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PRE 2010 DOCSCity of Fridley, Blinn. BUILDING PERMIT Date: Owner: ' _ Builder. Address Address e-,4i TI�V OFF-�NG No. _� ,,,, Street � � -6 _ Part t Lot +.__ Block Addition or Sub -Division Corner Lot _ Inside Lot _ SetbackSideyard ---- +� Sewer Elevation ...... Foundation Elevation DESCRIPTION OF BUILDING To WUsed •�. i :/. c Front `-" Depth Height lC r _ Sq. Ft. Cu. Ft. t Depth Height � Sq. Ft. Cu. Ft. Type of Construction`; � , �' � Est. ,-_ —r 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 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 �n� city limits and this permit may be revoked at any time upon violatAon of any of the provisions of said - -' ' ` Building Inspector s �[. g a NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for thews homy APPLICATION FOR BUILDING PERMIT CJTY OF FRIDLEY, M7[N WOTA Owner' 9 Name /f%�i'�2�✓ Builder _ L�� %�2G"J Address J f�L�� L Address /�2 LOCATION OF BUILDING No. Street_, Part of Lot Lot Block Addition or Subdivisio Corner Lot Inside Lot j / Setback 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 used as: Front ,� Depth Height �- Sq. Ft. � Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. _ems Type of Constructions-- Estimated CostO-V To be Completed • A The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinpres, and ruling of the Department of Buildi�ng�s, and hereby declares that all the ets and representations stated in -this applicat- n are true and correct. DABS ` SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) A City of Fridley, Minn. BUILDING PERMIT Date: June 7,* 1965 W? '7'763 Owner: AUan Peterson Builder Rand Builder's Address 565 67th Avenue N. E. Address 5243, 6th Stiml N, rho LOCATION OF BUILDING No. 565 Street 67th Ayemm N. E. Part of Lot Lot 9 _ Block 1 Addition or Sub -Division Rice Creek Terrace, Plate 4 Corner Lot — Inside Lot Setback Sideyard Sewer Elevation To be Used as: Type of Construction Foundation Elevation DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Front Depth Height Sq. Ft. Est. cost . _ 81.5..__ To be completed • Storm damage repair • Ca. Ft. Cu. Ft. 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 ail provisions of ordinances of the city of Fridley. �1�...4. In consideration of the payment of a fee of permit is hereby granted to Rand Builde= I to construct the building or addition as described above. This permit is granted upoa, the express condition that the person to whom it 3s granted asci his agents, employees and worlmnen, ffi all work done in, around and upon said building, or any part thereof, shall coffiorm is all respects to the ordinances of Fridley, Mizmesota location, construction, alteration, maintenance, repair and moving of buildings wiordtinan city ]units and permit may be revoked at antiy time upon violation of any of the provisions of said Allen Jensen Building Iw4pectov NOTICE: Ub pent dos not corer the construction, hahDadon for wirieg, phimbing, gas hee8ng, ower w wdw. Be sun to me the BWMIng Impator for aparah pwmhs for thea Umm APPLICATION FOR BUILDING PERMIT CITY ' OF FRIDLEY, mnmsOTA I ADDRESS_��� " Ca `� "� ADDRESS ..t LOCATION OF BUILDING No. Street Part of Lot LOT BLOCK ADDITION OR SUBDIVISION& (2tCX7_-eAAo Corner Lot Inside LOT Setback Side -Yard SE6JER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two,Certificates of Survey of'Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front Depth Height, S%. Ft. Cu. Ft. Front Depth ,Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost �I o m ° 44_�_4. To be completed The undersigned hereby makes application for 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). CITY OF FRIDLEY INSPECTION DIVISION e� Qj� act U ' So� J \ �'A'Qj S ,� Effective On January 1, 1999 -6431 University Ave NE Fridley, MN 55432 APPUCA71ON FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES (1 f n JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the wo herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — ® rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent —Fill Out Back) b bb ,19 Gas Piping (Needed with new furnace, $10.00 $ 1 . but not replacement) OWNER 1f Y) P Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ / ESTIMATED COST ���y �� PERMITNO. *Air Conditioning — All Sizes $ 25.00 OS DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) arm Air) Trade Name Size No. Commercial/Industrial BTU �, �, i� _ HP EDR 1.250/a of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge TOTAL FEE $ .50 $US S v MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU HP EDR HEATING COMPANY KpENDA&E MOOR AIR QUALITY, INO, 1108. 543!� Signed ByM., MTel No . L\ c�- Approved By Rough—In Date Final Dat CEaM NEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack L Has been carefully examined Yes No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes �/-) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes Q) No ( ) 6 Has total heating BTU's of 0�90 All other BTU's TOTAL BTU's i 12 , S Oo 7. Has a liner been provided for water heater Yes (A No ( ) 8. Has combustion air been provided for water heater Yes ()6) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: f GNOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 October 17, 2001 Mr. Jeff Palmer 565 67 Avenue NE Fridley, MN 55432 Re: Final Inspection at 565 67 Avenue NE Contractor: Dependable Indoor Air Quality Inc. Dear Mr. Palmer: A mechanical permit was issued on June 3, 1999 to install a furnace and air conditioner at your address. According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the mechanical work authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Mechanical Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permit and no further action will be taken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Building DJ/mh City of Fridley SUBJECT P 2 9477 AT THE TOP OF THE TWINS ? BUILDING PERMIT r I RECEIPT N O. COMMUNITY DEVELOPMENT DIV. : SEC. DA r � PROTECTIVE INSPECTION I 1 � I �•__1 CITY HALL FRIDLEY 55432 ti_._.11: '•� (/r` NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 90415 1A 5/17/991 1 JOB ADDRESS 565 67th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. g 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeff Palmer HWUR 323-3019 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ace RRRfjggxA Const. 6017 167th Ave NW Ramsey MN 55303 20001884 88888889 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION 0 ALTERATION REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Reroof house and garage (26 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 OCCUPANCYLOAD 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2228 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 $83.25 Fire SC. $2.23 PLAN CHECK FEE TOTAL FEE c e SC $5.00 $91.59 SIGNATURE OFCONTRACTOR ORAUT14ORIZEDAGENT IDA Tt, M p ERLY VA (DATED THIS I YOUR PERMIT - S.GNATURE s OF OWNERJF OWNER BUILDER. IDATEI BLDG (NSP GATE NEW[ ] Effective 5/10/99 /1 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 5 �,�C UC- J\J, f _ Legal Description: Owner Name &Address: Tel. # Contractor: 4u L�� �fvGT��ia MN LICEN # Address: b b 11 l ���- q "c 1U v ) W� �_ 55 Tel. # Attach to this application, a Certificate of Survey of the — -- - -- 'a lot, with the proposed construction drawn on it to scale. �� OC a c(� DESCRIPTION OF IMPROVEMENT 2, J 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: Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: APPLICANT: Estimated Cost: $�6 Ido„ 4-- �.0070 8 _Ft x $ _ $ Tel. # TOTAL STIPULATIONS: $ qi.6 ' CITY USE ONLY Permit Fee $ ��, o'? Fee Schedule on Reverse Side Fire Surcharge $ 0`,1. 9 3 .001 of Permit Valuation (1/10th%) State Surcharge $ %, / / $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 5 -,Ob $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: $ qi.6 '