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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Owner: Builder Address Address N4 5962 LOCATION OP 41LDING sv cApNo. Street "-KV, 0 AW5--e--Part of • Lot _ Block ---tea Addition or Sub-Divisi , Corner Lot Inside Lot — � Setback � -- Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING TheU Front Depth Height _ Sq. Ft.. Cu. F Front Depth• eight! Sq. Ft. "Cu. Ft. Type of truction Fast. :""- -To be Completed Aff 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 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 withinthe city limits and this permit may be revoked at any yp u viorT of any of the provisions of said ordinance Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumhing,M gas heating, sewer or water. Be aura to we the Building Inspector for separate permits for these. hems. .' APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA 00 owner's Name Builder Address.,4 S Address LOCATION OF BUILDING c^ No. J Street_. art of Lot Lot Block Ad ition or Subdivision M:tk-x Corner Lot Inside. Lot Setback.11::Side-Yard,_ SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be use o Front j:�O„ Depth' Height Sq. Ft. &7161 Cu. Ft. FrontDepth height Sq. Ft. Cu. Ft. a Type of Construction ______ Estimated Cosa 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 2 -SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and C%n Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location— WATER ocation PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... L x $1.50 $—G}'— /4 Future Fixture Opening — _ x 1.20 -9 $ New Fixture Old Opening .............. x 1.00 z Catch Basin ............................ g$ �� p R N WATER HTR. - GASF $ GAS FITTING FEES: NO. RATE TOTAL 1st 8 Fixtures ...... ................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd 3rd _ 4th Future Connection Openings withioa I Sewer El New Fixture, Old Openings Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... L x $1.50 $—G}'— /4 Future Fixture Opening — _ x 1.20 -9 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTW ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 8 Fixtures ...... ................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ Z 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, Minn- oz� 19i�� Kind of Building Used as To be completed about Estimated Cost, $ AMM-LNew. Building Permit No9� Z Permit No. Signe By Business Phone No ROUGH FINAL 422M Application for Power Plants and Heating, Cooling, Ventilation, .Refrigeration and Asir Conditioning Systems and Devices 9 4 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 $ 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 NO RATE TOTAL 1st 3 Fixtures ...................... 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 $ 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 $ X iH rA ROUGH FINAL Dept. of Bldgs. Phone SII 4-7470 s --®2,y = W-- 6 i e'u� r - 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- B— --'U — G 19 — Owner Kind of Building Used as To be completed about 90, Estimated Cost, $ Old Building Permit No. / �� — Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water, arm Air No Trade Nam Size No -,319'151— ?y Capacity Sq. Ft. E.D.R BTU H.P. �-1—Total Connected Load � o Kind of Fuel ?Zo BURNER —Trade Name Size No Capacity Sq. Ft. EM.R BTU H.P. (REMARKS -OVER) Signe JARNIG PLUMBING & HEATING By ANOKA, MINN. . HA. —1.13382 ws. - 48 zM 7-89 Business Phone No VITY O - 4g N HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Ins ation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Appliect Yes—No I Yes—No 19- 171.1 Room Length ad Width /3 Height J F1.ILIAeQ Room I Length 11 Width Windows and Doors—Crackage and Area Width Helsht No. of Llaeal ft. Ares No. or Pane of Dane Ilghte of crack sq. M Windows and Doors—Crackage and Area Width Height No. of Lineal t . Area No. o! pane o[ Pane lights Total Btu. / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length / Width 17 H o[ crack eq. ft. 47 R-- / 3(. 0Y /S' aL37 3y 31- A ! / Coef. Btu Infiltration X/O ,rL a /O –6,; yv X260 Glass 11 /a� Exp. wall ,E t) b O F.xp. wall 30 A Pr 2& y Floor Net exp. wall Int. wall Int. wall / y q' / ;LFloor Ceiling D D Ci Floor y(, 0 1 7 f .A Q Total Btu. / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length / Width 17 H Windows and Doors—Crickage and Area yo Width Height No. of Lineal ft. Area No. of pane of pane Ilghte of crack sq. ft. / Alf (,Ir-- ,7 /7. / . l b / t/ 3 Btu Infiltration YO Glass Exp. wall Net exp. wall / ? y / J / Int. wall Ceiling / Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area Flies . A� Ron. I Length 9 §?–Width I Z Height IIInfiltration II Glass Exp. wall Net exp. waU Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l F Q.g,,gQ Room I Length `f Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area of Pane of Pane lights at crack eq. ft. y ® of `✓ Coef. Btu Glass yo .1 YO / 6v `YYV /t/2 3 Ceiling Y Y Floor X/O ,rL a Glass –6,; Glass Ar I v 11 /a� Exp. wall 744 Int. wall 7'rN A" 10 sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l F Q.g,,gQ Room I Length `f Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area of Pane of Pane lights at crack eq. ft. y ® of `✓ Infiltration Ai 6 O Glass Be 6.3/Q,6 Exp. wall 2 v Net exp. Wall Int. wall 3 Ceiling Y Y Floor Windows and Doors—Crackage and Area Room I Length Width . Height d— Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Be 6.3/Q,6 Width Height No. of Lineal ft. Area No. of pane of.pane lights of crack sq. fL Coef. Btu Infiltration /� - 3 X/O ,rL a Glass –6,; Glass Exp. wall v d O Exp. wall p (� Int. wall Net exp. wall Floor (, Int. wall Ceiling / y q' / ;LFloor 1 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area B.D. 218 Required sq. ft. E.D.R. or sq. ins. WA. Leader area ZO vsv I 0 FLI Room I Length Width . Height d— Windows and Doors—Crackage and Area L, 7 J �� r Width Height No. of Lineal ft. Area No. of pane of.pane lights of crack sq. fL CME Btu Infiltration / X/O ,rL a Glass Exp. wall Net exp. wall 01 Int. wall Ceiling Floor 11 Total Btu. ired sq. ft. E.D.R. or sq. ins. WA. Leader ate& SUBJECT PERMIT City of Fridley 20784 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 , EIPT N COMMUNITY DEVELOPMENT DIV. r r � � PROTECTIVE INSPECTION SEC. 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/25/91 JOB ADDRESS 25 - Wi Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 3 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Paul/Lisa Christenson 26 - 661i Way NE 571^6978 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install bay window; patio door; reside dwelling; 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. 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 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 VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $9,000 $4.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $108.00 Fire 3C $9,00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE - $121,50 SIGN T EOF RIZED AGENT (DATEI WHEN PR O ER AL A THIS IS YOUR PERMIT �ROR CW S)G ATU E OF OWNER OF OWNER BUILDER) (DATE) DATE NEW [ ] ADEN [ ] AUM [ ] Construction Address: Legal Description: Effective 1/1/91 R-1 AND R-2 Building Permit Application Owner Name & Address: Tel. # t37/ �7c� Attach to this application, a Certificate of Survey of the lot, with the proposed cmwtn=ticn drawn on it to scale. DEqCjtIBTICK CF IIF9 ZmVEI�iP LIME AREA: length Width Height Sq. Ft. GNRAM AREA: length Width Height Sq. Ft. DBCK AREA: Width Hgt/Ground Sq. Ft, Corner lot [ ] Inside Lot [ Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: Approx. Cm pletion Date: M2A4 I i ' 121 Proposed Driveway Width If New Opening Is Desired: - Ft. $. _ $ Width + 6' See Back Page DATE: 4"25--g( Appuaw: t�Tel. # 6171 -&q -7a QTY 1;]SE CBLY Permit Fee $,jam (� Fee schedule on Reverse Side Fire Surcharge $ Q,06 .001 x Permit Valuation (1/10th �) State Surcharge $ �, �� $.50/$1,000 Valuation SAC Charge $ $650 per SAC Unit Driveway Esmvw $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Ea�g'ging Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ l TOM $ S'I'IPULATIMS: 9006 SUBJECT P 707-7] City of Fridley 6 5 2 6 5 3 9 AT THE TOP OF THE TWINS BUILDING P E R M I r NO. COMMUNITY DEVELOPMENT DIV. _ �' PROTECTIVE INSPECTION SEC. Y NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7-10-98 JOB ADDRESS 25 66 1/2 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 3 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 586-9712 Mark Hove 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO 20107290 Thermal Window & Siding,2005 Bush Ave _ M 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Window Replacement 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIREO 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 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 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUA 13N SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �2 140 $ 1.57 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 Fire SC$3. 14 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TO EE Licens SC $ .00 $96.96 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI N P OP ALIDAT HIS IS YOUR PER BLO INSP )ATE SIGNATURE OF OWNERoF OWNER BUILDERI IOATEI MAY -26-1492 13:35 FPO -M OITY OF FRIDLEY TO ?M0415 P.04/05 NEW (] Effective 11119$ ADDN [ ] CITY OF FRZ11L]EY ALTER I l SINGLE FAMDGY AND DUPLECS�R-ate R-2 �4 q1 SUxI ING PERIr�'T' CaaitructionAddrass•—...-a— Legal Description: owner Name &Address: � � P 1� �-� � �!'�. Tel. # �� J, v � -71 ]� Contractor:ew RW 6 ^�mD — MN LICENSE # -�3 I dpi Address: 2005 Bush Avenue Tel. # -7 lye. - 9. C)ei2r ou radii _ftol, Survey of the Thermal Window & Siding Company AxMW2005 BushAvenue Won, an it to male;. St. caul, MN 55119 M01 MN Builder Corporation License #20107290 DESCRWnON OF UAMOVMWMT Phone 612.702.9998 - Fax 612.702.0415 LPMG AREA: GARAGE AREA: DECD ARRA: 4 irm"! L,eugth Width. Height Sq. Ft. %angf _._ _... • Width Leight• Sq. Ft. Width , Hgt/Ground Sq. Ft. construction Type: (Fee Cost: $ I '4 0. !Fere Scheedul a on Baake Driveway Curb Cut width Nem: Ft. -i+ d Ft � � Pt x S _ $ DATE: APpMiCAn; _ /i_= Tel. #—n—() 117 CM USE ohm Permit Fees $ .-e� C770.00Few Schedule on Reverse Side Fire Surcharge$ 3• ,001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge - $ $1000 per SAC Unit License Surcharge: $ $$.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "8" Above &05ion Control $ $450.00 Conservation Flan -Review Park Fee $ Fee Deterinined by En$Wftrin$ Sewer Main Charge: $ Agreemew Newssary [ I Not Necessary L I TOTAL $ �f� STD ULAIJONS: ` l ,® - JV yH ,00'�_'O o.vSLG 0� �ii��w��Gl•�� SUBJECTIT NO. City of Fridley 2 8 856 AT THE TOP OF THE TWINS ? BUILDING PERMIT r RECEIPT NO. - COMMUNITY DEVELOPMENT DIV. `L f PROTECTIVE INSPECTION SEC. �� 1 . � NUMBER REV DATEPAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 1/19/99 JOB ADDRESS 25 66 1/2 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 9 3 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Mark/Suzanne Hove 25 66 1/2 Way NE 586-9712 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK X - O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE X 8 DESCRIBE WORK Basement alteration 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Install smoke detectors to meet the State Building COde - in each sleeping room and on each level of house. 90WITE PERMITS x.70 SIRED FOR {RING,, HEATING, FLUMbING AND SIGNS. 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 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 1 ISTALLS 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 $2,000 $1.00 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- 62.25 Fire SC $2.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION gl,•j< Lr/A��e�� PLAN CHECK FEE T � AL FE 65 5 SIGN AT URE OF CON 7RAC TOR OR AU TMORIZEO AGENT IDATEI N P OPER LIDATED-IHIPFIS YO R PERMIT • / / SIGNATURE OF OWNEROF OWNER BUILDERt IDATEI .- BLO -NSA BATE/ NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION '-g a ConstructionAddress: 27 4o� z 6,A A/C— Legal Description: 1v f 9 XU� /- 3 lv-&n 6L-C✓e" � Owner Name & Address: #uye �25 (64= (,e,At 1W& -Tel. # !o/,7 sY6 Contractor:MN LICENSE # Address: Tel. # 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 I Imo! Width 16,2-, Height Sq. Ft. /9 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: f semen{ Estimated Cost: $ .2 00 0 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 1 Z/�9 APPLICANT: 141*X v& Tel. # 9&.l�,� CGv) f►�IMI�i1�:M�� CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge oI $ e ( .001 of Permit Valuation (1/10th%) State Surcharge $ / `'4V $.50/$1,000 Valuation SAC Charge $ $1050 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 [ J TOTAL $ f►�IMI�i1�:M�� ieee@eM MMUNIN Effective January 1, 2003 �N:ITY OF FRIDLEY INSPECTION DIVISION m1 x,543APPLICATION University Ave NE ey, MN 55432 FOR FLOWER PLANTS AND HEATING, COOLING, VENTILATION, (;763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES �rkX (763)" 571-1287 JOB ADDRESS (OCO'/a LOCIy NOS 2�s� RATE SCHEDULE OWNER Residential Rate Furnace Shell and Duct Work, Burner TOTAL BUILDING USED ASSet1� Also Replacement Furnace $ 30.00 $�co ESTIMATED COST �o PERMIT NO. (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER � J Gas Range $ 10.00 $ No. of Healing Unit_ Circle One Steam) (Hot Water) er) arm Ai a- Gas Dryer $ 10.00 $ Trade Name arrerxcc-n 5*cn6,cr8. Size No. BTUHP EDR "Air Conditioning - All Sizes $ 25.00 $ 0116•00 Fuel P�c> Total Connected Load f- All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1/0 of Value of Appliance or Work 16 kcy.-) $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. i9 TOTAL FEE $ 5C�• SO o DATE CD MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO S� ar`U Vkep: ^Oa LO REFRIGERATION/AIR CONDITIONING PERMIT IS 25.00 Signed 11i 1'-16 TEL # 66/• -act F5.9 a.0 O PLUS THE $ 50 STATE SURCHARGE FAX# CS71-� �a�f m REINSPECTION FEE $47-00/Hr *Air Conditioners can not be placed in a side yard without IL Approved By e Rough -In DatFinal Date CID N wrEtten permission from adjoining properly owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE m r 12/02/2003 01:57 6512289201 ST PAUL PLUMBING PAGE 03 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPL.ICA710N WILL BE RETURNED When , the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes No( ) and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer N specifications including sizing, length, number of elbows and termination. Yes 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 Yes &A No ( ) assisted and natural draft appliances. 11 `` The p. xistonarn a istinn ,air is sized and installed to meet the current codes Yes () No (� W a ar'e' and manufacturer's specifications. CeoCo. c.� r When required to iiin-stall a new cnmhustion air, it will be sized and installed to most the current codes and manufacturers specifications. Yes", No ( ) When instaUlnn a naw venting nystem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (�Nf� 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 #Z Type W H- BTU Input Yo e>66 Fan Assisted or Nat NaT Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances �Total Btu Input I na b , n Common Vent Type �J�C'r`t� Vent Height ®, �-� Diameter inches Appliance #1 Vent Connector Height ao ft Length ft Diameter S" in Type YEt+►� Appliance #2 Vent Connector Height &D ft Length `/ ft Diameter y „in Type_ Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By. Date: //�0-03