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City of Fridley, Minn. BUILDING PERMIT' N? 3194 Date: S77 ................. Owner . ...... ............... Address . ........7................. Address ............................................. LOCATION OF BUILDING No. Street V ................. Part f Lot ............4 ........11....... Blo k .. Addition or Sub-Divis Lot 7_6.'*** i�] ... . . .... .. Comer Lot ...... Lot ..... Setback B.S._ Sideyard . ..... DESCRIPTION OF BUILDING To be Used as: .7 ..... Front .4.1.. Depth Height ... Sq. Ftf�4 Cu. Ft. ........ .................... Front ........ Depth .... Height ..i; Sq. Ft. ........�Cu. Ft. ........ To be Completed ......... Type of Construction ... Est. Cost 4e.Y" Sidey d In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of permit is hereby granted to ......................... to construct the building or addition as described above. This permit is granted(kpon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. uiIding.. ...... .... . . ector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plum , gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. BUILDING PJEERMI'I' .a 3r 1 Village of Fridley; Minn. I 1V *,Date ... ... > ,�,�/ �r'�� Y Owner � ►' ..../ �i>� :. .. Builder 1 """� .r ,. Address !"". Address r Sat .'.. > f S' r LOCATION , OF BUILDING ` No. A •'..�........ Street . " '.'�'. ...... Part of Lot .. > <>, a � x Lot ................ Block ... ...... .. Addition or Sub-Division .......... °�` •,.•;aY X Corner Lot ....... Inside Lot ... Setback ............. Sideyard = g `A DESCRIPTION OF BUILDING sf To be Used as: Front Depth :.Height ... Sq. Ft. Cu. Ft. x # ... .. Front ..... Depth ........Height ....... Sq. Ft. .....•.. Cu. Type of Construction .. Est. Co ..y ... To be Completed k �s }t W In consideration of the issuance to me of a permit to construct the building described above, ISAMtdr the proposal work in accordance with the description above set forth and in compliance with all pr"Wons- b ordinances of tht village of Fridley. Aw ♦ •.•• �•r,;N ♦�{K.i„� �';� Se's. co de tion of the payment of a fee of$. permit is hereby grknted to ,. 4F i ... to construct the buildingaddition as described above. permit is ; the exp01 ress condition that the person to whom it is granted and his agents,employees and workmen, In all .µ At ' done in, around and upon said building, or any part thereof, shall conform in all respects to the ord 05 Fridley, Minnesota regarding location, construction, alteration,maintenance, repair and moving of bu In the village limits and this permit may be revoked at zany time upon violation of any of the provisi< ,of� � ,_ g n ordinances. I . Building 1A, h NOTICE: This permit does not cover the construction, installation or akteeation tot-Wring, ptumfAlle, s h *ewer or water. Be sure to see the.Building Inspector for separate perml#s,far;themeItems. • ..ten.. _ _ ,. _. ,... .. _ ,. ...._ }.,a .r 2x�+w,k,c City oFridley,f FMinn. Z�y2 o BUILDING PERMIT N? 6438 Date: _._�_/__..._.. _ ._..___.�y2._ ..._...._._.._...._.._..._..._...� Owner: _.__.... __ ..�s-[ ,P ..__._� Builder- _..._ ... -- Address :..._...........................__.._.........._... ..._..._._............................................ Address _...._.........._._......................- CA N F BUILDING No. Street .- .................. P f Lot -------......._.._.............. -.... Lot ... _ ...............- Block ....._.._..._..,�............._.........__. Addition or Sub-Division -. _. _.:?- ......, / CornerLot .................... Inside Lot .._..................._..............-gotback . ------ . ........ Sideyard ..... :.2. ........._..........................._...... _. r Sewer Elevation ...._....................................................................................... Foundation Elevation ...................._.........._.......-.__--_--..._..._.._........_.... _ DESCRIPTION OF BUILDING T L� as: E_y p�`� _....___ _.._ Front 1-. -_-- Depth .. Height ----... Sq. Ft. _ d._.. Cu. FI.J. `�1....�1 _._.._._.___..................._.._... nt __.___........._.. Depth .....__.. .. . Height ._.._ Sq. Ft. ..................... Cu. Ft. ................... Type of Constructio _... ...__.. Est. Cost✓.15..Ira-..._...................... To be Completed ............................___..........__ In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set fo and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of$._, ._._ ....._J. ._.., permit is hereby granted __.,........_.._...__.........:.._._...._........_. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sura to ace the Building Inspomr for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NANIF �/�C &44BUILDER f�/Ll C? ADDRESS a7 c/ ADDRESS LOCATION OF BUILDING No. - p 7 !�/ ��jStreet Part of Lot Lot 2- Block __Addition or Subdivision -r., . 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 us d as: r / Front Depth ,� 2 Height ,,, Sq. Ft, j 2b' 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 SIGNATURE (Scbedule of Fee Costs can be found on the( verse Side), City of Fridley, Minn. N° 8032 BUILDING PERMIT Date: Owner: _jercmze D. Miller _. Builder _George H. Vanderhoff Address . �4� .rZ .Avenue N. E._� __ Address 1208 Grand Ave. St. Paul] Mtran. LOCATION OF BUILDING No. 9_5__ Street 57th Ave2ltie N. E• Part of Lot Lot __..26_..__.__ Block _.—__8 __.__.Addition or Sub-Division Donny.!&ldd'tion— Corner tion .Corner Lot _._Y_._.._ .._ Inside Lot Setback _.____._......._._._.__. Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front _ ___ Depth --- Height ..........__. Sq. Ft. _.___.____ Cu. Ft Front ____r Depth ___ Height ._.._..._..___ Sq. Ft. cu. Ft Type of Construction Est. cost AR,024 a 5o_....._........ To be completed Storm Damage Repair In consideration of the issuance to me of a permit to cons b din bed hove, to the proposed work in accordance with the description above set , complian th ons of ordinances o!the city of Fridley. In consideration of the payment of a fee of 1© _.___._.., permit is hereby granted to Slrge H• _Vanderhoff to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work. done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buil" within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Allen Jensen. Building Inspector NOTICE This pumb does not eewr dw eondmdloe, lural dw for wi&g, phmbino, gas bsadug, www or water. ds sun 10 9" the duNino Inspector for oaparab pw ba for tbo»Imam I. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME `� ( BUILDER 17'1 klz�i ADDRBS'ji�,. - ,Z-Sre � �_ ADDRESS LOCATION OF BUILDING =N •� _ Street Part of Lot LOT _:�A---.BLOCK ADDITION OR SUBDIVISION r ___�A Corner LotInside LOT Setback Side-Yard .SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; Front Depth Height Sq. Ft. Cu. Ft. Front DepthHeight Sq. Ft. Cu. Ft.— ,Type of Construction 0 512��Estimated Cosi✓ 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 �^< /�4 SIGNATURE (Schedule of Fee Costs can be found on the Re rse Side). City of Fridley SUBJECT PE_ - 17 0 9 5 AT THE TOP OF THE TWINS BUILDING PERMiT f RECEI T NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. i I �"•'1 CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY 612-571-3450 910-F15 8/16/83 / JOB ADDRESS 505 - 57th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 26 8 Donnay's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bob Copeland 505 - 57th Avenue N.E. 574-1690 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Harold Barkley Contractor 1111-24th. Avenue N.E. , M ls- 55418 789-5633 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Cover trim wi,th. aluminum 9 CHANGE OF USE FROM TO STIPULATIONS 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 $1,6OO $1.30 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- $26.50 TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $27.80 IGN REOF NTRAcro RAU1HOR ENT I ATE) WHEN PR0 ER ALIDATED THIS IS YOUR PERMIT e SiGNATURE OF OWNER OF OWNER BUILDER) (DATE) I DA E CITY Of FRIDLCY Effective Aug. 1, 1981 ' APPLICATI91 FOR RESIDLNTIAL BUILDIING PER141TS (14cm, Alterations, Additions, or Repairs) OWNER: fob L7&-1o('(2S Coee (CZ-w14 'BUILDER: F-I01 d Isa�k►� Y r .T ADDRESS: Sy S 5 }� )jt. ADDRESS: /AVe, K) AA„o Is f5`/18 TEL NO: S 4016 y0 TEL 110: g 9 r S 6 3 3 S-6 ,5 Construction Location STREET NO: e STREET: � � +� ��1� . ME, 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 C01•;STRUCTION 1,,i edii,4 jA w,% Front: Depth: Height: T Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: ,,i A Estimated Cost: $ �i ebb, a� Tb Be Cbripleted: 8/1(� Ze —�— T Alt. A Alt. B Proposed Driveway width If New Opening Is Desired: $ $ SEE P.EVF:RDE SIDE OF SHEET TSie undersigned hereby makes application for a permit fcr the %:.,ork herein specified, agreeing to do -all work ir► strict accordance with the City of Fridley Ordinances and rulings of the Depzirtment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. MTE: /� SIGNATUr's.: APA Stimulations: l SUBJECT City of Fridley 28375 Irp`5?�= �T� F THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. RECEIPT r PROTECTIVE INSPECTION SEC. I i •_-•�; ";•J CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY i 612-571-3450 910-F/5 10/22/98 / JOB ADDRESS 505 57th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED OESCR. 26 1 8 IDonnay's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cecilia Bartniczak 572-1857 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D. L. Builders 1166 14th Ave SE M is 55414 378-0950 20096711 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 0 ADDITION O ALTERATION Qx- REPAIR O MOVE 0 REMOVE 8 DESCRIBE WORK Reroof house and garage 30 S Tear-off 9 CHANGEOFUSEFROM 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 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 1 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 2571 $1.29 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- STRUiCTION OR TH PERFORMANCE OF CONSTRUCTION $74.75Fire SC 2.57 \n1l\r\J PLAN CHECK FEE TOTAL FEE T.irp-nqp SC 15.00 1 83.61 SIGNATUAEOFC NTRACTOR OR AUTHORIZED AGENT IOATEI WHEN PROPERLY/VPLIDATED THIS IS YOUR PERMIT S,GNA TORE OF OWNER,IF OWNEA BUILDER, IDATE, BLD§f INSTIA1E NEW j ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY _ / ALTER [ ) SINGLE FAMILY AND DUPLEXES R-1AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �jf�S S`7 t) Legal Description: Owner Name & Address: Tel. # I YS7 Contractor: MN LICENSE#;? oo 9 Le `71 ( Address: l((_g Lo mz '% V�v,, SSy1k _ Tel. # 3"7 9—!)9�C 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: So Construction Type1��.¢r - Z Estimated Cost: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 1O - 2 Z •`'i B APPLICANT: Tel. #37 8--C}S6 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 9 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary j ] Not Necessary [ ] TOTAL $ 3 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION 6,451 University Ave NE Effective On January 1, 2000 *Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS 5o' S OWNER C 1 h 6Lt S 1 i Y12� � P_+ Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS 1 W2 { I in r Also Replacement Furnace $ 30.00 $ >U.00 (Side Vent - Fill Out Back) ESTIMATED COST o2 v500 . OC) PERMIT NO. L A1 Gas Piping(Needed with new furnace, $ 10.00 $ Gas Range but not replacement) $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) (Hot Water) arm Jr) Gas Dryer $ 10.00 $ Trade Name l'Q�2.9!Q-Y2.J 9LuAV0g0Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel_ )-a- 6A S Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE $ 30.50 Q•S0 / �1 DATE ld11 q�oo MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING%er City Sheet Metal, Inc. REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 992-8 Bluebi-rd St. N.V7 PLUS THE $.50 STATE SURCHARGE Signed _ Coon Rapids, MN 55433 TEL # 54-2199 REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved ByRough-In Date Final Date written permission from adjoining property owner. A FILL OUT BACK SIDE F1 STACK VERIFICATION ON REPLACEMENT FURNACE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION So 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 A No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes O No ( ) A(A 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 k() No ( ) When required to install a new combustion air. it will tie sized and installed To meet the current codes and manufacturer's specifications. Yes M NoYV ( ) 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 OQ 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 (A No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance#1 Type BTU BTU Input� Fan Assisted or Nat Appliance#2 Type tAfr,& Oa l� BTU Input -A,4-, Fan Assisted or Nat Appliance#3 Type BTU Input Fan Assisted or Nat Total Appliances_ _ Total Btu Input_q a, '- Common Vent Type Vent Height�Diameter inches Appliance#1 Vent Connector Height a'�- ft Length_ -�?_ft Diameter V' in Type G Appliance#2 Vent Connector Height_eft Length_2L�ft Diameter fz in Type Appliance#3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: ��- � -� Signed By: &421 Date : CITY OF FRIDLEY PERMIT NO.: 2005-00027 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/06/2005 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 505 57 AVE NE PIN 233024420011 LEGAL DESC DONNAYS LAKEVIEW MANOR ADD LOT 26 BLOCK 8 PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION 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. #A/C UNITS 0 VALUE OF APPL OR WORK 0 #FURNACES 0 #GAS DRYERS 0 #GAS RANGES 0 VALUE(FOR MINIMUM CALC) 251 APPLICANT HEATING PERMIT MINIMUM FEE 15.00 CENTERPOINT ENERGY/MINNEGASCO FURNACE SHELL/DUCT WORK 0.00 13562 CENTRAL AVE NE GAS RANGE FEE 0.00 BRANCH 1111 LOUISIAN GAS DRYER FEE 0.00 ANOKA,MN 55304- AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE,MECH FLAT 0.50 OWNER TOTAL 15.50 BARTNICZAK CECILIA A&C B PAID WITH CHECK# 1025391 505 57TH AVE NE FRIDLEY,MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or therform e of construction. Applicant Date Bldg Ins D/— SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION Effective 4/1/2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 763-572-3604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE Fee Total �? J ' Residential owner LIZ Z a, Furnace Shell and Duct Work, Burner& also Replacement Furnace $35.00 $ Building Used As f�LLQ��! &1L-1— Gas Piping(New Furnace, Fireplace, Insert) $10.00 $ ESTIMATED COST d S Uy PERMIT NO Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ #of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. *Air Conditioning-All Sizes $25.00 $ BTU HP EDR Fuel Total Connected Load All Other Repairs or Alterations(List on Back) 1%of Value of Appliance or Work $ Burner Trade Name Size No. Minimum Fee$15.00 for Residential or 5%of cost of BTU HP EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25%of Value of Appliance or Work(List on Back) $ and rulings of the Building Division,and hereby declares that all the facts Minimum Fee$35.00 for Commercial/Industrial/Institutional and representations Mated in this application are true and correct. State Surcharge $ HEATING COQ TOTAL FEE $ �' Signed �G �� Tel# ���/L � REINSPECTION FEE$50.00/HOUR FAX# ��v��t ��� Date 0� - *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 Approved b Rough-in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( ) No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacture'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 1 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 431 University Ave NE A�6-6>5 3-_ ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 763) 572-3604, FAX(763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR : :..:;;:. . Gas IWa h Floor Auto. Water Heater . " >> .-:...... .. .:..... Gas ElecainStories Urinal ower Tray Washer Range a t > ':'<> « Bemen sism Floor 01 Floor 2 Floor 3 Floor 4 'LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS dew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes 3eer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Slow Off Basin $10.00 and representations stated in this application are true and correct. ;atch Basin $10.00. 031500 lain Water Leader $10.00 -ATG. 20 >ump/Receiving Tank $10.00 BARTNICZAK A,CECILIA Nater Treating Appliance $35.00 OWNER 505 57TH AVENUE NORTHEAST Nater Heater-Electric $35.00 FRIDLEY,MN 55432 Nater Heater-Gas** $35.00 BUILDING USED AS (763)572-1857 1�20 ekc e, Sas Range*" $10.00 t L co "I 3as Dryer** $10.00 ESTIMATED COST 0 PERMIT NO. 3ack Flow Preventer Required ( )Yes O No NORBLOM PLUMBING CO. Type $15.00 PLUMBING COMPANY (612) 8274033 reinspection Fee$50.00/Hr SIGNED BY 2905 GARFIELD AVE. SJ�OI . 4LL OTHERS AND/OR REPAIRS AND ALTERATIONS , Ad& 1.25% of Value of Fixture or Appliance $ �c Approved By Rough-In Date Final Date State Surcharge MINIMUM FEE F R ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. 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 ( J No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ,) No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances Yes ( } No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes O 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 4 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 431 University Ave NE C69 —���� ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 763)572-3604, FAX(763)571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR fa#i✓r:::€<: Iaf =< _ Wash >.>:t: :::Floor ;��i�#�-::.:::. to. �<:::::<<:_:::: Gas `�'�"�?���>Water Heater ...........'..`..`........... ....."...`............ .....- ....:..::.. GasStri s Urinal Shower Drain .. . . .:> Tra t; Washer Range . Elec Basement ent a Floor 0 1 Floor 2 y F oor 3 _ I F o0 4 I r MN 'LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS SOW 15 OG'"(1 dew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 _ specified agreeing to do all work in strict accordance with the city codes Seer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Slow Off Basin" $10.00 and representations stated in this application are true and correct. ;atch Basin $10.00. 0315016 lain Water Leader $10.00 DATE: _'20 Sump/Receiving Tank $10.00 CECILIA Nater Treating Appliance $35.00 OWNER 505 57TH AVENUE NORTHEAST Nater Heater-Electric $35.00 FRIDLEY, MN 55432 Nater Heater-Gas** $35.00 BUILDING USED AS (763)572-1857 3as Range** $10.00 3t1as Dryer** $10.00 ESTIMATED COST `�W w PERMIT NO. 3ack Flow Preventer Required ( )Yes No NORBLOM PLUMBING CO. Type $15.00 PLUMBING COMPANY�F;��� Reinspection Fee$50.00/Hr SIGNED BY 2945 GARFIELD AVE. JSP jOI. 4LL OTHERS AND/OR REPAIRS AND ALTERATIONS , T&Ad 1.25%of Value of Fixture or Appliance Approved By Rough-In Date Final Date State Surcharge $ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. 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 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 O 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-LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes O No ( The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes O 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 O 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 O 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 O 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 b 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 Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da DATE t 1 D YOUR E-MAIL ADDRESS 1Q50kr\,ad®!R e TQC•C Cm\ SITE ADDRESS Jib 51.t—t- , "�— THIS APPLICANT IS: ❑OWNER JRCONTRACTOR PROPERTY OWNER/ NAME: `V\t TENANT ADDRESS: n CITY STATE_ZIP PHONE: CONTRACTOR NAME: Renewal By Andersen SUBMIT A COPY OF STATE LICENSE# 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 r STATE—ZIP WITH APPLICATION PHONE License #20130983 PROPERTY TYPE ❑SINGLE FAMILY/NE) ❑TWO FAMILY/NEW C 651-264-4777 PERMIT TYPE ❑ADDITION ❑GARAGE/SHED 1NDOWS ❑BASEMENT FINISH ❑ROOF ❑DRAIN TILE ❑DECK ❑SIDING ❑OTHER ❑SWIMMING POOL TYPE OF WORK: ❑NEW ❑ADDITION MAINTENANCE/REPAIR ❑REMODELING DESCRIBE WORK BEING DONE: l 11� ; SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq.Ft. ROOFING ❑HOUSE ONLY NUMBER OF SQUARES ❑HOUSE&GARAGE BASEMENT REMODELING cf IBMIT• GARAGES ❑ATTACHED GARAGE I. Existing Floor Plan PROPOSED SIZE: ❑DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Vinyl ❑Soffit ADDITIONS &PORCHES Sr BMIT• ❑Aluminum ❑Trim 1. Site Plan/Survey showing the existing structun ❑Other ❑Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 THE997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION$ 1 (p OCCUPANCY TYPE Permit Fee $ X�9 , 5 See Back Page for Fee Schedule Plan Review $ 65%of Building Permit Fee Fire Surcharge $ , �(D .001 times the total job valuation Surcharge $ 7,6b .0005 x Permit Valuation Minimum$.50 License Surcharge $ iOjS— $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$21 =$ 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 i conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes;that I understand this is not permit but only an application r a permit and work is not to start without a permit; that the work will be in accordance with the approve, plan in the case of all work wh h requires view and approval of plans. SIGNATURE OF APPLICANT RINT NAME,, 1:1)�,st%ft� DATE I O� Building BUILDING Permit No:: e Inspections RESIDENTIAL APPLICATION Received l3y: 763-572-3604 CITY OF FRIDLEY bat 00 763-502-4977 FAX EFFECTIVt la-2o10 DATE YOUR&MAILADI)1tESS SIT$ADDRESS X051 Av !Ll , THIS APPLICANT IS: ❑OWNER ,CONTRACTOR PROPERTY OW ER/ TENANT ADDRESS: _S OE, CJ14h Avc L CITY ���STAT'E44 ZIP - PHONE: S�a CONTRACTOR NAS: SUBMIT A COPY of STATE LICENSE#�,0�N`l Sty EXP DATE 3-:M- 1 1 YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS:�4 a 19 OMCIA 11x�,i m `CITY�I INSURANCEP14arE -le - » l q ww3TA1E�_2IP�� FAX Z�- -Ain PROPERTY TYPE ❑srNGl zr FAMILY/NEw coNsnucnw SIZE 0 TWO FAMILY/N)aW CONSTXXYCTION STORIES PERMIT TYPE ❑ADDITION ❑CARAGWSIED ❑WINDOWS ❑BASEMENT PrNISHf 0 ROOF ❑DRAIN TILE ❑1%CK 5aSm r, ❑OTHER ❑sWIMMING POOL TYPE O)F WORK; 0 NEW HOME CONSTVLU•CTION U ADDITION ❑MARTMNANCERtEPAIR VtREMO13ELING DESCRIBE WORK 8EING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH WIGHT SQ FT ROOFING Cl HOUSE ONLY 13ASEWENT REMODZ&9 S1CiI3MIT: NUMHETt OF SQUARES ❑HOU SP,&GARAGE 1. Existing Floor Plan +� 0 ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE:--- -- Cl DETACI M GARAOE 3. Llyr Of sIIueitual members to 6e ygrd PROPOSED M101I l STOINCr. FOR NEW CONSTRUCTION IKLUDINGDECIGS. ❑vinyl Asoffit ADDITIONS-&PORCI3Fd,9I-T' 0 Alumiq Ln �FLTrim 1. site plmd$urvpy showing the existing structures �,a r 5LFaseia and proposed project. 2. Two sets of cohstruetign plms `V MOWS 3. Energy Calculations : N-E-3aSMNGOPBNINGS ©Yes ❑No LOCATION OF WINDOWS FOR WINDOW'S-PROVWB U+VALUE AND OR FOR NEW OPENINGS-DESCRIIMB SIZE OF MANUFACTURE STICKER ONwmDOw, OPENING CHANGES&c TYPE OF WINDOW TO RF INSTALLED N[JM$F,R OF WINDOWS ALL FEES ARE RASED ON VALUATION,INCLUDING THE COST OF LABOR AND MATERIALS.- WS1 NC THE 1997 W&C FEE SCHEDULE) TOTAL 1019 V•AT.V,&TItON$ q,01 — OCCUPANCY TYPE Permit Fee $ 11 ta,a 5- See Back Page for Fee Schedule flan Review $ 65%of Building Permit Fee Fire Surcharge $ .001,times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum$.50 License Surcharge $ S C11 $5.00(State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit(Plans to MWCC for det&mination) Curb Cut Escrow $ ft+6 ft= fi x$22=$ Erosion Control $ $450 Conservation Pian Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary( ) Nan Necessary( } Total Due $ 7 7 71tT MAe thetics payable to: CW of Fridle Attach$ti ulations THIS IS AN APPLICATION FOR A PFkMIT-NOT VALID UN77L PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes;that I understand this is not a permit but only an application for a permit and work is not to start Without a permit on site;that the work will be in accordance with the approved plan in the case of 41 work oh requires review and approval of plan). SIGNATURE OF APPLICANT PRINT NAME DATE ( WV 96:££:66 0602/06!£:ale(] Z/Z:a6ud umou)jun :woi: