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AF - 45251City of Fridley, Minn. BUILDING PERMIT � �Oa'a � N° '7298 • Da�: -.�.� -._ � ��_ _. _..�_ � T • ...._..-1�I ,,�.---... Owner: ��j��'__ __ Bwlder ..... :._ _..._...._.�r_ Address Address No. ��,�I��Street TION Lot _..._....__.__..._....__ Block _.___._........._......_._.._..._....._. Addition or Sub-Division�-•�,ar.��f���•--� Corner Lot __ L� Inside Lot ._...�..---......._._.___......_... Setback _..�• .............. Sideyard ._.... .�i..�.._....._...._......._......_..._...._.._ �c� �i � �V1./f.Sewer Elevation _.�..�.�.�v'_...��...�T___.._._.__.._.____.._......_..__......_�en Elevation ....._.0....� .�.�._5....f�.:._._.__..___.__..._._. tb N a(� f�•a ri.,rg • � l���I �� 1 �i� � �i I ,� r �,i > . DESCRIPTION OF BUILDING � _�;Q.0 Depth ..�,.�:Q_. Height ��._.. Sq. FL����Cu. F�..�l� _�__._____......__._..._....._. t__.__...___ Depth _..._. Height .___...�.� Sq. F� .___.___...._.. Cu. F� ._.._._�_ Zj�pe of Constru ..._.. __.�_.....__.. Es� st ��,�d�._�To be Completed _..._.......___......_...__......_.__ In cansideration of the issuance to me of a permit to construct building described above, I agree to do the proposed work in accordance with the descriptiou abave set f and in com ' ce with pro�visio ordinanoes of the city of Frfdley. Ea carrsideration of the payment of a fee of ��...._......_.., permit is hereby grauted to__.._._._._ ..._ ... to construct the building or addition as descrlbed above. This permit is granted upon the expree�ss condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, sround and upon said building, or any part thereof, shall conform in all respects to the ordinances o� Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings �� dty limits and this permit may be revoked at sr�y� t� viola^on of any of the provisio�ns of said / !/1 Building Inspector NOTICE: ild� p�rmil dea net �ewr 11w eosMroeNoe. in�hllatien fe� wi�iao. Plw�bhiW Ya hwNn�, anw�r er waN►. B� wn to sM fh� Buildina In�paior for s�p�ralr p�nnits for fhu� itNn�. �� :� � sue�e�r � � � P �NO. , c;ty of Fr�a�ey � � 28761��� AT TME TOP OF TME TWINS ������ N� P E R M I T � - 572-3604 4� � �`V ����� COMMUNITY DEVELOPMENT DIV. RECEIP�� r � � PROTECTIVE INSPECTION SEC. J � . , � � �"'1 � CITV NALL fRIOLE� SS132 NUMBER REV O�TE P�GE OF •nvnOVED 8� �._--�•' ,•' 612-571-3450 9t0-F15 � � 12/15/98 �oe nooaess & ,5 57 5355 Fil more Street NE t LEWI ��uD�d. lO BlOCK TRACTORAODITION SEEAT7ACHED OESCR. Pt. 7 Auditor's $Ub. NO. 9�} SHEET 2 PROPERTY OWNER MAI� ADORESS 21P PMONE Mar Shields 1-8039 3 CON7qACTOR MAIL ADORESS Z�P PHONE LICENSE NO Nutzmann Bros. Const. 736 lst Ave NW N 1 ARCHITECT OR DESIGNEfi MAI� ADDRESS 21P PHONE LICENSE NO. 5 ENGINEER MAIL ADDFiESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION 0 ALTERATIAN � REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof double bun alow (27 S) Tear-off 9 CHANGEOfUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYP OFCONST OCCUPANCVGROUP OCCUPANCV�OAD SEPARATE PERMITS ARE REOUIFEO FOR EIECTRICAL. PLUMBING. MEATING, VENTILATING OR Alp CONDITIONING THiS PERMIT BECOMES NULL AND VOIO IF WORK OR CONS7WUCTION ZONING S�. fT CU FT. AUTHOR12ED IS NOT COMMENCED WtTHIN 60 DAYS. OR if CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 12p OAVS AT ANV TIME AFTER WORK IS COMMENCED, NO �WIG. UNITS OFFSTREET PARKING I HEAEBY CERTIFV THAT I MAVE AEAD AND EXAMINEO THIS APPLICATION STA�LS GARAGES ANO KNOW THE SAME TO BE TRUE ANO CORRECi. ALL PROVISIpNS OF LAWS yq�UAT10N SURTAX ANO ORDINANCES GOVERNING THIS TVPE OF WORK WI�L BE COMPl1ED WITM WMETHER SPEGFIED MEREIN OR NOT THE GRANTING OF A PERMIT 2313 l. IE) OOES NOT PRESUME TO GtVE AUTMORITY TO VIOLATE OR CANCEL TNE PEqMIT fEE SAC CHARGE PROVISIONS Of ANY OTHER STATE OR LOCAL LAW REGUTATING CON• STRUCTI pR TM PERFpRMA CE OF CONSTRUCTION F1T2 SC 2. 1 ^ PLAN CHECK fEE TOTA� FEE S�GN1iUAEOFCON'AACTQ RAUTMOQ�ZE04GEN1 iD�TE� WHEN PiiOPERLY VA ATED TNIS IS? OUR P RMI � � J �` $�GN47UAE 0% OWNEA��� OwHEA Bui�OERi �DATE� � � g�p O� � r��i N� � � ] ADDN [ ] ALTER [ ] ConstructionAddress : Legal Description: Owner Name & A Contractor: � Address: 73(0 7� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION I ,�' �� � [� ,: �'I ��.1 � �il.'% � '_ . - ;.7a � �%�C , ��� Effective 1/1/98 �� '���� � Tel. # �%/-U�9 _MN LICENSE # 2C�''���� Z Tel. # ���lo�-C�l�� Attach to this appli�'ation, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IM�'ROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. _ Sq. Ft. Sq. Ft. � � Construction Type: ` Estimated Cost: $ � � (Fee Schedule on ack) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =$• � DATE: � APPLICANT: L�OC� Tel. #� z FS- d%Z� CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ •� � $ •3� $ f•/� $ $ S�.Oc� $ $ $ $ � 3�22 Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 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 [ J Not Necessary [] O O O N C N � C � a� > U � W 0 Z O � U W n' W � Z Z N J Q M � � t1'� � � Z LL � C � � O � N M U�ti�i � � = W N N � N ('� �� O .t O � O Q � _ :::>:•.'•:::>:::;:c C� •'"?••,,•`�:�>::�s: � : ���{;�:� Z :�;.� o.... 0 J O C J O � Q � � F"' . ....... 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Uaci � � .` ¢ � COMMON VENT VENT CONNECTOR AND COMBUSTION AlR VERlFICATION When ret�lacina an existina furance, the undersigned hereby verifies that the venting haspbeen examined and is free from rust, deterioration, obst�uctions, and is securely supported and firestopped where required. Yes �% No () The venting system is plastic/PVC and meets all cur�ent codes and manufacturer specifications including sizing, length, number of elbows and terminatian. Yes� No (} The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the cu�rent codes and manufacturer's specifications. Yes� No ( ) Yes ( ) No ( ) ___ __ _ - — - - - . . ____ _ ___ _ __ __ _ _ _ _ - Wi�en required to install a new combustion air it will be sized and installed To meet the current codes and manufacturers specifications. Yes � No () When-installinp a new venting system, the undersigned hereby verifies that = it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes � No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes �() No () /� Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type STU lnput Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches ApRlia�#�-�eflt-Eanrre�t�r i�t�1�i _fif _ Lengf h_ : ft Appliance #2 Vent Connector Height ft Length ft Appliance #3 Vent Connector Height ft Length ft ALTERATIONS: (Describel Diameter � in Type Diameter in Type Diameter in Type I�i-P ;� �i �� . � �..�� �..�� s �� (' �1' � � ^ �� � ct �C� . ; - �� HEATING CO: , Signed By: Date : � i+ 2�U l i � � � o Q M M O � � 'a� v� N = l v e V C� s a� � � � L � m ` � � �z N �s o c/) Z 3�' =' � Lj'1 w � �Q u��i = O � y" O O c~nv , Z �' �v� Z p�� � }W� O s� w �„�j F- ' � a`�i c�o � �°�`"o H ~ �-°' w � � ^, > €'3��,m � � � �� G. 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