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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: Owner: At Builder Address _ _ _ _ _ Address N° 707 TION �F UILDING No. ... Street .�..._ L • r _ Part, t Lot .__ Block Ad 'tion or Sub -Division _ ` } Corner Lot _ Inside Lot Setback +I Sideyard Sewer Elevation Foundation Elevation DESCRIPTION .OF BUILDING, - i Front Depth �- Height � Sq. Ft xCu. Fro* Depth eiot ,yL� Sq. Ft. � Cu. Ft zr Type of nstruction s r Fit. Cos, To he Completed In consideration of the issuance to me of a permit to, construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $4� , 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 wig � city limits and this permit may be revoked at any urn violation of any of the provisions of said Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sure to sae the Building Inspector for separate permits for these Mems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY# MINNESOTA Owner's Name - Builder Addres0n .., ddress LOCATION OF BUILDING No. Street Part of Lot Lot 6 Block �� Addition or Subdivisio. Corner Lot Inside Lot SetbacIQ5, >,--Side-Yard— � SMIER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING be used as: FrontDepth Height�-� Sq. Ft. 42Cu. Ft. L�l dd;;eQ Front_,C2,r Dep• 3eight �-S �- Sq. Ft. Cu. Ft. D Type of Construction. Estimated Cost -Z-2 are:) 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNATURE � (Schedule of Fee Costs can be found on the Reverse Side). Application for Power Plants and Heating. Cooling, Ventilation, lob igeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, 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 MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ d. 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. IDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam .................. I ... 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 $ X 0 y GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 / $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE $ $ /' Y` ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 V – £ 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 — G 6 19 Owner ' Kind of Building Used as To be completed about Estimated Cost, $ -moo Old New uilding Permit No.` Permit No. o DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No yql" � Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load 4e'y ; Kind of Fuel BURNER — Trade Name Size No Capacity. (REMARKS—OVER) �wss� 42 iM 7-59 Sq. Ft. EM.R BTU H.P. Signed JARNIG Pf.UMBiNG & HEAflWG ANOKA. MINN. TEL. HAA. 1.1382 By Business Phone No BEAT LOSS CALCULATIOMTOWN DEPARTMENT OF B VILLAGE Weatherstrips A.SILVZ Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Y I Y o 19........ ( >r FL I Room I Length Width Height JFLoom I LengE2 Width Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. No. of pane of pane I lights of crack sq. ft. o 30 le Coef. Btu Coef. Btu Infiltration I djB y I I y(_) 1 191,60 Infiltration 1-/ y _ -- 4- v Glace Exp. wau d7)(-3 a - t Net exp. wall Int. wall Ceiling Floor Total Btu. PIN �i , I Sm ■m .RV Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length % Width Height Room I Lengthidth&OReight Windows and Doors—Crackage and Area I No oE,Bane of pane lights Lineal f ick sq. Et. ���c� / Windows and Doors—Crackage and Area No. of pane of Pane lightsP/,f crack sq ft. r a D� Coef. Btu Coef.j Btu Infiltration "0 1-74:1- Infiltration Glass v �3"� Glass Exp. wall -2 Exp. wall = Net exp. wall 6 o 1 16 a O Net exp. wall Int. wall Int. wall Ceiling Ceiling Floor Floor Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I„( Room I Length Width Height Fl. Room I Length Width Windows and Doors -Cracks a and Area Windows and Doors--Crackage and Area No. of !pane I off p! one I lights I of Lineal sq. fit. _ No. I o�iBd e o Pane lights I off cer�aek sq ft Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Btu II Infiltration Glass EV• wall a3 X Net exp. wall Int, wall Ceiling f�. Total Btu. Coef.j Btu I 1// Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Compliinefits of North Central Public Service Co., ' CITY HEAT LOSS CALCULATIONS TOWN DEPARTMENT OF BUILDINGS VI LLAGE Weatherstrips A.S.H.VX Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof I Floor Kind I How Applied Yes --No Yes—No i9.. FL Room I Length --'-Width Height FL I Room I Length Width Height dows and Doors—Crackage and Area (I Windows and Doors-�Crackage and Area Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room I Length Width Height Windows and Doors—Crackage and Area Doors—Cra.ckage and Area No. Width Height No. of ft. of pane of pane lights of crack Area aq. tt eal ft. of crack Area sq. ft. CoeLl Btu Infiltration Glass Coef. Coef. Exp. wall Infiltration Net exp, wall Glass Eat. wall Ceiling Exp. wall Floor Net exp. wall Net exp. wall Total Btu. i Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl_ I Room I Length Width Height Windows and Doors—Cra.ckage and Area _ Width No. of pane Height No. of of pane lights eal ft. of crack Area sq. ft. Coef. Coef. Btu Infiltration Glass Glass Exp. wall Exp. wall Net exp. wall Net exp. wall Int. wall Int. wall Ceiling Ceiling Floor Floor Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Coef. Btu Infiltration Glass Exp. Wall Net exp. Wall Eat, wall Ceiling — Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FL I Room I Length Width Height Windows and Doors—Crackage and Area _ No. Width He of pane o1 pane No. of lights Lineal ft. of crack Area sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Windows and Doors—Crackage and Area Infiltration Glass Exp, wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. it. E.D.R. or sq. ins. W.A. Leader area City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ 16S6 Future Fixture Opening ................ x 1.20 $ -R 0 New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ Ci O New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $—L ,5�0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $L /S—'kd 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. 0 Ownery—f-ey Kind of Building Used as To be completed about Estimated Cost, $ Old ew. tulding Permit Nov Q Permit No. Signe ROUGH FINAL -IMOA2 2M Rv Business Phone 196-;o Z S Z WATER HTR. gG 80 5 6 �°d �p R N GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings Connected with SewerEl New .Fixture, Old Openings Cesspool [] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ 16S6 Future Fixture Opening ................ x 1.20 $ -R 0 New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ Ci O New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $—L ,5�0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $L /S—'kd 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. 0 Ownery—f-ey Kind of Building Used as To be completed about Estimated Cost, $ Old ew. tulding Permit Nov Q Permit No. Signe ROUGH FINAL -IMOA2 2M Rv Business Phone 196-;o 52-84-5915.51 City of Fridley Application for Plumbing and Gas fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 46 N E 66th Way Number, Kind and Location of Fixtures Localf°n G7 I $ ce $ — x $1.50 $ y, Y Z o r2� ac z Z G� _ W O _jt� U�' •� W �U' z z �O • F • N WATER HTR. GELEC. ELEC. Base 1st 1 2nd 3rd 4th • Fugue Connection Openings e New Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ...... .................... Water Beater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures ............ I............ Additional Fixtures .................... Gas Range to 199,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code x $2.00 $ x $1.50 $ — x $1.50 $ — x $3.25 $ — x $3.00 $ x $3.25 $ — x $2.00 $ NO. RATE TOTAL x $2.00 $ x$.75 $ 1 x $5.00 $ 5.00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the feel and representations stated in this application are true and correct. Fridley, AUnn 9-30-68 19 - Owner W Habig Kind of Building frame Used as rvs _ To be completed about 10-4-68 Estimated Cost, $ 10- 00- Old—New. Building Permit No Permit o. Si e c By MINN LIS GAS CO. Business Phone No ROUGH f FINAL c'Ya Description ................. ..............................$ TOTAL FEE $ 3.00 -Ow4a REC. No. 47296 City of Fridley, Minn. N° 10248 BUILDING PERMIT • Date: Layer; , 1969 • Owner: Wydell Habig Builder Same Address 4.66.th_1je,y w - p— Address same LOCATION OF BUILDING No. 46) Street 66th Talar — Part of Lot Lot _ 5 -B -5A._....__ Block _ 5 Addition or Sub -Division Edgewater Gard an s. Corner Lot , Inside Lot _ Setback --_ Sideyard Sewer Elevation ___ ___ — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Additioh Front 20' Depth 11 ` Height 121 Sq, Ft. 220 Cu. Ft. Front Depth Height _ Sq. Ft. Cu. Ft. Type of Construction _ _ Est. Cosh , Q00. 0A _ _ __ To be Completed Jain LJ • 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 comp] a�ce�t a'll provisions of ordinances of the city of Fridley. � // _ , ..7._ Yl l In consideration of the payment of a fee of $ , eg. , permit is hereby granted 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 wig � city limits and permit may be revoked at any time upon violation of the provisions of said CLARENCE BELISLE NOTICE This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sower or water. Bo sora to no the Building Inspector for separate permits for these boom APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER 'S NAME - BUILDER ADDRESS %( /I% ,6E, L�l. Td 4) , ADDRESS NO. LOCATION OF BUILDING C: LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT ---- V -,-SETBACK SZDETARD SEWER ELEPATION TOP OF FOOTING ,Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used, As: Front ®i Depth -ZZ ' Height, / Square feet g°+ ° Cubic Feet out Depth Height�� Square feet Cubic Feet Type of Construction 5�=E7 Estimated Cost , To Be Completed / s 4r-- lel- The l The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with tb 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. A DATE SIGNATURE. (Schedule o Fee Costs case be found on the verse Side.) is City of Ridley d Dept. of Bldgs, Phone SM -3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location '7`� WATER HTR. j<�q1 iZ _ g3 3z 00 u a ® s O F N GAS ELEC. Ba^ — - - — — 1 2nd3r3 - -- -- -- - — 4th— ° k nature Connection Openings Connected ivltb --- --- --- * Now Fixture, Old OpeningsSewer I ❑ 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 $1,60 $ Catch Basin .. x $3.25 $ Water Heater (Up to 99,000 BTU) x $3.00 $ New Ground Run Old Bldg. x $3,25 $ Electric Water heater = $2.00 S. GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .... .... .... ,, x $2.00 $ Additional Fixtures ..... .............. x $ .75 $ (has Range to 195,000 BTU .............. x $6.00 $ REPAIRS & ALTERATIONS—Refer to Code Description .... ao TOTAL FEE � �—� 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 are true and correct. Fridley, Minye n,._�/� �l 3 19�� Owner W ' W /� , --b�-�1, Kind of Building 7YAA-A Used as To be completed about Estimated Cost, $ 15c) c ld New. Building Permit No.—_ _ _.__._Permit No. Signed. By- Business Phone No- ZK O ROUGH (� FINAL' U �b No 5003 Permit forFLUMBING AND GAS FITTING La ?d ;� N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit �,/ inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit,, DFSCE MON OF WOES Number, Kind and Location of Fixtures City of Fridley ,19� StU11P.8 C m O 'T. U Z a m m m F Z Y m m m Y Q = F Z; O 4 O tj) c Z O LL O u Z ttt m U m Z Q¢ 6' -OI _m EILL J O C Om m 2 O WATER HTR. GAS ELEC. Basement lst 2nd 3rd 4th Connected with Sewer -Cesspool Gas Piping for Openings Permission is hereby granted to do the plumbing and gas fitting, in the building describect in the stateme9t hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date Inspector. 42 Ian—"9-v Owner Location - Z Kind of Building Used as OF To be Completed ,19_ Estimated Cost $ 16® - Old -New. Building Permit No_ Date Inspector of Buildings. ciij • Application�' �'j', n�1 G= M;ng Pemit ..... . Dept, of Bld:s. Phone $=00 D1SCX"T109 or `VOA ,LoczL 46 N. E. 66th. Way ftamuee, Kind end l.oaeiiea e4 FtAtawf • F::^.:o Cc= c:::�-n Opo :ir;s Soeaae t xowr i i_•turb. Old O-„aairrs -- Cetsp� PARTIAL RATE SCHEDULE City of Fridley: l Thr undersigned 'hereby mikes application for a permit for the work, he -_9 .. specified, a.,rec.ng to do a.I wcrk in strict acct duk. ce lth the C. C=�•a'c and ruling of the Department cf Bu d,'r Zs. and hereby declares Lhzt - Lhe.fal • and representations statol Ln tis ..prl.catica are trLe arm eo.:ect• :�idley, Donn ...Au�tast�26 , 1275,19— Ownerd.-�� , PLt3xituG tFt iuRt �+Tg$t NO. RRTB TOTAL p S wAT(R "TR. �"�'~ •• Mari; I ����- o.4 7 2: 7' v N GAS G $_ x53.25 S Catch Basin ................... •---_____ Cater ifea to 'Ilp to 5.9.000 BTU) .... --- x 53.00 S • ye:+ Ground Run Old Bldg....:..:. ----- x $3.25x� E:Ktr'.c atOr Hata . . .. ... • .. • .. . o 'L r�• , E3cr_ GAS VIT?ING.FUS: NO. R;+TB TOTAL Ist 3 Fixtures ...... • • • • • • • ”" • ----= x $2.00 $ • x S .75 $ - ,A.dd.tioaal lrxtures.....:......... �---- G s ?..:.: ±e to 199.000 B M ........... ----- x 35.00 ' S 3:d 1 I '— • F::^.:o Cc= c:::�-n Opo :ir;s Soeaae t xowr i i_•turb. Old O-„aairrs -- Cetsp� PARTIAL RATE SCHEDULE City of Fridley: l Thr undersigned 'hereby mikes application for a permit for the work, he -_9 .. specified, a.,rec.ng to do a.I wcrk in strict acct duk. ce lth the C. C=�•a'c and ruling of the Department cf Bu d,'r Zs. and hereby declares Lhzt - Lhe.fal • and representations statol Ln tis ..prl.catica are trLe arm eo.:ect• :�idley, Donn ...Au�tast�26 , 1275,19— Ownerd.-�� , PLt3xituG tFt iuRt �+Tg$t NO. RRTB TOTAL x $100 S Number Fixtures ................ -.� — ' Fbti:re FZxture Opening .. • • • • • • . •.• x 51.50 S -••.--- New Fixture OM Oppnirg..... .. x :1.50 $_ x53.25 S Catch Basin ................... •---_____ Cater ifea to 'Ilp to 5.9.000 BTU) .... --- x 53.00 S • ye:+ Ground Run Old Bldg....:..:. ----- x $3.25x� E:Ktr'.c atOr Hata . . .. ... • .. • .. . o 'L r�• , QS V GAS VIT?ING.FUS: NO. R;+TB TOTAL Ist 3 Fixtures ...... • • • • • • • ”" • ----= x $2.00 $ • x S .75 $ - ,A.dd.tioaal lrxtures.....:......... �---- G s ?..:.: ±e to 199.000 B M ........... ----- x 35.00 ' S Kind of Building Used az dwelling To be completed about oAu�t�28�- 1225.00 'Estimated Cost, S Old --hew. -Building Permit NO.—�;T/u ' Signe By DelA.ir Conditioning( Inc. •-• Busiric s Flnure No 884.7491 ROUGH f ♦v. T1 .50 State.Surcharge ' �14i'Rs tc kL•T�'RJ►it®Tfs-�a•�a1r.�o Coad. ; . • 10 �,0 TOTAL r ►---- Adding -- air conditi�n�6�, Lennox HS8 261 - h/C- i 97-84-416051 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT • frame „ PLUMBING FIXTURE RATES: NO. 0 q 2.l=-ber Fixtures 1 $3.00 U . k a $ Water f ■ w A x $5.00 w cn. x $5.00 $ 100;000 8TU to 199,000 BTU x w $ Water Softener Heater $7.90 $ New Ground Run Old Building x $5.00 $ Electric Water Heater - _•T_ x $5.00 $ GAS FITTING FEES; , 1st 3 fixtures x $3.00 $ Mditional Fixtures _- x $1.00 $ .Gas Range to 199,000 BTU x $10.00 $ REPAIRS 6 ALTERATIONS Lq First $100.00 $5.00 $ each add. $100.00 or fraction lea 0 = u' a a c vi a k W w c� o� d x i3 ug 0 3as ist h6, • NE '66 jWayj st 111�r '2:nd re 4th . (R) - Future Connection Opening Connected with Sewer (�) - 11ew Fixture, Old Opening Water PARTIAL RATE SCHEDULE frame PLUMBING FIXTURE RATES: NO. RATE TOTAL 2.l=-ber Fixtures x $3.00 S Future Fixture Opening )i $2.00 $ Now Fixture, Old Opening x $2.00 $ Catch Basin. x $5.00 $ Nater Heater - to 99,000 BTU, x $5.00 $ 100;000 8TU to 199,000 BTU x $10.00 $ Water Softener x $7.90 $ New Ground Run Old Building x $5.00 $ Electric Water Heater - _•T_ x $5.00 $ GAS FITTING FEES; , 1st 3 fixtures x $3.00 $ Mditional 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 fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 RE2N4P£Gr`2(1N rFF Job Address _ ,k6 NE 66 Wap Department of Buildings City of Fridley I Tel. 11571-3450 The undersigned hereby makes application fora permit for the work h specified agreeing -to do all work in strict accordance with the City C land rulings of the Department of Buildings, and hereby declares that a the facts and representations stated in this application are true and Fridley, M.1. 8-9=77 19_ OWNER MMLL HART( frame KIND OF BUILDING USED AS res. TO BE COMPLETED ABOUT 8-9-77 ESTIMATED COST OLD - NEW BUILDING PERMIT N0. PEMIT NO.f o� 45rc wn Company ISGOASCO Signed By' Tel. No. ROUGH INSP. Date FINIAL INSP. �! Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT I9 $7.50 CITY OF FRIDLEY INSPECTION DIV. Effective On January 1,1995: 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 20.00 $')0- oC) (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ Gas Range Gas Dryer $ 10.00 $ $10.00 $ *Air Conditioning — All Sizes $10.00 ' -_Acbx All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial I% of Value of Appliance or Work State Surcharge TOTAL FEES Er MINIMUM FEE FOR ANY HEATING/COOLING VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 _ PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS l0 6t' V La'L V— 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. % BUILDING USED AS ESTIMATED COST PERMIT NO. 1 1 t s - l ix 1 I c' No. of Heating Units / Ci Is One (Steam) (Hot Water) (Warm Air Trade Name Size No. BTU Q HP EDR ow Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING CO 61ANY v � J Approved BXga Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace. CHIMMY 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 No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes,,() No ( ) 6 Has total heating BTU's of U U All other BTU's TOTAL BTU's (00 J P 7. Has a liner been provided for water heater Yes ( ) No ( } 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: HEATING CO:_I-r Ir PI, mc. e", Signed By: Date: �q•�'� CITY OF FRIDLEY BUILD INSPECTOR TO WHOM IT MAY CONCERN: I (WE) MR. OR MRS. CLIFF FLECKTEN GIVE ROLAND AND JANE DIEDERICH OF 46 -66TH WAY (PERMISSION TO INSTALL AN AIR CONDITIONER ON THE SIDF,Op THEIR HOUSE. � I RESPECTFULLY MR. AND/OR MRS. FLECKTEN SUBJECT PERMIT NO. City of Fridley )5095, AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. L r PROTECTIVE INSPECTION SEC :?03/ NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/1/97 JOB ADDRESS 46 66 Way NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR, I 5A/5B 5 I Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roland Diederich 46 66 Way NE 572-0057 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Alice's Restoration 766 Stewart Ave, St Paul, MN 55102 222-2432 20070247 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 p ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. i 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 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 1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,650 $.83 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $54.00 Fire SC $1.65 PLAN CHECK FEE FEE I4cenSC 00 $6 1.48&�TRACTOR.RALITED GNATUR FCONAGENT(DATEj N AO Y VALIDA ED THIS IS YOUR PERMIT S,GNATURE OF OWNER0F OWNER BUILDERi IDATEi BL INSP D TE NEW [ ] Effective 1/ 1 /97 ADDN [) CITY OF FREDLEY ALTER [ ] SINGLE FAMILY AND DIJPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: xf, Legal Description: S r^ Owner Name & Address: t/L I Tel. # 7a -am s 7 Contractor:��� CSS f'Sr� 2�i i6 MN LICENSE Address: 1 ' Tel. # Attach to this application, a i to o Survey of`tli'e` lot, with the proposed construc ion drawn on it to scale. DESCRIPTION OF ROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground - Sq. Ft. OTHER: yi r I � Construction Type: Estimated Cost: $ , DO o (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = �Ft x $ = $ DATE: 3APPLICANT: Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ �`�, � Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 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: 0 91 SUBJEtY City of Fridley 30922 AT THE TOP OF THE TWINS BUILDING PERMIT r 16 RECEIPT NO. v ______ COMMUNITY DEVELOPMENT DIV. SEC. r 1 PROTECTIVE INSPECTION lJJ'vA'(�J1 1 � CITY HALL FRIDLEY 55432 AL""A= NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/8/00 JOB ADDRESS 46 66 Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5A, 5B 5 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Diederich 46 66 Way NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Steve Snedeker Construction 11657 Palmer Rd, Bloomington, MN 55437 990-2042 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (20 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 $1,745 $.57 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV - UTHORITY TO VI ATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY OTHER S ATE OR LO AL AW REGULATING CON- $63.15 Fire SC $1.75 STR CTIO OR NCE OFC STR CTION PLAN CHECK FEE FEE T7$70.77 License $5.091 SIGN "TUQE OF CO •QAC A AUT ED AGENT tDATE. EN ROP VALID T JF THIS IS YOUR P RMIT S.GNATURE OF OWNEROF OWNER BUILDERi iDATE, p5v gArE 0 91 NEW [ ] Effective 1/1/2000 ADDN [ J CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION rr11 �j Construction Address: Legal Description: 0 a Owner Namei ddress: i- Tel. # Contractor n MN LICENSE # �� Address: 1Tbi/ Tel. #tg - 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 GARAGE AREA: DECK AREA: OTHER: Construction Tvr Length Width Length /'Width Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Estimated Cost: $ / Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE APPLICANT: Tel. # v CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Call (763) 572-3604 for Permit Fees if mailing in application Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $ c�% $.50/$1,000 Valuation $_$1 100 per SAC Unit $ C�® $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above R $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: $ N SUBJECT P IT NO. City of Fridley 3 0992 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. v ------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �� -7 r PROTECTIVE 1 i J� ,•� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By L 612-571-3450 910 -FIS 5/30/00 JOB ADDRESS 46 66 Way NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5A, 5B 5 I Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roland/Jane Diederich 46 66 Way NE 763-572-0057 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite Home Improvements 8400 89 Ave N, Brooklyn Park, Mn 55445 425-2227 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20039258 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace 9 windows & 1 patio door; Reside House; Acrylic Liner and surround 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Permit Inspection Cards T. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONSOCCUPAY LOAD� VENTILATING OR AIR CONDITIONING JOHOMep est 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 1 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 $17,064 $8.53 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK F TOT EE Licen S $5.00 $ 3.84 SIGN A TUBE OF CON' RACTOR OR AUTHORIZED AGENT IOATEI EN ROP LIDA THIS IS YOUR PERM T/+J�J / V SIGNATURE OF OWNEROF OWNER BUILDER, [DATE, Bl0 ,NSP qA it N NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY rl_ ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: - ((04h LjCAy Legal Description: Owner Name & Address: Ro�ondk # pian e 17 i _d en i c h Tel. # S -]Z - 00ZE7 Contractor: MN LICENSE # ZOG 3gZ5f� Address: 811GO g AJ2 ill " Li!00 (3r-,00<w.r% PcartK, IiiN S544STel. # (763) LI25-ZZZ7 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 GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Construction Type: v „� q(- ;� �,� .���;� Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: /� 000 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 5,60 - Q I nd� L4 e -,S CITY USE ONLY Sq. Ft. Sq. Ft. Sq. Ft. I1 I OL'o M1 Im Tel. #11630 L1-26-2227 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,003 Valuation $1050 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 t ] Not Necessary [ ] $ (3,93, 7� STIPULATIONS: �I��D� �D/« ��l erg /"IV 71-05 10 V�oz- CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, `20000 "7V Reinspection Fee $47.00/Hr SIGNED BY -1—, TEL N037 .®�' O ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance ? ®- Approved ByRough-In Date Final Dateb State Surcharge $ .50 R ANY PLUMBINGIGAS PERMIT IS $20.00 MINIMUM FEIE1 TOTAL FEE $ - PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE �K n PLUMBING FIXTURE RATES: NO. RATE TOTAL Lj JOB ADDRESS (4, New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 r specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 o� , 20 0cb. Sump/Receiving Tank $ 7.00 , Water Treating Appliance $10.00 Owner o a N Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As 60M � Gas Range" Gas Dryer** $10.00 $10.00 % Estimated Cost PERMIT NO.—/ Back Flow Preventer Required ( )Yes () No Type $15.00 Q PLUMBING COMPVQY Si D Reinspection Fee $47.00/Hr SIGNED BY -1—, TEL N037 .®�' O ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance ? ®- Approved ByRough-In Date Final Dateb State Surcharge $ .50 R ANY PLUMBINGIGAS PERMIT IS $20.00 MINIMUM FEIE1 TOTAL FEE $ - PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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 manufacturer's 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 combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When Installing a new venting 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 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 : CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NIIMRFR nF MYTI IRFG Tr) RF ❑UCTAI I Rn rW I=erru M nnD Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas*"_ Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $Z0--5 JOB ADDRESS 54NE is dtZl.5IE�e 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. DIEDERICH, ROLAND -'0 / 46 66TH WAY NORTHEAST FRIDLEY, MN 55432 Owner (763) 572-0057 Building Used As T)�61'D%1J Cit. Estimated Cost PERMIT NO. PLUMBING COMPANY ©I),=m PtDeakr, _ SIGNED Approved 20012. Rough -In Date Final COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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 S pecifications :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 existing 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 Installing a new venting 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( Apaliance 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 : Building MECHANICAL Permit No.: p - C)W5' q Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D'�'� 3 DATE YOUR E-MAIL ADDRESS // SITE ADDRESS (A Cp - t THIS APPLICANT IS: ❑ OWNER VCONTRkeTOR PROPERTY ; NAME: cx r\ 8 bi C` if- C OWNER/ ADDRESS: LA U - VJ �� \ ITY r ( 1 STATE n S Sy 3a TENANT PHONE: '_1 (n3 - ` S1a. ' O dS CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY CONTACT PERSON: JOANN Z INKEN SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 9320 EVERGREEN BLVD STE BITY "COON' -'RAPIDS sTATEMN zIP55433 APPLICATION PHONE 763 - 757 -- 6202 FAX 763--757-6701 PERMIT TYPE V'<NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTIONOF WORK Mrs - \cLoiP_ PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) S t O �OEquipment Installed MFG: MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _✓_FURNACE _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 _DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 y Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 �_ x $35.00 = $ �S 5 ,� State Surcharge = $ .50 Total = $ 2;5,S0 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT eA, NAME ROGER HOFFHEIN DATE J' oZCF'G City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.