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PRE 2010 DOCSVillage of Fridley, Minn. `'.�'.. - N° 180 BUILDING PERMIT Date: ...,%! .J..........__ Owner....................................... Builder .........�G Address...................................... Address ..... LC qq / LOC ION OF BUILDING No. . /..l .... Street .... (®.. ........... Part of Lot .....�P....... Block ..... ........... Addition or Sub -Division.. �� .(...Ce ' .!..... ... �3 Corner Lot ........... Inside Lot ... .. Setback . ... Sideyard ...?7... y.............. DESCRIPTION OF BUILDING To be Used ..... ' ........ ........ Front `�. � . Depth '�'�'�z� Height�G.✓e!/ Sq. Ft. Cu. Ft. eve . .... Front . ? q... Depth (.. Height ' �.`S. Sq. Ft. ........ Cu. Ft. ........ Type of Construction Ca .. 1. 0� ...... Est. Cost Z k .............. To be Completed ............... V// 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 village of Fridley. is hereby granted to In consideration of the payment of a fee of $/..� `�' permit 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 village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ......................... Building Inspector NOTICE: This permit does not c , er a construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to a the Building Inspector for separate permits for these items. City of Fridley Application for Plumbing and Gas Ming PenWt Dept. of Bldgs. Phone 860-3450 DESCRIPTION OF WORK ? /� Number, Kind and Location of Fixtures Location °�Rr' �'�— dt Cl �i 3 — x $1.50 $ ii Z m N Y i z rc 3 F C LL — x $3.25 Z {Yu �Q z O LL G u EO S J U` w O Ci c ? z C� O • • N WATER HTR. GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings * 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 Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures .......................... 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 $ _ a $2.00 $ NO. RATE TOTAL x $2.00 $— x $ .75 x$.75 $ x $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 fact and representations stated in this application are true and correct. Fridley, Minn 19— Owner C Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. Signe By _ Business Phone No_S— ROUGH FINAL /" .5- % 2- 0� Description ..... ............. TOTAL FEE $ 42 Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam . .... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH $k9.00 See Fee Schedule Surcharge $--,50 TOTAL FEE $10.50 Dept. of Bldgs. Phone 560-3450 Locaffion 391 67th Avenue N.E. City of Fridley: 1248 $10.50 ()k 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, A2inn_ September 20 , 19 73 Owner Richard Kind of Building Used as To be completed about 40 Estimated Cost, $�� Old—New. Building Permit No. Permit No. �7 G DESCRIPTION OF WORK Trade Name/ i/Size No,�/�l/�J4�� Capacity F®� Sq. Ft. E.D.R BTU P. Total Connected Load 4:;: �_a2c'16— Kind of Fu BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. r Effective Date May 1, 1988 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer Back Flow Preventer Required. Type RATE TOTAL $ 5.00 $ m $ 1.50 > m $ 5.00 $ o $ X N 5.00 Water 5.00 $ 7.00 $ 5.00 $ E 010 Smi Q m N Heater m .rt B W'd A 1N o u o9 r 3 w° U M, 3 t� lec 1st 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer Back Flow Preventer Required. Type RATE TOTAL $ 5.00 $ 3.50 $ 1.50 _ $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 Yes ( ) No ( ) $ 5.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE S Job Address Department of Buildings City of Fridley Tel. #571-3450 _The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this appy ation Te_true andgect Fridley,//��Mn. F , 19 OWNER ' 7`t r �. 540 P ry ,► i S �. KIND OF BUILDING USED AS TO BE COMPLETED ABOUT/a ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. ROUGH INSP. Date FINAL INSP. Company _�-AIIFV'10111 ME, Signed By d Date APPROVAL FOR PERMIT (� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE SUBJE& PE City of Fridley 30188 AT THE TOP OF THE TWINS BUILDING PERMIT r � NO. • COMMUNITY DEVELOPMENT DIV. _ r � PROTECTIVE INSPECTION SEC. � 1 . � NUMBEF1 REV DATEPAGE OF APPROVED By CITY HALL FRIDLEY 55432 �J 612-571-3450 910415 9/8/99 JOB ADDRESS 391 67th Avenue NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 3 1 Rice Creek Terrace Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Saverinske 571-8452 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Dale Cole Const. 6452 Bluebird Cir. Maple Grove 55369 559-2045 6907 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 JEk REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (22 Sq) Tear-off 9 CHANGE OF USE FROM 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 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 $1923 $.96 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 $69.25 FireA $1.92 PLANCHECK F TOTA EE Li e $5 7 .13 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEj HEN IDA BL NSP T HIS 1 O R P IT TIA TE S,GNATURE OF OWNEROF OWNER BUILDER, ,DATE, NEW[ l _ Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION o � Construction Address: Legal Description: Owner Name & Address: 6 z C # AQ SA $k f i A15 Tel. # J� 71 Contractor: P1914- 6 .2.'r- C o lfr> T MN LICENSE # �® Address: j �IY,,9 &14,e / &) 55 3 6 9 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: 6f= 1146 Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ lga3 E99 DATE: APPLICANT: Tel. # TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ 9 5 Fee Schedule on Reverse Side Fire Surcharge $ /. g a .001 of Permit Valuation (1/10th%) State Surcharge $ 94 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ S.00 $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 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 5 /L -36U4 YAX: 1 %631 571-IL57 PERM 0.:2004-00906 DATE ISSUED: 06/15/2004 ADDRESS : 391 67TH AVE NE PIN : 143024240061 LEGAL DESC : RICE CREEK TERRACE PLAT 3 GAS RANGE FEE : LOT 6 BLOCK 3 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 2,400.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER.COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL AN AIR CONDITIONER. # A/C UNITS 1 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 APPLICANT DAVES APPLIANCE HEATING & AIR INC 160137 AVE NE COLUMBIA HEIGHTS, MN 55421 (763)781-6901 OWNER LINDA SCHLATTER 391 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 perfo ce of construction. Applicant___,n Date M :MA`WOsem?- HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 0.00 GAS PIPING FEE 10.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 34558 SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE .i Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS�l Fee Total � Owner L � 1(1 �t^� 1 J o- h $35.00 $ Building Used As $10.00 $ ESTIMATED COST L(N*TDPERMIT NO $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. $25.00 $ BTU HP EDR Fuel Total Connected Load Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Burner Trade Name BTU HP Size No. EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Tel # of i- i , ASIN Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION 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 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: 0 Date