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PRE 2010 DOCSm City of Fridley, Minn. BUILDING PERMIT No 4 s o` Date: -30010 r' Owner: _._! _._......... _ r Builder ..................... Address ___._..._...._....__.._ . _ _ Address __ ��.._.�_ OF, BUILDING TION No. _..� .-. _ .. Street _.__ ... ... __ ....._ ..�..._......._..._ Part of Lo_...... .... .. ....... Lot ....._......'�.._........ Block ....._........... .......................... Addition o Sub-Divis`.... Corner Lot .......................... -........ Inside Lot ....._... ............. Setback .... ..._...._....... Side and .. - . .._ ` "...........--.._.. Sewer Elevation ............ _..................... _._._._......._...._-----.---._..-..._...._.._---- Foundation Elevation ....................... ....... _........ ...... ....................................... _. DESCRIPTION OF BUILDING To Used as J Front ..... Depth Height-•- Sq. Ft. Cu. Ft. Front _ 4Depth ....�.. Height !. Sq. Ft. � Cu. Ft......_:..:. f, Type 1 Construction .....W -W .. Est. Co �.�t t -........... To be Completed ..... _............ _.............................. �P Tf,dS PER-,,,; p 0R ZE °Vj0LAT- �iL��'ic L ,FAL C®ViE(Vagn1TS AND 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 city of Fridley. �y► _.,fl;_......_._.._...____._. In consideration of the payment of a fee of $ KIW4 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 timeu� viol4tfon�f any of the provisions of said ordinances. ---,%I 11J Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or wafer. Be sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION pF BUILDING No. � L Street - & 1� �.�- Part of Lot Lot '�i Block `S Addition or Sub.Div. -4.Atj j&ZL"� Corner Lot_,.�Inside Lot_2L­Set Back_LZL L.Side.YardzE je) SEATER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION -OF ,BU=ING ¢� i To be used as t� Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be The undersigz%d hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordanc®'with the City Ordinances and ruling of the Department of Buildings, and hereby declar s that all the facts and representa- tions stated in this application are true and orrect.. (A Schedule of Fee costs can be found on`the Reverse Side.) W � I .-, 9 9 - - - 08 0 Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-/7470 GRAVITY WARM AIR: RATE TOTAL Location -3,F — Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ NIECE. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ®® each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .......... . ...... 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR 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 �' ,� GAS BURNER (up to 400,000 BTU) ....................... 5.00 $� GAS FITTING FEES: NO RATE TOTAL .� 1st 3 Fixtures ...................... x $1.50 $ l Sb Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS REMARKS: $ See Fee Schedule $ TOTAL FEE 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 ar/e true and correct. Fridley, Minn./,) P/ 19�o Owner FA � A i' !� I (! 195— Kind of Building Used as To be completed about , --5— ® $ 5-- 5--C, if'® Ing Permit No. Z-6 10 195— DESCRIPTION OF WORK HEATING or POWER team, Hot Water ar�A:I:r No� Trade Nam Size No_ _�trV 141– Capacity Sq. Ft. E.D. ��,!®� BTU H.P. Total Connected Loa Kind of Fuel Oy ,� �sQ, BURNER —Trade Nam ' �" Size No� Capacity Sq. Ft. E.D.R 1* BTU H.P. Sign �t CIO V AJ 11 Posr 1M-12-58 Business Phone No— �� !�✓ City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures IL6XJ�r z LZ3C7 ,<�iW W Z « WATER HTR. a ? 3� o� g�Li0 < F N GAS ELEG Base 1st 2nd 3rd 4th Future Connection Openings Cowith nnew I Sewer E] New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL. Number Fixtures ...................... x $1.50 $ 21067 Future Fixture Opening ................ x 1.20 $ =4 New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTI) ...... x 2.00 $ ® d New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ......................... Additional Fixtures ................... Gas Range to 200,000 BTU ............. REPAIRS & ALTERATIONS—Refer to Code NO. RATE TOTAL — x $1.50 $ �® — x .50 $ — x 2.00 $ Dept. of Bldgs. Phone SII 4-7470 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 City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Owner Kind of Building Used as To be completed about Estimated Cost, $ Old New Building Permit No WZMI 10 Permit No. Signe ROUGH—, /— FINAL Description ................................................$ TOTAL FEE $� 42 2M By _ Business Phone No 4�5C'A;045; 19W City of Fridley Application for Pkl&ng and Gat Fktbg Pelmh Dept. of Bldoe. Phone MD -3490 DESCRIPTION OF WORK Number. Kind and Location of Fixtures 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 .............. a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures 1 x 32,00 ; 2.00 Additional 313durea .................. x $ .75 $ Gas Range to 199,000 BTU ... ,........... x $5.00 $ install (1) gas lite 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ............................................ ; TOTAL FEE $ 5.1?� Lao1e, 38 NE 66 Way City of Fridley: 53-84-V15.51 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 May 19 1972 19, Owner Perry Hoag Kind of Building frame Used as residence To be completed about i` U 19, 1972 Estimated Cost, $ 10 000 OMPLNew. Building Permit No. Permit No. �SCDS� Signed 'Z� I& By Business Phone No ROUGH FINAL CVass "R" Surcharge -EC',: IVA • • WATER MTR. GAS ELEC. Base 1st 2nd 3rd I 4th I I I I I I I i i ruture Connection Ojenins + New Fixture, Old Openings Connected with Sewn ❑ Cesspool ❑ 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 .............. a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures 1 x 32,00 ; 2.00 Additional 313durea .................. x $ .75 $ Gas Range to 199,000 BTU ... ,........... x $5.00 $ install (1) gas lite 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ............................................ ; TOTAL FEE $ 5.1?� Lao1e, 38 NE 66 Way City of Fridley: 53-84-V15.51 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 May 19 1972 19, Owner Perry Hoag Kind of Building frame Used as residence To be completed about i` U 19, 1972 Estimated Cost, $ 10 000 OMPLNew. Building Permit No. Permit No. �SCDS� Signed 'Z� I& By Business Phone No ROUGH FINAL CVass "R" Surcharge -EC',: City of Fridley SUBJECT PERMIT NO. 12965 AT THE TOP OF THE TWINS BUILDING PERMIT r _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i -_-•� �i " "'j CITY HALL FRIDLEY 55432 L s12-Sea345o RECEIPT NO. 1-16tr aeyo r91F15 REV. DATE PAGE OF APPROVED BY JOB ADDRESS nre 1 LEGAL DESCR. LOT NO. 4 BLOCK 5 TRACT OR ADD) I N SEE ATTACHED Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry Hoag, 38 - 66th Way N.E., Fridley, Minnesota 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residence 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Insulate and reside with steel 9 CHANGEOFUSEFROM TO STIPULATIONS ����UtIlIt18S �IRIN��, Before digging call local D F®R ���V1t� TELEPHONE . ELECTRIC . GAS Etcw E PER�il Is N� SIGNS. REQUIRED BY �' S�PERA P1LuAgING A HEASING„ SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TYPE OF CONST. Frame OCCUPANCY GROUP OCCUPANCY LOAD THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ZONING -1 SQ. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $l, 5OO.00 SURTAX .7S DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $9.00 PLAN CHECK FEE TOTAL FEE $9.75 ZLQNATURE OF CONTRACTOR 9R AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT �-7JP 5=27-75 BLDG INSP DATE SIGNATURE OF OWNERIIF OWNE(BUILDER, ' 1 ATE) — - 1 s , APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: �� �/a- BUILDER:. ADDRESS : 3�– �v %2 ?�/ Q-c�, ADDRESS: NO:. R S STREET: a -- LOT: '� BLOCK: -S ADDITION: CORNER LOT: INSIDE LOT: V1 SETBACK: SIDEYARD: .Applicant attach to this form Two Certificate, 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:�Y62sek 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 : '`"'Z /' /� SIGNATURE: �'�' (See Reverse Side For Additional Information.) 97-8t,416051 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT • PLUMBING FIXTURE RATES: NO. RATE a 1%%"- er Fixtures '� $3.00 u Future Fixture Opening • x o $ water x $2.00 a� Catch Basin, x $5.00 $ b „n $5.00 G d x w $ Water Softener Heater o o .. x $5.00 $ Electric Water Heater - �_ x 01 M w GAS FITTING FEES: iC ' lst 3 fixtures ►1 Eel $3.00 $ A3diticnal Fixtures __� x $1.00 $ � x b w REPAIRS 6 ALTERATIONS ' 3n First $100.00 $5.00 $ as lee 0 - U a of $ ,_. 50 vi 3 $ 8,00 '1st � • tad ]rd ' 4th (R) - Future Connection Opening Connected with Sewer (•) - Ifew Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL 1%%"- er Fixtures x $3.00 S Future Fixture Opening • x $2.00 $ Now 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 BTO x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building � x $5.00 $ Electric Water Heater - �_ x $5.00 $ GAS FITTING FEES: lst 3 fixtures x $3.00 $ A3diticnal Fixtures __� x $1.00 $ .Gas Range to 199,000 BTU x $10.00 $ REPAIRS 6 ALTERATIONS ' First $100.00 $5.00 $ each add. $100.00 or traction $2.00 $ State Surcharge. $ ,_. 50 TOTAL FEE $ 8,00 REINSPECTTION FEE Job Address 38 66 way NE - - Department of Buildings City of Fridley Tel. $571-3450 The undersigned hereby makes application lora permit for the work het specified agreeing -to do all work in strict accordance with the City Co( and rulings of the Department of Buildings, and hereby declares that al; the facts and representations stated in this application are true and cc Fridley, Mn. - 7-5-77 , 19 OWNER PERRY HOAG ' KIND OF BUILDING fr�ma USED AS res. TO BE COMPLETED ABOUT 7 =12 -77 ESTIMATED COST 10.A0 OLD - NEW BUILDING PERMIT N0. PE T NO. % Company M1 CO Signed By' Tel. No. ROUGH INSP. Date FINI}L INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 ;lass "A" Surcharge .500 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 8 0" RATE TOTAL New Fixture& $ 5.00 b w $ e u A o �'t w a a a w yyo Mater Heater $ 4.00 $ blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Nater Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ BuNP or Receiving Tank lot 5.00 $ Mater Treating Appliance $ 7.00 $ not Mates Neater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 2" 3rd 4th (R) 0 Future Connection Opening (e) - New Fixture, Old Opening Connected with Sewer Mater RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixture& $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening. New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Nater Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ BuNP or Receiving Tank $ 5.00 $ Mater Treating Appliance $ 7.00 $ not Mates Neater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS Is of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE IN sttective Aug. 1, avtll Job Addriss Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby uakes application for a permit for the work herein specified agreeing to do all work is strict accordance with the City Codes and rulings of the Department of Bu..ldings, and hereby declares that all the facts and representations stated in this application era true and correct Fridley. at. ONMER Yma!5-N-C-0 RIND OF BUILDING USED AS 70 BE COMPLETED AMM ESTIMATED COST V(41 OV OLD - NEW BUILDING PERNIT No. PERMIT NO. f D l ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE -suejEcr MI N0 . City of Fridley 2'R 4 19 9 AT THE TOP OF THE TWINS BUILDING PERMIT Ir? RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � CITY HALL FRIDLEY 55432 NUMBER REV DATE AGE OF APPROVED BY 612-571-3450 910-F15 5/22/96 JOB ADDRESS 38 66 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 5 1 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Mastro 38 66 Avenue NE 574-9317 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement Inc 7401 Central Ave NE, Fridley, MN 55432 784-7543 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 4840 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 0 ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (22 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 @ $1, 760 $.88 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- Fire SIC $1.76 STRUCTIO THE PERFORMANCE OF CONSTRUCTION. $56.75 PLAN CHECK FEE TOTAL FEE License SC $5.00 $64.39 SI N TUREOFCONT A T RORAUTHORIZEDAGENT f (DAktj WHEN PROP V`VAL a CQ�y..L B G NSP ATEDTHIS IS YOUR PERMIT )A r _ S,GNATURE OF OWNER,1F OWNER BURDERI iDATEi NEW C ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: -q.5 _ /a a //-?- A_�_' J/z _ Legal Description: Owner Name & Address: Effective 3/1/96 _ Tel. # 5`2V--e731;Z Contractor: D & D Home Improvement, Inc MN LICENSE # 4 R 4 n Address: 7401 Central Ave NE Fridley, MN 55432 Tel. # 784=7543 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 ] Ft. Yd Setback Side Yard Setbacks Type of Construction: A9L_��� Estimated Cost: $ "J"G-1 Approx. Completion Date: jig=Z4 /ft UA .(Cost on Back) Driveway Curp Cut Width Needed.: Ft. + Ft = Ft x $ = $ DATE: APPLICANT: Tel. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 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 [ ] CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 5723604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS�(�+h 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 —� U orepresentations rulings of the Building Division, and hereby declares that all the facts and Also Replacement Fumace $ 30.00 $ stated in this application are true and correct. (Side Vent — Fill Out Back) - `�� 11998 Gas Piping (Needed with new furnace) $10.00 $ `nn OWNER 1 yn 1 V 1 yAS-T�. Q Gas Range $10,00 $ BUILDING USED AS Gas Dryer $10.00 $ _ ESTIMATED COST O d PERMIT N0. 3Z *Air Conditioning — All Sizes $ 25.00 $i t 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 Trade Name Size No. Commercial/Industrial BTU -15,000 HP (3 EDR 1.25% of Value of Appliance or Work $ Fuel N X—\ Total Connected Load _15 !p O a State Surcharge TOTAL FEE 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. Burner Trade Name Size No. BTU HP EDR HEATING COMP Y V U7<T 12 � N e. Signed By Tel No. 7,--3q 33�� T Approved By Rough—In Date Final Date FILL OUT BACK SIDE FO STACK VERIFICATION ON REPLACEMENT FURNACE CHEMMY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 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 04 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 '3� 0 0 o TOTAL BTU's I 13, O C7 b 7. Has a liner been provided for water heater Yes M No ( ) 8. Has combustion air been provided for water heater Yes W No ( ) Remarks: I 1A 50vy\-F- -SCALA �,)6 I t N Eg k—, 0.1< List ALTERATIONS Being Done: HEATING CO: Signed By: Date: C�)yAC\-Tcr i I2 ,` t,)C - SUBJECT City of Fridley 29 337 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. � COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 . � 6�3`/L�� 7 �J "e-1, CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 1 J\ 612-571-3450 910415 4/29/99 JOB ADDRESS 38 66 Way NE 1 LEGAL BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ILOTNO. 4 5 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charyl Mastro 38 66 Way NE 574-9317 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rainguard Construction 12008 Pennsylvania Ave N, Champlin, MN 55316 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 421-8897 6061 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (24 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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 REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO RUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX ANDAG THIS TYPE OF WORK WILL BE COMPLIED WITHHEREIN OR NOT. THE GRANTING OF A PERMIT $1,545 $.77 DOEO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROT R ST OR LOCAL LAW REGULATING CON•TRU $51.25 Fire SC $1.54 ANCE OF CONSTRUCTION PLAN CHECK FEEOTAL FEE Lice S $5.00 .56 5CTOAORAUTHORIZED AGENT iOATEi ENMPjEATE�Dl IN YO T gAfE $-GN4TURE Of OW NEA iiF OWNER BU4 DERE IDATEi NEW [ ] Effective 1/1/99 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION </ � L� ConstructionAddress: ,�� G /�//�- (T Legal Description: Owner Name & Address: "- A5-1-Ifd Tel. # Contractor: MN LICENSE # 6 6 Address: h76ciJ Tel. # L2/ f'r22 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Construction Type: �,, Estimated Cost: $� Wee Schedule on Back) .Driveway Curb Cut Width Needed: Ft. + 6 Ft Z x $ _ $ DATE: Z APPLICANT: Tel. # TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ a �' Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.501$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge _ $ a -CSU $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: Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DatMW U L 2 0 DATE YOUR E-MAIL ADDRESS SITE ADDRESS Darlene Toedter THIS APPLICANT IS: 0 OWNER *ONTRACTOR 38 66th Way PROPERTY NAME: Fridley, MN 55432 OWNER/ ADDRESS: 7635713034 ZIP TENANT — PHONE: CONTRACTOR NAME; STATE LICENSE # CJ EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS-. 21QS77fiC/ 2—le S CITY s'e..1 I sSTATE,&t4gIP S-f�000 LICENSE WITH , PHONE 7- yo3 FAX 2 APPLICATION PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK: ❑ 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 = •FORXROJECTS WHERE LABOR EXCEEDS -S -500, -FEES ARE BASED ON $10.00 PER FIXTURE,'EXCEPT..'M. ERE-NDTED :FIXT4!RES,,tMIGATE TOTAL NUMBER OF EACH BELOW) — BATH SINK/LAV _FLOOR DRAINS _ SHOWER _ WATER PIPING —BATHTUB _ GAS PIPING (xmD ctiyuc. z) _ SWIMMING POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER —KITCHEN SINK_ WATER CLOSET _ BACKFLOW PREV. ($15) _DISHWASHER --LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION WATER METER OTHER s, Permit Fee $ Number of fixtures @ $10.00 x $10,00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15,00 = $ Number of fixtures @ $35.00 _/ x $35.00 = $ 3S.Oo TOTAL DUE $ State Surcharge = $ .50 Total = $ . SO 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 appH . n 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 1 o w ' r uires review and approval of plans. SIGNATURE OF APPLICANTPRINT NAME Jed' 4/,011 rV7 DATE 15105- — ""1'-'"e, �gq MLI�` " E i t a� °3 �' B tYi a p rr r` `s a s E �' AM City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977