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PRE 2010 DOCS• • City of Fridley, Minn.. P- s 3 6x BUILDING PERMIT w® 7192 Date: "- Owner: _ Builder Address _ Address ON �j�F BUILDING No. !�-' Street L� del �r�� _ _ P Lot •-_ Block '� Addition or Sub-�l e Corner Lot Inside Lot _ _ Setback _ Sideyard Sewer Mevation ____ _. Fo dation Elevation DESCRIPTION OF BUILDING To M. Front j Depth __ J. Z Height L.- _ Sq. Ft.l,M Cu. Ft. (�Y o Fro tDepth Co" ht ` Sq. Ft. Cu. Ft. Type of Construction _. _ . Est.��L yC�v__� To be 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 compliancetl all provisions of ordinances oP the city of Fridley. , I In consideration of the payment of a fee of $ &2 -- , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the peon to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any pari thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time ups violation of any of the provisions of said ordinances .� 1 NOTICE: ihb permh does not cover the construction, hufaMon for Wing phnubinB. 6a heating, sewer or water. Be wre to see the Building Inspector for apm to ponnNs for thea items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME (�j BUILDER ADDRESS � sG� ADDRESS LOCATION LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Subdivision2.��i��, A Corner Lot -Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION -ELEVATION Applicant attach to this form Two Certifitatds of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). • • CJ City of Fridley, Minn. BUILDING PERMIT Date: April 8, 1968 No owner: _Wayne S. Nelson Builder _.._ DeVac Sales Inc. Address 445 67th Ave. N. E. Address 5900 Wayzata Blvd. 4 (40 9656 �// /i%..z ?- - LOCATION OF BUILDING No. 445 Street 67th Ave. N. E. ________ Part of Lot Lot 5 -_ Block 4 _ Addition or Sub -Division .-- Rice Creek Terrace Flat 3 Corner Lot ____ Inside Lot Setback _ _ _ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Alum. Siding Front Depth _ _ Height _ _ Sq. Ft. Cu. Ft. Front Depth _ _ Height Sq. Ft. Cu. Ft. Type of Construction Alum, Siding Est. Cost $2.400.00 __ Tobe 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 c p fiance wi�� provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ �5 • 00 , permit is hereby granted to DeVacX= Sales jnc . to construct the building or addition as described above. This permit is granted upcn the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Inspector CLAIRENCE BELL NOTICE: This permit does not cover the construction, Installation for whing, plumbing, gas heating, tower or water. Be sun to ase the Building Inspector for separate permits for these Nene. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME_ _.�/• , BIjtLDr:R' ' Q ADDRESS��"" _ z LOCATION OF BUILDING. No.-... -'�eS- STREET LOT tea- BLOCK _ ADDITIQN OR ,SUBDIVISION a CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING�� Applicant attach to this form Two Certifitatea.'of•.Survey of Ldt:;and proposed building location drawn on these Certificates. + DESCRIPTION OF BUILDING To ;-Ae Wea As.: Front •DepCh height-- a=- Square feet Cubic Feet rn o Front .•• 'Depth Height i h , Square feet ¢pbi Feet Type of Constructio Estimated Cost To Be Completed1X_AQz 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 _ �� SIGNATURE_?�'� (Schedule of Fee Costs can be found on the Reverse Side). r �- • J.—, C S " __" /� C • SUBJECT City of Fridley - rO 15 4 2 4 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT N • COMMUNITY DEVELOPMENT DIV. i Lu ......I PROTECTIVE INSPECTION SEC. I � i ;,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 8/30/79 JOB ADDRESS 445 - 67th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Rice Creek Terrace Plat 3 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Carol Nelson 445 - 67th.Avenue N.E. 571-1607 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SaICIe 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 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd but not 3rd roof. Install ridged galvanized valleys. SEPERATE PERMITS REQUIRED FOR WIRtiriG. HEATING, PLUMBING 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 SQ. 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 VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,000 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $8.00 SI NATURE OF CO�TOROR �AUTHORIZED AGENT (DATE) WHEN PROPERLY V"ATLED THIS S YOUR PERMIT SIGNATURE OF OWNER IIF OW ER BUILOERI IDATEI BLDG INSP DATE CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: 0 4 /Z,-' I , ef)z A �� BUILDER: ADDRESS: 4<-)e A) ADDRESS: TEL NO: 7 ° 7 TEL NO: Construction Location STAT NO: STREET: LOT: 5 BLOCK: ADDITION: "eC7 c eek c L Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION AZA Front: Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: Estimated Cost: $ '!b Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . 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: fl�3 /7/ SIGNATURE: ` ®!�. >�-• Stipulations: o• C� kJ6 -: 3,U /urruc� SUBJECT City of Fridley -2--2 !-�5' AT THE TOP OF THE TWINS BUILDING P E R M l T� i .TNS' RECEIPT NO. � COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/27/94 JOB ADDRESS 445 67 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Rice Creek Terrace Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron Widland 445 67 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. C 0 Field Co 2940 Harriet Ave S M ls. MN 55408 824-2631 5000 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 ❑R REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SJAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND O DINANC GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH W ETHER ECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $7,000 $3.50 DOES N T PRES E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI S OF Y OTHER STATE OR LOCAL LAW R GULATI G ION, STRUCTI OR TH PERFORMANCE OF CONSTRUCTION. $90.00 Fire SC $7.00 PLAN CHECK FEE TOTALFEE 2"� �� License SC $5.00 $105.50 ' SIGNAT E OF CONTRACTOR OR AUTHORIZED AGENT IDATEI PROPERL VALIDATED THIS IS YOUR PERMIT AZA BLDG INSP 9- 77� DATE SIGNATURE OF OWNERUF OWNER BUILDERI IDATEI NEW [ l Effective 1/1/94 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application -4-- 3Ve— � � ConstructionAddress: L6-�-v A V, �" ,' Legal Description: Owner Name & Address: u Q < ID Tel. # Contractor: C U . • NZ t,q C v MN LICENSE # Q o S?�0v Address:L� 1-4 a.� i2��-� L\y E S�, . 01Q L!> Tel. # _ iS 2-4-?,() I Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width HgdGround Sq. Ft. OTHER: -VI, S7-- - S + n -P Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $--7 © o o Approx. Completion Date: (Cost on Back) DrivewaMC ut Width Needed: DATE: APPLICANT: Tel. # Permit Fee $ 0 • �� I1Y USE ONLY Fee Schedule on Reverse Side Fire Surcharge $ C' 6- ..001 of Permit Valuation (1/10th%) State Surcharge $ $:50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ S $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Pian Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: SUBJECT 09WMITN -. City of Fridley 26383" AT THE TOP OF THE TWINS BUILDING PERMIT ' , NO. COMMUNITY DEVELOPMENT DIV. ______ r I v PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J` 612-571-3450 910-F15 6/29/98 JOB ADDRESS 445 67th Ave t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Rice Creek Terrace P SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Widlund 445 67th Ave NE 4 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Stock Roofing, Inc. 289 Liberty St NE Frid1gy M 55432 780-3561 3112 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE N0, 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 26 S 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 $2 168 $1.08 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 PROVI IONS DF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire SC $2.16 ST TON OR THE PERFO ANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE .'ac ,% License SC $5.00 $82.99 SI ATUREOFCONT CTORORAUTHORIZED AGENI IDA, EI WHEN PPR�OOPPERLY LIDATED THIS IS YOUR PERMIT BLD INSP PATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� 4 BUILDING PERMIT APPLICATION ConstructionAddress: y H C; Legal Description: Owner Name & Address: Tel. # Contractor: A -N\ C MN LICENSE # Address:� �pQY-,� - `_ 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: �C4 FY Construction Type: Estimated Cost: $ d / � 1 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: to. -97 APPLICANT: Tel. #�� CITY USE ONLY Permit Fee $ , ®%S� Fee Schedule on Reverse Side Fire Surcharge $ ! % .001 of Permit Valuation (1/10th%) State Surcharge $ % . D ® $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge _ $ - UC) $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 $ O' Z STIPULATIONS: • . . "/ 4 , MIT NO. 6621 SUBJECT City of Fridley 2 AT THE TOP OF THE TWINS BUILDING PERMIT NO. COMMUNITY DEVELOPMENT DIV. I v r PROTECTIVE INSPECTION SEC. hof/ NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 17/13/98 JOB ADDRESS 445 67th- Avp NF 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron Widlund 571-1607 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin Cit Exteriors - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 2599 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION YJ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Repairs on s I 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 $500 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 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- $21.00 FireSC..50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TAL FEE License $5.01,427.00 SIGNATURE OF CON' FACTOR OR AUTHORIZED AGENT (DATEI E PRO Y VA LI ED THIS I OUR PERMIT /(( S.GNATURE OF OWNER OF OWNER BUILDER) IDATEI B G INSP DATE "/ 4 , MIT NO. 6621 NEW [ ] ADDN [ ] CITY OF FRWLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 7TI Legal Description: Effective 1/1/97 Owner Name & Address: R0,) (42Ln n_ _� _;2�C11� S� Tel. # S✓7 / - l�O '7 Contractor: ��,rJ T-�Jj� 7iQ�1� �S MN LICENSE #��_ Address:506-4) i}'f�S1P1�t ✓�✓'�3�% 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: U -n-0 Width Hgt/Ground Sq. Ft. OTHER: Construction Type: SToR.M Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: - - APPLICANT: 4�6 Tel. # �,.�"„ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: i CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley. MN 55432 572-3604 APPLICATION FOR PLUI MARK NLIMR;:R nt: MY n lace rn cc FITTING PERMIT /�Ll C AAe e• I • Effective On January 1, 1997 Water:<:: RATE TOTAL New Fixtures ?::I WashnAuta $ 4.00 Beer Dispenser ::::::_. :Gita>:;::,.: Gas Mis//ww;.ct Water Heater Stories Urinal S 7.00 Shower Tray :;:<.: $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas" $10.00 .Ctrs $10.00 Gas Dryer" ;Stick;. Back Flow Preventer Required ( )Yes () No :Fotln..: "..<': �>� �::: Washer $15.00 Range :i=ixL>: Gas Sec Basement W�a :: r.. - � •:�<::-:::� •::::: Floor 1 ::: f....... Floor 2 ..f. Y.0 Q o r3 Ji:;•iii'' SCt�..{iii { :-'•:iir •:v':•,::{:?: is i.:;i'Y�y:::>.=i-i Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening. New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader S 7.00 Sump/Receiving Tank .S 7,0_0 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas" $10.00 Gas Range" $10.00 Gas Dryer" ✓10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr JOB and and PLUM ALL OTHERS AND/OR REPAY+$ ANU AL i cwanoNS ®� h 1.5% of Value of Fixture or Appliance Apprc State Surcharge $ .50 MINI I TOTAL FEE $2!�a PLUB "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) it eby makes application for a permit for the work herein I o all work in strict accordance with the city codes 1- Riding Division. and hereby declares that all the fads a stated in this application are true and cprreeL 1998 PERMIT NO. dc�7�o / wr1 II' .� u r: rt -i � n, e�•i r.n�z:� In Date Final Date `3 IMBING/GAS PFRMIT IC !ten nn A. MINIMUM SIZE 9 SO INCHES. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTI IRF.R TO RF INSTAI I Fn nM FArH I=1 nnR Effective On Jan 1, 2000 ® �'R �. to • 4• � F - PLUMBING FIXTURE RATES: New Fixtures Old Opening, New F Lbture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appian ice Water Heater -Electric Water Heater - Gm;** Gas Range** NO. RATE TOTAL JOB ADDRESS._ -'M1'fE I -s dta OIE 12— "7 �e� �P / Ale Gas Dryer' _ Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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 P_uilding Division, and hereby declares that all the facts .and representations stated in this aoDlication are true and correct. WIDLUND, RONALD 445 67TH AVENUE NORTHEAST FRIDLEY, MN 55432 Owner (763) 571-1607 Q1.31 , 2003 Building Used As IPE'R 3 ?, 00 Estimated Cost PERMIT NO. tt; 7 Z (e PLUMBING COMPANY SIGNED BY TEL N0. Z" O Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $20.00 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 Ids • i Com® PLUMBING FIXTURE RATES: New Fixtures Old Opening, New F Lbture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appian ice Water Heater -Electric Water Heater - Gm;** Gas Range** NO. RATE TOTAL JOB ADDRESS._ -'M1'fE I -s dta OIE 12— "7 �e� �P / Ale Gas Dryer' _ Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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 P_uilding Division, and hereby declares that all the facts .and representations stated in this aoDlication are true and correct. WIDLUND, RONALD 445 67TH AVENUE NORTHEAST FRIDLEY, MN 55432 Owner (763) 571-1607 Q1.31 , 2003 Building Used As IPE'R 3 ?, 00 Estimated Cost PERMIT NO. tt; 7 Z (e PLUMBING COMPANY SIGNED BY TEL N0. Z" O Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $20.00 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 rep_ lacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstri fictions, and is securely supported and firestopped where required. Yes () No ( ) The venting.,system is. plastic/PVC and meets all current codes and manufucturer 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 cokflLusdoa air, it will be sized F;f �d '­,staiied 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 al 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 Vert 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 Diameer 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 PERMIT NO.: 2004-00036 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/14/2004 572-36U4 FAX: (763)571-1287 ADDRESS : 445 67TH AVE NE PIN : 143024240072 LEGAL DESC : RICE CREEK TERRACE PLAT 3 : LOT 5 BLOCK 4 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A INSTALL GAS WATER HEATER # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES WIDLUND C OL M 445 67T ENE F . Y, MN 55432 WIDLUND CAROL M 445 67TH AVE NE FRIDLEY, MN 55432 0 VALUE OF FIXTURE/APPLIANCE 0 # GAS WATER HEATERS 0 # GAS RANGES 0 # WATER TRMT APPLIANCES IV'01e &-n ilCc. d; Ja OWNER 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 worl 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 costruction or the performance of construction. AnnI Date PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 27546 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 1 0 0 20.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 20.50 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 : 445 67 AVE NE : 143024240072 : RICE CREEK TERRACE PLAT 3 : LOT 5 BLOCK 4 : HEATING : RESIDENTIAL : ADDITION/ALTERATION PERMIT O.: 2004-` DATE ISSUED: 07/28/200 VALUATION 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 GAS FIREPLACE (MAJESTIC, 30,000 BTUS) # A/C UNITS 0 VALUE OF APPL OR WORK 1600 # GAS DRYERS VALUE (FOR MINIMUM CALL) APPLICANT MASTER GAS FITTERS 2263 N MCKNIGHT RD STE 2 NORTH ST PAUL, MN 55109 OWNER WIDLUND CAROL M 445 67TH AVE NE FRIDLEY, MN 55432 0 # GAS RANGES 1600 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 worl 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 regalt conatr tion or the performance of construction. Annlicant /1 Date // 0 HEATING PERMIT MINIMUM FEE 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 16.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 16.50 PAID WITH CHECK # 9777 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION Effective 4/1/2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 763-572-3604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONINGSYSTEMS AND DEVICES th� "T JOB ADDRESS / ltd /V& RATE SCHEDULE Fee Total ` I n n Residential � Owner on. -L �� E l� t� °�° W B cX x ns Furnace Shell and Duct Work, Burner & f1 Z GS d�en'T also Replacement Furnace $35.00 $ Building Used As_( Gas Piping (New Furnace, Fireplace, Insert) $10.00 $ /0.&0 ESTIMATED COST_Z4;4; L& && PERMIT NO an -L1' L) & Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. *Air Conditioning-AllSizes $25.00 $ BTU HP EDR Fuel Total Connected Load All Other Repairs or Alterations (List on Back) L _P Uodfi P, 1% of Value of Appliance or Work $ Burner Trade Name 1 / /rti , Es ,� Size No.Z_ Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/IndustriaVInstitutional and representations stated in this application aretrueand correct. ' � State Surcharge $ : ��' HEATING C0� <cS TOTAL FEE $65 L� Signe Gc : Tel #IaSZ %441 2%% REINSPECTION FEE$50.00/HOUR FAX#/,,�s / - 7-IX7L Date %3'G'�— *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 Approved 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 existina 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 Tctal 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. A. Inspections RESIDENTIAL APPLICATION Received 763-572-3604 CITY OF FRIDLEY Date Recdd:: DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑OWNER CONTRACTOR PROPERTY NAME: 1"i STATE�4�ZIP � OWNER/ ADDRESS: r S - CITY ErAwl TENANT coNTRACTOR COMPANY NAME:Anderson HeafingandAir -Conditioning SUBNUT A COPY OF CONTACT PERSON: A6� YOUR STATE STATE LICENSE a N/a 4347 Central Ave N.E. _STATE ZIP LICENSE WITH ADDRESS: �pj, HtS, Mn SS421 '�.J 90 APPLICATION PHONE �� " /�- l+°S�� W PERMIT TYPE INGLE FAMILY El TWO FAMILY O TOWNHOUSE TYPE OF WORK: C3 NEW 17q REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DE�CRIPTI4N OF W9RK 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 �[W 1H�ERE NOTED. FIXTURES: (INDICATETOTAL ',' MBER OF EACH BELOW)MODEL: C? rr 7�Ili'�l` SIZEBTU Equipment Installed MFG: a SIZEBTU MFG: MODEL: SIZEIBTU MFG: MODEL: _ _—_— GAS RANGE/OVEN $10.00 1A/C $25.00 —FIREPLACE (GAS) $15.00 _NEW GAS GRILL $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 GAS UNIT HTR $10.00 _BOILER $35.00 FURNACE $35.00 '-'POOL HEATER $35.00 CHIMNEY LINER $10.00 —GAS DRYER 510.00 — VENTILATOR $15.00 — GAS PIPING $1000 ,.. DUCT WORK $lo.00uiGi2'�it7T ;RNK&m t:,TS`0. R $5Q C'4 Permit Fee $ �+ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 0 Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ TMS 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 (. Lt,YU}_LLM S,4,V--PRINT NAME --- City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 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 I14C 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations