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PRE 2010 DOCSf • Village of Fridley, Mian. N° 937 WELDING PERMIT Office of INSPECTOR OF BUILDINGS Owner Architect Fridley, Minn., Builder LOCATION OF BUILDING' % NoStreet �L1_f ori �J-A c C� Part of Lot . ��' Lot Block Addition or Sub -Division DESCRIPTION OF BUII,DING Frontes Depth s -a Height Stories L" tY_ Manner of Construction T ---- To be used as To be completed Estimated Cost Permit is hereby granted to -ice' to A the building described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. ` Inspector of Buildings. a AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, day of w �- r. A.D. 19' = 0 Minnesota, this U APPLICATION FOR PLUMBING AND bAS PITTING-EH11IT 97 9h-879001 N (R) - Future Connection Opening (•) - !tow Fixture, Old Opening Connected with Sewor Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES; NO. uWator .,, h%=ber rixtures u $3.00 $ Future F!xture Opening x •�, $ New Fixture, Old Opening . x $1.00 $ Catch Basin, x w S i.Wator Heater - to 99,000 BTIU Heater Lo . U C w E" .N x �; W�° Water Softener ..4 .c S v x $5.00 $ Electric Water Heater - ►. 0 n 0 .2. '� '� 4 p b G 8 p K x $3.00 $ p O as lac 0 r u' a p q {ill x A V1 w PG rirat $100.00 l9 $ each add. $100.00 or fraction $1.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 is c 5 nil c't• an e 2nd 3rd - j. I- J th N (R) - Future Connection Opening (•) - !tow Fixture, Old Opening Connected with Sewor Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES; NO. RATE TOTAL h%=ber rixtures x $3.00 $ Future F!xture Opening x $1.00 $ New Fixture, Old Opening . x $1.00 $ Catch Basin, x $5.00 S i.Wator Heater - to 99,000 BTIU x $5..00 $ 100;000 ETU to 199,000 BTU x $10.00 S Water Softener x $7.Q0 S New Ground- Run Old Building x $5.00 $ Electric Water Heater - x $5.00 $ -CAS FITTING FEES; , lat 3 fixtures x $3.00 $ i iditional Fixtures x $1.00 $ .Gas Range -to 199,000 BTU x $10.00 $ REPAIRS '& ALTERATIONS rirat $100.00 $5.00 $ each add. $100.00 or fraction $1.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 Job Address 621• Rainbow Drive NE � Department of Buildings i� • City of Fridley I Tot. N571-3450 The undersigned hereby makes application lora permit for the work specified agraoing•to do all work in strict accordance with the City and rulings of the Department of Buildinge, and hereby declares that the facts and representations stated in this application are trua aro Fridley, Mn. 9-1377 , 19 OWNER Olesinki. ' KIND OF BUILDING frame -- USED AS res. TO BE COMPLETED ABOUT _ 9-20-77 r _.• ESTIMATED COST 10.00 OLD - NEW BUILDING PERMIT N0. P E IT NO.r Company mlolft'C SCO Signed By* Tal. No. ROUGH INSP, Data FIN41, INSP. Dato ' APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT 19 57.50 '63-84416051 CITY OF FRIDLEY APPLICATION FOR PUMBING AND GAS FITTING PERU T PARTIAL RATE SCHEDULE W PLUMBING FIXTURE RATES: NO. > a ::.:=!�er FLxt:.res X $3.00 $ :`ut:re Fix -,are Opening x $2.00 $ Water e m m .0 x $5.00 M C M ro W 4 $ � (do WUC w $' Water Softener Heater a ++ .-� x r. o E+ J w Ur H C Ra x $3.00 $ -3•t-x) Additional Fixtures X $1.00 - Cas Range to 199,000 BTU — N cO $ S U MC First $10.00 $5.OQ $ each add- $100.00 or fraction $2.00 $ State Surcharge " $ .50 TOTAL FEE 4+ +J 0 Ww WU N .5Soa 1@Ca N O d5 '-s= 13r rn 3 -lea ter :3 20 4 zi f m Future Connection Opening Connected with Sewer L(a) t") m I:ew Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL ::.:=!�er FLxt:.res X $3.00 $ :`ut:re Fix -,are Opening x $2.00 $ New Fixture, Old Opening X $2.00 $ Catch Basin x $5.00 $ :later :eater - to 99,000 BTU x $5.00 $ 103,000 B=J to 199,000 BTU x $10.00 $' Water Softener x $7.00 $ \ew Ground Pan Old Building x $5.00 $ Electric water Heater X $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ -3•t-x) Additional Fixtures X $1.00 $ Cas Range to 199,000 BTU x $10.00 $ R5?AIRS & ALTERATIONS First $10.00 $5.OQ $ each add- $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE REINSPECTION FEE ($10.00) Job Address 6221 Rainbow Drive Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for t':e 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 ccrreet Y Fridley, Mn. 1-7-81 , 19 O'+1NER Olesinski KIND OF BUILDING fgamP USED AS res.. TO BE COMPLETED ABOUT 1-15-81 ESTIMATED COST 510.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. 63 43 Company 7 y ;Z� Signed By MINNEGASCO Tel. No. ROUGH INSP. Date FINAL INSP. JO- 3 ii 1 Date APPROVAL FOR PERMIT i MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCcieAIME C HOUSE HEATING TEST RECORD ADDRESS 6221 Rainbow Drive APT. FLOORBaseCITY SUBURB Fridley OCCUPANT Anthony Olesinskl OWNER HEAT LOSS DATE HTG. INST. SOLD BY MI-nnegas0o INSTALLED BY Electrical Work By Gas Line By% TYPE OF HEAT GA FA HW STEAM SPACE HTR. X UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Warm Morning MAKE OF BURNER Model - a Model Seria I ? IF Max. BTU Rating INPUT 20M MAKE OF FURNACE Model CONTROLS THERMOST T Heat PIOg Vent Size Valve 0 - 41 ° = C e KIND OF LINER SIZE NONE Limit Draft Hood Limit Setting Fi Iters Regulator Size Number ran setting Chimney Location Inside Outside Pilot Type Chimney Construction �05%v" Pilot Make Pilot Model Smoke Bomb Pilot Timing ®�� Draft L.W. Cut Off Door Pressure Lighting Inst. Pressure Percent CO 2 Date Tested v 4 Input CF1 Percent 02 Company Testing ' Stack Temp. Percent CO Name of Tester — + ' Wiring — Test Tag Form 235 SUBJECT P City of Fridley 2 6 6 8 7 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. `y COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. `� y 113_ r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 7/20/98 JOB ADDRESS 6221 Rainbow Dr 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Emily Olesinski 571-1716 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Premium Roofing 6680 Lucia Ln #11 Fridley MN 55432 741-2646 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 [S REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (23 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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 1918 $.96 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 ONSTRUCTION. 62.25 Fire SC 1.9 ,c� '�L �/C-" PLAN CHECK FEE TOTALFEE Lice se SC $5.00 $70.13 SIGNATUREO ONTRACTORo AUTHORIZED AGENT IDATEI WHEN PROPERLTED THIS IS YOUR PERMIT 7� r BLOt INSP 4ATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 ('YI�� Ll ConstructionAddress: Legal Description: T�,4rf f Owner Name & Address: �/�/L (�( S//�S%T ( Tel. # S �- l71� Contractor: MN LICENSE # Q09 -- Address: 61,'k(J 4,CC//_Tel. #Zc 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. GARAGEAREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 'a 3 �5n/ ;FeW 0)1'-� rI uoi '' Construction Type: Estimated Cost: $ 1943 - (Fee 4 3(Fee Schedu a on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =9 DATE: — APPLICANT: elf(C- Tel. #.57�2,2%3 STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/ 10th %) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 4 $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 d./- s--2(),.-/-3 STIPULATIONS: 7