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PRE 2010 DOCS.OF ON for Power Plants and Heating. Cooling, Ventikdon. Rs/rigem1we and Air Conditioning S"em and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: HATS TOTAL Furnace Shell & Duct Work ................ .. $10.00 = Replacement of Furnace .. ..... ..... 6.00 ; Repairs & Alterations—up to $500.00 6.00 $ _ Repairs & Alterations each add. $500.00 3.00 MECiL WARM AIA Furnace Shell & Duct Work to 120,000 BTU ..$10.00 $— each add. 60,000 BTU .................... 3.00 i Replacement of Furnace .. .. . .... 6.00 $ Repairs & Alterations—up to $500.00 .. 6.00 $ Repairs & Alterations each add, $500.00 &00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. Furnace Shell & Line --to 640 sq. ft. EDR Kot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3,00 Each add. 320 sq. ft. EDR Hot Water 3,00 $ OIL BURNER—to 3 gal. per hour 6,00 $ — over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ..... 8.00 $ over 199.000 FM See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 100 $ Additional Fixtures x .75 $ Gas Range to 199,000 x$ 600 $ AIR CONDTIRONENa FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH F1NAL '7- // - % V ®,oCa See Fee Schedule TOTAL FSE (SURCHARGE $_.50) rapt. of Bldgs. ftone M-3180 0 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 Ordinance. - and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correcL Fridley. Minn � Owner A 12 A-9–kez Kind of Building ._ Used as To be completed about Estimated Cost, Old—New. Building Permit No. Permit No.�� l.�'./tC�GLQ�� HEATING or ]W= TS tram, Hot Water, Warm Air—No— Trade Name Size Capacity Sq. Ft. E.D.R. BTU H,p Total Connected Load Kind of Fuer BURNER — Trade Name Size No Capaci Sq. Ft. E.D.R- BTU Hip. (REMARKf-OYER) FIRE DEPARTMENT MEMO TO: BUILDING INSPECTION " ASSESSING SUBJECT: FIRE DAMAGED STRUCTURE FIRE HAS OCCURRED AT DATE: March 17, 1980 61 ME 70th flay, owner: Clint Ward 574-0906 (ADURE55) March 16, 1980 (DATE OF RE FPB -6 N sok SUBJECT Po City of Fridley 15624 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. -------- COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 3/19/80 JOB ADDRESS 61 - 70th Way N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Pt. 23 Aud. Sub. #77 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clint Ward 61 - 70th Way N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Du -All Cleaning Co. 3851 Central Avenue N.E. 788-9411 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Fire Re aix on House 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING;, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS I GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,500 $.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 PROVISIO OF ANY OTHER TATE OR LOCAL LAW REGULATING CON- $9.00 STRUCTI N R TH PERFO ANCE O C STRUCTION. PLAN CHECK FEE TOTALFEE $9.75 91 NATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI n. WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT v uj— 1 �� BLDG INSP O E SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: ��/�J� F1►�1, BUILDER: -n aT ALL C4,64-evJN4 ADDRESS: 61 70 Al. ADDRESS: 2&5-1 eZ;,V7 ,#4 444f. •U. - TEL NO: TEL NO: 7 gall Construction Location STREET NO:� STREET: LOT: Q3 BLOCK: -- AADDDITION: UAW U '). I Corner Lot: Inside Lot:y Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION ��rvpp .� &ront: Depth: Height: Square. Feet:- Cubic Feet: Front: Square -Feet: Depth: Height: Cubic Feet: Type of Construction: .s Estimated Cost: $ /,5100•47d To Be Cbmpletea: , S. �•/". Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. /? • i /1 ABB h DATE: 3 - j Cl- et) SIGNATURE: Stipulations: 9,00 - eTx ® , SUBJECT -rE—RM NO. City of Fridley - - ) - 115 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T r COMMUNITY DEVELOPMENT DIV. `� 8 r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATEPAGE OF APPROVED BY 612-571-3450 910-F15 5/5/81 10B ADDRESS 61 - 70th. W -ay N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 Aud. Sub. #77 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clint Ward 61 - 70th Way N.E. 574-0906 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. HCH.Construction 3hc., Route #3, Box 292, Monticello, M 55862 295-5398 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 O; NEW ElADDITION 13ALTERATION ElREPAIR ElMOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 301 Garage, 9 CHANGE OF USE FROM TO STIPULATIONS Owner agrees that this, garage can never he attached to house unless frost footings are provided. Owner agrees to notify next owner of this stipulation. Provide.a hard surface driveway. WARNING SEPERATE PERMITS REQUIRED FOR WIRINV, Before digging call local ublides HEATING PLUMBING AND SIGNS. ELEPHONE - ELECTRIC m W Etc, SQUIRED BY 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 SQ. 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 $7,371 $3.69 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $34.89 SIWTURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) 2 WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT, ,jNV_ BLDG INSP IiAT SIGNATURE OF OW NERIIF OWNER BUILDER) IDATEI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS ((dear, Alterations, Additions, or Repairs) OWNER: BUILDER: - — 6^#e A C' ADDRESS: h� � ADDRESS: _ f3 Sos ?L'?, Oh ' e N TEL N0: 5-71 0 10 TEL NO: Construction Location ' STRE , T NO. STREET: % D :"`C LOT: BLOCK: ADDITION; Corner Lot: !� Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTIOPN Front: Depth: '3 Q Height: Square. Feet:Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: Estimated Cost: $ e z S 7 A-00 Zb Be Oarapleted:y Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET S.iie undersigned hereby makes application for a permit for the work herein specified, agreeing to do•all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: Y -,2 1 — � % SIGNATURE: Stipulations; ,f) Cj O CI -g c am► �J't�-1 S �c d� R m�- OwAi cQ i1e� aer-a T P ®T, � � / /CITY OF FRIDLEY /ZZ:7 DARREL CLARK Chief Building Official Civic Center 6431 University Avenue Northeast Fridley, Minnesota 55432 (612) 571.3450 2x(" fzfar-qxv�.s GQ-, K1, Yz 31 !Z� Ik 0 U S 'r 4L�yv 0'mo( ) 10� �OS`Sek &vp rVw- (4,) r1j !Z� Ik 0 U S 'r 4L�yv 0'mo( ) 10� �OS`Sek &vp rVw- (4,) • e I, r owner of the property located at %Q,have no objection to the City allowing the construction of a to be located at �p f� �� without the required certificate of survey that deCity ordinarily requires for all new construction. ' Witness I Signature if> Address )��24 Date v SUBJECT City of Fridley 313 31 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPTSV � rry COMMUNITY DEVELOPMENT DIV. ___._ _ INSPECTION SEC. S r � � PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910415 8/21/00 JOB ADDRESS 61 70 Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 2 Ostman's 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Katherine Bergman 61 70 Way NE 763-586-0389 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 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION Cj REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Reroof House & Garage (21 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 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 AFBER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT 1 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 $.92 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,835 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 F E TOT FEE YqA .96 1G NAi URE OF CON'RA OO. OR AUTHORIZED AGENT iD/A/TE. HE P VALI TE IS ISR „/ - 71� $.GNATURE Of OWNS of OWNER BUR iD fEi r v SLAG NSP OArE v NEW [ ] Effective 1/1/2000 ADDN [ ] - CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� fl°� BUILDING PERMIT APPLICATION \ Construction Address: W Legal Description: Owner Name & Address: k ms, h2 bei ryyAn Tel. # %ion -EZ6 �3 Contractor. MN LICENSE # Address: L —WaA4 Tel. # -7(02 LIVING AREA: 17_��'j1:��1� 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 DECK AREA: Length OTHER: Width Hgt/Ground Sq. Ft Construction Type: Estimated Cost: $u-e� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: 9) Z1 6U APPLICANT:LTel. G �� CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ o Fee Schedule on Reverse Side $ / .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $_$1 100 per SAC Unit $ $5.00 (State Licensed Residential Contractors) "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ J 61 SUBJECTRMIT NO. City of Fridley i 798 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. -__; COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 572_360/E f 1 � = ' /"'1 CITY HALL FRIDLEY 55432 �"""A� ,'j NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-FIS 5/4/01 JOB ADDRESS 61 70 Way NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 2 Ostman's 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Katherine Bergman 61 70 Way NE 763-586-0389 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 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION j] ALTERATION 9 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel Basement 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 12Q 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 I 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 SE COMPLIED @ @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,000 $1.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. Fire SC $3.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 PLAN CHECK FEE TOTAL FEE -011 $87./5 GNATURE 09 CONTRACTOR OR AUTHORIZED AGENT D TES EN IiROPE V IDATED THI IS YOUR PERMIT X��.GNAT.R�OWNER BlD �NSp -1/AfE �itOAER.Ua�11,= i0 TES 61 NEW [] ADDN [ ] CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Effective 1/1/2001 (763) 572-3604 Bldg Insp Tel. ]12- 5&(4 -c,30 Contractor: ®Z 727,P - v 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: 12, 4_ -- Construction Type: Wooct Fmmp� Estimated Cost: $� �9C9�7 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 4-/b APPLICANT: Tel. #7 (P CSI-ZqO-19&7 w� CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $5� Fee Schedule on Reverse Side $ 3.OG .001 of Permit Valuation (1/10th%) $ /..Sb $.50/$1,000 Valuation $ $1150 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 [ ] EXG. OPERABLE WDW. Z \\D -D0/� E D APPROX. 16"W X 32" W oNr- --4- ^ JJv" j!=U7,o B ��1�D. � = c 3 0 D m D D i � Nkk E��mz m It- o 0 Z � N 67UMLN IV ul N D C) 2uolKDA 70 UlUO r D Z T7l NCP C 117- > o �00 O� `n 2'-4" X 6'-0"9 Z � e 2'-4" X 6'-0" L W L� y L-tw d �o rte, i I in 2'-6" X -2" 6'�6" O O on • c 1 = n r �m mll Zr- Ol 6' 0, ? rn r M XI ' T: D m 1 Z m� Du,� m U3 = n z z r� OEO OD Cos v = ' Z _ m Z m -��1 LN D�z � STC C c� o 0 I � � W V EXG. OPERABLE WIDW. EXG. OPERABLE WDW. APPROX. 16"N X 32" W APPROX. 16"H X 32" W No 24'-2" w'E N Q I.E E `" X w T m d r 3 O D E x-1i�ti mp �w0 mom b�m"'N DZZ� m0 QOZ CO M m E D DNr < m �z I - ---------- A 11-4 a � I Lo _ IN �c ,w J I � I i lIR g 141164 = T -I" m X N G� r Z d k n m F Z - r z 4 CITY OF FkIDLEY INSPEC•I0N DIV. /1 �� &"'g4'L 6431 University Ave NED l I C I 0 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Fridley, MN 55432 1 G I 763-572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR x� Auto. Shower _ Tra +W. `$< Drain�IIt1>>:. Washer Wa .Rtnries Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 4�0 1 New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" W� Gas Range" Gas Dryer" Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge Effective On Jan 1, 2001 Gas . < Water Heater <:: ..�:., Elec Rannp �F: Gas The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. IC) - 8 . ,2001 Owner Building Used As I—y� Estimated Cost PERMIT NO. PLUMBING COMPANY V�� - ��o�e� �arv' ' SIGNED BY j 141_-_ - TEL N0. 76-3 .P& , .1 Approved By Rough -In Date Final Date TOTAL FEE S� PLUS THE S.501 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When 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 manufacturers 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: I G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 14, 2003 Mr. Marc Bergman 6170 Way NE Fridley, MN 55432 Re: Final Inspection at 6170 Way NE Contractor: Roto Rooter Service Co Dear Mr. Bergman: A plumbing permit was issued on October 9, 2001 to install three plumbing fixtures at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date we have conducted the rough -in inspection but the final inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. 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 mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY INSPECTION 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 RATE SCHEDULE 1]PIRi[sP► Effective On January 1, 2002 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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 All Others/Repairs & Alterations (LIST ON BACK) 1% of Value f Appliance or Work �� S� Commercial/Indust ia�' I ✓ 1.25% of Value of Appliance or Work JOB ADDR OWNER Rate TOTAL BUILDING USED ASP�SI $ 30.00 $ ESTIMATED COST . PERMIT NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. BTU HP EDR $ 25.00 $ Fuel Total Connected Load 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. 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. HEAT Signe DATE d /S D�_ FAX # t �3 Approved Byl Rough-In Date Final Date Ll� o FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON V NTS VENT .ONN TQR AND n0MR11STION AIR VFRIFI ATInN When re la _ing 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 cnmh is inn 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 #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 HEATING CO: Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS 6170 WAY NE PIN 103024440008 LEGAL DESC OSTMANS 3RD ADD LOT 7 BLOCK 2 PERMIT TYPE PLUMBING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERM T NO.: 2004-01126 -- DATE DATE ISSUED: 07/16/2004 VALUATION : $ 400.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL AN ELECTRIC WATER HEATER. # ELEC WATER HEATERS 1 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) 400 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) 0.00 0.00 NORBLOM PLUMBING CO 2905 GARFIELD AVE S PLBG FIXTURES (EXIST OPENINGS) 0.00 MINNEAPOLIS, MN 55408-2173 WATER TREATMENT APPLIANCE 0.00 (612) 827-4033 WATER HEATER - ELEC 35.00 WATER HEATER - GAS 0.00 GAS RANGE FEE GAS DRYER FEE STATE SURCHARGE, PLBG FLAT 0.00 0.00 0.50 OWNER BERGMAN KATHERINE J 61 70TH WAY NE TOTAL 35.50 FRIDLEY, MN 55432 PAID WITH CHECK # 28680 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 regulatfiS cons# uction or the performance of construction. , I W - 4W-�W'1-,� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. f Effective April 1, 2004 ,ITY OF FRIDLEY INSPECTION DIV. 431 University Ave NE ridlej, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 768) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTAI t Fn nN FACN Fi nnR )LUMBING FIXTURE RATES: Jew Fixtures Ad Opening, New Fixture Seer Dispenser Ilow Off Basin 'atch Basin lain Water Leader lump/Receiving Tank Nater Treating Appliance Nater Heater -Electric NO. RATE TOTAL JOB ADDRESS Nater Heater - Gas** I as Range'* I as Dryer** 3ack Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 $15.00 Reinspection Fee $50.00/Hr kLL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE $ -3 _ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this annlinn inn arc frim -nnA correct. BERGMAN, KATHERINE 61 70TH WAY NORTHEAST 20 Qt{ FRIDLEY, MN 55432 OWNER (763) 586-0389 BUILDING USED AS Y�SI �eor►G� ESTIMATED COST q60 ov PERMIT NO. (5;'?0Com' l PLUMBING COMPANY NO f_Yom` OVA UAI .v SIGNED BY TEL N0. (�plZ8L%-1/033 Approved By 7t, Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina 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 Installina 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: