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AF - 43643� � . City of Fridley, Minn. BUII.DING PERMIT N°• 3 8 6 S I1ate: . �^. /. .!. . . . `�: . . . � . . . . . . . . . . . . . Owner ....................................... Builder �:��'�:�.`�r!�Z�a� f.CJZ� Addre�ss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . �� .�.I . . � . �:� . �G.�. . . . � / �V �� LO�CA O�I OF BUILDING " Na � . � Street . . k�� . . �:�F`t1.� .. . . . . . . . . . . . . . Part of Lo . . . . . . . . . . . . . . . L . .,,jBtock .. G� ...... ....... Addition or Sub-Division .e��Q:�l.��. Corner Lot ............ Inside Lot ...!�....... Setback ��:.� Sideyard .�C� � ... ............. DESCRIPTION OF BUILDWG To be Us . �/�1 cy� o G / Y f �/ /� % /' /�. . . . . . . . Front •�•�1. '�� Depth ��. .�. Heigh� J. . �� Sq. Ft. /. �.�.,/. (1 Cu. F`t. /. . ,W � �'Ls� .��e�. . . . �� .� De � d : . � �h�/ f '/' Front pth �. V��Sq. Ft. a.�. Gti. F't. � �+^pe of Cons ction . . . . . . . . . . . . . . . . . . . Est. C�t. . .C. !. j . . . . . . .�. . �-i'o be Completed . . . . . . . . . . . . . . . . . . . In consideration of the iss�uance to me of a permit to construct the building desribed above, I a�ee to do the proposed work in accordance with the destxiption above set fo in compliance th all provisions of ordinances of the city of Fridley. "` ' . x . .................................... �(/ � In consideration of the payment of a fee of $.�J......., pernut is hereby granted to ................... ......................... 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 woriunen, 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _ / : Building Inspector NOTICE: This permit does not cover fhe construction, installai�on or alteration fo� wi�iny, plumbin�, gas heatinp, sewer or water. Be sure to see the Buildiny Inspeclor for separate permits for these Itema n.. .` '� � h� Appticafiion 'Fo+' Pawer Pt��l�s c�d He�ating, Cao�ing, Ventilation. RefrigercEtion �d Air Canditior�ing Systenis and Device�s PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Sheil & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00 $ Replacement of Furnace ............................. 5.00 $ R.epairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTiT . . . . . . . . . . . . 8.00 each add. 60,000 BTU ..... .................. 2.00 Replacement of Furnace ............................. 5.00 Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . 5.00 Repairs & Alterations each add. $50Q.00 . . . . .. . . . . . . . . 2.50 STEAM or HOT WATER SYSTEM Furnace Shell & Isines—to� 400 sq. ft. EDR Steam ...... 8.00 Furnace Shell & Line�—to 640 sq. ft. EDR Hot Water ... 8.00 Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 � (� d-�t1 � � $ $ $ $ $ OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTiT) . . . . . . . . . . . .. . . .. . . . . . . 5.00 $ v' � GAS FITTING FEES: NO RATE TOTAL lst 3 Fixtures ......................� x$1.50 $!• S v � Additional Fixtures ................. x .50 $ '� Gas Range to 20d,000 BTU . . . . . . . . . . . x 2.00 $ AII#' CONDIT;ONING FAN HEATING 3YSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS REMARK3: $ See Fee Schedule TOTAL FEE $ %� �d Dept. of Bldgs. Phone $U 4-7470 Locafion ,�.. ''F� � �o�+a.�"u--- �l . City of Fridley: /�; i ��. `,-! ��.. �'� ;; �� d� f �� r The undersigned hereby makes application for a permit for the work herein 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. Fridley, NLinn. � "' � � , 195� e Owner ' — 195— Kind of Building �� 195— Used as To be completed about / �"" ��'-" J / Q'(.� Estimated Cost, $ � Old�. Building Permit No. � � � � DESCRIPTION OF WORK HEATING or PO R FLANTS--Steam, Hot Water arm Ai No. � Trade Name ^'�a'�-- Size No. �� i�� Capacity /Sq. Ft. E.D.R. �6 • g a"�s � R'rTr 1 H.P. Total Connected Load 3� �� L Kind of Fue BURNER — Trade Name Size No. Capacity Sq. Ft. E.D.R. BTiJ H,p, Si B��n�a�i� EtV�1NEERIN� 'CORPORA N 4626 LYNDALE AVENUE NORTH 11 Posr 1 M-12-58 Business � �T,�o��,J u� w� w �' JAckson 9-9549 SUBJECT � P E . . City of Fridley 12104 ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • / � � � CEIPT NOy..- � `L �_�___ COMMUiJITY DEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. � � i �4 � /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF . APPROVED BY `•'-'� � ,'� 612-560-3450 / / 910-F15 4/20/73 JOB ADDRESS 6446 Baker Avenue 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. S� 2 of. 2 Moore Lake Highlands SHEET 2 PROPERTYOWNER MAILADORESS 21P PHONE Clayton E. Nolby 6446 Baker Ayenue N:E: 3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO. S ane 4 ARCHITECTORDESIGNER MAILADDRESS 21P PHONE UCENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE tICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 1 1 lt Addition to garage 11' x 21'2" 9 CHANGE pF USE FROM TO STIPULATIONS Provide a hard surface drive TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIFIED FOR ELECTRICAL, PLUMBING, HEATING, Wood fram VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CW. 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 COMMENCE0. 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 WORK WILL BE COMPLIED $5, 858. %9 �L .OH WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PFOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � ��.�..00 / PLAN CHECK FEE TOTAL FEE o�-�-- � �� 13 . 98 � SIG TUREOFCONiRACTORORAUTHORI EDAGENT IDATEI EN ROPERLY VALIDA IS IS YOUR PERMIT ' � v� L--_ 4%20/73 �4 Of .3 SiGNATURE OF OWNERUF OWNER BUILDERI IDATEI � DA � � APP�IC�T�QN F�� RE�IUE�TTA�, A�T�i�►T�AN, Q� �AA�TTQN ��ILDTN� P�RNjI� ��T� pF ��I�� MI��SOT� QW�1ER' S N�E : C..= �.4y�'�• �,,,_ �/�v.�g i� BUILDER s � m z= ADDRESS : lo�� -C� .�,�c,=,2 �vc� �AD�S:3 : .�.f,�� , , � � . ?�Q .� l,� � 5` � �?.'R��T�,,... g''4"'��_.��;._.-� �.= ., ,�..,. �';, .�a / 3 $LUGI�, �- �I:A7Gi��0I�T�,�„ oo,�� , �-A-,rc= /�`�l9,�,/�AtiQS �R LQT; �1�� 0'�; S�TBACICt SIDEY�.RD:��,,, .��,�a� ��,ac� i:u �;� �+�_�,�,o, Certiffeafies of SurveY of La� atid propp$ed �i�� .�tiox� dr�a c� t#�s� Certif�cates, � fl��Cl��'TION OF BUILDING � ��, ii��d A�a : �.�1?��n1, �� z � ° (� _�+t�: /3 ` � �� ei�ht : '��— � � Sq�a�e �'�e�; � 3 _ 0 Cu�►iac �'�e�3 ��.e �� ra��: / / ' o�` Depth; Z� � z'�' Hei.�ht; /o ' o r, � , Squa��s �eet; Cubic FeeEt �jT�+ °� Gon�txu��i.�ap� �,��u�c�� at�mated Cos�: �r� �+ 4va�splq��d� / Y"�.�,tz � � �` � � �t u�+�r�i�aed hereby a�sk�� ap�licaKirn� for, a pe�it fax th� wpxk h�areir� �psa��.�d# ag;ea�.n� tr� c!u a1.1 i�Q�ck in� stt�.ct accozdance wf.tt� ths ��.ty a� �it��' �l�d�.�aaces �d �CUli�a �P� #� �ParGeen� Qf Bu��di.n�e, +e� �e7cebY tl��axe� � a].1 �he� ��tcta �d ��resentations a*ated i�t xhis appi�.catian ��a � a�d cv�rec� . �+,�; �- z� — �3 si�ru��: � � (#�� t+�v�'as �� Fo� 41dd�t�onal. In�o�atian. j r-- �� R r�� , � �� S ��, �.-� .S' � � �� R' `J� � �1.�.�� -gUT�ATN� P�RMIT F�� H�DU�E S��T��N �� The Inegec�ox pF $w�ldings s�al�, befoxe iasui�g permit� for �he ��on oF any bu�lding Qx s�ructure, ox for any addition to any �ist��g ��d��g ox stx�c�ura, or f4� any alteration or xe�airs to any ex��ting �� or stxuctuxe, upo� �pp��ation theref�re, requ�re the p�ym��t by �hs ��z��i��ttt fpx such pex�nit o� ��es Co the aatount herein below set fax�� a�d �� in� max�a�ex hex�in p�avided � �c�-wi� : UN�FORM BUzLDING COI}Et Type I� 2& 4-$2.15 for each ane t.h:ous,�.d cubic ��e�fi, ,p� £�action th�7cea�, i.n su++c�kit cubical con�ents. �pe � & 5 = $�,$S ;Eo7r +�a�b p�s �l�ousand �abic �eet. A�D � T�{)1�iAL I NFC)�A'i I ON Fo� th� puxpo�e of �ampu�f.n,g �ees for building pextnits, the cubical contents Qf any building or addition, i� detesrmined by mu3.�ipl��.n� the ground area Cay!�;eti ��om a poi�t� ��x ��i� in+�hes below the flavr line qf the basement ��he �C��.la� �o the average �eights of the upper surface or to the avera�� #t s�� e �oc�� st�xface a� the main &ab�e c�t a pi�ched xoo�. ��i�cs ox a1��ea�io�s �o aa existin� s�ru�tsarey �,e fee shalJ. be �� h� �a�� n� $3,�0 �ae�e ��,�h f�ve h�dred dollar� f$500,00) � f�tion the�so� in �� cc�a� a� a11 �xxa�ased wo�� Z� � case shall t�e f+�e �,�d foz auxy pe�i� a� set ��t� i.n Sea��iQ� 2 be �.� t,i�an $5. Qf). � V�R��1�'Ti�N oF ��NUAi'IQN �iQ�2 ��mits iQx �a,�s�xue��on wil� be issued a a�3a��.� o�' �4 hc>urs ��t �1ns �'� a� ,app2icat�o�, �o a��aw �o� Pra�ex review af tk�e pxopos+ad a��u��,7re a�nd fi��` t�e �t�txu�tian &ite. ' �# �Ce��.�i�d �ur�� o� �h� �ra�, is#�.it8 t� �,aeat� e�f �h� ��aunclatia�, c��,� �.� �a� �aa�a r.ac��s�tr�d�, wiil b� �cec�uir�d befare Aroceedin� w��h �h� fra�i�g. � C�RTI�IGA�'� QF Q��PAN�Y A�li��a�i� f� a��.��.s:at.� c�� Q�cupancy �ha�l� bs made+ ��x� (1Qi t�a�� xi.Qr �� h� �s+� px gc�upa.tic� af �ty at�ck�e fcsr which a� bu;l�d�.n� pex�+ai.� has b�sr� iss�te�; �td sai.d s�cu�tuXe �'�al�, �xot be used a� occ�ap�ed until a��tifi.cate vf Oo�upap�cy � beex► �seued, e C._.i� o ��id�Ce � � ANOKA COUNTY 6431 UNIVERSI'fY AVENUE tVE November 13, Z973 Mr. Clayton Nolby 6446 Baker Street N.E. Fridley, Minnesota 55432 560-3450 y '"�/ i ,� �J � � � , (� ,; � FRIDLEY, MlIVNES�TA 55421 Re: Electrical Permit Due Dear Mr. Nolbq: The following is due for the electrical work done at your address: 1-10 Outlets $3.00 1-10 Sockets 2.00 Surcharge .50 Affadavit .50 AMOUNT DUE $6.00 LE/mh '-�-�:; � � yi i�Irl� � �4' '/':•.3 .l, f�( -'l�l�l...��(:...1....f .��k e�LEONARD ETCHMILLER � Electrical Inspector sue�ecr PERMIT . City of Fridley 2 6 9 , , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T CEIPT N. r � � � • COMMUNITV DEVELOPMENT DIV. Q ('� i ; L��'�..� , �- �l t.1 r � � PROTECTIVE INSPECTtON SEC. -�C�' i_--_ A,��'�';'; CITV HAI.L FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED 8V Z '� b12-571-3450 9t0-F15 % % J08 ADDRESS 6446 Baker S��ee� N. E. t LEGAL LOT NO. BLOCK TRACT OF ADDITION SEE ATTACHED DESCR. Pt. 3 2 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDAESS ZIP PHONE Clayton Nolby 6446 B:aker Avenue N.E. 3 CON7RACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Earl Johnson Construetion 1935 Sh.eridan, St. Pa,ul 55116 698-1781 4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGtNEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WQRK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Remove closets into garage dnd change interipr walls, 9 CHANGE OF USE FROM TO STIPULATIONS See natations.on plan �C��;�A?'E Fr,��qiTg Rr_^}Jtp . Vy'ft�iNia, H��'tiVG, P�U14?i�iTdG AND S! ��;.�:.�p�)�w,� GNS. b ��' e: � {y �. Before �iig��,�� a.E f,�r �11 utitity 1C�.�:::�,75 4��-Crt�Z R�4�IR�n � � �A �� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REQUIREO FOR EIECTRICAL, PLUMBING, HEATING, VENTII.ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORRED VS 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. OWLG. UNITS OFFSTFEET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �2 � SOO S�-•25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHAFGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ Jr� � OO Fire SC $2. SO ST CTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE C� �i",�, � /'2- 'z. t -r'j o $ 57 . 75 SiGNaTURE O CONTRACTOA OR AUINOAl2ED AGENT � nrEi HEN PFOPERLY VALI TED THIS I VOUR PERMIT /� SiGNATURE OF OWNER UF OWNER BUILDERI IDATEI ��BIDG WSP � TE NEW * [ ] Effective 8/16/90 ADI�J [ ) R-1 AND R-2 k�I�R [ ] BuilditxJ P�ermit Applicatioaz �� constniction Addres.s : G y y� �3 �tK t� }�` �' i= IP.�gal DesGxiption: `S o �' 7�-I-- �r �,� c? �� a�-- 3 ��v �,e 'z �Wf�i NafiE sc Addi�eSS: �- LJ'� �''T�+,✓ /l✓ v L�? j Te.l. #�� - s�`S� �ritx'dG^�AZ': �/��- tj�+�JS`p/J GL'OUS�72vc,rlanl 'I�21. # 6S�'-/7�/ Address: . l� 3 S- s��e � oA-�J S 1� �9� � �,� s7-��6 Attach to this application, a Certificate of S�rvey of the lot, with the pr� oonstYUCtioal drawn oai it to scale. I�;r. �; ��M � � �.' �v�a;•��'/a�,,i�� LNIIJG AREA: Ler�gth Width Height Sq. Ft. GAR�,GE AREA: I�gth Width Height Sq. Ft. DElCK AREA: Length Width iigt/Gr� Sq. Ft. OR�aRi /t�7U(�� CGU StTS /NTO (� �4-/L/.�-f> E � G/�/7�'7✓G t %.V �'Yt / J/� LtJ %{7-�-S Corner Lot [] Inside Lot (�'] Ft. Yd SetbacJc Side Yard Setbacks 'Ij�pe of Construction: ta a �� nr�--m L Estimated Cost: $� S'Z o,�' Approx.- Ccenpletion Date: / � o n- r� Proposed Driveway Width If N�w Opening Is Desired: Ft. $ $ Width + 6' See Bac.k Page i�I'E: / �- �-z 7 l D APPLICAN'I': �7+1� L S o Hfi/ S a r/ 'I�21. # � S S- /'7 b' / P�ermit Fee $ �`�%d6 Fire Sumhan�e $ �� .5 � State Si�rrharge $ 1, �;15: � SAC C2�rge $ Driveway Escraw $ Park Fee $ sewer Main c�arge $ i'�• STIPUTATIONS: CITY IISE �TII,Y Fee Schedule on Revez�se Side .001 x Ppxmi.t valuation (1/lotn �) $.50/$1,000 Valuation $600 per' SAC Unit Alt. "A" or Alt. "B" Abwe Fee Determined bY ��9 Agre�nt NecessaYy [ ] Not Neoessary [ ] $ � `J- %5 � ��. �C`cN�� S , � � �\' � � �l � � �, � �� ..�--� -•. z, �� ?,. �'..� � � �. � ;�:. � w y �t, < � � c�. F� �v � �' \� , . � � � "9 � c � `�, e :Y � � , ., c d/ � � �A � � `, � �., ,,: �c.' � "� � ;� �- , � �� J � � � �r; � J f�`�. � `� � .ir V° (� 0 j �— _ _ ,�` _ _ �, . , � _ ._. o. i �- \ � i r. `� �;; � + � �. � � � . , �;. ; %�, v ; 1 �� ~ � . ' C7 I I � � ' � I � i 9 � i i � � � { , � \ ------ ---.._. __ _. __ ___ __�.,a_,, . . .. _ . _ _ _ _ _ . � I � ` � � , � i 4 � � � i L ., r� __._ . ":+ - - � ,1 � � �'�- 1 � � k � �r �a t ,� . � � f --r � P '� `� \ �, �` ` �,. `�, �`� �., I.. _.___ __ __ _ - _-------� � �y�o , �z / % n +:,; // ; �i�:. � � .L `: h i �� . Ly ! ..� � ��, .� ar I .,r� c J I � -� �, - ' � � � .� �' ; ti � �, X' ` .-�.. -- � }, _-, �,.�.-� ' ` �� ' . , City of I'ric�tey S" AT THE TOP Of TNE TWINS , � � � , � r�-------, � � ' i � , � ti___� ,'---�.� IP17ER-OEPARTMENT REOUEST PUBLiC WORKS OIVISION CITY HA�� FRIDLEY SS432 !12' b60' 3480 SE�[ER STOPPAGE SEWER STOPPAGE AUDRESS 6446 Baker DATE 1-7-90 CALL RECEIVED BY Walter Lach CREW LOCATION WHEN NOTIFIED Home EQUIPMENT TAKEN TO SITE Pickup and jetter CAUSE OF STOPPAGE Unknvwn � AT 1: 00 pm ( AM )( PM � TIP1E STOPPA(;E RELIEVED 2:10 pm DESCRIBE DAMAGE (IF ANY) _Some carpetinq was wet, approximately 8x20 area (total) � in 2 places. NOTE ANY STATEMEPlTS MADE BY CREW OR H�IEOWNER REGARDING DAMAGE OR POSSIBLE CLAIM Told homeowner about Servicemaster, and had them come out. REW Af�D NOURS Greg Kottsick and Walter Lach - 2 hours each ! � � . � _ _ 1 -- - -- � , � � — ---� CITY OF FRIDLEY INSPECTION DIV. �, Effective On January 1, 1997 I 6431 Unive�sity Ave NE �' �, , � ��) ( 9 7 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND•��ATING, COOLING, VENTILATION, �-� 572-3604 REFRIGERATION AND AIR CONDITIONING SYS�'EMS AND DEVICES J0� �1bDRESS � C� f:�t� RATE SCHEDULE , '�f�.�';, Th�,�dersigned hereby makes application for a permit forthe work herein Residential Rate TOTAL specifi,ed agreeing to do all work in strict accordance with the Ciry Codes and Furnace Shell and Duct Work, Burner — rulingg.of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ � repr�s�ntations stated in this application are true and correct. (Side Vent — Fill Out Back} - f�/- �- 1 gg� Gas Piping (Needed with new fumace) $ 10.00 $ _ Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Afterations (LIST ON BAC� 1°l0 of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work P�-�� G �i�.� G� $ 10.00 $ $ 10.00 $ $ 25, 00 $ , A- fi S��'`� 0 State Surcharge �� TOTAL FEE $ $ $_ , 50 � -��< , .11 /J"� 1 .% �4 5.�� MiNIMUM FEE FOR ANY HEATING/COOLI�ENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 Si�ATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining properry owner. OwN��___L� _ %7/ S' ? � ' S'' 7.s'a BUILC�,ING USED AS! ESTIMATED COST %�G �pd PERMIT N0._ ;f�C�(� DESCRIPTION OF FURNACE AND OR BURNER �, No. of Heating Units Trade Name BTU : FueF� _ Circle One (Steam) (Hot Water) (Warm Air) Size No. HP EDR Total Connected Load Burner Trade Name Size No. BTU HP � \ HEATING COMPANY � C � 4 ,�S � �� h. � Signed By Tel No,__7� �� %�O Approved By Rough—in Dafe Final Date �ILLOUT BACK S1DE F A STACK VERiFICATION ON REPLACEMENT FURNA E From: City of Fridley To: 7634228988 Page: 2/3 Date: 6/4/2009 3:40:27 PM Building MECHANICAL Permit No.:� Inspections RESIDENTLAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D��'�� 763-502-4977 FAX �rH•tcriv�z-��-a� uATt � ` - SITE ADUK�.SS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APP L.ICATIO N PERMIT TYPE TYPE OF �'VORK: ❑ N'N �:R NAM�: AUll IZESS: PHONt:�_ COMPANY NAME:, CQNTACT PEI2SON: STAT� LIC�NSt t� ADll1i�SS: � PHONE '� .iKINGL� NAMILY ❑ N�w �r DETA(LED DESCR[PTION OF WORK �-MAIL N- `� CITY �12LCL�� STA ��:IA 7�1 '/ � i t a �� ' s'� 7(� g' 1 L ' � / i� i ��rJ � � .. ii ! _ ❑ TV�'O FAMILY LAC;rM�NT QC ❑ TOVJNHOUSt ❑ ALTEIZATION/K�MQDEL z�/Ytcc. c � vF- A-�G� ATE "�'LII�+�� FN,�,5 AIiN: BASN:D OV 510.00 PER F 1X'fURN, C�P'�' �VH 'RE VO'f�;D. FIX'fUR�S: 1C '�'1'$ I� L VUJ16�:1i UF EACH ) tqnipment Installed MNC,: ��t�� MOUE • �� O(J SI"Lk:/BTU �� MNG: %�L%,eJ�,� M011�L�7r//�/T v� V S1'Lk:/BTU �•� ✓ �•' �A/C $25.00 �AIR TO AIR �XCHANC,��R $ )5 BO1L�.R $35.00 LHIMNEY LINEK $10.00 UUCT WOKK $10.00 MNG: M011tL: NIR�PLAC� (GAS) $ISAO FiKtiPLAC� (WOOD) $35.00 ✓�URNACE $35.00 C,AS llRY ER $ I 0.00 GAS PIPING $10.00 SI'GFJBTU C,AS RA1VG�/QVtN $10.00 _NtW GAS GRILL $10.00 GAS UNIT HTR$10.00 POOL HtiATtR $35.00 V �NTI LATOR $15.00 TH1S 1S AN APPLICATION FORA P�RMIT-NOT VALID UNTIL PROCESSEll I hcrcby apply for a building permit and 1 acknowlcdgc that thc information abovc is compictc and accuratc; that thc work will bc in conformancc with thc ordinanccs and codcs of thc City of Fridlcy and with thc Minncsota Construction Codas; that I undcrstand this is not a permit but only an application for a permit and work is not to start without a permit; that thc work wilt bc in accordancr. with thc approvui plan in thc casc of all or � l�ich •cq ires rcvicw and approval of plans S►GNA'CUR�.ON APPLICANT PIZINT NAMt %JI D�!// / DATt � City af Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977