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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N° Q57i5 Date: CWner: � Builder •.0 Address Address i — -- CT•�ON OF BUILDING Lot __ Block Addition or Sub -Division ? Corner Lot w_ Inside Lot � Setback �� Sideyard za Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T e UsedW, f F49;vront Depth Height W Sq. FL 4 nt Depth eight Sq. Ft. Cu. Ft. of Construction Est. �To be Com leted 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 adl provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of . YA 71_ , 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances." NOTICE This permit don not cover the condrudion, hutallation for wiring, plumbing, Bae heating, sewer or water. Be sure to see the Building Inspector for separate pormhs for these Hems, APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name_LL:Builder Address Address LOCATION OF BUILDING No. z Street ��e art of Lot Lot Block Addition or Subdivision C Corner Lot Inside Lot ��`a Setback&:)_Side-Yard�h 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 `40 Sq. Ft. Cu. Ft. i Front,-�-�—Depth—I, L' .- Ieight . Sq. Ft. Cu. Ft. Type of ConstructionEstimated Cost,,,1��� 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct DATE_. e — SIGNATURE -� (Schedule of Fee Costs can be found on the Reverse Side). 0 10 i • M Application for Power Pkmts and Heating. Coding. Ventilation. Refrigeration 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 ............ 8.00 $ each add. 00,000 BTU ........................ 2.00 $ Replacement of Furnace ............................. .§.00 $ Repairs & Alterations up to $500.00 ................. ............ 5.00 $ Repairs & Alterations each add. $500.00 ....... :...... 2.50 $ STEAM or HOT WATER SYSTEM $ Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line --to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 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 Fi;E $ ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 AA Location ®1 _' I 4 If & C, �Y 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 L-7- 6? Owner / G2"A_e- 'lj '//' e , Kind of Building Oil Used as To be completed about a -n Estimated Cost, $ /'l 6 Permit No. / Permit No. C DESCRIPTION OF WORK HEATING or P WER HANTS --.Steam, Hot Wa WarmAir— Trade Name eg& dtA-�rJ Size No / B --a Capacity, �S/q. Ft. E.pD.R AK �0( BTU H.P. Total Connected Load -7 • a a Kind of Fu BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signe y By 4637 CHICAGO AVE. MINNEAPOLIS 7, MINNESOTA 42 2M1 7.59 Business Phone No J= (REMARKS—OVER) � p . OF BUILDINGS � t' '" NIINNEAPOLIS. MINN. 'Heigh tf''' No. Insulation Roof Floor Kind How. Applied �. , 7, ,k- Room I Length r Width Height Windows and Doors—Crackage and Area Coef. P Infiltration t`' I,p Glass ;'d x -- ut: eT 1 nRS ret rr n srrnxc Net exp. wall Int. wall 4' JWm I LengtV7 Windows and Doors—Crackage and Area No Width of pane Height No. of Linea► it. Area of pane —lights of crack eq. ft. it g� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � p . OF BUILDINGS � t' '" NIINNEAPOLIS. MINN. 'Heigh tf''' No. Insulation Roof Floor Kind How. Applied �. , 7, ,k- Room I Length r Width Height Windows and Doors—Crackage and Area Total Btu. Required sq. ft. E.D.R. or sq. ins., W.A. Leader area El I b1�2, D--- I t __—L air VFI:.t.L V.-* Windows and Doors—Crackage and Area Coef. Btu Infiltration t`' I,p Glass ;'d x Exp. wall *, le orl lCoef.1 Net exp. wall Int. wall Btu Infiltration Ceiling ' 2. to Floor it g� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Total Btu. Required sq. ft. E.D.R. or sq. ins., W.A. Leader area El I b1�2, D--- I t __—L air VFI:.t.L V.-* Windows and Doors—Crackage and Area wicim F =- Width Height No. of Lineal ft. Area No. of pane of pane llghte 'of crack Xft. Windows and oors—Crackage and Area Glass Width Height No. of L neal ft. Area No. of pane of pane lights of crack sq. ft. x Exp. wall A 4, <'dr d lCoef.1 "Itoef.1 Btu Infiltration Infiltration " t'" � "'. Vii. 2 1 2, 'r = V'2 g� Glass Exp. wall Required sq. ft. E.D.R. or sq. ins. W.A. Leader area arr: ra 1 ,.s n - - i r ---.L +s... • Net exp. wall Exp. wall f d Int. wall MI-Sv?,4& Net exp. wall Int. wall Int. wall Vz el d '7-0 I I 1 Ceiling ' We Ceiling ,`�• ,`"' / ; Floor '6,, . Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I r 1. 14 p i7_ moom I L.engm I P ..n wicim F =- rtelgnr er Windows and oors—Crackage and Area Glass Width Height No. of L neal ft. Area No. of pane of pane lights of crack sq. ft. x Exp. wall A 4, <'dr d Coef. "Itoef.1 Btu Btu Infiltration " t'" � "'. Vii. 2 1 2, 'r = V'2 Glass Floor Total Btu. Exp. wall Required sq. ft. E.D.R. or sq. ins. W.A. Leader area '06 ra 1 ,.s n - - i r ---.L +s... • Net exp. wall :'Lr..:_L• ".7 ... f d Int. wall MI-Sv?,4& Ceiling ,* a A, oop Int. wall Vz el Floor I I 1 9, q 40 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Width No. of pane Height of pane I No. of lights Lineal ft. of crack I Area eQ. ft Glass '' x Exp. wall A 4, <'dr d Coef. Net exp. wall Btu Infiltration Windows an Coef. Btu Infiltration Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Glass '' x Exp. wall A 4, <'dr d Coef. Net exp. wall Btu Infiltration Int. wall Ceiling y / 'r = V'2 Glass Floor Total Btu. , Required sq. ft. E.D.R. or sq. ins. W.A. Leader area '06 ra 1 ,.s n - - i r ---.L +s... • .VFY:-I.L W.' :'Lr..:_L• ".7 ... Windows an oors—Crackage and Area r Width Height No. of Lineal ft. Area No. of pane of pa a lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Coef. Btu Infiltration y e 'r = V'2 Glass + ",; '06 Exp. wall ' kv ' ;h Net exp. wall Net exp. wall Int. wall Int. wall Ceiling Ceiling ,`�• ,`"' / ; Floors . Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /R -117—k, R..I Len.thY ',' Width Height Y - Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pa a lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling / ; Floor,. . Total Btu. ft. E.D.R. or sq. ins. W.A. Leader City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures y N 2 uS W 6U' Z F N WATER HTR. GAS ELEC. 3 �,F w 3� o�G S <3 t�9•d (�9Sa (�90 Base % 1st 2nd 3rd 4th • Future Connection Openings Connected with Sewer New Fixture, Old Openings Cesspool E] PARTIAL RATE SCHEDULE M PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... aO x $1.50 $ Future Fixture Opening ................ x 1.20 $T - �---� New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ U New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ C) Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE—�-�-C� Dept. of Bldgs. Phone SU 4-7470 City of Fridley: The undersigned hereby .makes application for a permit for the work here! 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, tz Owner Kind of Building Used as b,^��� To be completed about Estimated Cost, $ 1;2 ® ` Old—New. Building Permit No � 7 Permit No.,—Aa Signe By Business Phone No ROUGHS® - G 7— FINAL ��12060 City of Fridley, Minn. BUILDING PERMIT Date: March 122 1973 Owner: E nest Harper Builder— Address __._..352._: 69th Avenue .VN ..F . Address _.._Same.__._.._.._._—...._.. _.--.. LOCATION OF BUILDING No. 257__ Street 69th Avenue N.E. _ Part of Lot �. Lot 2 _ Block _ 1 _ _ _.__— Addition or Sub-DivisionRiC—e_. CTeek -Ua7-a...NQrth_. Corner Lot __. .__ _ Inside Lot Setback _ ___ _ Sideyard Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING Addn. to Garage Front -!Ql— — Depth _.221_'_c Height _..._....1.4-1 Sq. Ft. _._ _ _ Cu. Ft. y --- Front Depth — Height __ Sq. Ft. — Cu. Ft. -- Type of Construction — Frame Est. Cost _ ... 15QQ.DD - ..--_ To be Completed .._._..4 months SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. 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. .75 State Surcharge 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Inspector T.ARF.NCF. RF.T.TST,F. NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 M AMICATION FOR RESIDENTIAL t ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, NINN9SOTA Bim; w 9 �ti $LOCK i our 10N ZORMM LOT: I=IX LOT:, ._,SETBACRII SIDEYAU:„,.,�,, A,Vptivant attach va tip i+ =_Wo Certificates of Survey of Lot and proposed h"Wtag location dr *a mese Certificates, DESCRIPTION OF BUILDING -To Be us" As-. 0 ► f p At Devth: G& ,-2 !/ ,Height: Stwaare Feet; Cubic. Foet3 Tract t —Depth; Height; Squares Feet; Cubic Feet: Trfa of Construction, ^ �i� Estimated Cost: To Bei "feted i . TM undaroigned hereby makes application for• a pe=it for the, work herein speaif WL, agreeing to do all work in stttct accordance with the City of ftUley Drdi"nces 4U4 -XUUASS Pf the Departme4 pf Buildings, apd 'hereby & ajarev #fat all the facts and representations stated is this appItcation ssre true =4 correct, SIMATO$E : Romeo Side► For Additional Information..) ,,-�,-, a - J,47"L,) CL/Lae Oc&ln 76 49 9 1s� THE E. B. MCDONOUGH CO. FE. 5.6611 1959 UNIVERSITY AVE.. SAINT PAUL 4 TELEPHONES SCALEI 'I INCH FEET 406 NATIONAL BUILDING. MINNEAPOLIS 2 MI. 6.6858 MI. 9.5072 PLAT OF��9Lm� r J.. O� PROPERTY' OFG/'/7Gf.5�/`% - ,e%t-- ✓a le.. e6-1 ez bESCRIBEO AS. FOLLOWS�`%��� Ai?O.�Q Lo . ..SO fty (0-9 ' • • • .3 � � - 49.53 .�3. a -� CERTIFICATE OF LOCATION OF BUILDI- G CERTIFICATE OF SIJ1R , I hereby certify that on —�• 19 '� I bereby certify that on _19 , !� I'made a survey of the location of the buildiuff(s) on the' above described property and that the location of said I surveyed the property described above and that the ubuvr� building(s) is correctly shown 9n th�bove plat. lat is a correct representation of said survey. E. B. MGDONOt,Ui-r REGISTERED SURVEYOR. No 1990 PAUL J.CRANkF� •• Na. 4449 In"N J, RVAN •• •• Nr. AAA9 �I SUBJECT MIT NO. .� City of Fridley 26364 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. _ f PROTECTIVE INSPECTION SEC. 370 1 . � REV GATE PAGE OF APPROVED BY I = '—.1 CITY HALL FRIDLEY 55432 �'' 612-571-3450 LBIER 0-Ft5 6/26/98 JOB ADDRESS 257 69 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ruth Salmela 257 69 Avenue NE 586-0039 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. e- 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof House & Garage (29 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 1STALLS 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 $2,418 $1.20 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $78.36 S ATUREOFCONTRACTOR OMAUORIDAGENT IDATEI WHEN PROPERL ALIDATED THIS IS YOUR PERMIT / %SG?NATU4RE aOF OWNER OF OW ER BUILD, IDATEI .1 BLD INSP r)ATE NEW ADDN ALTER ConstructionAddress: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 Legal Description: & Address: ve 2L Tel. # S,9/� - ®� Owner Name Contractor: MN LICENSE # Address:. 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: U Estimated Cost: $ (Fee Schedule, on Back) 411 L / l� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: O �� " l APPLICANT: Tel. # 2 2 (C CITY USE ONLY Permit Fee $ Y- Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: ----- ------ -_I r Are CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 August 9, 2000 Jason Zemke 257 69th Ave. NE Fridley, MN 55432 Re: Final Inspection at 257 69th Ave NE Contractor: Marsh Heating and Air Conditioning Dear Mr. Zemke: A mechanical permit was issued on April 30, 1999 for the property located at 257 69th Ave NE for a furnace and humdifier. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical system. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, P._t1301 CITY OF FRIDLEY INSPECTION DIVISION oo Effective On January 1, 1999 p� fA31 University Ave NES Fridley, MN 55432 APPUCA71ON FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3504 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS S &V`4 , RATE SCHEDULE The undersigned hereby makes application for a permit for the work 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 $ 30. representations stated in this application are trued correct. y (Side Vent —Fill Out Back) ��3 �� 17 ,1998 Gas Piping (Needed with new furnace, $10.00 $ but not replacement) OWNER Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST 4 -3s00.00 PERMIT NO. 3 *Air Conditioning — All Sizes $ 25.00 $ 11 DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (UST ON BACK) %.-� 1 % of Value of Appliance or Work $ �--� No. of Heating Units �� Circle One (Steam) (Hot Water) arm A Trade Name 'WPW& Size No. 7-14Y 09,o P ci tlv Commercial/Industrial BTU 9a, 00-4 HP EDR 1.25% of Value of Appliance or Work $ _ Fuel Total Connected Load 3Y yf State Surcharge $ .50 Burner Trade Name Size No. TOTAL FEE $ BTU HP EDR � �� HEATING COMPANY �✓��� ��.�,.�i�rq C'�e�, MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION/C� REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By / � ' � Tel No. S56 Com' PLUS THE $.50 STATE SURCHARGE 61 REINSPECTION FEE $42.00/Hr Approved By A Rough—In Date Final Date &� D *Air Conditioners can not be placed in aside yard without FILL OUT BACK SIDE FOR S4 VERIFICATION ON REPLACEMENT FURNACE written permission from adjoining property owner. CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1:_ Has been carefully examined Yes ( No ( ) 2. Is free from rust or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes (N) No ( ) 4. Is securely supported Yes (X) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (x) No ( ) 6 Has total heating BTU's of All other BTU's �0 we TOTAL BTU's 7. Has a liner been provided for water heater Yes () No (9 ) 8. Has combustion air been provided for water heater Yes No ( ) Remarks: List ALTERATIONS Being Done: \J 3 0 D ✓ � HEATING CO: Signed By: Date: i y t ADDRESS: ZS 7 APT: FLOOR: CITY: C- 7 DATE: 1 /a! y OCCUPANT: OWNER: HEAT LOSS: HEATING INSTALLED BY: ELECTRICAL WORK BY: S P� �1 GAS LINE BY: 3 TYPE OF HEAT: GA FA ROOFTOP SPACE HTR UNIT HTR OTHER GAS DESIGN MANUFACTURER: .4Nr MODEL: TL) Yoe© W! ?W,3 V SERIAL: /1) 30 3 / Z Q 7 &- INPUT: ®CAo CONTROLS THERMOSTAT: 7-��66) VENT SIZE: � - VALVE. �-' 2 KIND OF LINER: SIZE NONE LIMIT: jDRAFT HOOD: REGULATOR: LIMIT SETTING: FILTERS- SIZE: f-1 NUMBER: / FAN SETTING: (CHIMNEY- INSIDE OUTSIDE PILOT TYPE: !CHIMNEY CONSTRUCTION: PILOT MAKE. PILOT MODEL: SMOKE BOMB: WIRING: S P, 40z - PILOT TIMING: DRAFT: TEST TAG: /414-s� L.W. CUT OFF: DOOR PRESSURE: LIGHTING INST: PRESSURE: 34"' COZ 7 DATE TESTED: INPUT CFH: %02 COMPANY TESTING:5 STACK TEMP: 1% CO NAME OF TESTER: 1 NJ SUBJECT City of Fridley 33156 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . i NUMBER REV DATE PAGE OF APPROVED BY I A �.� CITY HALL FRIDLEV 55432 ��"' __-- L J ` 763-571-3450 910415 10/11/02 JOB ADDRESS 257 69 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jason Zemke 257 69 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Board & Room Remodeling 3836 Harriet Ave S, Minneapolis, MN 55409 612-823-9128 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 4978 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reside House & Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. Caulk and flash all exterior openings. 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 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 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,000 $2.00 DOES NOT PRESUME TO GIVE AUT ORITY TO VIO ATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI ONS OF ANY OTHER ST OR LOCA W REGULATING CON- STRU ION R THE PERFORM OF CTION $97.25 Fire SC $4.00 CO PLAN CHECK FEE TOTALFEE / Zicxnse SC $5.00 $108.25 IGNATURE OF ON7RACTOR OR AUTHORIZED AGENT IDAr WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT I SP QL\` ^ MATE S-GNATURE OF OWNER,IF OWNER BUILDER,- IDATEI 1 NJ NEW (J CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: aq -4-7 6 �A N, 'C, Legal Description: Owner Name Nddress, Contractor. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: _I -A S"d N Tel. # p+ se'la p-.- g U /G4i1sc MN LICENSE # °eieloer 4l/ S`- Tel. # ?9L3 '9/JT Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construction Type: `( 01 Estimated Cost: $ � Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE :�u '"�` T APPLICANT. Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ J TOTAL $ /) (5 -07SI STIPULATIONS: SUBJECT City of Fridley !7:7 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. SEC. r � � PROTECTIVE INSPECTION -67-3/ 1 . � NUMBER pEV DATE PAGE 0� APPROVED BY CITY HALL FRIDLEY 55432 L 763-571-3450 910415 10 /15/02 10B ADDRESS 257 69 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 2 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jason Zemke 257 69 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Board & Room Remodeling 3836 Harriet Ave S, Minneapolis, MN 55409 612-823-9128 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 4978 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION XO REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Replace windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. 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 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 $33500 $1'75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS qF ANY OTHER STATE O LOCAL LAW REGULATING CON- $97.25 Fire SC $3.50 STWU ION OP THE PERFORMANCE F ONSTR ION PLAN CHECK FEE TOTAL FEE License SC $5.00 Y07.50 iGNATUQE OFC 'aACTOP OR AUTHORIZED AGENT 4DATE, F N ROPE LIDAIED HIS IS YOUR PER IT 0, ;100/ s S-GNATURE OF OWNER. -F OWNER BUILOM iDATE. gL gar riA NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDIS! (] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 05-1? /f Legal Description: Owner Name & ddress: � �'� �Ir Tel. # Contractor ddb eio MN LICENSE # � Address:_ , �'.3 A/A 16'11F-11- Tel. # o' 10 0'93YIA? Attach to this application, a Certificate of Survey of the C' 5V lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construction Type: LI) / 101)1) Ph"(y Est d Cost: $ � �—Cro • Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE:.A — /-1f- ` d °� APPLICANT: Tel. # �a /g Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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[ J TOTAL $ 102,0 STIPULATIONS: 0 _1 SUBJECT PER . ­ 1 City of Fridley 33268 AT THE TOP OF THE TWINS BUILDING PERMIT-RECUr F , T NO. 1 L DEVELOPMENT DIV. v ------COMMUNITY r PROTECTIVE INSPECTION SEC. 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F 15 11/21/02 JOB ADDRESS 257 69 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jason Zemke 257 69 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Board & Room 3836 Harriet Ave S M ls. MN 5540 612-823-9128 A 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 8' Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. See variance stipulations from 11/13/02. PERMWAnnialwNG BefOre digging call for all utility locations P0 4`40002 3i6 S E S OF LAW 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 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 1 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 $12,000 $6.00 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 PROVISIO S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $209.25 Fire SC $12.00 S RUCTI N OR THE PERF MANCE CONSTRUCTION PLAN CHECK FEE L en a SC $5.00 TOTAL FEE $232.25 $IGNATURE CO N'RAC iOR OR AUTHORIZED AGENr iOATE� EN PROPERLY VALIDATED THIS IS Y UR PERM(T •/�J \W-10 1A. -I MSP OATS _ S-GNATURE OF OWNERJF OWNER BWLDERI JDATEi 0 _1 NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN I ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name 8 dress: �� Sv ������ 1 Tel. # Contractor. 06 ivL MN LICENSE # :L,9 2� Address:a ��i�l �r S Tel. # i6 / ,'l Jf9 3 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT (0,/ g 7j::6 R �-zj 5;- a -r LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: CtKL662--- C�A Construction Type: /(f & - Estimated Cost: $_/ U Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: < Oa APPLICANT• Tel. # 6 /' Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ /,2r..a a .001 of Permit Valuation (1/10th%) State Surcharge $ !r,- ov $.50/$1,000 Valuation SAC Charge $ / $1200 per SAC Unit License Surcharge $ --<7-- 60 $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 $ • �S STIPULATIONS: 1)� "-wct 'A111W i�-i3-off 01 Oct- -2002 15:33 From -MN DEPT OF COMMERCE +6512977891 T-677 P.002/005 F-381 I• Permit Number MECeheck Compliance Report Checked 13y/Date 2000 Minnesota Energy Code MECcheck Software Version 3.3 Release 1c Data filename: \\FP2-cougar\users\psmith\ema11 projects\Mncheek files\Board and Room.cck TITLE: Jason Zemke COUNTY: Anoka STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 10/08/02 DATE OF PLANS: 10/8/02 PROJECT INFORMATION: 257 69Th Avenue NE Fridley, MN COMPANY INFORMATION: Board and Room Remodeling 38736 Harriet Ave South Mp1s, MN 55409 COMPLIANCE. Passes Maximum UA = 58 Your Home = 53 8.6% Berter Than Code COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R- slue U-Faceor i A Ceilin 1: Raised ar Ener T 192 38.0 0.0 5 ill 1: Wood Frame, 16" o.c. 360 19.0 0.0 18 Window 1: Above Grade, Wood Frame, Double Pane with Low -E. 9 0.330 3 Door 1: GIass 41 0.330 14 Crawl 1, Masonry Block with Empty Cells, 3.7' ht/0.0' bg/3.7' insul 148 0.0 10.0 13 Proposed and Maximum U -tactor Averages Proposed Maximum Averagc U Factor Allowed iU'-F'acTor Above -Grade Windows and Glass Doors 0.330 0.370 Includes Foundation Windows > 5.6 ft2 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, Uroni4r4LAIt Ur ut:toVFANLY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. 70 ::OUVO01 aC 3L iill:i'3J 10� = x,169 L. Its 04 �?J (�sM01IOA sr 0381HOSaq . Z�6zaAU.I'S, JO 11'yIcd ZLOG.E 'IW Z SI'IOdV3NNIW 'ONIO'tlfle -IVNO11VN 001 BGIUO.O '1WS9NOHd3931 V -IhVd 1NJVS '-3AV AlIS83AINA Crag '341 133! OC•. HON1 1. 13'iV7S GG 1100.9 '0=) Hnnomoo:iW •9 '3 -3H1 Nip oa-s r 6m- - .., 'L (Isp\Z -'�t3 (9(o X77 OS6 ev.,,v &.TRY/ % In - d�)6 OOjoe A-,�400Ix -K -./O/z 7�k Nps SF. / I M, Lo LO E 116TAI.At-11ABa-1PO-IleS-Ilk ENTAAWE AS REQID 2X& 94A(A, D. VL -0 muc) pnrw PARMY IN 'MOD Ka*4, Wb. vC Tup tjMka5 6RrUD4(L + subf4,a-)Tz. rrbylpt KWW or). k3o. FLant wo mA;reH Wr>nwe. Hp. WO, Fi^*IKV, r-- 2-6Ak CAAA6E AND LSUpL p.,5,S,Nf 04 84 -&-TR PITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Ffidley, MN 55432 m (763) 572.3604 W cs a 0 - Effective On Jan 1, 2002 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR cD PLUMBING FIXTURE RATES: z ,c • . Urinal n...a,, Shower Wash Tray Floor K Drain �,. Auto. Washer` x '' Gas . Range ec Stories ;: Basement xw,_ Floor :1 m4£iBo-0Floor U-WAalerater 2v$.Floor.3,� Floor 4 AM EM' A FIM ` cD PLUMBING FIXTURE RATES: z NO. RATE TOTAL Water Treating Appliance $10.00 J New Fixtures $ 7.00 a- Old Opening, New Fixture $ 4.00 U z Beer Dispenser: $ 5.00 w Blow Off Basin a $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric - $ 7.OD Water Heater - Gas'" $10.00 m Gas Range" $10.00 Gas Dryer" $10.00 Back Flow Preventer Required ( )Yes () No IN Type $15.00 LO Reinspection Fee $47.00/Hr "T ALL OTHERS AND/OR REPAIRS AND ALTERATIONS m 1.5% of Value of Fixture or Appliance r - m m M m r - co State Surcharge TOTAL FEE 900. o $ 50 $_220 - Sb JOB ADDRESS s 7— (0T-8 A.e) The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance wish 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. . 1I- 2 7 ,2o_o2 Owner Building Used As Estimated Cost PERMIT NO. PLUMBING COMPANY 7_) e S nr0rfSS) O� J f OW)I&Iii SIGNED BY Awm&(— TEL-NO7b3. q.y 1321 FAX# Approved By COMB TION AIR SHALL BE PROVIDED PER UMC $ CTION 504(A) AND TABLE 6-. • �it,�l �v �� C� � ,Aoe COMMON VENT INFO ON BACK SIDE 07/03/1997 02:54 612-428-7321 DEAN'S PLUMBING PAGE 04 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED FNT VENT CON,NFCTOR AND COMM ISTION AIR VERIFICATION When MpImAnn an enintinn f1jr2nen, 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 plasticlPVC 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 @idgfinn rnmhus4inn Orr is sized and installed to meet the current codes and manufacturer's spedfications. When required to install a new wink s ipn aiTfiwili be sized and installed to most the current codes and manufacturer's specifications. When Installinn a DON yanting SyMem, 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 favi assisted and natural draft appliances. 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( ) Yes( ) No( ) Yes ( ) No( ). Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Not 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 Diiameter�in Type ALTERATIONS- oweribal _ O ugh - HEATING CO: Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 VAX: (763) 571-1287 ADDRESS 257 69TH AVE NE PIN 143024220002 LEGAL DESC RICE CREEK PLAZA NORTH ADD LOT 2 BLOCK 1 PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT N .: 2004-00960 ,> DATE ISSUED: 06/21/2004 VALUATION : $ 3,000.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. BASEMENT FINISH PER PLAN. APPLICANT ZEMKE JASON P & ROCHELLE M 257 69TH AVE NE FRIDLEY, MN 55432 OWNER ZEMKE JASON P & ROCHELLE M 257 69TH 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 wor will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or ca c 1 ' provisions of any other state or 1 cal 1 regulating c s/e rformance of cons Annlic (L__ Bate MIA10 BUILDING PERMIT FEE PLAN CHECK FEE FIRE SURCHARGE STATE SURCHARGE, VALUE TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 83.25 54.11 3.00 1.50 141.86 NEW [ ] CITY OF FRIDLEY Effective 1/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: LzE :7—, 3 Lta— 9�_-E e c IPi.Az .ad ag o l Owner Name &Address: JA60 jP 4- P05ffZUZ Z!&Mz a Vg Tel. # 76.742(-4726 Contractor. aW NU, MN LICENSE # Address: 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: F(Nlsff Construction Type: Estimated Cost: $ , Driveway Curb Cut Width Needed: Ft. + 6 t = Ft x $ _ $ DATE: APPLICANT: Tel. # 763- ;77/--y Call (763) 572-3604 for Permit Fees if mailing in appli on. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ 63•g4r - $ S.00 $ 'I, $ 5ti41 CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $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 [ ] TOTAL $ H STIPULATIONS: ESI NEW NW y GLDS� r a °i�•`E sF � i � &GAS G1 DtJ � J � ' j eov c�j Mi dL -S�+EI,aI�MG SSS Mud 51do}JIJ �S�D /i r -i r I 3R•�" #7 IAI DI � i REVI WED 4S `' ylljw mj�lb 0 LODE \ --- ---- _ - - _ _. FIANCE -. GrJ1NQ" Ow BL nsp or Qi 5' u-t�l i'� � Jt'a�v�a�, Eas�w►evk 0 1 0 � N Genf —. w Col � %-t, kv�: . N "F— LoY 2 ,BLo GK �- KI6E TREE K PL azo N69TP KDOI-rlOt-I CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 �7�I11L' ! i!/ �:FirL�XII•Y� Q �tyi ADDRESS 257 69 AVE NE PIN 143024220002 LEGAL DESC RICE CREEK PLAZA NORTH ADD LOT 2 BLOCK I PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT .: 2004-01189 `V DATE ISSUED: 07/28/2004 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 ONE SUPPLY AND 2 RETURNS. # A/C UNITS 0 VALUE OF APPL OR WORK 400 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 400 APPLICANT MARSH HEATING & AIR CONDITIONING 6248 LAKELAND AVE N BROOKLYN PARK, MN 55420-2937 (763)536-0667 OWNER ZEMKE JASON P & ROCHELLE M 257 69TH 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 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 construc on or the performance of con tructio . Ap Date Bldg Insp HEATING PERMIT MINIMUM FEE 15.00 FURNACE SHELL/DUCT WORK 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 15.50 PAID WITH CHECK # 70576 SEPARATE PERMITS R$OUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Bumer & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - Ali 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 Z IT % to /4 Fee Total Owner TASoof z -7fo3-571— g776 $35.00 $ Building Used As $10.00 $ ESTIMATED COST "'PERMIT PERMIT 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 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 Fuel Total Connected Load J/ Bumer Trade Name Size No._ BTU HP EDR QPAP / 5 A -'O 2- e -f> ) e 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. r � � -� HEATING CO 14142911 11 ,L71"�9 A,6 Mt Com Iry pQ/�9i � lvC Signed A5/ 444 Tel # 74,3-53b-10667 0144 FAX #-536 '0 '76-3D FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE 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: Date CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 ADDRESS : 257 69 AVE NE PIN : 143024220002 LEGAL DESC : RICE CREEK PLAZA NORTH ADD : LOT 2 BLOCK 1 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01670 910 DATE ISSUED: 09/27/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. BASEMENT REMODEL. # 0-100 AMP CIRCUITS 3 APPLICANT ZEMKE JASON P & ROCHELLE M 257 69TH AVE NE FRIDLEY, MN 55432 OWNER ZEMKE JASON P & ROCHELLE M 257 69TH 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 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 construction or the performance of construction. Applicant Date Bldg Insp Date ELEC CIRCUIT FEE (0-100 AMPS) STATE SURCHARGE, ELEC FLAT ELECTRIC FORM FEE TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 40.00 0.50 1.00 41.50 CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT R 6 09- (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Stones ::��: �?�: Urinal .:::::.:;:::>::::> T4..:<.:<. Shower 1'::::> Wash Tray1"?01t111r :��::»��>�. Floor Drain::::::>: � t Sher <.��-�<> Gas Range :.. :::. 9 :<4;:.::.:: Wate r Heater `'=>. Gas Elec Basement :'<' ':::`. ;. Floor 1 Floor 2 Floor 3 :`<<> Floor PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 9- ` 00 �t% New Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $10.00 and representations stated in this application are true and correct. Catch Basin $10.00 j Rain Water Leader $10.00 DATE: 1 20 O Sump/Receiving Tank $10.00 �?'5 O / &n 2 �-, „r Water Treating Appliance $35.00 OWNER !•e Water Heater -Electric $35.00 !�/1 c /) Water Heater - Gas** $35.00 BUILDING USED AS / l s Gas Range** $10.00 ��PP�� Gas Dryer** $10.00 ESTIMATED COST ®vv� PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY � f V �� 7�®'� �` �'� Reinspection Fee $50.00/Hr SIGNED BY TEL NO.716I� �/ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS '► 1.25% of Value of Fixture or Appliance Approved By Rough -In Date r__._...__ ---- Final Date State Surcharge $ 20.50 MINIMUM FEE FOR NY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ aO a 50 OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE i 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 terminatidn. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No When required to install a new combustion air, it will be sized and in6talled 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 Fumice V6nting Tables for fan assisted and natural draft appliances. Yes () NO( ) le 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: Date: ��oo building Permit Fee BUILDING 4�4 . Z5- Permit No.:96 Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY D4fM' Ate 763-502-4977 FAX $ /, d® .0005 x Permit Valuation Minimum $.50 License Surcharge $ EFFECTIVE 1-1-2010 $5.00 (State Licensed Residential Contractors) SAC Charge DATE YOUR E-MAIL ADDRESS P_4Y_44F/J lL. dM I; Z-FMkF_(9C,M/�C 1 SITE ADDRESS 25 N7 � �n,7 rtf A vF_ $ THIS APPLICANT IS: ) OWNER ❑CONTRACTOR Erosion Control PROPERTY OWNER/ NAME: JASOQ 7_9M ki-7 $450 Conservation Plan Review TENANT ADDRESS: 247 /a 1O`1T"AV& _CITY F9.I ®lP—Y STATE H NJ ZIP 5- 3Z Fee Determined by Engineering PHONE: 763 —571-4-77fp $ CONTRACTOR NAME: Total Dae SUBMIT A COPY OF 4i 117.7 6 Make checks pavable to: Citv of Fridlev Attach Stipulations YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE 2 . @4:WW s 1z ❑ TWO FAMILY/NEW CONSTRUCTION STORIE� PERMIT TYPE❑ DON ❑ GARAGE/SHED AITISEMENT ❑ WINDOWS FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR MODELING DESCRIBE WORK BEING DONE: FII -FISH f; AaS1y_M b1kF , — 56s9m 1--1y"pP :( SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CO NSTRUCTION INCLUDING DECKS, ❑ Vinyl []Soffit ADDITIONS. PORCHES SUBMIT: & El Aluminum ❑Trim l . Site Plan/Survey showing the existing structures 13 Other ❑ Fascia and proposed project. Z. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS – PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 4ine- OCCUPANCY TYPE Permit Fee $ 4�4 . Z5- See Back Page for Fee Schedule Plan Review $ 45,61 65% of Building Permit Fee Fire Surcharge $ Z <ao .001 times the total job valuation Surcharge $ /, d® .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Dae $ 4i 117.7 6 Make checks pavable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all rk which�e Iires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME i DATE I PLEASE NOTE: SEPARATE PERMS ARE REQUIRED FOR PLUMBING. ELECTRICAL AND MECHANICAL WORK I �uRN� I Sf-ti i:dc=sM 7Zr-,2 CL � -- act �ul ler k 1,- 6,e 4,1 sr) N4 aRpSS w I o vwws W14bow W;i.0 s r nit i H3 Sy ..yam ""W":=u7;> '.aa n -r i i' "'�' .LiS�m.`.ii%. �..•`^ d 'y qq�.0^ a 7 t