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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 7057 • - Date: r.5 -� f Owner: Buil s Address Address — — • ION OF BUILDING .17 No. _O— Street - Z � i�,L�i-� a-/,�- P ofyLJot Lot — �- __ Block — .�`� _ Addition or Sub -Division f>« e f Corner Lot --- Inside Lot Setback _, --_ Sideyard Sewer Elevation FwaidsWon Elevation ?6 O 7or� oh �a�Ti�G DESCRIPTION OF BUILDING T Front 431— Depth 6i4 Height �® Sq. Ft Cu. Ft Fr est Depth _ Height _ _ Sq. Ft. t Cu. F Type of Construction ,,Fit XaTo be Completed In consideration of the issuance to me of a permit to construct b g des bed+v:h I agree to do work in accordance with the description forth compH ce provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ -a . . 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 reg location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon viola�aagoY any of the provisions of said ordinances. .1 , 1 NOTICE: als permit does not ca"r the construction, installation for wbhi& plumbing, gn heathm sower or water. Be sura to see tie Buildhig lesp r for separate permits for these home. e► . I— . �`T-'Pos APPLICATION FOR BUILDING;PERMI CITY OF FRIDLEY, MINNESOTA OWNER'S NAME ----_ BUILDER_ ADDRESS ADDRESS LOCATION OF BUILDING No. .Street Part of Lot Lot Block Addition or.Subdivision Corner Lot Inside Lot Setback Side,Yard. SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of -Lot and .proposed build- ing location drawn on these Certificates. . DESCRIPTION OF BUILDING To be used as: Front Depth Height Sq. Ft. Cu. Ft... Front Depth Height Sq. Ft. CU. Ft. Type of Construction. Estimated Cost .To be Completed The undersigned hereby makes application for a permit for the.work herein specified, agreeing to do all work in strict accordance with the City'of Fridley Ordinances and rulings of the Department, of.Buildings,, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNAT .,(Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas Ming Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK &. /4 a 2 je Number, Kind and Location of Fixtures Location j �` �i < 12Z_ se Z Q t = m ~a Z 9w T 7 2 � d • F • N WATER HTR. GAS ELEG K LLG V t3 �$ 0 o0 Base Z Z L ist 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings I Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL 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 BTID ...... 2— x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ / `0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE .5 City of Fridley: The undersigned hereby makes application for a permit for the work herei 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 19!(Y Owner Kind of Building / Aw-- L Used as To be completed about Estimated Cost, $ Old a Building Permit No Permit No. 11-3 11= j'W �'% C-.0 Phone ROUGH �y FINAL a ATTENTION OF: I e City of Fridley L_4_4lA4z_Minnesota --55-42-,4---- SUBJECT Possible Health Hazards City Manager City of Fridley 6431 University Avenue N.E. Fridley* Minnesota 55421 DATE April 21, 1966 tin cans, Also, an open basement behind these vacant lots, (2) Messy property at 1500 Mississippi Street Northeast (Gardner) Newspapers (3) open basement at 6841 Oakley street Northeast. owner is K. C. Paape, ----------1103--P,ike__Lake_- DrJLve,---Nw-- on# - Minnesota-,--- Phone__Xo._fi63!_-_5609_._ ____ --Enclosed-- -is- Ord pas-sed--=--second--mvad-i-ng-at-the-meet-JL-ng-- of the City Council on April 18, 1966. Publication will be on April 27-1866, --And- ordinance -will-be --Garbage- and - refuse in yard-- al ZWC 74th - Avenue Northeast -.- Apparently— -- no garbage pickup. Complainant thought the name was Hanson. SIGNATURE el -AL I Earl P. Wagner, city manager REPLY: Owned , by,,. Donnay Home_ Bldrs. Ltr. sent to clean and clear,.- Lots2l. 22, 23, Bl. 8, Donnays Lakeview Vianor. 2. Maintining an open dump to rear of property. Ordered to clean 1. ,and- clear. 3. Bldg. permit taken out after. ltr. sent to fill in or -star -t -- construction. 4. Thank you. -5. Missed will got this week. DATE 5-6-66 SIGNATURE JjTBT REPLIER'S COPY -RETAIN FOR YOUR FILES SUBJECT PERMIT NO. City of Fridley 2069 AT THE TOP OF THE TWINS BUILDING PERMIT CEIP I � _ COMMUNITY DEVELOPMENT DIV. a. PROTECTIVE INSPECTION SEC. / r9 L ®& / f r U "1 CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY tj 612-571-3450 910-F15 12/11/90 JOB ADDRESS 360 - 74th. Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 5 Melody Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Chies 9920 Villa Street N.W., Coon Rapids, MN 55433 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Craftsmen 11408 Quinn Stre.etp Coon Rapids, MN 55433 757-9422 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Double Bungalow 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Structure 9 CHANGEOFUSEFROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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 2 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 $4,000 $2.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire STRUCTION OR THE PERF RMANCE OF CONSTRUCTION. $63.00 PLAN CHECK FEE TOTALFEE J2111 $69.00 SI ATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI - -WHE PROPE LY V T D H IS YOUR PERMIT G INSP GATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] Effective 8/16/90 ADEN [ ] 1-1 AND R-2 AMER [ ] Building Permit Application Construction Address: legal Description: 2 Ll 7'(1,�4v6 �2flJ /; Owner Name &Address: o2U ILEA S 7� : C d04 S A-r4w �-->Contractor1/, , Tel. # j% Address:lG%�j (U Jew s C C f eC��1Jc' c>S Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Lrii V Apim: 1 eng q-h,� wiam O -W tieignr e�- 5q. rz. GRTdM AREA: Length - — Width Height Sq. Ft. DECK AREA: length Width Hgt/Ground Sq. Ft. oma: Corner Ict [ ] Inside Lit[[ "] Ft. Yd Setback Side Yawl Seet/b�a1cks Type of Construction: ( i1�� L Estimated Cost: $ ` Approx. Cmipletion Date L,—)A 5, Proposed Driveway Width If New Opening Is Desired: Ft. $ $ i th + 6' See Back Page DATE: 1 d APPLICANT: !y1 ✓u Tel. # CM USE ONLY Permit Fee $ , o U Fire Surcharge C) C9 State Surcharge $, SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TO $ o STIPULATIONS: Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY PERMIT NO.: 2004-01435 6431 UNIVERSITY AVENUE NE -- FRIDLEY, MN 55432 DATE ISSUED: 08/30/2004 572-36U4 N'AX: (763) 571-1287 ADDRESS 360 74 AVE NE PIN 113024240074 LEGAL DESC MELODY MANOR LICENSE SURCHARGE LOT 2 BLOCK 5 PERMIT TYPE BUILDING PROPERTY TYPE : DUPLEXES CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 1,000.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DUPLEX PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. INSTALL A BASEMENT EGRESS WINDOW. STATE LICENSED CONTRACTOR 1 APPLICANT TRENDY ROOFING SONS INC (20027543) 210 ZACHARY LANE PLYMOUTH, MN 55441 - ABLE PROPERTY MANAGEMENT 9920 ZILLA ST NW COON RAPIDS, MN 55433 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 regu co coon or the performance of construction. Applic �� Date % -1 ;;SN Bldg Insp. BUILDING PERMIT FEE 38.75 FIRE SURCHARGE 1.00 STATE SURCHARGE, VALUE 0.50 LICENSE SURCHARGE 5.00 TOTAL 45.25 PAID WITH CHECK # 7135 SEPARATE PERMITS REQUIRED FOR WORK ETHER THAN DESCRIBED ABOVE. NEW (] CITY OF FRIDLEY j2 a�b /Effective 4/1/2004 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 5714287 Fax BUILDING PERMIT APPLICATION '�®oC)/��5� Construction Address: )K4� Legal Description: Owner Name & Address: �k � Tel. �^ �� Contractor: Cz fN 1 C1\ MN LICENSE # Address: (® ` <V��o ��.� v\� �^r�' �� Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG AREA: Length Width Height $q. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Typestimated Cost: $ ®� - Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: � � �� APPLICANT: Te"- Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] TOTAL $ �� STIPULATIONS: 1$„ I 7' v �Sz ML C ecn-t oc to LL--=-=� CaSe�Rni a x a �r4-,A of) CON V\s;att �;7 n Sf �) LJ� dJl Sa" otr elord< <cfo �c koo �' o Sj �0 13 ��—(c►ri. o �C r �., : �a ova -� R�rnq, REVI 'AOR CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 -/63 ) c2806 - a z1T.-d Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT' need! nII IRA12CD nC MYTI 101=Q Tn RG INCTAI I Gr) MI FA(W GI nnR PLUMBING FIXTURE RATES: NO. Urinal •:4�i::> Shower ....t:.•�::: Wash Tra :::>::>::: :.:�?4t: Floor:::::' Drain :>:� Auto. Washer ::::>>::>:: Gas ��-. `�>�>� Range 1;`:::> Water Heater Stones :I~��?�<> �> '.>. Gas Elec Basement Water Treating Appliance $35.00 Water Heater -Electric $35.00-'- 35.00`-Water WaterHeater - Gas** $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Floor Type $15.00 Floor 2 Floor 3_ Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00-'- 35.00`-Water WaterHeater - Gas** $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE $ .50 JOB ADDRESS 0 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 applicatioL_re e and correct. DATE: , 20 OWNER BUILDING USED AS 1 L ESTIMATED COST 7�) PERMIT NO. PLUMBING COMPANY l�'' SIGNED BY TEL N0. 7Z7 Approved By /)S..Z 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 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 41 The venting system is plastic/PVC and meets all current codes and manufacturer w specifications including sizing, length, number of elbows and terminati6n. Yes () No ( } The undersigned also verifies that the replacement unit is a listed assembly BTU Input and meets the current codes and manufacturers specifications. This does Appliance #2 Type include AGA-GAMA Category I Central Furnace Venting Tables for fan Fan Assisted or Nat assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes�� Total Appliances and manufacturers specifications. Yes () No( ) Common Vent Type Vent Height When required to install anew combustion air, it will be sized and intalled,;� Appliance #1 Vent Connector Height to meet the current codes and manufacturers specifications. Yes O No ( ) When installing a new venting system, the undersigned hereby verifies thpt ft Length it is a listed assembly and meets the current codes and manufacturers Appliance #3 Vent Connector Height specifications. This does include AGA-GAMA Category I Central Fumice ft Diameter in Type 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 : ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE VALUATION NOTE: PH:763-781-6901 #FURNACES CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 JFAX: 360 74 AVE NE 113024240074 MELODY MANOR LOT 2 BLOCK 5 HEATING COMMERCIAL ADDITION/ALTERATION APPLICANT DAVES APPLIANCE HEATING & AIR INC 160137 AVE NE COLUMBIA HEIGHTS, MN 55421 (763) 781-6901 OWNER ABLE PROPERTY MANAGEMENT 9920 ZILLA ST NW COON RAPIDS, MN 55433 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 consfruction or the performance of construction.' Bldg PERMIT NO.: 2004-02274 DATE ISSUED: 12/13/2004 • ;A. FURNACE SHELL/DUCT WORK STATE SURCHARGE, OTHER TOTAL PAID WITH CHECK # 35679 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 35.00 0.50 35.50 CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE es'dentia Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Total $35.00 $�—L $10.00 $ $10.00 $ $25.00 $ 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 t..ommercialllndustrial ' uti na 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 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESS ,2i 7 l °' g c n =�MAN - Building Used As ESTIMATED COST PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units l 'rcie One (Steam) (Hot Water) (WAir Trade NamSize No. BTU HP EDR Fuel Total Connected Load Burner Trade Name BTU Size No. HP EDR The undersigned hereby makes application for a permit for the work herein specked 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 Tel # FAX #1 �r Date Approved by „ Rough -in Date Final Date PILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When realacina 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 manufacturers 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 Installina a new venting system, the undersigned hereby verifies that it is a fisted assembly and meets the current codes and manufacturers specifications. This does include AGA -LAMA 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( ) N_ Appliance #1 Type i L '` V� BTU Input �- Fan Assisted or Nat Appliance #2 Type BTU Input ( / Fan Assisted or Nat -mow Y Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Types Vent Height ( Diameter �_ inches Appliance #1 Vent Connector Height ft Length Lft Diameter in Typ Appliance #2 Vent Connector Height _J ft Length - ft Diameter n Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) 1 n i If � -� L� �� Building Inspections 763-572-3604 DATE SITE ADDRESS --,'A THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS O OWNER VEZ COMPANY NAME:_ CONTACT PERSON: STATE LICENSE #_ PHONE —7 6 "-711- °SINGLE FAMILY 0 TWO FAMILY O NEW `FREPLACEMENT DETAILED DESCRIPTION OF WORK FAX Permit No.: Received By:_ Date Rec'd:_ ATEMZIP&y39- EXP DATE //�� CITY STATF�IP�I� O TOWNHOUSE p ALTERATION/REMODEL PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05= FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIX//T��URE, EXCEPT W:7ffi ,EpNNo D. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) MODE LS%I� I%1 3�1 �� SIZEBTU Equipment Installed MFG: MODEL: SIZE/BTU MFG: SIZE/ETU MFG: FIREPLACE {GAS) $ MODEL: GAS RANGE/OVEN $10.00 )QA/C $25.00 — $35.00 _NEW GAS GRILL $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35GAS UNIT HTR $10.00 BOILER 535.00 ' KFURNACE $35.00 '—POOL HEATER $35.00 _CHIMNEY LINER $10.00 —GAS DRYER $10.00 VENTILATOR $15-00 DUCT WORK $10.00 —GAS PIPING $10.00 — _ - _....__.. _...,..��.��,�r ... - .��a��i�,�b��.. : • . Ili Permit Fee �QKMVL)b" $ .� Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE ��.� Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit aacknowledge that the information above is complete and accurate; that the work will be in nd conformaA*th the ordinances and'°codes of the I Fridley and with the MinnesotaConstruction Codes; that I understand this isnot a permbnly an application f it and wo;k not to start without a permit; that the work will be in accordance with the approved e -case of fill wqr r u s_ eview d approval of plans. :. DATE SIGNATURE OF APPLI,ANT PRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION, NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES - 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 .with MN Amendments 2. Make-up Air (See note below) & IMC Chapter 5 with MN Amendments 3. Venting a_ Gas appliances IFGC Chapter 5 with MN Amendments . b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air.' calculations Building Inspections 763-572-3604 DATE d — a 1 "n SITE ADDRESS ' THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR MECHANICAL RESIDENTIAL APPLICATION ❑ OWNER COMPANY CITY OF FRIDLEY YOUR E-MAIL ADDRESS Received By: Date Rec'd; CONTACT PERSON: V . SUBMIT A COPY OF 1W r� YOUR STATE STATE LICENSE ' STATE ZIP LICENSE WITH ADDRESS:r / CITY APPLICATION PHONE 7 P 3-7 "A I •' �S_ FAX PERMIT TYPE ❑ SINGLE FAMILY -YTWO FAMILY ❑ TOWNHOUSE ❑ NEW " REPLACEMENT ❑ ALTERATION/REMODEL TYPE OF WORK: l" DETAILW DESCRIPTION OF WORK PER MS 16B.66a the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or -replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05= FOR PROJECTS WHERE LABOR EXCEEDS $50,-0, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT( W13ERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) MODEL: ` SIZSIZEIBTU BTU Equipment Installed MFG: MFG: MODEL: SIZEIBTU MFG: MODEL: __ FIREPLACE (GAS) $15.00 —GAS RANG RILL $ $10.00 IA/C $25.00 —FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR TO AIR EXCHANGEER $15 --FACE $35.00 _GAS UNIT HTR $10.00 BOILER $35.00 —GAS DRYER $10.00 _POOL HEATER $35.00 —CHIMNEY LINER $10.00 — _VENTILATOR $1500 —DUCT WORK $10.00 _GAS PIPING $10.00 . ` MMM) ��- r ` 'Number of fixtures @ $10A0 x $10.00 = Permit Fee $ S-. C7 Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = TOTAL DUE $ ,50 $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 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 pertzff and wor t to start without a permit; that the work wiN be in accordance with the approved plan in the c of all work w ich re review and app val of plans. n � �� NAME AA _ 4Z5if Y Z�-t�b SIGNATURE OF APPL City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 76k502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) & IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments . b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per NN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. RCCA Manual D NOTE: Centerp oint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE —:31 - D (O YOUR E-MAIL ADDRESS SITE ADDRESS 3 (o f% THIS APPLICANT IS: edRWNER ❑CONTRACTOR Received By: Date Rec'd: PROPERTY OWNER/ NAME:[V��,ILr[ See Back Page for Fee Schedule Plan Review ADDRESS: 3 �0 0 ` 1 ��/ % w1 /J !� CITY STATE e%w TENANT .001 times the total job valuation PHONE:�� $ .0005 x Permit Valuation Minimum $.50 CONTRACTOR NAME: $5.00 (State Licensed Residential Contractors) SAC Charge STATE LICENSE # EXP DATE $1550 per SAC Unit (Plans to MWCC for determination) SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION PHONE FAX ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE Fee Determined by Engineering PROPERTY TYPE $ O FAMILY/NEW CONSTRUCTION STORIES $ _ PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED 49MINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION (+ ❑ MAINTENANCE/REPAIR ❑ REMODELING G DESCRIBE WORK BEING DONE: (LC S SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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 CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF v+(II S P OPENING CHANGES & T TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA EXIALJ: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL TOB VALUATION $ 5sr)n_nin OCCUPANCY TYPE Permit Fee $ 3 « See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ _ Make checks payable to: City of Fridley 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 theordinances d codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application f a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w requires review and approval of plans. _ `` SIGNATURE OF APPLICANT PRINT NAME v0 y L DATE �L�j ,�,,,/ --,41- )e;—,07 Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: f*Z1 763-572-3604CITY OF FRIDLEY Date Rec'd. DATE I10 h 6 YOUR E-MAIL ADDRESS SITE ADDRESS ® %V —Au! A) THIS APPLICANT IS: ❑ OWNER PCONTRACTOR PROPERTY NAME;o e -dei u& ADDRESS: 36 V 7N — AJ e eL!sG CITY fit, bC —ICY STAT) IP TENANT PHONE: -74-3 -% p 5- 3 3 3 y CONTRACTOR NAME: i Ray 000 2A c le 2 #'L Lt rh . <BJ to e ^-I � STATE LICENSE # 514 q P Al r EXP DATE ®P � � / % u (' �1� I C ' 0 �G 6 14 •c E Pm4i AGIP SUBMIT A COPY OF YOUR STATE ADDRESS: )L S' / CITY o .� LICENSE WITH PHONE 1& 3 S7 7— - 841 ?d AX .163 S14 P41-9 APPLICATION PER UT TYPE sql SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK cam% PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV FLOOR DRAINS —SHOWER _WATER PIPING _ GAS PIPING (NFm cm'ucEmo _ SWIMMING POOL —WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ _ DISHWASHER LAUNDRY TRAY _kWATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER .�. ..i�.t17:59� z �? 4 d t L �P"'" ` = �..t,. _- . r �,. "7 ..l 2 11"I'y 1 a,�,!`.y,. . , 'r .s2: ,.; s."_!�2...., ri Permit Fee $ . G O Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ 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; that the work will be in accordance with the approved plan in the case of alter h requires review and approval of plans. , SIGNATURE OF APPLICANT PRINT NAME DATE(" ..�,....,- City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No.: -;-® CV4-4r Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd:��126 DATE Vl!1 SITE ADDRESS QO THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE ��qq�� YOUR E-MAIL ADDRESS /Gcc.- UMWNER ❑CONTRACTOR .Ess: 3(b ?5` E: f) 6 -moi% -,3 DW Tr��IP 5f I NAME: Nva )L-;- STATE LICENSE # Z o4 I (.ofoi q14 EXP DATE 3-3 — U-1 ADDRESS: CITY STATE ZIP, PwnNF. FAX _ FAMILY/NEW PERMIT TYPE r - "'n" " "'"""�'• jMASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: 5UEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: f SIZE OF IMPROVEMENT LENGTH -W WIDTH /J(' HEIGHT RZ" Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor PROPOSED SIZE: ❑ DETACHED GARAGE plan 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl []Soffit ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ONO LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF 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 $ OCCUPANCY TYPE Permit Fee $ III See Back Page for Fee Schedule Plan Review $ '73. 31 65% of Building Permit Fee Fire Surcharge $ ®® .001 times the total job valuation Surcharge $ SCD .0005 x Permit Valuation Minimum $.50 License Surcharge $ ® $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $Agreement necessary ( ) Non Necessary ( ) Total Due $ I ing. ake checks payable to: CityofFridley Attach Stipulations I hereby apply for a building permit conformance with the ordinances and permit but only an application fo plan in the case of all work w re u SIGNATURE OF APPLIC IS AN APPLICATI FOR A PERMIT -NOT VALID UNTIL PROCESSED d I actin edge that the information above is complete and accurate; that the work will be in es o the City of Fxi&eywith the Minnesota Construction Codes; that I understand this is not a wand wor t- `start without a permit; that the work will be in accordance with the approved o revs approval of plans. % P T E 0 OS_ / / �j V DATE Or ^(1� 340 R— THIS ,SOB C SHALL I3F AVAILABL THE J B SITE FOR HE FRAMI.{G AND FINAW INSPEC'TIO 1' EWEP. CODE LIANCi ks (, c 24 (v bN 6�, 4- -j)eje • �t' ' `/, 11 � L.�L�-�e'!- �/`%� (,r,`�-�-'VJC- LQM�a�"%'p.i� rrvF