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PRE 2010 DOCSSUBJECT PERM City of Fridley FOUNDATION PERMIT ONLY 15130 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � � 1 r---/ CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPIO-64Yr. / L j- 812-580-3450 910 -F15 4/17/79 JOB ADDRESS 195 - 79th Way N.E. 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 4 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kenneth Hinrichs 1330 - 95th Lane N.E. 786-9474 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDR PERATE PERMITS RE(�U f�ED FOPOWIR11�a` NSE NO. ���f 6 USE OF BUILDING I PLUMBING AND SIGNS.- . Residential Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 28' x 48' Foundation for House and a 24' x 24' Garage 9 CHANGE OF USE FROM TO STIPULATIONS provide a verifying survey before capping. Provide sod in the front and side yards. OBTAIN SEPARATE PERMIT TO MOVE HOUSE INTO CITY Provide a hard surface driveway. SEWER LOCATION: Approx. 9.5' Deep In Street 43' E. of Manhole (Inv. 850.05) WYE ELEV: 850.18 TOP OF FOOTING: 853.80 Minimum WATER LOCATION: 11' E. of Sewer Serlice, 60.9' N.E. of San. Manhole Services off 79th Way N.E. HC, Before digging. ca1I INN Utiliti DRIVEWAY DEPRESSION COST: 19' + 6' x $15.75 = $393.75 Tt* ELECTRIC - GAS EV CITY OFDOES NOT TELEPNONE - ACCURACY OF UTM LOCATJONS AND +yA R U1RED BY L�+ rOi Tt DATA I8 FOR INFORM ITON P PURPOSES ONLY ANS USa Q BHQ" ON just Vow TY CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Masonry 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. $5.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $11,000 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- $425.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $66.05 PLAN CHECK FEE TOTAL FEE $16.51 $513.06 S ATUREOFCON ACO �RAUTHOR E AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT l L� �l-t -7 f`� � p� �u -r8- BLDG INSP DATE SIGNATURE OFOWNER (IFOWNER BUILDER) IDATEI CITY OF FRIDLEY . -APPLICATION FOR RESIDENTIAL BUILDING PERf�IITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) owCJS Address: �� �f/ham � Address : (330 qt r. ALL, No.: / 9,5' Street: LOT: / 4 2 CORNER LOT: ^� BUILDER: Address: Tel. No.: BLOCK: '7 ADDITION: INSIDE LOT: S;:TBACK: Applicant attach 'to this form Two Certificates of Survey of Lot and proposed • building location drawn on these Certificates. • • 3 DESCRIPTION OF BUILDING To Be Used As: Front: Depth: �/ •0- Height: U Square Feet: /3 yq Cubic Feet: 'Front: `i Depth: �/� Height: /O r Square Feet: Cubic Feet: ad. Type of Construction: Woo er Estimated Cost: $--sem{-�QO d To Be Completed: 6 —1 "-7 Alt. A Alt. B i Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional informat'on. _Z j DATE: �l / -7 / SIGNATURE: /�� _.P�,., /X Stipulations: c, k) . PCIZ,11;jr 16.51-Z X' q.0d Z sreadl*M lv� ` fit MP3 /T - &3 biz o denotes iron monument brarings shown are assumed scale: I" = 30 cKE1TH GM. GRAHAM 421-4100 `Land -,Surveyor • Theater Building. `Anoka. 7l-linnesota'55303 , CER ! iFICATE OF SURVEY for Kenneth Hinrichs ����� '(M� DES1.:RIPTION Lets I & 2, C.0Black 4, S1'RI''yV GVP %'t�Q�b BROOK PARK, Anoka County, Minyes�1O0 OctS DD`RM'�A'��041 vpW 0" Iti Al(EY ti 00 0� Before 111g �,U local utjiities d+ Etc• GAS TEVEPH0NE-&ECZRiCY LAW r !RE® 8 Rr 4CV0 79 ih W4 Y V, E" �'—Savfh lz�e of NW ,4� of SF%4 of o Sec. 3 T30, Rea 0 C CAUTION ��,. "VISION SAFETY CONTROL ZO OR PLACE ANY - DO NOT PLANT THING IN THIS AREA WITHOUT AP PROVAL OF THE CIT( OF FRIDLEr- 1 hereby certify that this survey, plan, or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under.the laws of the State of Minnesota. DaLe:J _3 Bf / 9 %ff Reg. No. 11703 C', + —�- L� I �', 'I E/7 L�GW I/1�/,/,'V v� L .1.% • 41 L Jr�tnc�h� G' job Jla. 78-9,-' book 114 Page /a 4:. 3 r 30 1.-?'.'- I �4 — - 8 n 6o�ogP ti 4CV0 79 ih W4 Y V, E" �'—Savfh lz�e of NW ,4� of SF%4 of o Sec. 3 T30, Rea 0 C CAUTION ��,. "VISION SAFETY CONTROL ZO OR PLACE ANY - DO NOT PLANT THING IN THIS AREA WITHOUT AP PROVAL OF THE CIT( OF FRIDLEr- 1 hereby certify that this survey, plan, or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under.the laws of the State of Minnesota. DaLe:J _3 Bf / 9 %ff Reg. No. 11703 C', + —�- L� I �', 'I E/7 L�GW I/1�/,/,'V v� L .1.% • 41 L Jr�tnc�h� G' job Jla. 78-9,-' book 114 Page /a 4:. 3 r 30 1.-?'.'- ,,-�fvx, % �5 1,4�k�r f �� 413 : , OF .-�,/V, C;r;vv, ?,50,0s,) Asa, /9 vg,�ee�sS,�,o, cosi 5 CITY OF FRIDLEY • APPLICATION FOR PLUMBING AND GAS FITTING PERMIT .PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures $3.00 $ v 4 � • a New Fixture, Old Opening Water $2.00 V • E+ 0 H &I Cp 4 61 $ Water Heater - to 99,000 BTO iJ W w j x Heater te a .�1 03 $7.00 $ ne °�� -.c i $ Electric Water Heater q "4 I A ••� a ti ° 1W 1st 3 fixtures x '$3.00 o S 'c $1.00 $ Gas Flange to 199,000 BTO o o g ,y M ti First $100.00 o $5.00 lee each add. $100.00 or fraction r $2.00 $ 0 wo ra w U a� REINSPECTION FEE e� 3as 1st 2r.3 3rd 4 ti (F?) a Future Connection Opening Copnected with Sewer M s New Fixture, Old Opening Water .PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures $3.00 $ Future Fixture Opening 4-- $2.00 $ New Fixture, Old Opening x $2.00 $ 0 Catch Basin x $5.00 $ Water Heater - to 99,000 BTO x $5.00 $ 100,000 BTU to 199,000 BTO x $10.00 $ Water Softener x $7.00 $ 2:ew Ground Fain Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: ° 1st 3 fixtures x '$3.00 $ Additional Fixtures x $1.00 $ Gas Flange to 199,000 BTO x $T0.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE f510.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a Permit fair 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, Mn. , 19—ZY— OWNER A,41,� A !7" i kI C� S KIND OF BUILDING E ik 4,f VLes C a'' USED AS TO BE COMPLETED ABOUT S6 ESTIMATED COST /o o o �e •OLD - NEW BUILDING PERMIT NO. PERMIT NO.. Company Signed By Q� Tel. No. 7 d V V6 34 ROUGH INSP. Date FINAL INSP. ®s f P .4 Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLOg $.SO STATE SORQt = SUBJECT . City of Fridley MOVING 15162 AT THE TOP OF THE TWINS P E R M I T r RE O. v _ COMMUNITY DEVELOPMENT DIV. � PROTECTIVE INSPECTION r � SEC. 1 � ± CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 812-580-3450 910-1`15 15/l/79 JOB ADDRESS 195 - 79th Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 4 1 Spring Brook Park Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ken Henricks 1330 - 95th Lane, Blaine, MN 786-9474 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ernst Machinery & House Movers Corp. 9400 - 85th Avenue N. 425-2822 -T-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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Move house into Fridley to be located on above legal description 9 CHANGE OF USE FROM TO STIPULATIONS 6 %60A — Route: Central to to East River Road to 79th Way to lot 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 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 ]- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WO ILL B COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE RANTING O A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO IOLATE O CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STAT LOCA LAW ULATING CON- $ 65.00 TRU TIO O THE PERFOR F CONS N. PLAN CHECK FEE TOTALFEE AA, A$65.00 SIG11114FCONTRACTORORAUTHORIZED AGENT (DOE) WHEN PROPERL VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) City of Fridley SUBJECTPermit No. AT TKE TOP OF T14E TWINO r MOVING PERMIT APPLICATION Receipt No. Z, r 4 ----- CONOWNITY OEVELOMNEWT DIV, - 1 i PMOTIZCTIVQ =-UCTIOEI OPT, CITY WALL FRIOLMY 0002 R+LMM REV. DATE PAGE OF APPROVE By 910-F21 0 2/15/73 1 1 800 Property OwnerAddress Phone_ 9 ew �7VRtCIL S /33 6 95"-6' n/E jai 7SC-'iV74.F/ xesen___._Lot No B ock No Tract or Addition Legal`- - To Be Moved To 407- I ypfz/ty PC)Ole 79th Ce,,A�� Mover Address Phone License m. ERNsr /y2r•ic-TZ7 c—/y00 65-'& Expected Time in or Thru Fridley 1 Estimated Cost Routing cASy2���R r 1?D Cc A/ 7 3 V To 7 `i � �`'� L ,'- Approved By: Utilities Notified: State whether notified and date Minneapolis Gas Company Engineering Department 372-4850 Northern States Power Company Customer Business Office 330-5540 Northwestern Bell Telephone Co. Business Office 332-4112 Approved By Water & Sewer Department: All Bills Are Paid Services Are Disconnected The undersigned hereby makes application for a permit to move the building !described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby declares that all facts and representations stated in this application are true correct. Contractor VV�� Date CITY F' ®LEY p 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 66432 / t TELEPHONE ( 812)571-3450 August 7, 1979 Mr. Kenneth Hinrichs 195 - 79th Way N.E. Fridley, MN 55432 Re: Final Inspection at 195 - 79th Way N.E. Dear Mr. Hinrichs: A final inspection was made on August 6, 1979 of the above address and the following items were noted which must be completed before the structure can be finaled out; 1. Complete the fire wall by September 28, 1979. 2. Install a fire door by September 28, 1979. 3. Post house numbers on structure by September 28, 1979. 4. Provide City with copy of verifying survey by September 28, 1979. We will expect the above items to be completed by the scheduled date when a reinspection will be made to determine compliance. If you have any questions on these items, please contact me at 571-3450.- Sincerely, 71-3450. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT � t • _ COMMUNITY DEVELOPMENT DIV. " � SEC. r PROTECTIVE INSPECTION 1 i � I "'1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 3/20/00 JOB ADDRESS 195 79 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 4 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Flemming & Associates 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Mark Osborne Const 2921 Golden Valley Rd, Mpls., MN 55411 522-3858 20143166 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 ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (18 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS This permit does not include the roof framing repair that was completed. Separate permit required for framing repair and interior alteration. This roofing can be the 2nd layer but not the 3rd. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S0. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,181 $.59 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS PERMIT FEE Inv Fee SAC CHARGE OF ANY OTHER STATE O LOCAL LAW REGULATING CON- STRUCTION OR THE PERFOR ANC ONSTRUCTION $44.85 $44.85 Fre SC $1.18 ve&fA PLAN CHECK FEE TAL FEE 2_az�� — License $5.00 $9 .47 �G NATu E OF CONTRACTOR AuiNORi2E0 AGENT iOarE, P PERLY ATED T IS YOUR PERMIT rN SLOG ;ESP r�AtE SIGNATURE Of OWNEROF OWNER BUILDER, tOATE- NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: IV -5- "')q 'may Legal Description: Owner Name &Address: ✓-0 QUO' % (- 1. Contractor: S `/ Arlrlracc• r7 6Y -2 S Effective 1/1/2000 (763) 572-3604 Bldg Insp '+q Tel. 5— /- .5- cf�6 MN LICENSE # 2—c9 Tel. # �� 2 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: e Co Z ` — S P tiG Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: `` APPLICANT: Tel. # SZ z -1g Sg 3 CITY USE ONLY - Call (763) 572-3604 for Per itF i 3es)fmalling in application Permit Fee 0S- Fee Schedule on Reverse Side Fire Surcharge $ /. ��� .001 of Permit Valuation (1/10th%) State Surcharge $ 5-9 $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ UJ $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 $ � � 7 STIPULATIONS: J SUBJECT PERMIT NO. City of Fridley 3 0 8 37 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE � A ;"',•� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF AOPROVEO BY ---• L J\ 612-571-3450 910.F15 4/17/00 JOB ADDRESS 195 79 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 4 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Fleming (612) 386-3992 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO House Medic 1387 Ashland Ave, St Paul, MN 55104 (651) 221-0590 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20156629 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION] REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct interior stairwell 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. This permit does not cover the roof repair or the bathroom .remodeling. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED VVITHIN 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 1 HEREBY CERTIFY THAT 1 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 WHET CIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,200 $.60 DOES N PRESUM TO GIVE A ORITY ANCEL THE PERMIT FEE SAC CHARGE PgOVI IONS OF AN OTHE E,. LOCAL LAW REGULA NG CON- Fire SC $1.20 STRU TIO R TH PE R ANCE OF CONSTRUCTION $44.85 PLAN CHECK FEE TOTA F E Il fay Licen C $5 . $ . 65 S11NATU ',IACTO.OR EN R P lf l ALIDA D IS IS YOU PERMIT � y i S-GNATURE 09 OWNER,IF OWNER BUILDER, DATE. J NEW [ l Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: N l►J :F d�-� Legal Description: [__ 0 2 Q2LOCAL S -4V�k— Owner Name & Address: Tel. # 6 (L Contractor: F- inn , I 2u- S F- At A/c MN LICENSE#_��fdcZ9 Address:___--E'l A�w�.,as tet' �c� �� �,� ��L 1;q toy Tel. # ewSl 22-t 0SCW 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 g Width 4 ` Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width OTHER: INta-t�tL ��1L t �-tRLvc.u� Construction Type: srt Aiwa & Mkj�Estimated Cost: $ t 2rpo � A" Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �, 1`5- ccs APPLICANT: Tel.# 6s"1 2zi os o CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ ��� Fee Schedule on Reverse Side Fire Surcharge $ % v28 .001 of Permit Valuation (1/10th%) State Surcharge $ C5 $.50/$1,000 Valuation SAC Charge $ _ $1100 per SAC Unit License Surcharge $ -DU $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 $ S/, &S STIPULATIONS: � N • h , h i i VU 15- 44 1z; r -. u I I P. 07"04 CD i:L W 0 Pao ti . z -n K3 m� ill aP iJ CD ti K3 FROM : FLEMING PHONE NO. : 612 905 9800 May. 08 2000 02:06PM P1 ('.£l1CGlCd'� 0 ,Aemhy >902 &&&"-% , 4ktm - 9&&A&:r A"56A-0'6) Pkone 651-905-5806 FAX COVER SHEET •+ A Ak FAX# 5.71—► -).g # OF PAGES_ -Jol RE. 7'fifr h/ COMMENTS: Fax 651-905-9800 Ldd FROM : FLEM I NG PHONE NO. ' 612 905 9800_ .. May. 17 2000 10:14AM P2 tP57 '79-f� trv: `L�f I el .. G�1�'(�&4YolA�TfrShNo ADD Mf-TAt - frfz Amit-A4To aorm StpEt of Ne -w -Moo"?-. SC"w tAr %p4TO f,"u.2007 V-ao'F� yNE�Z'NiN4 w/ ty►�N. 4 - stA► x s/a'� N1ETAt. S �Ev�t S S �GT�U N A aoT -To SGh.�!= jeyinj \ Ex tsTi me,, rAEw z- K o& -r t,s�vr�Er s 4t G,"oG• To Ery , i D TO WA%tom w S- I ad 00- 666 O JEfU 1-1 /tt�4 PAMAGc15 VMjn-'--� T= O JE�-1rt�N G� Cz.�p�1SZ Wi4K N. e- FROM : FLEMING PHONE NO. : 612 905 9800 May. 17 2000 10:13AM P1 COMMENT'S: X900 Jog p%inne 65.1-905-9806 FAX COVER SHEET DATE - — 0 - TO FAx # 76, - s7/- fAS 7 # OI' PAGES _,VugavtSi2 7,74` kllft 9 yaX 651-905-9800 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# ©0os - Residential Application City of Fridley See Back Side For Required Information Date LZb S -16,S Site Address: i 9S— 7 y �vri Iib The applicant is: (cirlce one) Owner ontract - Property Owner. SP Z mmy A M t►V Address: City: �l ' State: A zip: 'SS �- Phone: 3- -W Cell: Fax: - d Contractor Information Company Name: Contact Person: River City SheetMetal, Inc. Address: 3290 Main St. N.E., Suite 39 City: Fridi ft MN 32 Zip: Phone: 764-2199 Cell: Fax: Email: ax _ MN Bond# & Exp Date Type of Work (circle one): Newlacement Alteration/Remodel Detailed DescripA''on of work: Equipment Installed: MFG: Model:IJ6-/° -6 7 Size/BTU: MFG: Model: E" -r- Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _A/C _Air to Air exchanger $15.00 _✓Fumace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 _Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ 35-, ° o (Total from above -Minimum fee $35.00) Surcharge $ 0.50 Total Due $ 3 �'• S'o Make check payable to City of Fridley 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 understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in case of all work which requires review and approval of plans. Signature of Applicant: Date: fL�S� Approval Inspector Signature: Date: s Please Note: Separate permits are required for Building, Plumbing, and Electrical work Revised 6/14/2005 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations