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AF - 36505City of Fridley, Minn. � � 9 4 2 6431 University Ave. N. E., Minneapolis, Minn. 55432 "- BUILDING PERMIT Date: _ December 29, 1972 �ex: Richard Miller Homes gu�der _._..__._.. SAME ,Address 16 0 0 R i c e C r e e k Ro a d �, Address .._.__.._...__ S�E.._____._._..._.._._.._.___...__..__.—.._ LOCATION OF BUILDING Na - � 1-� � Street � J:� ��.� 1 e_C O u T t Part of Lot _-_-•----•---..._.._._�___.r.. _.._.._ . - ----_�...__.-----�--_.._......---��------ - • Lot 8 Biock ._._..3 ...__.—._ Addition or Sub-Division _._.__ B r 1 a r a a 1 e.._..__..A_____:_� Corner Lot ._ Tnside Lot .._._._.��._�_.�.. Setback __..__�.�...'._.._._.__�__ Sideyard 10_�._..___._—.__._�___ k�e��r IIevatian ,.._ 909.49__ 912.49 Minimum — ��rX Elevation ___�-----•--.-----_.._.._ ____�_..___� �1ve To= of Footing DESCRIPTION OF BUILDING To be vsea as: Dwe l l i n��_____ Front ___ 4 �. � Depth z 6�� Height _... 2_�_�..__ Sq. Ft. ._.1.,.0 4 0� F� 2 0, 8 0 0 G a r a g e ____ Front _._._Z �� Deptn _?? 1._ Height .....1_�_,__ Sq. Ft . .............4_.49 cu. Ft .---4-=-4 0 0 Tyi�e of Construction _._..IAIa.g�.�x�._ Est, Cost ...$.3_4...,2.1.�.._._..__..__ To be Completed ._.. June,__ 19 7 3� STIPULATIONS: provide a hard surface driveway. Provide a verifying survey before capping. Storm sewer escrow of $269.10 i.s due whe� wa�er meter is taken out. WATER LOCATION: Stop box 9' E. of Sewer. 90.0' N.E. of PP in rear of Lot. SEWER LOCATION: "Y" 51 N. of Maahole In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions oE �rdinances of the city of Fridley. • �,y�,C-�A ' �� K: ", ` `. � � � ` �Y� "k.�._Y_- L� $17.11 State Surcharge In consideration of the payment of a fee of $._5.ar._...Q..Q...__.._._.., permit is hereby granted to_..._.R1Ch_ard Miller Homes .�...••_•-_-_.--..._.._ ..............................._.. to construct the building or addition as described above. This permit is granted upori the eacpress condition that the person to whom it is granted and his agents, employees and workmen, in all work $one in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances oi Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings yyithin the city limits and this permit may be revoked at any time upan violation of any of the provisions of s$id oz�diiiances. `:��''�..� _ _ Building Inspector DARREL CLARK NOTICE: This permit does nof eover the consfruetion, insfallafion fo� wiring, plumbing, gas hea�ing, sewer or water. Be sun to sw � , ths Building Inspector fo� separate permits for these items. . ■ \ r._....___ __�_�._.---.---..___. _._._ _._..___._ _ _ .,_._ ►U�� o„��ry r�It�'// t t'rf�i bH,s N,N,,w,,, N�, �5 N f � lond Surv�y�ny � ' � � M�nneap0{�� so,�, ,r,,,�9 (� ll�lll�'�'illl�, •iJ�r. M,�� ss.3� :��I Eng�nee.�ny Tel�pl�on• 7��-0066 Mun�c�pa� Fng�i.eer�ny Engiiieers BL sUCVeyOI'$ Areo COQ• d11 � / Certificate oi Survey for_�"i�_-� �i� �►'��.�� .'��MG'�� ___ • .� � � � J�. � �� i� � �' � �,•ii --� � � �. �''� ♦ ------ � f�, ��.< '-%.. . t� s.: �.� N ou j►-. � �� . ` f.�R�;� �:��1 �' � � ;t��h;_ v �,v.� �K7- 'J 1 r�; �_�' s /i , �\ � �� c � * ,: R,,r. �� / % :;� " _ �� /t, ! ,� ,. , � ; � �\ �1 '�� f' � , ; ; � _. , , � ��Fr�E . � ' % , ` , 0�,. � , tij� , ' i - �'f,4 � �' i d�<\_ \ � �, � � i , , i � -- - ,,—� �;, � a. , _ —�^�V:: �-. . / t,..-., r�,` „� t . , _ --_ . .,�-� "• f� / � `'�• '. -- -t �. . . . ? � - __. .--- � , __ . ._ , _. _ ___ . `�C' * ._.. - r n �� I".' _� OG �OT � C � IA DALE ., /� ! � l ° Jr�,�te� �r'uc� rr,�n�mQn� f-- \(IOKQ l,4UnT� ---- --�,1 , ------------ , ��.'c; ��•��no�Y. � l��i��` otirn�� h.��ee� c�r��f� �I�o� rh�� s o t.ur ond cor�ecr r�p��tnto►�on o� o•u.v�y o� �h• bovndsr�e� of �h• abov• d�scr:tred �and, ond o� the Ivca��on o� oll build�n t� the�eon� ond all vi�ibls encrOachmentf� i/ p�y, hom ot O�+ saio lond 4s t�iY�ytd by m• /l�i� doy of�;�t _ y 4.D. 19.��. l , �� 1m�h c�� i ae s�C �: c � _— SU�URSAN ENGINEERIN(i, INC �n9�n��rf � SM►v�rOi� b v'.� _ �. � �_'_ `�!�Y � 0 p� -f;�,.:, �- l,,J �.._ t c�Pu... m-� � �d�.,�.L.�. ��6�. to � - 4.> �-� it.� � � APk�I��C�TIQN FCI�t Ft�SIPEIVTT�t.�. A�.T�RATIQN, OR. ADAI'��ON B�JZLDING F�RMI�' G�TY 0F �RIA]��Y, MINN��OT�# owrr�'s riat�: BUILDER:,,,��cue.ao ,��uEt� �-loea� , ADDRESS: AS�tES3; ileAO fZICE� (2o�D,, �RIDL�Y �fl,,, �0l30 s��T: � N�D�4L� C'cc�e��T , �r: � �z.oc�; �� A��iort: 8i�ia ED�LE �pRNER LOT: �1��AE LOT: �CX . ^ SETBACICg 35� SIDEY�IRD: /D � ��,�� a,�Cac� �� ,a �+�t�i„c? Certificates of Su_ zvey of Lc►t a�d propp�ed bai,id,�g �acati.ox� dr� ozi #�#asae Certificates� — � ��SCR�PTION OF BUILDING �.b �e i��;d 1� : ,,,�� I I � ��, �� ;-o �� : �� $��$�nt : �o � squaxe ��e�; IO 40 cu�� ec; �o So0 ��A�,�E� � �'ro�t : 20 Depth ; 2_Z Hei.ght : (� � �qua��t �'eet; Q-g-O Cubic �eet: „��QO . �y� of �oAStruc�i�# ,FR,��cJ,� �stimated Cos�: � �Oa . i-. .. � �c� � ��.�t+�ci s _ Co —1— 7 3 -- � u�s�xRi$ned hexeby a�alces ap�licaGivn �or, a pe�7n�t for the wo�tc hsrein �peCi�isd, ag�eeing �p do a�� Wo1�k in sttict accoxdance with the Gi,ty p� F�'�.�l�e�' i�xd�.aasi+ces �� uli�s �f �e Departmen� qf Bu��din�s, � hereby d+e��ax� � all �ha ��tcts a�d ��resentatione s�ated ��his ap�+l�catian �9 �x't1e � CU�T@C �� . ��; 1�,�� zG f r q 7 Z szcr�a�URE : � - k�-��K" , (Se� R�e�ve :��dia Fox �ddiR�.ona1 Inios�atian. ) ^". ..�5 � � � ( ,, / � � � ' � ' f � .. ...� , . �, ` ^�h.-,.. _ �� // . � °;�3 �„�` r.. �- I./ � �-� �; 0 ., 0 � BUII�AING PERMIT F�E S�H�DUI,E ��T�Q� �* The Inepec�o� pf Bui.ldinga s}�al�., befox� �.asui�ng perniit& for the ��on o�' any building o� structure, ox for any addition to any �cisti�$ ��3i$di� oz struGture, ox fo� any alteration or re�airs to any exi�ting ��ir��L� or stxucture, upan �ppli�ation theref�re, require tk�e payment by �he a�y��.i�di�t fPx such pennit o� fees �o the amount herein below set �Arth $�d i.n ��n� manx�ex hexein pr�vided �a-w:t�: UI+�IFORM BUzLDTNG COAE; �pe 1�, 2& 4� $2.15 for each a�cte �t►ousaRt�tc� cubic - ,�e��, p� f�action th�xeaf, in such cubical cot��ents. Type 3& 5-$1,85 �ox �aC� ons ttt�usand c�tb�.c �eet,. A�D�TIflIaJAL INFL��iMA'TION Fo� th� �u�Fose of Camputing fees for building permits, the cubical contents o€ any bu�lding or addition, i8 dete�xmined by mu3.�iply�.n$ the ground area e�aq,e�+��. #7�om a pviri� ��x ((�j in�hes below the fl.aor line of the basement ��►e �C�lla� to the average heights of the upper surface or to the averag�* �i,�t �f �e 1ro�f st�face o� the main gable Af a pi�chec� xoo�. �,c� �i,rs ox alt��a�ious �o an existin� s�r�tuXe, the fee shall. be �� the �a�� o� $3.�fl �►e� e�r�� five �t;Rdred dollars ($30Q.04) or f�a�t�on tYeer�of in th� cos�� o� a11 prc�p�+sed woxk„ ��n c�ts� sha�l t}�e �se �d foz airy pexv��.t as set fo�th �i.n Se�tion 2 be i+�tst t.�an $3 . At�. w V�R��ATiQN �F ��t1NAAi'IDN I�ii�= Pe�nnits fqr ��s��tation will be i.ssued a�ini�m o� Z4 ho�.irs fxam Xhe ��e o� applicatiork, �o al�aw �o�c pra�ez review of �he pxoposed s�ru��u�re �d �� t�e �st�u�tian site. ' � C��,�i�p� �uxY�l �� fi.hE lttt.� ��in$ ti� �.oeatia� of �h� �oundati�rct, Qx�ce �.� �� b�� st7C��t+2d�, wiil b� �ec�uired be€ore proceedin� w��h ths fr�ing. C�RTTF�CA�'� QF QC��IPAN�Y Appli�a�io� �ox a�e��.�'i�t,.� u# Occupancy ahal�. bs mada �en (1Q) days �x�ox to �he �se Ax ac�up�nc�* �� ,arcy a�cture for which a build�.ng pextn�.0 has beer� issued; .�ud s�id s�uGkttxe i�hal� �ot be used aa occup3ed until a�ertificate of p��upa�ncy ha� beer� �.ssued. � �ity of Fridiey _ �►PP�ication /o� Pl�q and Gas FiMi�q hn�it Dspt. of Bldq�. Phon� 560-3490 DESCRIP'tION OF WORIC L�� / �,�) /�1 Nlumb�r, Kiad and Local�oa o! Ftxtures < <1 ` ffi y1 y� �{ 1� � � N � h � � Y � � Z � � g Z F Z � � � i �� S y � I3 7 S� � N 3� o�. � �3 t�2 �3 V ua V$ Base / /r Irt 2nd 3rd 4th � Fllxllt� �.'OOaK�OII �tl�ll� Ci00II�Cid �� + N�w Fixtur�, Old Op�ninps PARTIAL RATE SCHEDULE WATEN MTII. � � / M GAS ELEC. �•= o �� n PtIIMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures . . . . . . . . . . . . . . . . ' ,� x 32.00 ; °20 Cj U F�ture Ftixture Opening . . . . . . . . . . . x a1.50 5---- New Fixture Old Opening. ... .... .. . x a1.50 E_---- Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 3 Water Heater '.Up to 99,000 BTU1. ... ____L_ x�3.00 $ �, DU New Ground Run Old Bldg. . . . . . . . . x a3.25 $ Elect�3c Wat�r Ii�at�r . . . . . . . . . . . . . . s s2.00 : 3AS FITTING FEEB: NO. RA'IE TOTAL lst 3 Fixtures . . . . . . . . . . • . . . . • —.�— x s2.00 : °� � � U Additioaal PYutures . . . . . . ..... . . . . . x = .7b ; Gaa RanQe to 199.000 BTU ..,.. ...... x a5.0U i REPAIRS Ac ALTEAAT10MS--R�i�: to Cod� Descriptlon ..... .......... ....... ................._ TOTAI. FEE ; a� . � City of F�idley: � / The undersigned hereby makes application for a permit tor the vrork herei specified, agreeing to do all work in strict accordance with the Cit� Ordinance and ruling of the Department of Buildings, and hereby declares that ali the tact and representations stated in this application are true and correct /% P�ileY/.l Minn e�E�L,�,�.,� � , 19� r Ii • �fl��.��=��s/!i!��-� . . . � � i" ir _ . . �� _ _ /I,,,. - - To be completed about Estimated Cost, �—IYew. Building Permit ROUGH FINAL 3 ' � � ' � S , -� ., ,_ ./_l�_ _�� .`�'� �: ..!I,� � � A,pplication �or Power Pla�ts and HeaHng. Cooling. Yentitation� Rs�feig�rcrtion and Air Conditioning S�ste�ns and Devic�s PARTIAL RATE SCHEDULE EaAAV*'AY WARM AIA: !�1►9'f TOT�lL Furnace ShelI & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . a10.00 � Replacemeni oi F�rnace . . . . . . . . . ...... . . . . . .. .... . . . 6.00 ; Repairs & Alteraiions—up to �500.00 . . . . . . . . . . . . 6.00 3 — Aepairs dc Alterations each add. �500.00 . . . . . . . . . . . . . . . 3.00 ; 1RECH. WARM AIR Furnace Shell dt Durt Work to 1�0,000 BTU . . . . . . . . . . . .$10.00 ;�-�• �0 each add. 80.000 BT'U .. ..................... 3.W # R.eplacement of Furnace . . .. . . . . . . . . . ... . . . .. . .:... . . 6.00 ; Repairs & Alterations--up to a500.00 . . . . . . . . . . . . . . . . 6.00 � Repairs & Alterations each add. ;500.00 . . . . . . . . . . . . . . 3.00 ; 37'EAM or HOT WATER SYSTEM F�rnace Shell & Lines—to 400 sq. !t. EDR Steam . $2Q.00 a Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 a Each add. 200 aq. ft. EDR Steam . . . . . . . . . . . . . . . 3.0(1 j� _ Each add. 320 sq. it. EDR Hot Water . . . . . . . . . . . . . . 3.00 � OIL SIIRI�iER—to 3 gal. per hour . . . . . . . . . . . . . . . . 6.00 � over 3 gal. per hour�ee Fee Schedule G1\S BIIRNER (up to 199,000 BT� . . . . . . . . . . . . . '. . . . . . . . . b.00 j 5. 00 over I99,000 B1'E1 See FN Sch�dul� GAS FI?TING FEEB: I�iO Rl►TE TOTAL lst 3 F�xtures . . . . . . . . . . . . . . . .. . . . . 1 xi 200 # 2.00 Additional Fiat�res . ....... ........ : .76 i Gas Range to 199.00Q . . . . . . . . . =i 6 0� ; uR �p�rt�ot�a WEST: SLO-36 (3 ton-1200 CFM) F11N HEATING STSTEit SN PM Seh�dnL VENTILATIl�G SYSiZM ]►LTERATIOIiB t REPAIAS TOTAI. FZE ROU(3H �rru. �' �a r - � � Dept. of Bldys. Phon� 580-3490 La„t�oa 6130 Bria.rdale �,' . � \1, City oi Frldley: The euidersigned hereby makes application for a permit for the work hereIr. specified, agreeing to do all work in strict accordance with the City Ordinance: and ruling of the Department oi BuiIdings, and hereby declares that aI} the facts and representations stated in this application are true and correct. �icitey, Minn_ MaY 9� 1973 , IgE — Uwner Riehard Miller Homes Kind �i Building ZrBme vse� as residential _ To be completed about 6f 10�73 Estimated Cost, ��,��Q Old—New. Building Permit No. Permit No. � cG ��-� DffiCRIPTIOlf OF WORK iIEATING or FOWEA PLANT�-�-.Steam, Hot Water� Warm Air—No_ � Trade Name �STINGHOUSF - __ _ Size No �UB-110 Capacity 88.000 gq, �, �,g g� g,p. TOt81 COnIIeCtCd Z.09d 6h i �� .�, IUIId Oi 1�1l1('t9 c BURNER — Trade Namp SAME A.S AB()VE �u p� Cspadty 3q. !'!. E.DR BTU Hp. �18.00 COPY OF HEA.T LOSS ATT�.CHED. SAI�SMANs John Borry � .50 SURCi�E �3 5. 50 S (REMARKS-OVER) < B� Ph � V � ��' N� �OpDmONING ��r � * !$9-6767 � �• ss4� _ _r�.a� ��7 ![� � ., r� ... . . a� , � ' � y - " � [�°--•--' � , . r�,.r+�""""�'�' � i .,'I C�.... . s'`"/'�%'L.,q^--�°'r.�,1 S . . . � �J �.� �� c�� _ � ..d �� HFAT L(3� CALCEJI.ATI4N� ��""°�`�"�--��-��-�.��---�"' Co / 3 U�3 r i a►- d o� `it � � . - V6''eatherstrips A.S.H.V. Conatructioa No. Irssulation Guide Windows � Doors Reference Out. Wall Int. Wa�ll Ceilia� Roof F1oor Kind How Appii�d � ' Yes—�lo Yes—I�1€s 19_ Ff.� ,,-�.,,� Ro�rm Lcngth � Width 1 Height �',� a. Fl.� . RaoYn Lcngt� �ae:� ��lidch `=� I-�ez�ric `��-�'�;f Windows and Doors—Crackage and Area Windows and Doors—Crac�age and A:�a ; tvfdth Height No. ot L1nea1 tt. Area ^/� � Wldth Hefgtit No. ot Lfneal ft. Area . No, ot paae ot Dane iSghta of crack ap. Pt. � �"1 0 - No. o[ Dane o[ Dane U6hta � of crack aQ. [t. 6 r � ". ^ t.� .�,%�.% i � � ,�'`'". � � r,� .,/, J a - �C1 ' � �� .�..-- -? ,< `°�' - ��`�� - � .� a Coef. Btu Coef. ��u _ Infiltration °� � y ;� � �: Glass �` �=° ;,.a Exp. wall ' �'" Net ezp. wall �,,,e � f�� „/. Int. wail �� _ �S. � �„ � Ceiling � � Floor ' 7�otal Btu. ,� � � ' Req�irtd sq. �t. E.�.R, tas aq. ina. W.A. Leader naea / �.� s�T..-�"'' F�oam d l.en�th ,,,�' ;a _ Width ,a . Heigbt � �Jindows and Doors.-.-�ft��jcage and Area � Wldth HeiYht - Np, ot Ltneat dt. Area � No. ot yane of Fana ��ght� ot crack p. 1t. a- �--- 1 � / , '` '� 4? r;�; � = " : � .� �'i ,,? . � � Coef. Btu Infiltzation S �, �, � � 4 Glasa ..5� � .�5 <� !� �[p. wa�i �1!', / ry�k� � Net ezp. wall A! .?-,„ � `D Int. wall Ceiling .�: ., ^ f - g' �` Floor Total Stu. - � Reqeaired sq. ft. E.D.�. or se�. irt�, W.A. E,�ader area J � � ��a :;:.. ,ti : J F{. �.,�r � f�o��n l.�n�th ,d",,,�.,._t�Jidch ,;�°;� . Hei�ht �'�,; We�clows �nd Daors—Crac��ge and Area . Wtdth Ralght ho, o! Llnoal tt. Area "� � No. of yane �t Dgne S1gAts ot crack sa. ft. � � „L=-- 7 7, � � ' : f �� . � � ,� �° d ' , .� � �'.�� .. Coef. Btu ` e . �� InSaIlsafion �„a � „��y_ L.�, 1n61tration • " i�� ; °: �., ;,,, Glass . ' '� '% .5 Glass s•.� ��a �` ; �cp. ava41 �._:wa ' �r �? Ezp. wall ;a � :,-F,P � �� L� , , Net tzp. watl �';p' r^ � "'° � , . . , __., _ ..._. - ! �.� ,�'_� ; tdet exp. wall ,. .�.� ,r � ! � � � I�t. ��valt ' � �' ,,. ,�'' � -j� -� �,� y ', Int. wall � g r /G',:"� _ . ,�� " , . ..� .�..4 •I' : �y ,. ' Ceilin ,r„�-t� , ,�' " ,��' t� Ceiiing �i }� laor Floor Tota! Btu. �,�' ,� �+,,,a Total Btu. `Requ►red sq ft E.D.F�. OF Ei�. ins. W.A.1„cader area ` Required sq. tt. t.u.K. or sq. ins. WA. {.e�ckr ar�� __ j,I; �' ° ' �f .�`% �.,�" �'',,.l�crcr�, �Len�ti� ,,/ �" ��idtia / � Hr_�ght �'�,�;R_-II � �, �... t1 Rcc�� 1i.en th �--- �lidth Hei k�t �'� ,:�.M�..,"�,,,, s �°`<; .�„�' � �'�` ' W.sadaws ar�c$ ��orm--Crac�age and Area • Windows and Daors-=Crackage and Ar�a . Wtdth HelghY 2�0. pt� Llneal tt. Ares � � � � ' . � � �.. No. of p¢ne ot Da.ne lfgn4s ot crack ep, ft. � Width Helght No. of Lfneal ft. Aree � � �� '. +y �r No. ot pane of pane Ilghts of crack sQ. ft. � `�,� C-�'� ' <. ��I .�-�J. �� % E ' + g'1� �: � dr Gf`f �.. � (: ^J � _ � ° "�"` Ga " sG.f,, i ':. . ' -✓ . .s.- �--. . . C, _ �`� k� Ia6ltration � .,� :�.;a�., ,f,if� Glass �'�% '�s �a � �J c, �`: Exp. wall � `� ,�,.) , 13et e: wall '" `' ' P• �' � �! ( � `?' � Int. •,rall Ce.�ing �t�- �r" �,F ,� r Floor , .--�°"� T'ota! Btu. `"�' :�,�f Required sq. ft. E.D.R. or aq. ins. '�J.A.. i.►ader area f Fl.i ;�,_.�_..-;s------RoomlLength �'..:: ��Iidth s�_ I-��a� t;:•'::'� ; Windows and Doars—Crackage and Aeta r Wtdth Hefght No. ot Ltneal tt. �� Arca � � No. of Dine ot pase ll�hte oL crac!c eq. (t. ,.r �' �" ; l .� � Infiltration Glass Exp. W al) ,,,i°,„�= ;r Net exp, wall Int. wall Ceiling Floor , _.: �..,� � _ _ _ __ -- Yotal Btu. � � t-( �.. ' Etequired sq. ft. E.D.R. or sq. ins. W.A. 9..ead�r area e� j'. Fl•� ,,•�;-�,_�;;�3.,,,.. Room 1 Length i' � i'Jidth � H�i�ht�,::�.' ti/indows and' Doars—Cracka�e and Area Wfdth Hatght No. of Llnesl tt. Aren �� No. of pnna ot pane Ilghte of crnek � sQ. !t. � - �' i.� �? � '.� � � �i �'' � ss �� . ,. f Cc f B COGf� Infilttatioa �' �.� �� ,, Cl�ss � �-'� � . �p. wa31 .-7 � ( bE.-a'.� . Net exp. wall � � lnt. �+all :-,A. ` Ceilin� ,,,�� ,� , � N loor �- Tocal Btu. � Required aq. ft. E.D.R, or tq, ins. W.A. Ltader area , � . � . . fi , , £, � . , ,-. . ,�. Btu J ! '�°1 i . % � ;,'"" n "' U '�' ,L_ !�. �a wa 'COGf. B4U sw Infiltration � � ^�� p �� Glass -� c�' �� o � � Exp. wall /C� . Net exp. wall Int. wall Ceiling ,r� �' � Floor Total Btu. ,�� -�/��. e 1 ,�' � s� �`r � � - °�' a rv• '� �'G�r7 � �� Required sq. fe. E.D.R, or sq. ins. W.A. l.eader area �.: __ ...,.. _ . _...��.,.�.„��,�,._.�,,„. � t,:; M� //� � a HEAT LQSS CALCULATIONS G / 3 v � � � � ` `' �� V�%eatherstrips A.S.H.V. , Conatruction No. Inaulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind Now Applied Yes—No Yes—No 19�. �'�: FI �'' ;".'.; Roam Length .' Width , Height '°"" ''. '- - �'`.�- Fl.� Room � Length Width Windowa and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vldth HeigDt No. of Llneal 1t. Area Wldth Helght No. ot Llneal tt. Area No. � ot pane ot Dane Ilghta o[ crack �q. ft. No. of pane af Dane tlghts ot crack �Q. [t. �� s,..f' `� �`� -�. . � . C,�� / /_ Coef. BW Infiltration ,�;: cs' � ,. � '.J � � Glass f , s-� �. �.. ; J Exp. wall /� ' '';., ; . < .. _. � ~-� •, 'i' ') . Net exp. wall 7 ,;, r Int. wall Ceiling Floor ,��' / 5 `i �, .'� , Total Bru. � � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / t:i'� . FI ��;.-, <•::` Room � L.ength ,' Width `- Height f': Windows and Doors—�rackage and t�rea Width HeiYht No. of Llneal ft, Area No. ot yane of pane llgAt• ot crack eC. [t. In6ltration Glasa Ezp. wall Net ezp. wall Int. wall Ceiling Flaor Total Btu. COGf Btu I.s "�`�� ..> � .. G.'i � � ,--.' .,::� .:3 Required sq. ft. E.D.R. or sq. in�. W.A. Leader area ! ; Fl. _ Room Length Width .. ' Height i_� Windows and Doara---Crackage and Area Width Helght No. ot Lfneal It. Area No. of pnne ot panc Ilghts ot cpack sq. tt. ..-, .� f. . � . � „ • / . . Coef. Btu lnfiltration - •'-s° • ..s. '_' l'<� y� �� elass ,' .. _; . �xP. waDl ` � ,%..�� Net exp. wall �-� � ej l Int. wall �- � �� Ceiling Floor ,f � �S b= =r w� . Total Btu. �f �, ,� ,.� _Required sq. ft. E.D.R. or aq. ins. W.A. L,eader area % ;�� Fl. r`r - .,.<_ _ Room f Len�th f'..<. Width '"� H•ish� �:�-... I Windows artd Doors—Crackage and Area Wldth Helght No. ot Llneai [t.� Area No. of pane ot Dane itght■ ot crack ea, (t, � � � � ^ �— f �.: ,•� /� Coef. Btu Infiltration `� � �.-.., , ,-� �f; �. Glaas : �- ' r , Exp. wall � - �' - , %iCt t7[p. W8u r; . �°�,' «� �, � i :?.. - 9 Int. wall �,; t-- �K�.. � �, ' �.__ ... Ceiling Floor ��' ,�:r� -� .. . Total Btu. � �� `� � '� � /', ;:� ;-� .-:. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / � Inhltration Glass Exp. wall Net exp. wall Int. • ✓all Ce��ing Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.I Room I Length Width Windows and Doors—Crackage and Area Wldth Hefght No. ot Lineat ft. Area No. ot pane of pane llghts ot crnck sa. [t. Height Btu Infiltration Glass Exp. wall Net ezp. wall Int. wall Ceiling ' Floor Total Btu. . Required sq. ft. E.D.R. or sq. iris. W.A. Leader aren Fl.� Room I Length Width , Height Windows and Doora—Crackage and Area Wtdth Helght No. ot Llneal tt. Area No. of yane ot Drne i1ghU o[ crack �Q. tt. Infiltration Glass Exp. wall Net exp. wall Int. wall Cei�ing Floor 7�otal Btu. Required sy. ft. E.D.R, or sq. ins. WA. Leader � F7.� R�ocn I Len�th --- - VVidch Windows and Doors—Crackage and Area R'ldth Helght No. ot Llneal ft. Ares No. of pane of Dane Itghts o[ crack �Q. tt. Btu � _ �� Heighc _ Coef.� Btu �, Infiltration Glas� Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sqe ins. WA. L.eader arra — �i _'� _'� �� -- ;s,r, � � �-J HOUSE HEATING TEST RECORD ADDRESS ` APT. FLOOR CITY SUBURB OCCUPANT OWNER HEAT LOSS DATE HTG. INST. GAS C0. METER BADGE #_.. SOLD BY �` , INSTALLED BY � '" y' ' Electrical Work By Gas Line By TYPE OF HEAT GA FA '�'� HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE , MAKE OF BURNER Model - Model i $erial Max. BTU Rating INPUT MAKE OF FURNACE Model CONTROLS THERMOSTAT , Heat Plug Vent Size Valve �� ' KIND OF LINER f`- SIZE ' NONE Limit '`' ' � �� • Draft Hood Regularor < Limit Setting Filters $ize Number Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make ' PiloT Model Smoke Bomb Wiring Pilot Timing ,-:� Draft Test Tag L.W. Cut Off Door Pressuro Lighting Inst. � ... . Pressure ' Percent COZ �' Date Tested `� t Input CFH Percent OZ Compa�y Testing '' ` r' $tack Temp. Percent CO " �' Name of Tester Form 235 � �-�� .� � �� -�� :�, �Qc�� v��, ��.��;��:�� z� a� :� �� 3 �� RARTi�►L R�TE SC��L� a��vtrr w�i� sr�: �� 'fo:u.. �n�re sr.@ii a� n�rc wo�t .. sio.� � Replacem�nt of Plxrnace g.pp � Rcpai-� & Altcrations--up to s500.00 . g Op � Repairs & Alteraiions each add. 5500.00 . 3 W i 1QC}� WAR� AIR }lunace Si�eIl dc Duct Work to 190,OG0 BTU eac� add. 60,00o sTU . . . . .. . . RepLcem�at of Flirnace Repaira dc ATteratians--�p f.o ;540.00 Iteyairs & A}terations each add. 5500.00 .ai000 s 3.W i 6.00 ! 6.0o b 3.00 = 3TEAM oz HOT WA'i'ER EY�TEB[ F�mace Shell Sc Lines--to 400 sq. ti F.DR Steem �:O.�JO S. F�rnace Shell 1t� Line--to 640 sq. ft. EDR Fiot Water 20.00 S. Each add 200 aq. fl. EI�R Sfeam �.(lf) � Each add. 320 sq. ft. EDR Hot Water 3.00 S OIL BQRPiEi?—to 3 gaL per hour 6.00 S.__._..,�� over 3 gal. per hour—See Fee Schedule GAS affiR1�ER (up to I99,0�0 BTU) 6.00 ; oa�er 139,OQ0 BTt7 S� FM Seh�dul� GJ13 FI1`fINC FEES: 1�80 AATE T07AL Ist 3 flxtures xB 200 E AddiUonal Fixtutes x .7b i--- -- Gas Range tb I89.Of� zi 6.OU ; — A2R CO�I3ZOIaEFdO PAlf ii�E.iTi2SG BY�iY,�3 vno�n�r�c a�r�z� JeLT'iERJ►Ti02613 � REPAIRi4 �;�vax rn��: ,� -�� - 7S— State Surcharge .50 � �n nn �—r�—v. 4— W2 S t . � Fso Sc�ho � .ro,.,a�, � a i o. s o �t. 6� �a.��. �� -� L�� 6130 Briardale Ct. City oY 1�Yidls�: The unctersigned herF�v malces applicaLion for a permit fos the work Aereiz s�ec�fied. a$reeing to do a13 aark in sirict accordance with the City Ordisianeet- ar.d r�iling oi the DepaTtmrnt of IIuiidings, and hereby declsres ihat aIl the facif and repre.sentatiuns statrd in this appiicatioa are true and correct. F�id1eY. Minn 6-26-74 14 � �WnPT Richard Miller Homes Kind of Building , f rame rJ�a $4 residential �'o t�e �omp�ete� about._ 7-30-74 Estimated Cosc, g. 572. 00 Oid—New. Building Permit No. _^__ _ p�rmit No. Q ia��..r"Y'YO�t OF �i►O� iiEATiNG or F0�5'ER FLAN�',,—�.S4,ram, Aot Water, Warm Air—No Trade Name Size No Capacity__. Total Connected -- 84. �'t. E_D.R BTU 8.P l�ind or F1ie� BUR?dER — TY�de Na+mP Siu No Ca�pRCity 3q. iR. L.D3i B1Zl S�F SL036 3 tons 1200 CFM FRED VOGT & CO. �i�; HEATING & AIR CONDITIONING ,� `% p260 IiorFism Av�, 929-6767 � .`'C�LG�+�C�' �� " . �r, Eou4 Ci� eAlm!mts ssasa ��7' / �`' �'z_ �� .A��o�R� SALESMAN: John V. Borry #4684B sua�ecr PERMIT NO. City of Fridley ,. BUILDING PERMIT ✓ � ��8 AT THE TOP OF THE TWINS ' r � � , � RE IP N . � • COMMUNITY DEVELOPMENT DIV. r � v � PROTECTIVE INSPECTION SEC �� i � � � � ' � ��1 � CITY HALL FRIDLE� 55a32 NUMBEA AEV DATE PAGE OF APPROVED �'"""�'� �'' 612-571-3450 910-F15 10/2/95 / / JOB ADDRESS 6130 Briardale Court NE � LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Briardale Addition SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PHONE Craig Fischer 6130 Briardale Court NE 571-8699 3 CONTFAC70R MAIL ADDRESS Z�P PHONE LICENSE NO Rite Way Waterproofing 448 Lilac St, Lino Lakes, MN 55014 786-0550 4 AFCHITECT OR DESIGNER MAI� ADDRESS 21P PHONE UCENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WOFK Install drain tile in bsement 9 CHANGE OF USE FROM TO STIPULA710NS TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMiTS ARE REOUIFED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING Sd. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OA ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OFFSTAEET PARKING I HEREBY CERTIFV THAT I HAVE AEAD 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 WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2 530 I.00 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGU�ATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ]L}. ]S Fire SC 2.53 PLAN CHECKFEE TOTALfEE 2 ua OF CON' aC OA �OAREO E r iDnrE� WHEN PfiOPER , ALIDATED THIS IS VOUR PERMIT s .7, �O� � us: ' 4 , — �y�iyq{..g6g iDA�Ei " B� G �NSP rc7E NEW [ ] Effective 8/1/95 ADDN [ ] CITY OF FRIDLEY ALTER [i} SINGLE FAMILY AND DUPI,EXES R-1 AND R-2 Building Permit Application �3�� Construction Address: � l 3 v ��r� � r �1 l �'� �� _ �`� �� r► �,� �z" �2-� � � -�, _ Legal Description: C r�a-� y F� _� c�-r-+ �-� Tel. #`� '% 1- S?�, �� Owner Name & Address: �., ��: �_i>�a-�.o�c� �� ,��_ r��t� �� Contractor: f;ri t� -��4-t �E'E=ii �'�'2t�c�(��ti1(-r MNLICENSE# Address: < < � � l i ►'I C�- � �7 � l ti� � ( �4 k c : � . �1`i �tl �� 1 � � Tel. # ' /5 �- - C' � �,`� c % 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 Widih Hgt/Ground Sq. Ft. OTHER: 1�:' J 7, r� L.. [_ �-� ( l c�` � � �� ( �� i�v ��1�/1 T� �� Corner Lot [� Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $�� ,3 z �'-` T Approx. Completion Date: /� - � - �� " (Cost on Back) Driveway Curb C�t Width Needed: DATE Permit Fee rire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: �_�� $ 2. S� $ I . r� $ $ �x �� r� P �" $ $ $ $ $ `��.?� Ft. + 6 Ft = Ft x$ CITY USE ONLY Fee Schedule on Reverse Side _ $ Tel. # r ;��`-�� ,;�� .001 of Permit Valuation (1 / l Oth `. $.50/$1,000 Valuation $850 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] �, � � � � � '�� ' BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: � TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,()O1 to $100,Q00 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $S00 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof,.to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCRQW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus b feet times $13.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of ?� hours from the time of application to allaw for proper review� of the proposed structure a.nd of the construction site. A Certificate c�f Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. s�e�ecT PERM17 NO. City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T I? f,.� � r — , ; � RECEIPT NO. � COMMUNITY DEVELOPMENT OIV. r � ti � PROTEC7IVE INSPECTION SEC �� i i ' , �'��1 � CITY HALI FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED 8� �'"'"�� ,�� 612-571-3450 910-F15 7/17/96 � � JOB ADDRESS 6130 Briardale Court NE t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Briardale Addition SHEET 2 PROPERTV OWNER MAIL ADDRES$ ZIP PHONE Craig/Joyce Fischer 6130 Briardale Court NE 571-8699 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO PTL Contracting 2526 N Ferry St, Anoka MN 55303 323-7400 5294 a ARCNITECT 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 O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (23 Sq) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCVGROUP OCCUPANGVLOAD 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 CERTIFV THAT 1 HAVE READ AND EXAMINEO 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 $1'897 �,95 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIO�ATE OR CANCEL THE pEfiMIT FEE SAC CHARGE PROVISI N OF ANY OTHE /S ATE OR LOCAL LAW REGULATING CON- STRU 10 OR TH � ERF NCE OF CONSTRUCTION �59. 5� Fire SC � 1. 9� //�%� PLAN CHECK FEE TOTAL FEE i�X/ K-�z��%�"'�- License SC 5.00 $67.35 S�GNAT aeoFCO��'AacT OFlAUTHOA�ZEDP.GENT ionre� WHEN PfiOP Y VA IDATED THIS IS YOUA PERMIT �' c�� -/ S�GNnTUREOFOWNER�iFOWNERBU��DER� iDA7Ei g;+ CY�NSP ��F'E NEW ADDN ALTER �] [l Ll CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application / ) ConstructionAddress: � (.� � v�� /-�-�-� C� I.egal Description: Owner Name & Address: Contract� Address LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 3/1/96 .,� Tel. # S `� l -� �� TS�' MN LICENSE # �—=�-1 � Tel. # � .� 3 '— � �c� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length DESCRIPTION OF IMPROVEMENT Width Width Width �r Height Height HgdGround Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot. [] Ft. Yd Setback Side Yard Setbacks ' __i� GIl Type of Construction: ,� ��, � � _ � -� Estunated Cost: $ - /�� Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ DATE: �T / APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ S%- S (� � � 9� � , �C $ $ � .LL $ $ $ $ , _ � �. % � CITY USE ONLY Fee Schedule on Reverse Side _$ _ Tel. # 3�� - 7y0o .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $900 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ,. � BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1;000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. .._,� CITY OF FRIDLEY INSPECTION DIV. 6431 Universiry Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLU M MARK NUMBER OF FIXTURES TO BE I� , Wash Drink`> Stories C(oset >' Urinal Tub ` Shower Basement . ':'... _ _.:�: , Floor 1 Floor 2 Floor 3 Floor 4 . PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB AD New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7,00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater — Electric $ 7.00 Water Heater — Gas•• _� $10.00 Gas Range** $10.00 Gas Dryer*• $10.00 Back Flow Preventer Required ()Yes () No Type $15.00 i . Effedive On January 1, 1997 �S FITTING PERMIT EACH FLOOR � tct� Auto. Gas . Gas sin ; Washer A�oL. Ran � Water Heater Gas Elec The unde ereby makes application for a permR for the work herein specifie to do all wo�k in strict accordance with the city codes and rulin e Building Division, and hereby declares that all the fads � and-repr ons stated in this application are true and correct. a � , 1998 Owner '�.�" � � Buildi PLU M Reinspection Fee $42.00/Hr SIGNi ALL OTHERS AND/OR REPAIRS AND ALTERATIONS t.5% of Value of Fixture or Appliance �D� ao Apprc State Surcharge $ .50 MINI! . TOTAL FEE $.�6,.h a PLU S **COMBUSl10N AlR SHALL BE PROVIDED PER UMC SECTION 5o4(A) ! �'� �` �v?3�'/ PERMIT NO. L�. JY �/�/��TL�� F /�/ wc�/� C�/,Y, ' '� a�i�d TECNO. "/v<I b��CJ U ough—In Date Final Date � � . )R NY PLUMBING/GAS PERMIT IS 320.00 3TATE SU RCHARGE �: -A. MINIMUM SIZE 9 S� INCHES. �-