PRE 2010 DOCSCity of Fridley "
Applicafto for ftmbbg mfd Gass R"I" ftm*
K2_R}i_9l K_ �1 Dept. of Bldgs. Phone 980-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures 305 NE 76 Ave.
�
NO. RATE TOTAL
Number Fixtures ................
FF
Future Fixture Opening ...........
x $1.50 $--
_New
New Fixture Old Opening ..........
x $1.50 $ �«
Catch Basin ....................
��cc
3i
U
y
v
New Ground Run Old Bldg.........
x $3.25 $
•
I
•
N
WATEN NTS.
GAS
EIEC.
Base
Additional Fixtures ..................
x $ .75 $
Gas Range to 195,000 BTU.. .
x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ........................................... _
TOTAL FEE $ 5.00
Class uAP Surcharge .50¢
1st
2nd
3rd
4th
-Future
Connection Openings
* New Fixture, Old Openings
fCesspool
connected with
Sewn ❑
❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
x $2.00 $
Future Fixture Opening ...........
x $1.50 $--
_New
New Fixture Old Opening ..........
x $1.50 $ �«
Catch Basin ....................
x $3.25 $
Water Heat4rltt'�hl 99,190ATUl ....
. x woo $ 3.00
New Ground Run Old Bldg.........
x $3.25 $
Electric Wates Heater ..............
a $2.00 $
GAS FITTING FEES:
NO. RATE TOTAL
tat 3 Fixtures ..................
1 x Uop $ 2.00
Additional Fixtures ..................
x $ .75 $
Gas Range to 195,000 BTU.. .
x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ........................................... _
TOTAL FEE $ 5.00
Class uAP Surcharge .50¢
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 alt the fact
and representations stated in this application are true and correct
Owner
Fridley, Minn July 27, 1971 19_
Robert Blosky -
Kind of Building fr. _
Used as res •
To be completed about Aug. 2
Estimated Cost, $ 10.00
<� .
Old—New. Building Permit No. Permit No.
MINNEAPOLIS AS 0
-Qicmad
Business Phune
ROUGH
FINAL
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
r
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARDi AIR:
RATR
TOTAL
Furnace Shell & Duct Work
$17,00
§
' Replacement of Furnace
7, 00
Repairs & Alterations -up to $5QO.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
yS
MECHANICAL ItiARDl AIR:
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
each add. 50,000 BTU
4.00
$
*Replacement of Furnace
7.00
$ 7 _ 00
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500,00
4+00
STEAM OR HOT WATER SYSTEM:
Boiler & Lines up to 100,000 BTu
$;2.p0
$
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.pq
$
each adds. 50,000 BTU
P.- op
OIL BURNER- BURNER- to 3 gal. per hour
$4 -pp
$
each add. 3 gal. per hour
}A.QA
S
GAS BURNER- from 100,000 BTU �o 1",8
W—Rq
10.00
(over 199,999 BTU see Fee Sc4eg4;f!J
GAS FITTING FEES:
1st 3 Fixtures �_ x
$ I -pp
q1.
Additional Fixtures x
$ ;:AR
_00
Gas Range to 199(000 BTu x
lO,OQ
AIR CONDITIONING
FAN HEATING SYSTEMS
$
See Fee Schedule
VENTILATING SYSTEMS
ALTERATIONS 4 REPAIRS
$
State Surcharge
$ .50
TOTAL FEE
Q0.50
ROUGH INSP.
Date
FINAL INSP. /
Date
APPROVAL FOR PERMIT
REINSPECTION FEE
($10.00)
NSNI.+^'K FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
aob Address 305 - 76th Avenue NE
Department of Bullangs
UY of Fridley
Tel. #571-3450
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.
Fridley, Minn. 12/31 1980
OWDJER Robert_ Blos
PND OF BUILDIIJG frame
PsEP AS - dwelling
TR RP PIQMPIXTPR RoTp 1/2/81
FSTTW. P.R PPsT 900 (�
PH - PyTR�l �1qG FPmTT NQ. PERMIT NO. n
P,ESORTPTTO.q pF FPRNACE/BURNER
PP,TTNr- Ar RQWM P?�iTSf Si:€8M( Nol: P14tert Wqzm At�- No.G[JBlo0
Trade Name Fri er7ri ch S.Ize No, c7R100
Cap=Lty
$q.• Ft. EDR100,000BTU HP
Total Connected Load rexJacement Kind of Fuel natural, CjaS
BURNER - Trade Name Friedrich Size No. GUB100
Capacity Sq. Ft. EDR 100, 000 BTU HP
Company Northeast Sheet Metal
Signed By a'_J04��
Tel. No. 781-2776
CITY OF FRIDLEY
APPLICATION FOR HEATING REPLACEMENT
CHIMNEY AND STACK VERIFICATION
THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM.
LOCATION 305 - 76th Avenue NE DATE 12/31/80
OWNER Robert slosky ADDRESS same
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
2.- Is free from rust or deterioration
3. No foreign objects are lodged within
4. That it is securely supported
5. That it meets all current Code requirements
for size and total BTU connected
6. Total Heating BTU 100,000
All Other BTU
TOTAL
x
REMARKS We'replaced furnace, gas to gas, added A -coil in plenum,
installed fresh air intake, used existing ducts.
HEATING PERMIT #
SIGNED C ��
Licensee
by Northeast Sheet Metal
Address 4347 Central Ave NE
Telephone 781-2776
Fridley City License # 16119
I40
SUBJECT
5R�u
City of Fridley
2 4 8 0 8
AT THE TOP OF THE TWINS
?
BUILDING
PERMIT
RECEIPT NO.
Ir
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
. /
j���
NUMBER
REV
DATEPAGE
OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
12/3/96
JOB ADDRESS 305 76 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
2
1 Osborne Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Dave Berry Construction Inc 14470 96 Ave N Maple Grove MN 55369 9204
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
868-3116
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
Reroof House 15 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED 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
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
$1,237
$.62
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFO A�NC%E DOFF
$43.00
Fire SC $1.24
PLAN CHECK FEE
OTAL FEE
CONSTRUCTION
License/A
00
$49.86
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
H PR
THIS IS YOUR PERMIT
RaG INSP
AVILIATED
- X1.3 - ij�
GATE
SiGNATUREOF OWNEROF OWNERBUILDERI iDATEi
I40
NEW [ ] Effective 3/1/96
ADDN [) CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application ;T3ConstructionAddress: � 0 � -7� �Z k+ U L /V
Legal Description: --0 r` /), �� • � C r
Owner Name & Address: Tel. #
Contractor: V6 `'S �-� C;;t�� •T it,L MN LICENSE
Address: ti/ Tel. # 31/L�,
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF UAPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: �'�Rnc� �c.tS� j 5` Tn z
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost:
Approx. Completion Date: ® -
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = -- Ft x $
DATE: 1 —�? (� APPY 7r AM -$ , "U k I �I \ - a _
ME
Tel. # 8'& �-- -:� I L/,=7
STIPULATIONS:
CITY USE ONLY
Permit Fee
$.->_
L �'
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.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
$
419"6
STIPULATIONS:
Building
MECHANICAL
Permit No.: 2,6 O 2,
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
DatRiOdFEB 2 j
CITY OF FRIDLEY
763-502-4977 FAX
IEFFECTIVE 2-19-09
DATE b as a ot YOUR E-MAIL��ADDRESS
/I e 1y
SITE ADDRESS3C)� -DL V G,
THIS APPLICANT IS: ❑ OWNER XICONTRACTOR
PROPERTY
NAME: �fGv_ OL�L M
OWNER/
TENANT
'n �
ADDRESS:30S _IL0 1�1V+e ME CITY r 1d t -e. STATE1'y+'ZIP $i3oZ
PHONE: �(03' a a a -+ RFl��
CONTRACTOR
COMPANY NAME: CENTERPOINT ENERGY
CONTACT PERSON: JOANN ZINKEN
SUBMIT A COPY OF
STATE LICENSE # BOND 22013346 EXP DATE 08/1912009
YOUR STATE
LICENSE WITH
ADDRESS:9320 EVERGREEN BLVD NW SUITE B CITY COON RAPIDS STATE MN ZIP 55433
APPLICATION
PHONE 763-757-6202 FAX 763-757-6701
PERMIT TYPE
t6'4INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON S10.00 PER FIXTURE ,'�j CEPT WHERE NOTED. FIXTURES: INDICATE TQQTAL NgM ER OF EACH BELOW)
Equipment Installed MFG: Ft.� MODEL: 1 oul p'j SIZEBTU
lk.AA =5 1000
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZE/BTU
A/C $25.00 _FIREPLACE (GAS) $15.00 RANGE/OVEN $10.00
_GAS
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_:FURNACE
_BOILER $35.00 $35.00 UNIT HTR $10.00
_GAS
CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00
_POOL
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
ERE,"
k
,a�
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{,�✓�� �'+7�-.'^'YN.�:
.42"��.'K� i.*u �,ci�.�ta t' y�,�d. �zu'. z"'�iw, ��°.€a: �e iss�;.�, �"� >.;^'.' "".�?�`�T ''��� ;:
��,,. '• x�� � '�" x�C.T-�,,�t"�'�`��� '� �' an���'�c
tF:�E> �,�?. +�Y ,.,
�'�Lx' ra�' ,�' ;P n"4 ty�T�,ytR ��L.Y' "�''��;k-'Xs ' �.�'°sa fs';�a^}� �'i'��Y,� z '�i ,may P,K z � �f,��,�' � a L. ,�,_"�'9 ?4'.�✓.��.
4+ik
�eF i � T. �' 1 cf L•'Y��W /` � L4.Y Y, KsT.'.
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application fora permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case all work whi hr uire review and approval of plans.
� o ROGER HOFFHEIN
SIGNATURE OF APPLIC PRINT NAME DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977