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PRE 2010 DOCS0 City of Fridley, Minn. BUILDING PERMIT Date: .. ��J...� ............. . Owner. e.4,a Address .02.... �. -.... N® 3087 Builder Address............................................. LOCATION OF BUILDING No. .�R g/ .... Street .6.? ... ...................... Part of Lot ............... r ...... .. Lot _3 ..... Block ................ Addition or Sub -Division .. ...... Corner Lot ............ Inside Lot ...`./ ..... Setback .$:J ..... Sideyard /A .. .. / W. DESCRIPTION OF BUILDING To. be Used as• , I Front �®i.® Depth Height Sq. Ft. Ft. ........ 0077 .X.1... Front,/ �.j Depth ..:. ' /y, H�ig`ht ®�� Sq. Ft. .. �. `u Ft. ........ Type of Construction .. ..... Est. cost... ��� . e✓.......... To be Completed ..... ` . . r In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in co c w�'i �f) all provisions of ordinances of the city of Fridley. �� �i ,'' / ••.Ts M •..hA..i.................•..... In consideration of the payment of a fee of $..� . permit is hereby granted to ... 51�• ... . ......................... 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. --, Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. O suedEcr PERM City of Fridley 129°79 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT-NO. L L ------COMMUNITY DEVELOPMENT DIV. 11633 PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-660-3450 910-F15 5/30/75 JOB ADDRESS 291 67th Avenue R.E. ' 1 LEGAL LOT NO. 3 BLOCK 4 TRACT OR ADDITION SEE ATTACHED Rice Creek Plaza South Addn DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stanley Nehring 291 67th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. S` Milton L. Johnson Company 2513 Central Avenue 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK roof repair 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. shingle OCCUPANCY GROUP OCCUPANCY LOAD 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 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 $285.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .5O 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- 5.00 STRUCTION OR THE PE ORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE `o%to,..) s - 3 � - �.� 5.50CTOR SIGNATURE OF CON AOR AUTHORIZED AGENT (DATE) WHEN PROPERLY V LIGATED THIS IS YO PERMIT W;�BLDG (NSP GATE SIGNATURE OF OWNER (IF OWNER BUILDER( (DATE) O APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: S T,4 /0 1 � N� H �t �T BUILDER: �%i r8,j °Ja tf 'U S -G yc. A--Z-T/3 l�N%��L ADDRESS: ADDRESS: a �%I � 6 7 ^ � d� JV- � , NO:. -2-q / STREET:, le" 2 ai e5&,e. V l LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth : Square Feet: Cubic Feet: .Front: Depth: Height: Height: Squa^ Feet; Cubic Feet: Type of Construction:' Estimated Cost: $ S' 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: S " 3 7 SIGNATURE: (See Reverse Side For Additional Information.) 0-'v .6 SUBJECT PER O. City of Fridley o 192Ir 9 6 AT THE TOP OF THE TWINS BUILDING PERMIT EIPT � COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---_ L f\ 612-571-3450 910-F15 1/11/87 JOB ADDRESS 291 - 67th Avenue N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 4 Rice Creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Nehring 291 - 67th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings Co. 6331 Riverview Terrace N.E. 574-9966 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 ❑ ALTERATION [ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling (Aluminum) 9 CHANGE OF USE FROM TO STIPULATIONS 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 BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,300 $1.15 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRO ISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR C ION OR THE PERFORMANCE OF CONSTRUCTION. $38.50 �A' PLAN CHECK FEE TOTALFEE $39.65 SIGNATURE OF CONTRACTOR OR AUT # ORIZED AGENT (DATE) WHEN PROPERL VALIDATED THIS IS YOUR PERMIT BLDG ,NSP SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) DATE NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 1 ALTER. [ ] Building Permit Application Construction Address: - Legal Description: Lot 3 131oe-k eAnF k P,-.fzd Je- , Owner Name & Address: F Ale A R' N6 Tel. # Contractor • IZ i c D Zf d iV 6S Tel . Address: J� 3 3 uj€-r 0 e -3 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Corner Lot [ ] Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: AL -ion Approx. Completion Date: //?-6 Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ L300. oa Alt. A Alt B $ $ See Back Page for Explanation DATE: JZ �� APPLICANT: J-� Tel. # Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 20.4-0 Fee Schedule on Reverse Side 25% of Building Permit Fee - $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT City of Fridley 2773 AT THE TOP OF THE TWINS BUILDING PERMIT NO. ____ _ COMMUNITY DEVELOPMENT DIV. 1 v PROTECTIVE INSPECTION SEC. III ,ya NUMBER REV DATE PAGE OF APPROVED BY 1 ­--I CITY HALL FRIDLEY 55432 ..J 612-571-3450 910-F15 9/11/98 J68 ADDRESS 291 67th Ave NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 4 Rice Creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ericka Nehring SAme 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings 6332 ft Riverview Terrace NE Fridley 55432-4846- 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 M REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage 20S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS R>4xxxRx Underlayment must comply with the State Building Code. 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 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 $1,714.00 $.86 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE ToFEE k$ i se SCV-00 $64.32 SIGNATURE OF CONTRACTOR ORA, NORIZED AGENT IDATEI E ROP ALID THIS 71J.R PgR 0 G INSD DATE S,GNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION A ConstructionAddress: -Z'F/ 67V Legal Description: Owner Name & Address: rP,,c-tcA, eE A c Tel. # Contractor: k t �S �- e S MN LICENSE # S Address: 6 33 i 9 "j 0. P, 6 a , i-i�;- iL Tel. # 5-7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF RAPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: r) S� Construction Type: 7-4- t2 o I Zcr 41:7- Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: r 1 ,rP APPLICANT: 9 Tel. # TOTAL $ �4/ STIPULATIONS: CITY USE ONLY Permit Fee $ (0, -S Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ U $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 5�--/�© $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 $ �4/ STIPULATIONS: 01 SuBjECT City of Fridley e2 8 AT THE TOP OF THE TWINS BUILDING PERMIT , r R 1 46V COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 2/5/99 JOB ADDRESS 291 67 Avenue NE' I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 4 Rice Creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ericka Nehring 291 67 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Richard Hastings Contractor 6331 Riverview Ter NE, Fridley, MN 55432 4051 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 574-9966 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION? REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace Siding 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. 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 BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $900 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- F SC $.90 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $32.00 r �-- PLAN CHECK FEE TOTf F E '38 40 SIGNATURE OF CONTRACTOR OR AUTHO ZED AGENT IDATEi N ROPE A I T 7 I UR ERMyT�� SIGNATURE OF OWNER,IF OWNER BUILDER/ (DATE, BLO .NSP DATE 01 NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 650 0 ConstructionAddress: Zq/ C2 A� Au..E , Legal Description: Owner Name & Address: f R; c K,4 A5/ � - Nc Tel. # Contractor: 2; c� h p - b MN LICENSE # �lo S i Address: 63.31 Z u — 2 v i ,L-� 7`e tz 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 Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: &1744c,- A&mt 55 el ' C - Estimated Cost: $ 70® . a® (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Z S F APPLICANT:Z � / — Tel. # CITY USE ONLY Permit Fee $ c;�?, 00 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.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 [ ] TOTAL STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION Effective January 1, 2003 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 V 5013 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Approved By/� Rough -In Date Final Date JOB ADDRESS p�W ( 7a AR /fl F OWNER CriGKc�_ *Ve_ r;nh TOTAL BUILDING USED ASP�c2 $ f ESTIMATED COST-QD PERMIT N0.c'"l, -' - DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. $ S� BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR A/C- -CeVri eie AT 1 110aq a'3,40--) $ The undersigned hereby makes application fora permit for the work herein specified agreeing to do all work in strict accordance with the City Codes ar $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE -Z CenterPoint Energy Minnegasco HEATING C013562 Central Ave NE, Anoka, MN 55304 Signed 002 ame/.o., q:�`AVWOK- i�l�--763-757=6202 I NJ FAX # 763-757-6701 Approved By/� Rough -In Date Final Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED ing furance, the undersigned hereby verifies that the BTU Input BTU Input When rpnlananrl a^ eYie venting has been examined and is free from rust, deterioration, obstructions, and firestopped where required. Yes (1) No ( ) and is securely supported Fan Assisted or Nat The venting system is plastic/PVC and meets all current codes and manufacturer of elbows and termination. Yes XI No ( ) specifications including sizing, length, number Total Appliances The undersigned also verifies that the replacement unit is a listed assembly fFumuace and meets the current codes andmanufacturer's include AGA-GAMA Category I C Venting for fan Yes (x) No ( ) assisted and natural draft appliances. Appliance #1 Vent Connector Height The gx tfi^a cn hustion ait is sized and installed to meet the current codes Yes No ( ) and manufacturer's specifications. _ft _ = Length When required to ' ' t will be sized and installed and manufacturer's specifications. Yes) No ( ) to meet the current codes When jnStaWDg "�^bne cye _m� the undersigned hereby verifies that sis'a fisted assembly and meets the current codes and manufacturer's oes iclude AGA-GAMA Cat gory I Central Furnacepecifications. This d Yes f) No( ) Venting Tables for fan assisted and natural draft appliances. insta led Is the common vent and vent connectors sized as been removed from the commonvent alnd vented Yes after an appliance h Yes (x) No ( ) separately as per current codes. Ant an ni.cpT—Une and -go7pj `nmmen Venf and V Appliance #1 Type BTU Input BTU Input Fan Assisted or Nat Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type Total Btu Input Total Appliances Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length Length ft Diameter in Type ft Diameter in Type Appliance #2 Vent Connector Height Appliance #3 Vent Connector Height _ft _ = Length ft Diameter in Type HEATING CO: Centegoi 13562 Central ve NE, Anoka, MN 55304 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 ADDRESS : 291 67TH AVE NE PIN : 143024230052 LEGAL DESC : RICE CREEK PLAZA SOUTH ADD : LOT 3 BLOCK 4 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL PERMO.: 2004-00518 DATE ISSUED: 04/15/2004 VALUATION : $ 4,620.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE WINDOWS WITHIN EXISTING OPENINGS. STATE LICENSED CONTRACTOR 1 APPLICANT MINNESOTA EXTERIORS INC (2877) 8600 JEFFERSON HWY P OSSEO, MN 55369-0266 (763)493-5500 OWNER NEHRING ERIKA E 291 67TH AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Bldg Insp. BUILDING PERMIT FEE 111.25 FIRE SURCHARGE 4.62 STATE SURCHARGE, VALUE 2.31 LICENSE SURCHARGE 5.00 TOTAL 123.18 PAID WITH CHECK # 137177 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [] ADDN [J ALTER [ ] Construction Address: Legal Description: Owner Name & Ai Contractor: CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION .eaC* Effective 4/1 /2004 (763) 572-3604 Bldg Insp (763) 571-1287 Fax 25 Tel. # 79-'J'V — �� T -)— MN LICENSE # fie" — %> Tel. # 7i� : � 9/— 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: Construction Type- y Estimated Cost: $ o Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: f Tel. Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. ��� 'L / �`% % Effective April 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT u)Ajei2 (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS eV__ (Z7 Aue- New Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $10.00 and representations stated in this application are true and correct. Catch Basin $10.00 Rain Water Leader $10.00 DATE: C , 20 Sump/Receiving Tank _T_ $10.00—,�--�� `� Water Treating Appliance $35.00 J OWNER AJ c Water Heater -Electric $35.00 Water Heater - Gas** $35.00 J� BUILDING USED AS Gas Range** $10.00 � w Gas Dryer** $10.00 ESTIMATED COST PERMIT NO. Back Flow Preventer Required ( )Yes () No /!,, Type $15.00 PLUMBING COMPANY O)��'' v `C 16-4 SIGNED BY TEL NO. Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS �! 1.25% of Value of Fixture or Appliance c Approved By L State Surcharge $ 5; MINIMUM FEE F TOTAL FEE OF THE IMPROVEMI COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. Rough -In Date Final Date **PROVIDE COMMON VENT INFO ON BACK SIDE i FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENTa VENT CONNECTOR AND COMBUS710N AIR VERIFICATION When replacing an existing furnace, 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 terminatidn. 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 Fum4ce 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 _ Appliance #2 Type _ Appliance #3 Type _ Total Appliances _ BTU Input _ BTU Input _ BTU Input Total Btu Input Common Vent Type Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 : -/1 „ r— _-A Building MECHANICAL Permit No.:° l plat Inspections RESIDENTIAL APPLICATION Received By:E/ 763-572-3604 % 2 7 2009 CITY OF FRIDLEYA41 763-502-4977FAXEFFECTIVE 2-19-09 DATE S /3 / D YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: Er-760r/17{7'G OWNER/ TENANT ADDRESS:c?G%_/ l0 74-AAj. CITY �/�%C;�/P1J STATF�/%�l.�l Ili�.�J� PHONE: &3 �5-2Z- % 15:Q CONTRACTOR COMPANY NAME: D a CONTACT PERSON: %D/Y/ �S�eLcl� SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: I T Y tjy& Q STATELQZOP�� APPLICATION PHONE 2&3 Va V-- 83.3_ FAX :&!3 PERMIT TYPE SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK f (�� nae_e.. (Teal EXCEPT WHERE (INDICATE TOTAL NUMBER OF EACH BELOW) FEES ARE BASED ON $10.00 PER FIXTURE, HERE NOTED. FI Equipment Installed MFG: ,[,f_ a__l MODEL:(f�,2L,�' /%% �jr SIZE/BTU &Q U00 e MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 1FURNACE $35.00 GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 FEE $35.50 Total = $35-5-0 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 whichy ew and approval of plans. SIGNATURE OF APPLICANT �? PRINT NAME / [7DATE D PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK 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 Yl 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. i I rrh OFL� I h tM Area L080 ll3(Un) Area LOGO (fStUn Area Ar" EXPOSURE NO. Htg clg (R•) Htq Clg (In Htg Cig HV Clg Htg Clg 5 GrOW 8 12C 8.1 2.1 Boo "••• ••^500 •••• •^• ••^ •••- •-» •-•- Exposed b 14A 48.9 8.3 200 •••• ••+• 200 "•• "-• •^• »+ •-« »» walls and e ISA 11.3 0.0 500 `^• ^•' 500 ^' ••'• "^ •^• ^•" ^^ pates- d 0.0 0.0 0 ..« «,. 0 .... n•, .... .... .» «.. a 0.0 DA 0 .... .... 0 ..« «.. .... .... .... .... t 0.0 D.D p .... .... 0 «.. ^.. .... .... ..« ».. 6 W41Owm and a 2A 42.8 •' 70 2993 „•• 70 2893 "'• "" •"• 055 d00r9 b - 0.0 0 0 :^: 0 0 Fleecing C 0.0 0 0 0 0 d 0.0 •' 0 D'»" 0 0 •••• ""• '•" a 0.0 0 0 •' 0 0 •'•• F7' Wlndom aW North 31.0 25 "» 775 25 •"• 775 "•" •••• glas8 door'1 NFJNW 0.0 0 �w 0 0 •^ 0 n9 6Mr 80.0 26 2226 26 2226 SEISW 0.0 D "" 0 0 «•• 0 •'^ "•' Soum 48.0 20 »•• 860 20 «•• 900 "'•• "" Hoa 0.0 0 •••• 0 0 •••• 0 6 OUwi NW -7d 101• 28.e 7.e 42 1210 317 42 1210 017 b I O.D 0.0 0 D 0 0 0 0 c OD 00 0 0 0 0 0 0 9 Nei a 12C 8,1 2.1 688 5575 1461 881 8873 1451 evoaeo b 14A 40.9 6.3 ;m 91BU ms YUU 1r1w 1507 W445 " c ISA 11.3 0.0 Soo 562S 0 Soo 5825 0 partitions d 0.0 00 0 0 0 0 0 0 e 0.0 0.0 0 0 0 0 0 0 r 0.0 0.0 0 0 0 0 0 0 10 CediNs a 16C 7.9 3.7 576 4582 2104 5764502 .2104 b 18C 7.0 3.7 0 0 0 0 0 0 c 0.0 0.0 0 0 0 0 0 0 d 0.0 0.0 0 0 0 0 0 0 e D,0 0,0 D 0 0 0 0 0 f 0.0 0.0 D 0 0 0 0 0 11 Floors a 21A 2.2 0.0 $76 1214 0 516 1244 0 (Note; room b 0.0 0.0 0 0 0 0 0 0 Psrlmeter c 0.0 0.0 0 0 0 0 0 0 meq a o,D 0.0 0 o 0 0 D 0 for slab a 0.0 0.0 0 0 0 0 0 0 hoofs) f 0.0 0.0 0 0 0 0 0 0 12 fntnton a 1 $4.3 5,0 112 8083 663 112 BD83 583 13 Sttbtotidbss+4i•8..•11.12 ""' 36489 '•" •`•• 38{88 •••• �• «« »« »» heating Less '�•�' 0 W. 0 w• w eetc�rllal 0 0 �.. �. ..» heating radlstrlttutlon "^ 0 •»• p _ 14 Duct loss 0 0 "" 0 0 �•• •»+ •- 15 Tout loss m 13+14 ^" 38468 "" "' 38499 "'• "" "" •••• •^+ 15 kit gains, Peopled 300 4 - 1200 4 - 12W "^ Appl ® 1200 1 - 1200 1 1200 '•'• �« 17 Subw RSH gain +8..+12+1 B ^ ' •+•• 12468 - "" 12468 "•• •'•• •••• •^• Less e0WAI o001tng - 0 •••• •.« 0 .». »« ».. .... Leas transfer p »» 0 .... .... Cooling redia ftWon •••• •^• p .«. 0 ,++• "" 18 Putt gain 0 .... 0 0 - 0 10 TOW RSH gain-(17+18)•P(F 1.00 '•" 12468 1.00 - 12488 ""' '•" 20 Au MgWred (CIM) •"' 5571 887 •••• 087 001 •••• ••••