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PRE 2010 DOCSCity of Fridley r AT TNR. TOP OR TN[ TWINS rt.-------- COMMUNITY OFV[L.OrM[NT QIV, PAOT[CTIVR Nf%[CTION ORK, i r---� CITY HALL /NIOI.RY 11004 ....��� .J {i�•i0Q•3/R0 PLUMBING PERMIT APPLICATION jon Aaaress ner _ Address Phone % c L Lei' 2 Contract re s Phone Kind of Building Use � Completion Date v ost M O Repairs & Alterations See Description: Code State Surcharge .50 TOTAL FEE ,The undersigned hereby y mak ea application for a permit for the work herein specified, agreeing to do all work . in strict accordance with the City Ordinances and rulin of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application are true and co//rJJrect. f Plumbing Fixture Rates: NO. RATE TOTAL ' Number ! Fixtures x $2.00 /Z o -d I! Future Fixtures_ x $1.50 45-0 New Fixture -Old Open. i x $1.50 Catch Bastn x $3.25 I Water Heater -99,000 BTU x I $3.00 Ground Run Old Bldg. x $3.25 iElec. Water Heater x $2.00 i Gas Fitting Fees: 1st 3 Fixtures x $2.00 . o d i Additional Fixtures x $ .75 i Gas Range -199,000 BTU x $5.00 Repairs & Alterations See Description: Code State Surcharge .50 TOTAL FEE ,The undersigned hereby y mak ea application for a permit for the work herein specified, agreeing to do all work . in strict accordance with the City Ordinances and rulin of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application are true and co//rJJrect. f 71 SUBJECT City of Fridley jPERMIT35 ATTHE'TOP OF THE TWINS PERMIT ;. BUILDING RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. t � I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF -APPROVED BY 612-560-3450 910-F15 7/16/73 JOB ADDRESS 1443 - 75th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRA CT OR ADDITION SEE ATTACHED DESCR. 7 1 Geido's 1,$t Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE NK James Lund Construction 7709 Woodlawn Drive N.E. 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. 6 USE OF BUILDING. Residential 7 CLASS OF WORK JU NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK Construct 26' x 41' Dwelling and 26' x 22' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a verifying X1113M survey before capping. Provide a hard surface driveway. Z" x 16" anchor bolts 4' on center in 4" block. WATER TO BE TAPPED "Y" Elev. 885.60 "Y" LOCATION: 64' West of Manhole TOP OF FOOTING: 888.60 Minimum 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. Wood Frame 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 R-1 I U/IO ] ] 3`L 29 640 Tot OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 'HEREBY CERTIFY THAT I 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 $332325 16.66 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- 275.00 S RUCTION OR THE PERFORMANCE OF CONSTRUCTION. $55.00 PLAN CHECK FEE TOTALFEE s $346.66 T IGNA URE OF CONTRACTOR ORAUTHO DAGENT (DATE) WHEN PROPERLY VALIDATED -THIS IS. YOUR PERMIT BLDG INSP r)ATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI 71 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: 2. Lvv J 'RUTTA o C ADDRESS: ADDRESS: NO:. STREET:- LOT: TREET• LOT: BLOCK:- t -ADDITION: G ZL d rs LEE A LL -r vv\ CORNER LOT: INSIDE LOT:k�SETBACK: -Sig _8ar SIDEYARD:_ - / ( ' Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING 4A To Be Used As: AWELL1 Q Front: c�6 ` Depth: 144 Height: �d Square Feet: 0 14,) Cubic Feet: - � J Front: Z16' Depth: Q Height: Square Feet;_ '. / Cubic Feet: Type of Construction: WCC Fje �m o Estimated Cost:� a _ To Be Completed: ^The undersigned h eby ma�kesapplatvn for a permit for the work herein specified, agreeing to do all work in stfict 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: SIGNATU : (See Reverse Side For Additional Info n.) z e i 1 I 53-84-s-915.51 II, lisillil i lff !i S o v .so ,I ! Rase tst city of mss: The undersimed hrrft arches appHmtimm for a pomut for then 1 x herd mweifled. agteetnd to do an work in stylet mewdamm w to the 017 Owdinanwir and rating of the Depa of Buildiu^ and hereby dodarea that alt the farm- . and representations stated in this appOodim are true gad eorrect ham.. Man 9-12-73 >rB Owner Edward Chatlain 4b Kind of Huildift Frame _ ° tfia� N ®NowtL�e` Old ls�ar � Camped Used as Res. To W eoomfeted about 9-19-73 PARTIAL RITE SCHEDULE Estimated Cast. t 10.00 �dt n R.ra.it vk* �v W.UM®uiiding tKc rum_ N&R�►is Tar" N"abases ................ Mm limam ad.......... IF S • PbkswCatch a� and& .... ................ i Mater Raster !Vg to " B'!V1 O .. I : IM f New Ground Rues dd Bw ........ • i SM i ROUON. sheint! watar .............. a sm t. i % /� as G" L� s t� �/y��* im t&TZ TM.W bE i Ifisttarea .................. —XIM S Addb loaM IMsts i ............... n i " t Qss Ranee to M.Ow Fm ........... s am i State Surcharge $_SO ►ass st iu.'t�tatto�s—�.tr a era. - - .......InttaU Dryer 5.00 ................� rara��ss � CIM "A® Surcharge SUBJECT RMI of Fridley o 17�67 6 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T rpCity RE IPT NO. l6w• COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/21/84 JOB ADDRESS 1443 - 75th Ave. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 Gideo's 1St Add. SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Harold Lundberg 1443 - 75th Ave. N.E. Fridley 55432 786-1838 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Garage Addition of 384 ft. sq. 9 CHANGE OF USE FROM TO STIPULATIONS --.�,EPLRA i E PERI+ I Tb REQUIRED FOR. WIRI HFATlNr_ PLUMBING AND SIGNS, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,300.00 $2.15 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. $62.50 PLAN CHECK FEE TOTAL FEE 15. 80.28 PROP R V L A D THIS IS YOUR PERMIT NATURE OFC TRA ROR AU0 ED AGENT IDATEI,�If{. J SI F O N IIF O ER BUILDERI I A EI INSP nA E s. NEW I ] City of Fridley Effective 4/1/84 ADDN. �R-1 AND R-2 ALTER. I ] Building Permit Application Construction Address: lYY3 %SOhl J Legal Description: �07'� ' /oc�< �c/a/�eto!s Is>� 4c4/41aAo; Owner Name & Address: / 1(V6t d Aee_jie.rg -carne � Tel. # Contractor: Tel. # Address: 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 H/gt/G/round Sq. Ft. OTHER: w®t ush® i0'iiillC _A/1 e. �G/liNe�G �r'4ha 1 P.► Corner Lot [ ] Inside Lot P4 Ft. Yd. Setback _ Side Yard Setback Type of Construction: a'� Estimated Cost: $ &M-' Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: 6 ZZ& APPLICANT: Tel. #MK_ Apjao CITY USE ONLY Permit Fee $ A � Fee Schedule on Reverse Side Plan Check $ + � 25% of Building Permit Fee State Surcharge $ a�� $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ISO STIPULATIONS: r -fey wa /ana7 pw-o. r- SUBJECT PER City of Fridley 2 0 7 6 3 AT THE TOP OF THE TWINS BUILDING P E R M I T Ir � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. q r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/15/91 JOB ADDRESS 1443 - 75th. Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7 1 iedo "s 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS PHONE 21P 786-1838 Howard Lundberg 1443 - 75th Avenue N.E. CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. .3 Panelcraft 3118 Snelling Ave S, Minneapolis, MN 721-6628 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW CA ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 13' x 121 Three Season Porch-and 2 sq. ft, Deck Sol--q''q 9 CHANGE OF USE FROM TO 4Jd 060P)ift IS IL STIPULATIONS See notations on plan. WARNING Before digging call for all utility. locations 454-0002 REQUIRED SY A SEPARATE PERMITS REQIIIRED FOR MIRING, HEATING, PLUMBING AND SIGN& TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 1 STALLS I 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 $5,250 $2.63 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- $81,00 Fire SC $5,25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $88.88 SIGNATURE OF CONTR CTOR OR AUTHORIZED AGENT 16ATEI HEN PROPERLY VA TED THIS IS YOUR P RMIT - � I SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSP nATE NEW [ ] Effective 1/1/91 ADLN [ ] R-1 AND R-2 AMER [ ] Building Permit Application Construction Address: [YY3 7.5 r"A ✓e . Aj,5- . legal Description: Owner Name & Address: /0�0 / y Y 3 � S'`� � � - Tel. #_796 /d'3 � Contractor: Tel. # .Z / 6E K Address: 3119 /f✓B ,v '/�ItAcs /-?") Attach to this application, a Certificate of Survey of the lat, with the proposed omwtrtixckion drawn cn it to scale. LiVIIr. AREA: length Width Height Sq. Ft. GRRAGE AREA: Length Width Height Sq. Ft. DBCR AREA: Length X Width H#/Ground Sq. Ft. 47-41-) O►M: <��� 22.'7► = � �a.�6 a- �a3X�I5� lCog.7 (Ito. Corner Lot [ ] Inside Lot p4` Ft. Yd Setback Side Yard Setbacks Type of CorLstruction: ev57-,?- RewA-, Estimated Cost: $ ZZ± _,, '5 -') CU Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page APPLICANT: 27 /- Tel. # %Z / a 2b7 Permit Fee $ Fire Surcharge $ "s, State Surcharge SAC Charge ;• Driveway. Escrow $ Park Fee $ Sewer Main Charge $ S'T'IPULATIONS: Fee Schedule cn Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined ne by Engineering Agreement Necessary [ ] Not Necessary [ ] So? 5- r av Y,< /� Uc1 v 13 A' , r M i l7 Z 7R70_ 2x / o •-$ /g/ � !o s A4,. l Oro- 2x/o L604oE,? � � /'�E77s7G- J04tTNI��$,��c'S TYp cv ss� 6i P-7AM, zXBs. V P1,160 N 'T/e= - ZJQr S /gf "0. C. a 9 m z 0 0 IAJ z �2 U siz PC rr�cy�s�cor swats i / L vMM79a b -Szfo 5 133415- -1 V13a iS NOD N— V114 T LOCATION ON ',.. /-- - - - -, � f'RoPosEO �� DEck I I r )`<� J` --T PROPOSED I K 3 SEAS6A) ` Zy= 0 S HEsr ! of S HO&MAD LaAM AiS JY93 75 ^ Avc a.E FRIDLEY • MPJ 796-188 _ NV�d ON I VWdJ �03(1 HIM01 O y���ixZl I&C—v 3woH 1:7x3 S-11. NVld eN I NVdd 103a d3dd n st I mm fW ; 4 O O V D z I Sl�E7— y oFs- NOTA- 1364M &Vce<S SET W Agoi/E ExtST_ 13Ef4R/,14 Al -4.4—' MASS av wA,M&5 \� �\ zxa cEOAR f�sC�A Box IAl soF'll�tT To HArGH Ex/sr. CEDAR 2X25 6" O.c_ i611� y gt sI TY P. ALL RAILlAY65 SIDIA16 TO I%ArCki yorE STEPS NaT SMa".&) 7 -t /S 1-09dDR flILS To 5E- .36" RgoJE STEP AASSE r-A..Jr T6PS B"Mr4X R /SER S k 9" 1'!/n/. TREADS . Lor.�/ER D£c�c I I I I I I t l 1 1 1 1 l I I I I I 1 1 L_ BcridHS NOT TO SCB44.E SEf`V*ffr Z r.,A 5/Zc S FRONT VIEW w- CONST DETAIL ,- SiiEET ',! O 1 DECKING _ l• suBjECT IT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING P E R M I T r RECEIPT NO. • _____ COMMUNITY DEVELOPMENT DIV. 1 V _ r PROTECTIVE INSPECTION SEC 1 i 1 CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED By 612-571-3450 910-F15 8/26/96 JOB ADDRESS 1443 75 Avenue NE 1 LEGAL LOT NO. TRACTOR ADDITION SEE ATTACHED DESCR. 7 IBLOCK1 1 Geido's 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harold Lundberg 1443 75 Avenue NE 786-1838 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE R 8 DESCRIBE WORK Reroof House & Garage (33 S 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,046 $1.03 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 $74.75 i e SIC $2.05 PLAN CHECK FEE OT L FEE $77.83 SIGNA RE OFFCONTRACTOR OR A ED AGE T iDATE) PRO VALI A D THIS IS YOUR PERMIT OS,G!N�AT..;_O�<PrrF G )NSP TATE OWNER BUILDER) )DATE) l• NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: l yY3 % -0 Ave— Legal Description: Owner Name & Address: �� e-! ' � Tel. Contractor: sG MN LICENSE Address: SBS Tel. # ;7d'6-APJW' 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: Len Wid Hgt/Ground Sq. Ft. OTHER: e - "' c5 (� �i�'c 1�� Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks l Type of Construction: Estimated Cost: $ -2 r Approx. Completion Date: lD i (Cost on Back) Driveway Curb Cut Width Needed: Ft. + t = Ft = $ DATE: r1 -,2f G APPLICANT: ,o Tel. # % /JVJ CITY USE ONLY Permit Fee $ ���. S� Fee Schedule on Reverse Side Fire Surcharge $ 6-�^ .001 of Permit Valuation (1/10th%) State Surcharge $ /, e j $.50/$1,000 Valuation SAC Charge $ $900 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 $ v STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION Effective On May 10, 1999 6431 University Ave NE Fridley, MN 55432- APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 c REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Z�/Z 3 95� aae A) F, RATE SCHEDULE OWNER 41 - 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 of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL BUILDING USED $ 30.00 $ ESTIMATED COST�2LV-g) PERMIT NO. $ 10.00 $ 10.00 $ 10.00 $ 25.00 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. P DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units ircle One (Steam) (Hot Water) (Warm Air) $ Trade Name AtAt.-.p—, Gsvo* 33 Size No. BTU a,5 -x,- HP EDR Fuel Gc� Total Connected Load Burner Trade Name Size No. BTU HP EDR $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in tWILVA tion_are'true and correct. dba amide Ce>w MOW # 20090911 2700 N. Fairview Ave. HEATING CO '+ 0039011k MN 65413 651-633-2581 Signed - � DATE _ Approved By Rough In Date Final Date / 7 CHEMEY 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 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being D, Done: Yes () No ( ) Yes () No ( ) Yes () No ( ) Yes ( ) No ( ) Yes () No ( ) Yes () No ( ) HEATING CO: Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 S71 -36U4 V*AA: (763) 5"/1-IL37 ADDRESS : 1443 75 AVE NE PIN : 123024120034 LEGAL DESC : GIDEOS 1 ST ADD : LOT 7 BLOCK 1 PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT N < 2004-01055 DATE ISSUED: 07/07/2004 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 A FURNACE AND AIR CONDITIONER. # A/C UNITS 1 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT HOFFMAN REFRIGERATION & HEATING LTD 1709 S GREELEY ST STILLWATER, MN 55082 OWNER LUNDBERG HAROLD G & BARBARA 1443 75TH AVE NE FRIDLEY, MN 55432 4280 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 wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or canjel the provisions of any other state or local law regu qtulg co truction or the performance of construQtion. ADD11cant Date I I HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 60.50 PAID WITH CHECK # 3257 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. N 0 R .-,+ CITY OF FRIDLEY BUILDING INSPECTION 8"1 Urd"rsky Ave NI E Fridley, M X32 763-572-3604 FAX 783-5 o 1-1287 RATESCHEDU F Ideritial Furnaw Shell and Duct Work, Burner & also Replacement Fur new Gas Piping (thew Furnace, Fireplace, Insert) Gas mange Gas Dryer *PM Conditioning -All Sizes Efisective 4/112004 APPLICATION FOR POWER PLANTS AND HEATING, ICOOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SY'STM AND DEVICES ±a o $14.©0 $ $14.©0 $ M00 $ $2&00 $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Wiark Minfmum Fee $15.00 for Residential or 5% of cost of improvement whichever is greater on work less than $30D.00 CornMemia(ndustrhal/Inst 1.25Mof Value of Applianoa or Work (Liston Back) Mlnlmum Fee $35. for Oomrrr:rcial/industriaVinaUtu#icnal State Surcharge TOTAL FEE REINSPECTION FEE $E0.00/1-10UR JOS ADDRESS -LYV3 7 S'' A,e Budding Used #s S ( c&. r.1AA- IEI v ESTMATD COST -Z 6.0 PERMIT No " Lo CyL�.-� �: ' r + �' � � : 'r,; , .. � ► ► .iia : .�: ,N oFH eating Units, Circle one (Stsam) (,riot wester) m Air Trade Name Size No. BTU — %/2r ®rte HP EDR Fuel moi,:Lz e Z &. s Total Co WOAed toad Sumer Trade Name BTU Size No. HP EDR 'The undersigned hereby makes application for a permit For the work herein specified agreeing to do all work in .a tract accordance with the City Codes $ and rutins of the Eluilding Division, a nd hereby dedwas that al the facts and representations stated in this applications are true and correct. $ .50 IHEikTING $ ©. SO *Air Condit rk0a can inert be phxed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON 3EPLACEMENT FURNACE INJ FM Z/52-(2712- mite 7- fa -c7 C,,�4pPMWd by Rough -in Date Final Dater�� La JLN-17-2004 13:29 FROM CITY OF FR I DLEY TO 6514390312 P.03/07 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS CON WONVENT, ANT CONNECTOR AND COMBUSTION AIR VERPICATION When replacing an ex Ina tarmac$, the undersigned hereby verifies that the veftV is tin ewam d iss fiene te-mr P -W, detenoram, afthruccoamns, and is securely supported and firestopped where required. Yes (k) No ( ) Th-- was ",ern is p4astidPVC M,14 amts all cur.ent codes and manuffacruTer specdIcations including sizing, length, number of efts and termination. Yes NO( ) The under.-Ognad also m that the replaournent and meets the curTW codes and manufacturees spedfications. This does Include AGA-GAMA Categgory I Ca*al Furnace Venting Tables for fan amMed and nahmal draft applh-knew- Yes NO( The �,-WW fl-ranupwAurwe specificawns. Yes (>4 No(When required to !VON a now MMWMft air, it will be sized and installedto MW the Current codes and marRzfecturees speafficafi=. Yes W No it is a L%Wd assembly aid meets the cunwd codes w4 manufaduWs specifications- THS does include AGA-GAMA Category I Central Furnaw Venting- Tables for fan as*W and natizal draft "iancm Yesy) No Is the common andventconnectorstilm.Rand installed omctly after separately as!"' current codes -Tis. !. Ap0birm. _ _. _: Tim ,a and Vent mW V, -M Ap*nce #1 Type Ama A).- r6rrPik-r- - 13TU Input �b,, vc,, Fan Assisted or Not A/ A T- Appronce #3 Type BTU 1W Fan Assisted or Nat Totaltp ctG Btu Input Common ►.- Vent HeightDemeter c.:. AppO #1 Veal Cwnectir Heistd it Length ____# Diameter in Type Apve #2 Vent Connector Height ft Length ft Diameter in Type Appliance i Vent Connector Height ft Length ft Diameter in Type HEATING; Building BUILDING Permit No.:, PP066z-W fi XG Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: Z� DATE O` -- SITE ADDRESS I Y THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBWT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: �. 14V YOUR E-MAIL ADDRESS !-"-J f' ❑ OWNER OONTRACTOR ADDRESS: / 7 �_rldf J / PHONE:2ceT OV& — L ?3,Y STATE LICENSE PHONE - vir w WN INGLE FAMILY/NEW C 13 TWO FAMILY/NEW CONSTRUCTION ❑ ADDITION ❑ GARAG ❑ BASEMENT FINISH 04-0OF ❑ DECK ❑ SIDING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT_ KVVNLNIy NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other 0 INN NEXP DATE 'rE?�!26 ^CYT Z N sm CITY STATE ZIP SIZE STORIES -:/SHED ❑ WINDOWS ❑ DRAIN TILE ❑ OTHER ING POOL DN ELING d -- WIDTH HEIGHT Sq. Ft. ❑ HOUSE ONLY #-HOUSE & GARAGE FI -ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia )ASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures 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 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 $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 1 times the total job valuation Surcharge —.00 $ .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 $ 16-7,777 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 a owledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes e City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application M d wo is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work wd approval of plans. J SIGNATURE OF APPLICANT PRINT NAME/ M14 � � DATE