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PRE 2010 DOCSCity of Fridley, Minn. BiRLDIRG PERALT� Date,Owner:s r Builderr Address.. LO TIOVy'10— UILDING No. _� Street P t Lot _ Block Addition or Sub -Division Corner Lot _._ Inside Lot Setback -60-%F- '? Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING TOAUsed ..• Front Depth Height � _ Sq. Ft.1�4 Cu. Ft 40 o t --- Depth Height /'Sq. Ft. Cu. Ft. Type of nstruction F Cost " 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,. pair and moving of buildings within the city limits and this permit may be revoked at any�upon ' Iolatio of any of the provisions of said ordinances. , _ .� Building Inspector NOTICE: This permit doss not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits Por these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, IOTA LOCATION OF BUILDING No. Wdam� MA W17 Rum, of Lot Lot Block / Addition or Subdivision � A & �L aooir '00 - Corner Lot +Inside Lot Setback,_..?- Side -Yard " S3W 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 3/ LC oo . _Height Sq. Ft. /0 ?7 Cu. Ft. 9 C P Front` Depth Height Sq. Ft. Cu. Ft. d-6 Type of Construction Estimated Cost ,/3,, 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 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. C (A SAedule of Fee Costs can be found on the Reverse Side.) D City of Fridley Appcation for Plumbing and Gas Fitting Pemdt Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK o?�7 �z� Number, Kind and Location of Fixtures Lowiion PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures ...................... —� x $1.50 Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 Catch Basin ............................ x 3.25 Water Heater (Up to 200,000 BTU) ...... % x 2.00 New Ground Run Old Bldg. x 3.25 City of Fridley: The undersigned hereby .makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No \g:!r-3 , TOTAL $ 9 a a Signe $ -;Y 5/0 By $ Business Phone $ $ ROUGH FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ......... TOTAL FEE $ / 9D ae 2M 7-59 No. rq (9 R N WATER HTR. GAS ELEC. uZ-i �� LLo U <3 �� O m Base / 1st % 2nd _ 3rd 4th ° Future Connection Openings I Connected with Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures ...................... —� x $1.50 Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 Catch Basin ............................ x 3.25 Water Heater (Up to 200,000 BTU) ...... % x 2.00 New Ground Run Old Bldg. x 3.25 City of Fridley: The undersigned hereby .makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No \g:!r-3 , TOTAL $ 9 a a Signe $ -;Y 5/0 By $ Business Phone $ $ ROUGH FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ......... TOTAL FEE $ / 9D ae 2M 7-59 No. Application for Power Plants and. Heading. Cooling. Ventilation, Reh igm atian and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ..._�.................. Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 ............... iM STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam...... . Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... Each add. 200 sq. ft. EDR Steam ...................... Each add. 320 sq. ft. EDR Hot Water .................. 8.00 $ (✓ 2.00 $ 0.00 $ 5.00 $ 2.50 $ 8.00 $ 8.00 $ 2.50 $ 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE . TOTAL 1st 3 Fixtures ....... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL Dept. of Bldgs. Phone SII. 4-7470 Location City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn 19 Owner Kind of Building Used as To be completed about Estimated Cost, $ Old New uilding Permit No. Permit No. X0/ 6 DESCRIPTION OF WORK HEATING or P WER PLANTS -Ste Hot W ,Warm Air— Trade Name ��p��-e "°J Size No Capacity. Sq. Ft. E.D.R 11-vBTU H.P. Total Connected Load Q_ P7 , a(� Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. EM.R BTU H.P. (REMARKS—OVER) Signed RAY N. WELTER H PATI w8, E By 4637 CHICAGO AVE. "IMMCKPIT IS 7, MINNESOT,4 sK 4z 4N1 �_s9 Business Phone No. ,��r- e40 � _ HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS`' Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied es No es No 19_ i 12 11 o fhl fff/ W rIth 14 Heiizhtff" - 1-111 1%WIAA 1 LCI��Il ♦t aYYf ""- aa..aaYa Windows and Doors=Cracka a and Area Width Height No. of .Lineal f . Area No. of pane of pane lights r; of crack eq. ft. Coef.1 Btu Infiltration Glass Zzm WMAO Exp. wall , " o Coef. Btu Infiltration Glass Int. wall //SAP Exp. wall . Floor Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area —F1.1 bAa Room I Length 19 Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Wane of pane lights of crack.sqft. fight T II c.oer. ntu Infiltration Glass ' Exp. wall _ Net exp. wall 770 . Int. wall Ceiling 07 JIM IF Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI 1 c-, Ear Rnran, ll.onoth JjPA26Wi,4th Nnivhl ;P'Yo Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane Ilghts of crack sq. ft. Qj Aro A� Coef.1 Btu Infiltration Glass Zzm WMAO Exp. wall , " o Net exp. wall ifiEi Int. wall Ceiling' . Floor Total Btu. , Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and dors—Crackage and Area Width Height No. of Lineal ft. Area No. of.pane of pane lights of crack sq. ft. Qj Aro A� Coef. Btu Infiltration Glass a Exp. wall Net exp. wall Int. wall AP 4511POO Ceiling Floor & & Total Btu. ` Required sq. ft. E.D.R. or sq. ins.. WA: Leader ,area Height Windows and Doors—Crackage and'Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. - a - Coef. Btu Infiltration Glass Exp. wall Yjr Ir iw Net exp. wall AP 4511POO Int. wall Ceiling & & Floor Total Btu. Required sq, ft. E.D.R. or sq. ins. W.A. Leader area F1.1 � Room I Length1/ .Width Windows and Doors—Crackage and Area Width Helght No. of 11neal ft. Area No. of, .. of pyagne l�ight�� of crack j sq: ft.4040 Infiltration Al Btu Glass ,t4 Exp. wall Net exp. wall Int. wall Ceiling a f% Floor gre Total Btu. , Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r 0 SUBJECT PE City of Fridley AT THE TOP OF THE TWINS r BUILDING PERMIT 22447 � •i COMMUNITY DEVELOPMENT DIV. L �___�_; PROTECTIVE INSPECTION SEC. r � � 70 CITY HALL FRIDLEV 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 14/25/94 JOB ADDRESS 217 69 Avenue NE 1 LEGAL LOT NO. TRACT OR ADDITION SEE ATTACHED DESCR. 7 JBLOCK 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Glen Carlson 217 69 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. United Siding Contractors 3009 109 Ave NW Coo427-()969 Anq7 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 j] REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside house & garage 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. ZONING MOT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $6,900 $3.45 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOTSUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION C9F ANY OTHER STAT R LOCAL LAW REGULATING CON- $9000 Fire SC $6.90 TRUCTIO OR THE PERFOR E 0 CONSTRUCTION. PLAN CHECK FEE TOTAL FEE r,' License SC $5.00 $105.35 SIG A R 9 NTRACT AUTHORIZED AGENT MATE) OPE VALIDATED THIS IS YO� IT BLDG A GATE SiGNA URE O ERBF OWNfiA BUILDER) IDATEI 0 NEW ( j Effective 1/ 1/94 ADDN (] CITY OF FRIDLEY`�� ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: 1 % �.�----------------------..-------..— -------- -- —- _12--- �' ---- — Legal Description: __ -- L' 0 % (• �� 2 f` ,� /` f) Owner Name & Ad ss: C Cciviso u. -Tel. # Contractor: d c� r� ,,` z �'��/ f� MN LICENSE # Civ 40. 7 Address: 0 a5� -e Ai L-) �� Tel. # �7 QS-(, Attach to this application, a Certificate of Survey Wei 3 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:�t� ode /v, 1, 7 ""g. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: A V Estimated Cost: $ �, Approx. Completion Date: (Cos on Back) Driveway Curb Cut Width Needed: Ft. + F = -�Fkv -' $ _ $ DATE: I -,)-,T -� APPLICANT: - G(i ( Tel. # L/ a -I cF3' cf 3 C SEO_ IL— Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ e .001 of Permit Valuation (1/10th%) State Surcharge $ 3. $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge _ $ < CSC $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 DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On August 1, 19% APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE Wash r Floor s Auto. Gas Aid _ Water Heater k; Stories CI _ Urinal' Shower i Trayi�',?,;; specified agreeing to do all work in strict accordance with the city codes Drain girl Washer Ran I Blow Off Basin $ 7.00 . and representations stated in this application are true and correct. Catch Basin • $ 7.00 (R.,_ . a li- Gas Elec Basement g ;: $ 7.00 , ig Sump/Receiving Tank $ 7.00 Floor 1 $10.00 t" Owner Water Heater —Electric $ 7.00 Floor 2 $10'00 s' Gas Range** Gas Dryer** $10.00 $10.00 ..,..; Back Flow Preventer Required ( )Yes () No /%, Floor 3 $15.00 PLUMBING COMPANY OI/ _ �, Floor 4 SIGNED BY;��,��_ TEL N0. 3 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1,5% of Value of Fixture or Appliance PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS ;) 1? 6 9 r r / -(A-- /t/- P, New Fixtures $ 7.00 ar �� The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin • $ 7.00 Rain Water header $ 7.00 , ig Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner Water Heater —Electric $ 7.00 Water Heater — Gas** $10'00 Building Used As Gas Range** Gas Dryer** $10.00 $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No /%, Type $15.00 PLUMBING COMPANY OI/ _ �, Reinspection Fee $42.00/Hr SIGNED BY;��,��_ TEL N0. 3 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1,5% of Value of Fixture or Appliance Approved By Rough—In Date Final Final Date State Surcharge .50 �0 MINIMUM FEE FOR ANY PLUMBING_(GAS PERMIT IS $2000 TOTAL FEE $ , PLUS THE $.5o STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. SUBJECT P City of Fridley ! 23972 AT THE TOP OF THE TWINS BUILDING PERMIT Ir? L. RECEIPT NO. COMMUNITY DEVELOPMENT DIV. � r PROTECTIVE INSPECTION SEC �� NUMBER REV GATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 2/6/96 JOB ADDRESS 217 69 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Glen Carlson 217 69 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Artisan Carpentry Inc 16620 Dolomite St NW Ra791-454() 1741 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 C7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE % B DESCRIBE WORK Install a 12' x 8' Basement Bathroom 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $4,500 $2.25 WITH WHETHER SPECIFIED HEREIN O NOT. THE GRANTING OF A PERMIT DOES OT PRESUME TO E AU RITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRO I ONS OF ANY O E ST OR LOCAL LAW REGULATING CON- $99.75 Fire SC $4.50 STR R THE P F RM E OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE License SC $5.00 $111.50 SIGN TUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI HENPA�OPE Y VALIDATED THIS IS YOUR PERMIT BL G INSP BATE SIGNATURE OF OWNERUF OWNER BUILDERI IDATEI NEW (] Effective 8/1/95 ADDN [ ] CITY OF FRIDLEY I ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 I Building Permit Application Construction Address: 02 A/ NC FA 10 Lev dam% ,- J YT Legal Description: Owner Name & Address: 6ccr2i CAR-LSo'j Tel. # Contractor: �� % /S/9h� G� `,'' ?-� G RIO MN LICENSE% %� Address: f�2p � C S^i A) e -d SCi' �� Tel. #'0 � �5�� 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 40— Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $� T Approx. Completion Date: — / .9 .b/ (Cost on Back) Driveway Curb Cut Width Needed: F 6 Ft = t x $ _ $ DATE: — S APPLICANT: Tel. # !�3 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY P," , <,W.A,7R Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $850 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 [ ] I g\ -,ri -vAVM 4Y U Cv V -W A,_ -g -7 � �j %fv tzv �q :4 ry -JI ,r'X /S r,I.v4 L ,F&1, ✓4 d' -7 x' .Srun Nac t s, . Finris�/ -goriv J'ioEJ, Pk-'qov Foy AiINT, �x/ST/N!, .E3'/s7;I'V4 .Z- D x.3-6 y IM10osy ,B,ysE/yEiyT .F,9rH PAN .�ftJ'EME/�/T /NFD/G/NF L�AldiNt'T -Ex�.rrin/4 4 "P�uMBii✓4 J'r've& Pon, lag' 1 07S 1. Obtain necessary permits. 2. T/O 6" concrete slab for plbg. 4. Concrete patch after plbg. 7. Supply and install new 2"x4" partition walls, with access panel. '47?5b 5PZe, 7. Furr out existing block foundation walls. 12. Supply and install new 2/6x6/8x1-3/8" flush, birch, H.C. interior door. 14. Supply and install rough -in and finish plbg as per plan, water supply and stack over 5' from new bath. New plbg fixtures all white. 16. Supply and install a new G.F.I. outlet. 16. Supply and install a new light fixture and switch. Fixture allowance at $35.00. 18/19. Supply and install new 1/2" moisture resistant sheetrock q on the interior walls and ceiling of the new bath.��%�/; 18. Supply and install new 1/2" sheetrock on the exterior. walls of -the new bath. u. 18. Supply and install a new mud set ceramic tile tub surround, to a height of 6' over the bath floor. 18. Supply and install ceramic bath fixtures (towel bar, toothbrush holder, paper holder, soap and grab). 20. Trim existing window 22. Supply and install a new aluminum framed, tempered glass, by-pass door tub enclosure. 22. Supply and install a new 16"x22" recessed cabinet. 23. Supply and install a new sheet vinyl floor covering, medium grade, and new 4" vinyl base. 25. Cleanup, bath. by/0 �i a E' 5C- 7-0-/Z 49 �j4�f�' /.'��,, �i�� /mill 6-0455e/ �L� 5901 U 011, SUBJECT City of Fridley 30256 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. _ f PROTECTIVE INSPECTION SEC.® ��"'T;•j CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By L 612-571-3450 910415 9/21/99 JOB ADDRESS 217 69th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Glen Carlson 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Richard Hastings Contr. 6331 Riverview Ter NE Fridley 55432 574-9966 4051 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 -t3 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 21 S 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 S0. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN BO 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 1835 .92 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $66.20 Fire PLAN CHECK FEE TOTA E r/f 1L�.2 (ita►�. I,1C. C 5 . 0 7 96 SIGNATURE OF COIJ RACTOR ORA «ORIZEO AGENT (DATE. M P VALIOA IS IS P�j 10 / `61 i2.Y _ �b S-GNATURE OF OWNEROF OWNER BUILDER) iDATE, @COG iNSP _ZY gA1E 011, NEW[ ] „ Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION !J _ Construction Address: -.! 7 % yA AOS Legal Description: Owner Name & Address: Tel. # Contractor:(2 C' 1Z -0 l S ti, &I c 5 MN LICENSE # -�IpS / Address: 6133 / & o i�:: R o 4 7-1= Tel. # 577 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 2 L $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Construction Type: -rEA/Z a Fr 120 ,- r Estimated Cost: $ Park Fee Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 7b-1 Zz z APPLICANT: Tel. # 5'7 TOTAL STIPULATIONS: $ CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ A COV .001 of Permit Valuation (1/10th%) State Surcharge $ a $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ _ UG $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: $ ,0'_ 1:f/ 41&3 CITY OF FRIDLEY INSPECTION DIViSION °6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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 J, 4 -en I Others/Repairs & Alterations (LIST ON BACK) % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ �'e-Toe) 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. Effective On January 1, 2000 JOB ADDRESS I % 6� _X � &el OWNER >&1xn K, e_-154 ✓gM BUILDING USED ASS/.�1 ESTIMATED COST, ,51a/ PERMIT N0. No. of Heating Trade Names BTU—7,5 «1717 • • • is t Circle One (Steam) (Ho Water) arm Air Size No. HP EDR -Total Connected Load Burner Trade Name Size No. BTU HP 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. SEDGWICK HEATING &AIR CONDITIONING CO. HEATING 0910 Wentworth Avenue South Mneahalis, MN 55420 Signe (952) 881-99M TEL # Approved By/A Rough -In Date Final Date °� 1/0/ COMMON VENT, VENT CONNECTOR AN® COMBUSTION AIR VERIFICATION When replacing an existing furance, 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. HEATING CO: Signed By: Date: 4 - - oZ/i 6 ! -M av 1?6 �� When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from Hast, deterioration, obstructions, and is securely supported and firestopped where required. Yes Y4 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 manufacturers 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 Fu rnkOL- BTU Input K, Fan Assisted or Nat Appliance #2 Type Ul Lf BTU Input LJO /< Fan Assisted or Nat V Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances u Total Btu Input (, Common Vent Type Clc55 A Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter` in Type Appliance #2 Vent Connector Height ft Length ft Diameter n Type :iL Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) SEDGVV;CK HEATiNC & AIR QOJ, r,'ITIOINiiu 110. 8910 Wentworth Avenue Sou n Minneapolis, MN 55420 HEATING CO: (95 ,21881-9000 Signed By: Date . -SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (952) 881-9000 TEST RECORD ADDRESS ' ) a OCCUPANT TF:6 SOLD BY iDA=,4*! MAKE LeMd- SERIAL NO. 630001- Ml 1 THERMOSTAT -/Q® VALVE �4 /Q peB l LIMIT lieiM pK LIMIT SETTING E/ FAN SETTING %/lam PILOT TYPE 7 IGNITION MODEL P® 4'e' PILOTTIMING L Sem PRESSURE / PERCENT CO2 !T2/ PI A �_///�,r,� INPUT CFH ��'�/ PERCENT OZ STACK TEMP. 35040 PERCENT CO `ter FORM 235 (REV. 11/89) CITY F ( OWNER�A•� INSTALLED BY MODEL `Q 22 d 1-3 715: -4- IN P U- T - INPUT -�- Q®40 VENT SIZE �1 TYPE OF LINER LINER SIZE FILTERS: SIZE C� Z7 NUMBER WIRING RLILM sz. i ale TEST TAG LIGHTING INST. * --77 DATE TESTED G to/Gy / COMPANY TESTING NAME OF TESTES FORM DISTRIBUTION: WHrrE COPY - JOB FILE YELLOW COPY - CITY ilding PLUMBING Permit Inspections F763 RESIDENTIAL' APPLICATION Received By: -572-3604 CITY OF FRIDLEY DaAOXT 2 20C B 763-502-4977 FAX EFFECTIVE 1-1-08 YO E-MAIL ADDRESS �=D�DRESS THIS APPLICANT IS: ❑ OWNER OCONTRACTOR PROPERTY NAME: ADDRESS: C/(I CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE KSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT DETAIL D DESCRIPTION O RK, 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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10..00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINKILAV DRAINS —SHOWER _ WATER -PIPING _FLOOR SOFNG —_BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _WATER rNER ($35) WATER CLOSET PREV. ($IS) _CLOTHES WASHER _ KITCHEN SINK _ _BACKFLOW DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION — _ WATER METER —OTHER "E fF ' '. . r 1 r'11.u- • Permit Fee $ Number of fixtures @ $10.00 x $10.00 =$ Surcharge 0 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ __ )__. OR Number of fixtures @ $35.00 x $35.00=$ State Surcharge = $ .50 INIMUM $15.50 (MINIMUM $15.50) Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved plan in the cas fall wo c hich requires review and approval of plans. / SIGNATURE OF APPLICANT a'�--- PRINT NAME (ems DATE ` APPROVED BY DATE �4. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977