ 5.00
S 3.50
S 1.50
S 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
S 5.00
$ 10.00
$ 10.00
Rainepection Fee $ State Surcharge
($15.00) TOTAL PEE
TOTAL
$ _Ko>co
S
S .50
Ettective Aug. i, i`Jbi
Job Address r (® C9 ems_ 1,ACy--
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. 10 X� , 19 1
OWNER/ �L . e✓` /® ro C -0r1-5-S-T -C—
KIND
LKIND OF BUILDING 2- S-70 _ �A- 4
USED AS !� -i f® , - f A iv— P�
TO BE COMPLETED ABOUT ® �/ Ss -
ESTIMATED
aESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed ey
Tel. No. % -1
ROUGH INSP.
Date
FINAL INSP. l l il—eLe>
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
m
Water
Fpmp
a
gyp'
a
yto M
a
w
Heater
54
�c
u m
O
Ya
al
C
.MCi 0
O
ai yym
p�q�
a0i pm
t�
leC
H
U
b
00
N
i
W
N
W
U 10
3
l7
(7
O
s
�
r
lotf+a-
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
Hear Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Hydraulic valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Heater
Gas Range
Gas Dryer
NO.
_ (P
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
RATE
$ 5.00
S 3.50
S 1.50
S 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
S 5.00
$ 10.00
$ 10.00
Rainepection Fee $ State Surcharge
($15.00) TOTAL PEE
TOTAL
$ _Ko>co
S
S .50
Ettective Aug. i, i`Jbi
Job Address r (® C9 ems_ 1,ACy--
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. 10 X� , 19 1
OWNER/ �L . e✓` /® ro C -0r1-5-S-T -C—
KIND
LKIND OF BUILDING 2- S-70 _ �A- 4
USED AS !� -i f® , - f A iv— P�
TO BE COMPLETED ABOUT ® �/ Ss -
ESTIMATED
aESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed ey
Tel. No. % -1
ROUGH INSP.
Date
FINAL INSP. l l il—eLe>
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E., FRIDLEY, MINNESOTA 55432 • PHONE (812) 571-3450
February 11, 1985
Mr. John Bogucki
Rodney Billman, Inc.
151 Silver Lake Road
New Brighton, MN 55112
Re: Verifying Surveys for New House Construction
Dear Mr. Bogucki:
In checking our files it was noted that we have not recejA*'ed verifying surveys
for 445 - 63rd Avenue N.E., 475 - 63rd Avenue N.E., and 1472 - 66th Avenue N.E.
We would appreciate your getting copies of these surveys into our office as
soon as possible. If you have any questions on this matter, please feel free
to contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
O
CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEY. MINNESOTA 55432 • PHONE 1612) 571-3450
February 15, 1985
Rodney Billman Inc.
151 Silver Lake Road
New Brighton, MN 55112
Re: Final Inspection at 1472 - 66th Avenue N.E., Fridley
Dear Sirs:
A final inspection was made on February 13, 1985 of the above -address and
the following items were noted which must be completed before the structure
can be f inaled out:
1. Provide sod in the front and side yards by June 1, 1985.
2. Provide the City with a copy of the verifying survey by March 1, 1985.
3. Provide house numbers on the structure by March 1, 1985.
We will expect the above items to be completed by the scheduled dates when
reinspections will be made to determine compliance. If you have any questions
on these items, please feel free to contact me at 571-3450.
Sincerely,
CLARK
Chief Building Official
DGC/mh
d
L.L1. z SURVE:'O111
LANG SURVi:Y1NG SuHGPVisiGN DasiGN
TBLaPNONu 771•45645
085 Jff5816 ST. ST. PAUL. miNN. 55101
I hereby certify that this survey was prepared by me and that l am a duly
Registered Land Surveyor under the laws of the State of Minnesota.
Recd. No. 9051 Oate
o Indicates iron monument placed
. scales 1" = 30,
Int 5, Block 2, CREr' MDGE, Anoka County, Minnesota.
F
1t 9 SUv T*
0 0
Q�
P r nr , P -o oTt nl & r. L ro. P ?7, C//
(9
4.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Water:
Stories Closet Urinal
Basement
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Bear Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$ 7.00
Water Heater - Gas** I
$10.00 °
Gas Range**
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
JOB ADDRESS
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
JOV.7_1 11998
Owner (fq 2iS 57 7oZ i' j 1 3
Building Used As 14 °'" 'ic
Estimated Cost �s9"0 d PERMIT NO. G
PLUMBING COMPANY
Reinspection Fee $42.00/Hr SIGNED BY/l��c� ��-2 TEL N0. Sia -0Pv°Zd
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5°le of Value of Fixture or Appliance a e � v �
Approved By Rough -in Date Final Date 4eq
State Surcharge
MINIMUM FEE OR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $ jo.SO PLUS THE $ 50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE a -A. MINIMUM SIZE 9 SO INCHES.
susJEtr
PERMI
City of Fridley2
Z.
907 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i L
Q'
• COMMUNITY DEVELOPMENT DIV.
i ------,
fr� PROTECTIVE INSPECTION SEC.
r
/��
�;
I - �
NUMBEiI
REV
DATE
PAGE OF
APPROVED BY
I i--.1 CITY HALL FRIDLEY 55432
612-571-3450
910-F15
3/25/99
JOB ADDRESS
1472 66 Avenue NE
1 LEGALLOT
NO. BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5 & 5A 2
1 Creekrid a Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Chris Lawther 1472 66 Avenue NE
572-1493
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Town & Country Roof894-9365
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
20091282
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION OK REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage 37 S Tar -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REOUIRED 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 VVITHIN 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
$3,170
$1.58
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
$87.25
Fir SC $3.17
STRUCTION OR THE PERFORMANCE OF ONSTRUCTION
Id
PLAN CHECK FEETOTAL
KA
't'A y5
Lice s S
$
.00
SiG N//
ATURE OF CON'RACTOR OR 4UTMORiZED AGENT I AiEi
ENWPAdL
OUR ERM
v
LOGAN"
MATE
S-GNATURE OF OWNEROF OWNER BUILDER, iDA?E.
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 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 Pipin (Needed with new furnace,
ut not replac rent)
Gas Range
Gas Dryer T1
*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, 2002
JOB ADDRESS lZn� CCA J N E
OWNER___4q & Ay S6r)
TOTALi
f
BUILDING USED AS o 1os, �N ce
ESTIMATED COST 9700'06
PERMIT NO.
$ /0.00
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of HeatingUnits Circle One (Steam) ��
( ) (Hot Water) (Warm Air)
$ Trade Name G>keicjr� Size No. QUI 70
BTU '30,000 HP EDR
$ Fuel NG Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ 50 rulings of the Building Division, and hereby declares that all the facts and
�S representations stated in this application are true and correct.
DATE P` IR
HEATING CO �/ �� /�/FS��C)E dhri �;i6E)14f Ccrj�10r
Signed TEL # _d���
FAX #
Approved By Rough -In Date Final Date aJ �a
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VENT VENT CONNFCTOR AND COMRIIRTION AIR V RIFT CATION
When r _ la _ing an exit ing 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 manufacturers 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 comhustagn a04 it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes( ) No( )
When installing a n _w v _n ing 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 #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
HEATING CO:
Signed By: Date:
Mar -19-99 11:24A P_15
NEW [ ] Effective 1/1/98
A 1 SDN [ ] CITY OF FRIDLEY rp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 14/1,1 6(0
-6LAU-;-�, N -z-. � 1
Legal Description: t" pl--V a
Owner Name & Address: C` (~ �' Tel. # /� 3
Contractor Ml N LICENSE # 0 -1- �/ oZ �.
Address: / U . S %t{V Tel. # 7 `7� " 9 �Sr
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:
v l cJG,�
Construction Type: t` - -3�— Estimated Cost: $�?a, 466
STIPULATIONS:
(Fee Schedule 6n Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ = $
DATE: C APPLICANT:
aLoTel. # 3 ig
CITY USE_ ONLY
Permit Fee
$.0
Fee Schedule on Reverse Side
Fire Surcharge
$ . l
.001 of Permit Valuation (1/10th%)
State Surcharge
$ X,
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ ��'af>
$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: