Loading...
PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT Date: September 29, 1970 Owner: D. W. Harstad Gompgpy, Inc. Builder Same Address 7121 Highway 5 N.E. Address Same LOCATION OF BUILDING No. 119 Street 75th Way N.E. _ Part of Lot Lot ._._..._.Q.____ Block Addition or Sub -Division __.Nj.emann Addition Corner Lot _ Inside Lot —_X__ _ ._ Setback 50' _—_ Sideyard 11 & 12' Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING N 10848 To be Used as: Dwelling Front 52' Depth 40' Height 20' Sq. Ft. 1040' CU. Ft. 20,800' Garage Front 26 Depth 24' Height 10, Sq. Ft. 624' Cfy Ft. 6,240 Type of Construction Fl a Est, Cost _ L30 000_____ To be Completed 6 months Provide Hardsurface 20CUUM Driveway. Verify Location of Foundation. In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set,forth d in comp ance with a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of 50.00 , permit is hereby granted to D. W. Hars tad C o . 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 HANK MUNICH NOTICE: ids permit does not cover the construction, hwtaWon for whing, plumbing, gas heating, sower or wafer. Be core to as the Building hupeetor for separaM permhs for these Items. ZC zy �U APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: 6. v/ - 41Wesvw,�v ILDER: S'W'04C- ADDRESS :_'7/o/ A/r/ C !�' r1c- . ADDRESS: � tC NO ; . ! l STREET: LOT:.- BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK:- -SO" S I DEYARD : // 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: &4�gz, ,,�G Front: -6-Z f -c--) Depth; 40 Height: ;2 a Square Feet: /d ito Cubic Feet: 0-6' 8©6 64,eocc- 4U Front: 2-c Depth: � 4 Height • /o Square Feet; 4,zq Cubic Feet: G? fo Type of Construction: _�/1%�/� Estimated Cost: To Be Completed:®g / The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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. 4v DATE f _ 3 ® ��� SIGNATURE • - - (See Reverse Side For Additional Information.) V.,'Y/Zy NOGG Appleaftm for Power !huts and HeaMeg, Goofing. Venh*kd on. ReNgeeation and Air Conditioning System and Devices PARTIAL RATE SCHEDULE Dept. of Bldg& phone ow -um GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ CH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations --up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .. .$10.00 $ Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam .................... 3.00 $ Each add. 320 sq. ft. IDR Hot Water . . . ........ .. 3.00 $ OIL BURNER—to 3 gal. per hour . ... ... .. ..... 6.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 199,000 BTU) ......................... 6.00 $ over 199,000 BTU See. Fee Schedule GAS FITTING FEES: NO RATE TOTAL 19 3 Fixtures ..... ....... ........ x$ 100 $ Additional Fixtures ............... x .76 $ Gas Range to 199,000 ........... 34 6.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FIND $ See Fee Sehedalat TOTAL FEE City of Fridley: The undersigned hereby makes application for a permit for the work hereir specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind o1 Used as To be completed about Estimated Cost, $ Old -6t1 Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER NTS --►Steam, Hot Water, Warm Air—No Trade Name Size No 4y t Capacity Sq. Ft. E.D.R BTU,//,'I ® H.P. Total Connected L oas.,1 % /97 4� - Rind of Fue BURNER —Trade Name Size No Capadty Sq. Ft. E.DR BTU H.F. (aeauRKS—OVE0 SUBURBAN AIR CONDITIONING CO. Signed Rina CEWI€.R BRl4 MINNEAPOLIS. iNINNESOTA U433 City of Fridley Appro and GM Rig Dept. of Bldgs. Phone 580-3490 DESCRIPTION OF WORK Number, F:iad and Location of Fixtures as (7 WATER MTR. 0pZ< �2_ p � Z • • O I s H < a� at K U 5 7t 7 n I N GAS EIEC. Base - - - 2nd - 3rd - -- -- - 4th- ?uture Connection Openings Connected with --- - +� Now Fixture, Old OpeningsSewer I Cesspool E PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. IRATE TOTAL Number Fixtures x $200 Future Fixture Opening x $1.50 $ New Fixture Old Opening x $1.50 $ Catch Basin x $3.25 $ Water Heater (Up to 99,000 BTLA x $3.00 $ , v New Ground Run Old Bldg. x $3,26 $ Electric Water Heater s $200 $, GAS FITTING FEES: NO. RATE TOTAL lat 3 Fixtures .... .. x $200 $-1-, _VQ__ Additional Fixtures ..... .............. x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS R ALTERATIONS -Refer to Code Description .................................. ...........$ TOTAL FM :iLGZ!M 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 2 Owner A ' Kind of BuildingAx �-� Used as �'"'�Gjr"_� c To be completed about Estimated Cost, $ -'v®'o Old I e Building Permit No.— _. -Permit No. ----�� Signed By- Business Phone No 75 - ROUGH FINAL S- C - .RESIDENTIAL CITY OF FRIDLEY Effective May 1, 1990 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with now furnace) Gas Range • $ 20.00 s ao,00 $ 10.00 S $ 10.00 S Gas Dryer S 14.00 S 1- H5 aa- a6 C a -r,) ao • Air Conditioning (all sizes) $_10.00 S o All Others/Repairs and Alterations 6 pp It of Value of Appliance or Work S — iAC- �p COMMS CIAL/INDUSTRIAL S It of Value of Appliance or Work State Surcharge TOTAL PTE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed to !;&d,• yard without written permission tram adjoining mr igldx,r. s $ .5 Job Address I l - -7 S \ vv 1k Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432 City of Fridley Tel. 0571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. OWNER Fridley, Minn. Q U KIND OF BUILDING USED AS yq TO BE COMPLETED ABOUT ` - - r F / v� ESTIMATED COST OLD - NEW BUILDING PERMIT NO. y PERMIT NO. �®� r DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Were Air- No. Trade Nam +'"' Size No. G % 3M_ -i S Capacity Sq. Ft. EOR BTU 715/'r .^ / HP Total Connected load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. MR BTU aH T7�S�P LH -7 o � � � Company V�� H s�-'� � AtE L9Signed By -� 'Q• Tel. No.� Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,✓� Z. Is free from rust or deterioration Yes (� 3. Has no foreign objects lodged within Yes (✓� 4. Is securely supported Yes (+r 5. Meets all current Code requirements for size and total BTU connected 6. Has Total heating BTUts of S,©nc) BTU-Ak All other BTU's IfJt�O TOTAL 10 � Remarks 0(" CESS 3Cwt (,AWg a VLu.E No ( ) No ( ) No ( ) No ( ) Ye s (' No ( ) Company 4- A Ig - Signed By Date —O [- 0 '*-01419 HOUSE HEATING TEST RECORD Pei � �� ADDRESS ' C1 �' v A Y N Z APT. FLOOR CITY SUBURB Fr, i D L& OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY Electrical Work By TYPE OF HEAT GA FA A HW_ INSTALLED BY �r ffb VbCr C0 Gas Line By STEAM SPACE HTR. UNIT HTR. OTHER GAS --�sN14I (fix DESIGN MAKE MAKE OF BURNER _ Model Model Serial Max. BTU Rating — INPUT 75m MAKE OF FURNACE Model CONTROLS I1 THERMOSTAT1 Vol Q Heat Plug Vent Size Volvo 0 //�'' KIND OF LINER SIZE�Now Limit 3 ��� 1 i � j Draft Hood AlaCA 1 Regularor ,( Limit Setting_TTFilters Size Number Fan Setting Chimney Location InsideOutside Pilot Type P 1T d Chimney Construction CTF-V:L N SiS Pilot Make L_ Pilot Model _ Pilot Timing Smoke Bomb Wiring Draft 0 X Test Tao L.W. Cut Off Door Pressure Lighting Inst. N Pressure —� Percent CO2 Date Tested -I ` �-"'{ Input CFH t �! Percent 02 Company Testing Stock Temp.J®a Percent CO ®� 0 Name of Tester Q iM Form 235 Octobor 8;1 1�90 I thea Undvrwignidj approve of John "Sk i f l e "(1 19 '78th way 1E Fri dIvy) ', 'i,nstalYing e� central air conditioning comb 'e:aor�auni•t in tha side yard separating owr 2 houses. � r , Mic, aea1:-Born , 108 '75th Way, NE Fridley# MN LA N e City of Fridley SUBJECT P U� AT THE TOP OF THE TWINS BUILDING PERMIT Ir RECEIPT NO. ` COMMUNITY DEVELOPMENT DIV. ______ ~ M r 1 PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REVDATE GAGE OF APPROVED BY ,-J 612-571-3450 910415 8/3/95 / JOB ADDRESS 119 75 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 Niemann Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Stifle 119 75 Way NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Brunn Construction 1209 Old Hwy 8, New Brighton MN 55112 633-5458 4016 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 6 DESCRIBE WORK Construct a 12' x 14' 3 Season Porch and a 6' x 20' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WAR NCH 9i Before digging call for all utility locations 454-0002 REQUIRED BY LAW SEPARATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 5,094 $2.55 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. $112.25 Fire SC $5.09 PLAN CHECK FEE TOTALFEE License • 9�' SC 5.00 124.89 SIG ATUREOFCO4' AUTHORIZED AGENT igATEI WHEN PROPE VALI ATED THIS IXOR PERMIT BLIOG INSP rJA E SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW (( Effective 8/l/95 ADDN (( CITY OF FRIDLEY ALTER (� SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 4 � 'j Legal Description: Owner Name & Address: J ( w S� Tel. # Contractor: _ MN LICENSE # 001(o Address:2-c 01A H Vj Y S Tel- #. 633- S y.S l 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 b` Sq. Ft.�'�i/�.' OTHER: V_ %��X /4/ 3-s��S°�1P arc. Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks a 6 Type of Construction: 3 Qo s i 5 Estimated Cost: $/ d c o D O% Approx. Completion Date: 1 o -- / (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: — 3) S APPLICANT: TOTAL $ STIPULATIONS: CITY USE ONLY Permit Fee $ �� Fee Schedule on Reverse Side Fire Surcharge $et�J% .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge , cz $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV 6431 Undvereityy Ave HE Fridley, MN 55432 T4 572--3004 Iq t PLUMBING FIXTURE RATES; APPLICATION FOR PLUMBING AND QA8 FITTING PERMIT MARK NUMBER OF FMRES i wash Shower I . Trav NO. RATE TOTAL New Fixtures Stories "N".0 Urinal Oki OFerdng, New Fixture • sa Beer Dispenser Floor 1 r11 Floor 2 >•;# ;- Catch Basin Floor 3 u� - Sutnp/Reoering Tank Floor 4 Iq t PLUMBING FIXTURE RATES; APPLICATION FOR PLUMBING AND QA8 FITTING PERMIT MARK NUMBER OF FMRES i wash Shower I . Trav NO. RATE TOTAL New Fixtures $ 7,00 Oki OFerdng, New Fixture $ 4,00 Beer Dispenser $ 5.00 sow Off Basin $ 7.00 Catch Basin $ 7,08 Rain Water Leader $ 7.00 Sutnp/Reoering Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric ^ _, $ 7.80 Water Hewer — Ono* $10,00 Gas Range** $10.00 On Myer*" $10,00 Back Flow Praventer Required ( )Yes {) No Type $15.00 Reinspection Fee $42.0011 -Ir ALL OTHERS AN01OR REPAIRS AND ALTERATIO" NS � 0 0 1.5% of Value of Fixture of Appliance ' State Surcharge so TOTAL FEE fv BE INSTALLED ON EACH FLOOR Floor, Draln JOB AOORF.3SIIJ Effective On March 1, 1996 The undemlgned hereby makes application for a permit for the work herein specifled agreeingto do all work It solo accordance with the city codes and rulings of the Building Division. and hereby declares that all the facts and repressMadons stated in this agpaoation are true and cormoL Building used As 00 Estimated Ccs M PERMIT INO. ���' `��-C PLUMBING COMPANY siaNE� BY & WATER SPE IALTIES, INC. C.,,NIiA NWe COON RAPIDV, MINKS O 4$ (612) 755-6468 - Appoved ByRoute—In Date Final Date !mtNIMUm F ANY PLM t3 S PERMIT re smoo EW8 Tiff_ $J0 STATE jNTCHAm **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(J4 AND TABLE Q—A. MINIWM SIZE 9 80 INCHES, m IV M 0 CITY OF f:RIDLEY INSPECTION DIV. r�� 6431 University Ave HE -., Effective On March 1. '1996 51 Fridley, MN 55432 m APPLICATION FOR PLUMBING AND GAS FITTING PEWT 572-5804 a: J a MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 'Wash Floor. Auto. Das Water Heber Stories Urinal Shower Tray Drain Basement : h ' 9 �Yasher Ran a Gas Else ``- p Flout 1 l�ol�g�Ao Floor 2 Floor 3 PLUMBING FIXTURE RATES; N0, RATE TOTALN� • JOB ADDRESS New Fixtures $ 7,00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fbdure $ 4.00 specified agreeingto do all work In s&kx accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basun $ 7.00 and regresentations stated in this Catch Basin application am nd true a0arre0t $ 7.00 �� Rain Water Leader $ 7.00 Q Sunp/RecWng Tank $ 7.00 , 1998 e Water Truing Appilance $10.00Owner �la SI Q a Water Heater—Elsetric $ 7.00 — GAVIC & SO Water Heater — tae"* $10.00 Bugdhtg useAIATER SPECIALTIES, INC. Gas Ranges$90.00 U Gas Dryer*' MINNESOTA 5 $10 � COON RAPIDS, 9 Estimated Cost (612) 75$-Nor NO, Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING ODMIANY M Relnspectlon Fee $42.001Hr • ' SIGNED BY v ALL OTHERS ANOIOR REPAIRS AND ALTERATIQN IS TEL N0. 2 Lc 1.5% of Value of Fixture or Appliance '1/100 t-Y �� k ui Approved By Rough—In Data Final Dat State Surcharge 50 e INiMUML31-NO10AG PERMIT i8 $2o.00 TOTAL FEE. $ PLUS THE TE 8UFICHAR "COMBUSTION AfR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE Q--A. MINIMUM 81ZE 9 801 NCHES, 0 0 0 a c� 0 .n \ N r -I M O SUBJECT City of Fridley 2 9 863' AT THE TOP OF THE TWINS BUILDING PERMIT r -------COMMUNITY DEVELOPMENT DIV.��� PROTECTIVE INSPECTION SEC. r 1 I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910 -FIS 7/13/99 JOB ADDRESS 119 75th Way NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 9 Niemann Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Stifle CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Top Gun Inc. 5014 Parrish Ave NE Rogers MN 55374 428-4559 20155030 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION QC REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (31 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Permit Inspection Cards Will Be Mailed To Homeowner To, Post SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST.. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2709 $1.35 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 $83.25 Fire SC 2.71 PLAN CHECK FEE TOTALFEE Lice 5. 31 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEr�E ,;< MEN ROP Y ALIDA IS IS R P`IT fr V IN$p - QA TE S-GNATURE OF OWNEA,IF OWNER SUILDERI IDATEI MAR -25-1999 NEW [ ) ADDN [ ] ALTER [ ] 16:14 FROM CITY OF FRIDLEY TO ConstructionAddress: Legal Description: CITY OF FRMLEY SINGLE FAMILY AND DUPLEXES R-1 AND R -Z BUILDING PERMIT APPLICATION 4226 P.01i02 Effective 1/1/99 Owner Name & Address: / 7SGeJ e . # Contractor: TOP GUN, I N LICENSE 11_ J®/� ®�®_ Address: OG60 PAN --€687-4 y Tel. A /2 ! Z' — sy`� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF awROVEMENT LIVING AREA: Length Width Height _ Sq. it. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width HgdGround Sq. Ft. OTHER: -770, Construction Type: _ l�Gl� Estlauted Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + b Ft a Ft x S = $ DATE: APPLICANT: Tel. # Permit Fee .$ 3. CUM USE ONLY Fee Schedule on Reverse Side Fire Surcharge $ / .001 of Permit Valuation (1/10th%) State Surcharge $ /, $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ S(Q $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ TOTAL $ �. STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE 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 $ 30.00 $ 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. r'r 1�)-tu*r Effective On January 1, 2000 I - - OWNER TOTAL � D I� BUILDING USED AS $3 ESTIMATED COST 12 OC) PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR I+s ,T_hser - rlf Lop', $ 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 4_1 representations stated in this application are true and correct. DATE Y l HEATING CO /!% G�/ e 2rf El �D 1� (se—� �-+ I at _�v l Signed �^ l�— TEL # o 114 C1_1 J)� Approved By Rough -In Date Final Date COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR_ VERIFICATION When replacina an existina furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When installina a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date Building MECHANICAL PermitNo.: 006k Inspections RESIDENTIAL APPLICATION Received By: :;763-572-3604 763-502-4977 CITY OF FRIDLEY n fo' FAX EFFECTIVE 1-1-08 `DATE I E-MAIL ADDRESS M6 LhP_ � 7,90- �c9 n4 Aort . C ,� ^ 1 Y,YO/UR >SITE ADDRESS r 1 �7 l Y 1 I A %GytA Y -- THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: . 4 hV-\ ADDRESS: LI 6 �S Yi YI CITY Cid IY4 STATE % OWNER/ TENANT ��/l-( PHONE: 71f/ CONTRACTOR �`{ nqCI COMPANY NAME:" I� 1 �tX� (D-4elact NOTE: SEPARATE CITY CONTACT PERSON:/ASU LICENSES ARE STATE LICENSE # REQUIRED G� ��ELLX�� rP�D,�ATE ADDRESS: !4=.W;11Y1ezW,1A 1 1t,94 i STATEM D HVAC. .V _CITY "SUBMIT COPY OF BOND PHONE 7/O�� ,� �ctS6 FAX ANDINSURANCE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW 'PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ftfAA-Lgei j PER MS 16B.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 ) OR 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) ������ ` ^� 1 Equipment Installed MFG: MODEL L. '-t : STZFF/BTU O� 4 Q In MFG: MODEL: SIIZE/M MFG: MODEL: SIZEMM % A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 7-- BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 CHI1vIIdEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 _DUCT WORK $10.00 _GAS PIPING $10.00 VENTII ATOR $15.00 FEE PII:OMCF&FOR� [1 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ F . Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ - TOTAL DUE $ OR Number of fixtures @ $25.00 1 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $1550 Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 understated 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 Ian in the case of all work which requires review and approval of lags. SIGNATURE OF APPLICANT ,h NAME DATE APPROVED BY DATE PLEASE NOTE. SEPARATE PERMrrs ARE. RE , UIRED FOR BUILDING ELECTRICAL AND-MECHANICA-L WipR-K City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 lu