PRE 2010 DOCSSUBJECT
PER
City of Fridley
2 0 3 6 3
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEI NO.
COMMUNITY DEVELOPMENT DIV.
I L PROTECTIVE INSPECTION SEC.
97 7
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/17/90
JOB ADDRESS 110 - 6411 Way N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
1
Oliver Olson Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Steve Bodinski 15515 University Avenue N.E., Anoka, MN 434-5043
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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 O MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 5V1011 x 3W Dwelling and a 24' x 241 Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide a Bard surface driveway. Provide sod in the front and side
yards. Provide.City with copy of verifying survey before capping. Paid $750.00
Park Fee. See notations on plan.
SEWER & WATER SERVICES are in but not clearly tied on on as-built drawings.
Water box appears to be approximately 17" behind curbing and sewer service is
approxi' n4tely 10''-14 " east of water service..
DRIVEWAY DEPRESSION COST: N/A
WARNING
Before digging call for
all utility locations
SEPARATE PERMITS REQUIRED
FOR Wrrr•�Qa2
v11li?�s.en I.1,-�,-i•, .., I;
jf�*� (�
. .•.- G /'mill
�4J� ! t� SIGNS. RE�QI�� REQUIRED BY LAW
a
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$82,050
$41.03
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
p,
$1,204.03
S TUBE FCO RACT ROR AUTHORIZED AGENT ('pD/A_TEI
WHE PROPERLY S YOUR PERMIT
��
�IIA�EDM
SiGNATURE OF OWNER OF OWNER BUILDER) IDATEI.
BLDG )NSP DATE
IST
ADIIV [ ]
ALTER [ ]
Oonstn:cticn Address:
Legal Description:
CITY OF FRIDLEY
I--1 AND R-2
Building Permit Application
Effective
Owner Name &Address: ,Aey
Contractor: Sze kr Tel. # efye%. ® d1
Address: 15515 12441. Ave. N. C. ne 1f -o, j Mn
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
D£. IPTION OF neammm
LWnC ARM: Length 3 i0' 10' width Height sq. Ft. 1 I B 3
GUMM ARM: Length Width Height sq. Ft. 576
DECK AM:. Length width Hgt/Gux3 Sc Ft.
07IM:
Corner Lot Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks 17.5
Type of Construction: Estimated Cost:
Approx. Completion Date: MLJA ,31 lq q
Proposed Driveway Width If New Opening Is Desired: Ft. $ $.
Width + 6' See Back Page
DATE: - O APPLICANT': Tel. #
Permit Fee
$ 66a. co
State Surcharge
$ y I Al
SAC Charge
$� , b
Driveway Escrow
$
`Park Fee
$R
Sewer Main (barge
$
70M Ct E ilpz
STIPULATIONS: I -
CITY USE ONLY
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
d
r �4
I►•rf•rmino
the "U"
valet,
of
each sr-eTment
(1-9) and multiply by t -he ar.�
x
out.
ALD l-) :•Oi, TOTAL WALL SEGMENTS
ITi•;'•1 III �27i:�
F. Determine the "U" value of each segment (10-12) and multiFly by thy_ area :1s
! follows:
10. _Cl� X 11U" _
11. �c� 9 x "U"
Ct
ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS _
ITEM IV cV�- n
G. If Item III is the same as, .or less than Item I, you have met the inte::t
of State Building Code 6006 (c) -2.
H. If Item IV is the same as, or less than Item II, you have met the intent
of State Building 'Code6006 (c) 1.
I. Add Item I + Item II = ZR1) � C
J. Add Item III rj�•� + Item IV = ---"19-9
K. If the sum of Items III and IV are less than Items I and II, you have met the
intent of the Code for total envelope system.
The undersigned, as applicant for a building permit, hereby affirms the above
information- has been prepared and submitted by -himself or und•jr his direction,
pore -by acknowl* dnc•s tho information to be correct and accurate; and hereby
l resents the information with required plans in support of the building permit
al•c)lication.
Q
By: s (�o�Ct n S rZr4Z4 DATE:
i
iopt
,r .
.sls,a
ENERGY CU ISLUVATIOt4 SUPPLEMENT TO 13UILD114G PERMIT 'PLICATION
pl,ANNING AN!) 1NS1s1-JCTTr1ra
CITY 01' I•I:IUi,i:Y,
Thi:, i:, ptu•.icrrd to .i::f:ist the ,aI ):i t :.tt,t ir. rc,mrutinrl I:XTI•.I27t'P•'. ENVELOP%
AVL: Acl:: "U" FACTOR INF(;kNATION. 'Phis informat;on is rr.quirc.d so the FiUILULP.0
C1: , .'lr►L c,,:t 6• cCrintty. tu,f. r.ubmitted plans c:f.r!J- •+lit)1 t:ii'
DESIi;:+ CRITELIA of ti L. STATE BUILDING CODE (Sc -tion 6000) . It ifi the AP'PLICANT'S
responsibility to accurately compute the data; rrflCct the l:rol.cr DESIGN CRITERIA
in the plan::; sul:mi t product specif ica tions, if needed to --upport the "R" and "U"
'factors used; ar:d to assure construction is per approved plans.
JOB LOCATION:
OWNER/CONTRACTOR: S4-eye22
ADDRESS: ! �� tl n I
z. Av0 . �. �•� ��� A1�. PHONE:
A. Determine the Total Exposed Wall Area as follows:
1.
Tbtal wall window area
2.
Total door area
3.
Total slicing glass door area 90
4.
Total fireplace wall area
5.
Total wall framing area (average 10%)
6.
Total net wall area above floor(average 90%)
7.
Total rim joist area
Subtotal: Toil -.l exposed wall area above floor
8.
Total found&cion window area
9.
Total net foundation area above grade
Subtotal: Total exposed foundation area
GRAND TOTAL EXPOSED WALL AREA ll�
B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 Item I ;,> � ,r
C. Determine the Total Exposed Roof/Ceiling Area as follows:
10. Total skylight area n
11. Total roof/ceiling framing area (10%)
12. Total net insulated roof/ceiling area
GWID TOTAL EXPOSED ROOF/CEILING AREA
D. Multiply the GRAPID TOTAL EXPOSED ROOF/CEILING AREA X .05 Item II �-,3 , �•
r �'
TNS OtiY CF FF;!Di'' t�,^E: bIt?
A.00U-"rY OF U'FILI Y c�i_, �;�.�; .,�� � it -i
THIS DATA IS FOR 1NF0RP, ,",,T,0N' Puliposcs ONLY
AND PERSONS USING 1 HIS INFORMATICiiV SHOULD /
VE!?IFY IT ON THE SITE. j�
C^ is N'TT! !:;-.I ill T�-;i., ,? EA ' :?P
?riC:'•.'•,',L OF TI IE CITY OF F ?), c
.11
%10 N 4•• w
1'%.\ 0 ,h -b \ 6 0912
1
o 516
b \ O
011
\ 9 6.\
hoc
\ ®fit®� �`g�� locat�o�s � �� "� • \
u`14�
p0
N 160,21.94
ti
4-
tiby�
`t:3
60 urs,
ae,se��J
v u
114AAy anJ Vraknaage Cab& s
are h6owrl JIM"
5 , �'`� ho4 -to _.ca i8
_.
I hereby cei
tation of si
placed in tl
be designate
A)(DT
Cl r -CZ
x
,V /P
H loO
A-2
15 � f
C ---F VI C e
Effective May 1, 1990.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL_
New Fixtures
$ 5.00
'75
$
Future Fixtures
3
$ 3.50
Old Opening, New Fixture
Kk
W�
$
Water
S 4.00
S
Blow off Basin
$ 5.00
$4
-
$ 5.00
$
Rain Water Leader
$ 5.00
$
Hydraulic Valve
Heater
$ 5.00
S
Sump or Receiving Tank
$ 5.00
S
water Treating Appliance
$ 7.00
$
Hot Water Heater ®
$ 5.00
$�
Gas Range ✓
g 10.00
g `�
Gas Dryer i
$ 10.00
$
Back Flow Preventer Required.
. . Yes ( ) No
( )
Type
$ 5.00
S
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or
Appliance
U
a
State Surcharge
yO
Reinspection Fes $
u
TOTAL
FEE
_
$ e6/-. 00
O
l
f.
as
ec
lat
2nd
3rd
4th
(R) - Future Connection Opening
Connected with Sewer
(•) - New Fixture, old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL_
New Fixtures
$ 5.00
'75
$
Future Fixtures
3
$ 3.50
Old Opening, New Fixture
$ 1.50
$
Beer Dispenser
S 4.00
S
Blow off Basin
$ 5.00
$
Catch Basin
$ 5.00
$
Rain Water Leader
$ 5.00
$
Hydraulic Valve
$ 5.00
S
Sump or Receiving Tank
$ 5.00
S
water Treating Appliance
$ 7.00
$
Hot Water Heater ®
$ 5.00
$�
Gas Range ✓
g 10.00
g `�
Gas Dryer i
$ 10.00
$
Back Flow Preventer Required.
. . Yes ( ) No
( )
Type
$ 5.00
S
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or
Appliance
$
State Surcharge
S .50
Reinspection Fes $
($15.00)
TOTAL
FEE
_
$ e6/-. 00
Job Address
Department of Buildings
City of Fridley
Tel. 1571-3450
The undersigned hereby makes application for a periit 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 a plic tl a tcu�e and correct
Fridley, Mn. 1g 'Fy
OWNER � �� (�� Ancil) 01
KIND OF bUILUING gxi el
USED AS
TO BE COMPLETED ABOUT i
ESTIMATED COST
OLD NEW B LDING PERMIT NO. PERM104190IT NO.
company
Signed By
Tel. No. �p7�
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT M-
!1INIMUM
FEE FOR ANY PLUMBING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
CITY OF FRIDLEY
Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1% of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
State Surcharge
TOTAL FEE
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 in side yard without
written permission from adjoining neighbor.
OLD - NEW BUILDING PERMIT NO.
PERMIT NO. MS -1
APPLICATION
"t_9S-
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Ions
Trade Name �� r G Size No. /��e6 CCA! ;7-s�
Capacity :Z s `)elm Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR BTU HP
Company �A J
-i;
Signed By
Tel. No. 7�®-
Fill out back side for stack verification on replacement furnaces
/ 2
RATE
TOTAL
Job Address
$ 20.00
$
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
$ 10.00
F�
$ ! 0
Tel. #571-3450
$ 10.00
$
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
$ 10.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
$ 10.00
$
Fridl Minn.
f
OWNER
KIND OF BUILDING
USED AS
$
TO BE COMPLETED ABOUT
ESTIMATED COST
State Surcharge
TOTAL FEE
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 in side yard without
written permission from adjoining neighbor.
OLD - NEW BUILDING PERMIT NO.
PERMIT NO. MS -1
APPLICATION
"t_9S-
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Ions
Trade Name �� r G Size No. /��e6 CCA! ;7-s�
Capacity :Z s `)elm Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR BTU HP
Company �A J
-i;
Signed By
Tel. No. 7�®-
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 (,)
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5.
Meets all current Code requirements for size and
total BTU connected
Yes ( )
No ( )
6. Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Company _
Signed By
Date
SUBJECT
City of Fridley
-P
210 3 7
AT THE TOP OF THE TWINS
BUILDING PERMIT
f
' ,
REC
COMMUNITY DEVELOPMENT DIV.
-7
UU ______ 1
PROTECTIVE
r PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
DATEPAGE
OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8/30/91
10B ADDRESS 110 - Wi Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
1
Oliver Olson Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Arlin Peters 110 - 6411 Way NE 571-3398
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
&M Same
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
Construct a 201 x 161 Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
.WAMNG
won 44mv ceN for
afit t1 iliq 4matoris
454-M2 ..
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1 80.0
$.9.0
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
f
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$31.00
Fire SC $1.80
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
.
p FEE
TOTALFEE
$33.70
1 NATURE OFCONTRACTOR OR AUTHORIZED AGENT q^ IDATEI
WHEN PROP RL V T IS IS YOUR PERMIT
BLDG INSP DATE
S,GNATU OF OWNER OF OWNER BUILDERI IDATEI
MW [ ] Effective 1,/1,/91
ADfN [ ] A-1 AND R-2
[ ] B/wilding Femit Application
Oonstnxtion Address: 1 6 h `t' ON Q,
Legal Description: o -i , ®1® C-R.. O 1 ®� �, i �-c � j l 60,A-�
owner Na®e i Address: A r 1 +-t_ r'Ss-A,mc tc v vTe1. # _S_7)-3 398
y?�y—S
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed omys xuction drawn on it to scale.
.=r�; SVM �, •r I,I;e;OJ'l_yirA
LIMB AREA: Lergth Width
Height
Sq.
Ft.
GRIUM AREA: Length Width
height
Sq.
Ft.
eG=. AM: Length � 0
W�.;1i/y/dth �/yy
Hg M=z d '
Sq.
Ft.
1�/�/] V
vim. � J4 I ® Y '.-ff i �� N
74-0 0 G*__
Corner Uyt 1� Imide Lot [ ] Ft. Yd Setback
Side Yard Setbacks
Type of Construction:
Estimated Cost: $
l
D CJ
Apprrox. Om pletion Date:
Proposed Driveway Width If New Opening Is Desired: Ft. $. $
_ Width + 6' See Back Page
WM: ' 30-% APFrLICANT: C�-^ � S- —Tel. # �%) 33'V
'+_iii �:�_ • >`�_
A
Permit Fee Fee Schedule on R verse Side
Fire SurdkuVe .001 x Permit Valuation (1/10th $)
State Surd=Ve $ . Ct o $.50/$1,000 Valuation
SAC Cl=Ve $ $650 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. 'B" Above
Park Fee $ Fee Determined by
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
707%L
STIPJUMCNS:
�s
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On January 1, 1997
T � Z
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
JOB ADDRESS
New Fixtures
$ 7.00
The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture
$ 4.00
specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser
$ 5.00
and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin
$ 7.00
and -representations stated in this application are true and correct.
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
7// , 1998
Sump/Receiving Tank
$ 7.00
�-
Water Treating Appliance
$10.00
Owner 6
Water Heater -Electric
$ 7.00
Water Heater - Gas**
$10.00 06
Building Used As _
Gas Range**
Gas Dryer**
$10.00
$10.00
/
EstimatedTER N QIY "NT- / �o
��'��
Back Flow Preventer Required ()Yes () No
Type
$15.00
jQ�stry Ave. N. #114 p
PLUMBING_,... ►AAI-t,F.'til'� L
g"
Reinspection Fee $42.00/Hr SIGNED BY421-6140 4 q No
rAX
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance ;0.00 011
Approved By Rough -In Date Final Date '/S%00
State Surcharge $ .50 '
MINIMUM FEE OR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $•Sb PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES.
CI71'OE
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
September 11, 2000
Tom Godfrey
11064Y2WayNE
Fridley, MN 55432
Re: Final Inspection at 110 64'2 Way NE
Contractor: Mr. Rooter of Anoka Co.
Dear Mr. Godfrey:
A plumbing permit was issued on April 17, 1998, for the above noted address,
to install a gas water heater. According to section 4715.2800 of the State
Plumbing Code, a final inspection shall be conducted on the plumbing authorized
by this permit. As of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
DAVKOENSEN
Bui g inspector
SUBJECT
P O.
City of Fridley
29740
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
' •
f PROTECTIVE INSPECTION SEC.
76 7
I .
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/22/99
J013 ADDRESS 110 64 1/2 Way NE
I LEGAL
LOT NO.
BLO CK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
Oliver Olson Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mim gmftd Tom Godfrey
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
B & B Roofing Services 6760 Madison St Fridley 55432
571-0248 9042
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 JOK REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (23 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be 2nd layer but not 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
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
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
$2010
$1.01
DOES NO PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVI ON OF ANY OTHER STATE OR LOCAL LAW REGULATING CON•
$2.01
STR CTI OR THE PERFOR NCE OF CONS RUCTION
$83.25
Fire SC
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$91.27
SIGNATURE O CON-PACYOROR AUTHORIZED AGENT IDATEI
WHEN9PROPERALIDATED THIS IS Y UDRPERMIT
BL G INSO
QA�E
S-GNATURE OF OWNER,IF OWNER BUILDERI IDATEI
NEW [ ] Effective 1 / 1 /99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: //6�1 ✓ *i
Legal Description:
Owner Name & Address: Tela # ?
Contractor:
Address:
!_;7rye ._75-'r 7-AAr S�3a
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF 11"ROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type43 5 q 2- A dl-/4yf'g'
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $ C.-:;20/0
(Fee Schedule on Back)
Ft x $ = $
DATE: APPLICANT: /��`�%�� Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ 83 2
Fee Schedule on Reverse Side
Fire Surcharge
$ cZ 0 /
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1050 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 [ ]
&2"%
91:9_9E
TOTAL
$
STIPULATIONS:
Building
MECHANICAL
Permit No. . I
Inspections
RESIDENTIAL APPLICATI®N
Received By:
763-572-3604CITY
763-502-4977 FAX
OF FRIDLEY
Rgg,,C'
1 00
EFFECTIVE 2-19-09
r
DATE oeYOUR E-MAIL ADDRESS
SITE ADDRESS 4gyl ukv NE -
THIS APPLICANT IS: ❑ OWNER I CONTRACTOR
PROPERTY
NAME: TO 6
OWNETENANT
ADDRESS: I . CITY U STATE ZIP
PHONE: ., '
CONTRACTOR
COMPANY NAME: Sharp Heating & A.C.
CONTACT PERSON: Floyd Joswick
SUBMIT A COPY OF
STATE LICENSE # EXP DATE
YOUR STATE
LICENSE WITH
ADDREs9221 University Ave. N.E. cITYFridley STATE MN Z055432
APPLICATION
PHONE 763-572-0459 FAx763-572-0164
PERMIT TYPE
INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK VEV'
FEES ARE BASED ON $10.00 PER FLXTURE, EXCE4T WHERE NOTED. FIXTURES: (IN'Aff TOTAL NIIAIBER OF EACH BELOW
Equipment Installed MFG: MODEL: SIZEBTU &
����y
MFG: '"'�--- — MODEL: p� S SIZE/BTU
MFG: MODEL: SIZE BTU
C
A C 525.00 _FIREPLACE (GAS) 515.00 RANGE?OVEN 510.00
_GAS
_AIR TO AIR EYCHANGEER S15 FIREPLACE (WOOD) 535.00
_ GAS GRILL S10.00
_NEW
_BOILER 535.00 FURNACE 535.00 UNIT HTR S 10.00
_GAS
_CHIMNEY LINER S10.00 _GAS DRYER S10.00 HEATER S35.00
_POOL
_DUCT WORK S10.00 " GAS PIPING 510.00 VENTILATOR S15.00
Number of fixtures (a) $10.00 x S10.00 = $
Number of fixtures (a. $15.00 x $15.00 = S
cp
Number of fixtures (a) $25.00 1 x $25.00 = S
a+
Number of fixtures a $35.00 A_x $35.00 = $ 3,5,E
State Surcharge = $ .50
(MINIMUM FEE $35.50) Total = $ lU .
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 Constriction Codes: that I understand this is
not a permit but only an ap lication for a permit and work is not to start without a permit, that the work will be in accordance with the
approved plan in the case o all work hicquires review and approval of plans.
SIGNATURE OF APPLICANT , PRINT NAME DATE e
PLEASE NOTE: SEP TE PERMITS AlkE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
Uity of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
NEW HOMES/ADDITIONS - 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 consti action 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.