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AF - 45425SUBJECT ��ty of Fr�aiey AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � � � � ; v __�� COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � ` �"'1 � CITY HALL FRIDLEV 55432 NunnBEH �""� � ,'� 612-580-3450 910-F15 JOB ADDRESS 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 2 PROPERTY OWNER MAIL ADDRESS Drake De� 3 CONTRACTOR S�'' 4 ARCHITECT OR DESIGNER 5 ENGINEER 8 USE OF BUILDING resident 7 CLASS OF WORK X 8 DESCRIBE WORK House an� 9 CHANGEQFUSEFROM REV 7226 Riverdale Road MAIL ADDRESS MAIL ADDRESS MAIL ADDRESS DATE PAGE OF 10-1-?4 / / f��12'734 RECEIPT NO /� � � APPROVED BV SEE ATTACHED SHEET ZIP PHONE ZIP PHONE LICENSE NO. ZIP PHONE LICENSE NO. ZIP PHONE LICENSE NO. NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE TO e STI PU LATION S 1. Provide a verification survey 2. Provide a haxd surface drive Sewer Location: 102' East of M.H. (Inv. 842.93 Wye Elev. 844.56 Top of footing 847.75 Water Location:;, 11 ' East:�of sewer service ������,�11��.� P���;�v � ;�} ������,�E�i���t� FC�� y/fRIN�, �-���,`���r;�, �'����r��l�"���� s�� �. a � �� �f+��lSe TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. OOCl f ic1IRG� THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION �����.1L1i1 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GHANTING OF A PERMIT �-91 21Z. OO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � �3C. OO r�YG�NATL�E OF CONTRA�OR OR AUTH��fZE� AGENT 1 �" SI NATURE O OW R F OWNER BUILDERI " ID'ATET � I BLOG iNSP s � �� p CU FT. 84288�'6 � 800 6kFSTREET A G IGARAGES SURTAX 9.61 SAC CHARGE 300.00 TOTq�LF�- 61 34 D THIS IS YOUR ERMIT �� � �� 7� � APpLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME :_ �cVlZ.41C� � 1�e� s BL'ILDER : � M� ; . � ADDRESS : %�2�v r � Y. •s.P.�AI�� ��n _ ADDRESS : �Jbi� r�o:. '��/�'' s�ET: �-1�a�� LOT: y�d �i� BLOCK: .1- ADDITION: �1VC�1z �JLW ��1C..�,� CORNER LOT: INSIDE LOT: f�SETBACR: 3� SIDEYARD: «"�'� Applicant attach to this form �fiao Certificates of Survey of Lot aad proposed building location drawn on these Certificates. HESCRIPTION OF BUILDING To Be IIsed Ass 1"7'DCr"�. Front . ( �-d� 2�f Depth : � � Height : �-� Square Feet: p�� � Cubic Feet: /��a Cx�►-Q,�-�'r � Front : /� Depth : .2�i Height : % U Square Feet; � � g Cubic Feet: �- $ � � � Estima.ted CasC: $ % � ' �� � ��., � ��� , Z�rpe of Construction: �9 � ��_ To Be Completed: % /`7•� ` The untdersigned hereby makes applicatiaa for a permit for the work herein specified, agreeing to do all work in st�cict accordance with the City of Fridley Ordinances antl rulin.gs of the Department.of Buildings, aad hexeby declares that all the facts and representations ated in this application are true and correct. DATE : � 1 9� SIGNAT[TRE • . (See Reverse Side For Additional Information.) ^ ����.�,�'C,�l, HPP�UU�� l,�Ar�iH�v��_Ci� �L�C>� ; . "�� ` '. F . � /�(��� %� "-S`c�(� S� �; cg�t� ����� lS;l�l�'j�� , l f y � �,� � . ,� __ n•,. �^ , � •��- . , � . r � � BUILDING PERMIT FEE SCHEDULE SECTIOPI 2. The Inspector of Buildings shall, before issuing pexmits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or.repairs to any e.�cisting buildi.ng 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: LINIFORM BUILDING CODE: 1�pe 1, 2& 4-$2.T5 for each one thousand cubic feet, or fraction thereof, in such cubical contents. �pe 3& 5-$1.85 for each one thousand cubic feet: . ADDITIONAL INFORMATION For the purpose of camputing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average:� �height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an e�sisting structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for aay permit as set forth in Section 2 be less than $5.U0. VERIFICATION OF FOUNDATION NOTEe 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 tha construction site. " A Certified Suxvey of the lot, showing the location of the foundation, once it � has been constructed, will ba required before proceedin� with the framing. � �CERTIFICATE OF OCCUPANCY Application for a CertificaCe of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certifica.te of Occupancy has been issued. e� b � _�-1 B. H. BRADLEY CiVlL EN(i1N�'iR AND SURYEYOR 8828 -24TN AVHtdUE 30UTH MINNBAPOLIB. MINNBBQI'A � 724-2188 `� �I � �^ �k �-�:��� � �"v ru� �� � �1-��C� �%e� �+� �, .� ��r�. V �° , '' � i�'2Zl�o 1�t1d�°1�'�tz /+� �'0 8 � (�. V' tGIrJ �0�•' �T s0 - .�'cal� /"_ ��, • l�e � v i�'eS � F ap e�- �`i1' C� hn � �- s � :� � � � . �, � � �, �` � ._ .�, ��, � � � � � � � 0 ��V �"_r. ��- �, v�1 � �� w � •o �'� v0 � � � � � � � - � � "� � � ` �- � � �r - � � �' �� a �. .� � s , �a` �. � � �` � v c�' . � �- �. t � � � � - � + � ° � �� � � � � � � � .� � � .� � .h ! � � � -� a,�� � � � � � � � � � � � � u � � � �� � � . ��' � ° � .� � �, ° � �. � . � s -.. �, ,. � ' � �� `o �'' � ,� i� � h � ` � � -�+- u w � �� � � B. H. BRADLEY CtVIt ENOIN�R ANO SURVEYOR 3828 - 26TH AVENUE SOUTH MiNNBAPOL18. MIMNE�TA 66f08 �za.a�sa S�l� �IrNc,o� �. �'` � r ..-�: .� `� 7'%,,; p° f�.'`,? : a �K' r�:' d`.,.,�` r�',' ,;i� F'`� .� 1 �i'>� � G,- : .� .�. � i�+�'% ��\ t� s' w !"" � a�' y" � s°<ti ' . ;, s L � � � � .�e � ..� � td �'dds'i w ti.f �.. y3 i�� .�..m.,�,_._._.A.,� ._..�.,� � __.� �..��'�:. � � __. � � 4'.�'"' � 1 a �" e�'7 i + ` 2 � ;� y d i � � i ' i � � } ; ' ; f � ' � ¢ � K3 `t � j � ' �° (2 ; � ; 4 �� �� � � � }. � �. i � �L � s. �� � � q S � i/ � ' ! j � �� t� • � (p .'" s ����� � . � � c � �� i i � : t i � F � ,� . � % ,�I �+ � � • �.,� i � 1 t . ''s� `O : "�'e ; i ; : t � � .�e� -....,..".'� _..,_...o,..."�..f�...,... � � o._.-..-��-,,�'ea..�. �� d � � �.d1 � �- ;-i i ,,;• � " .- 'f a�,e" � e..d '4` °-'S I v i� 'L.+ g° `�z� E:°' � � :�.,� �' • - .:�' ..;� '��� `� .t ` Y+ ��},� . � �,� ,.. � �'�. r �� d� !r y.y � � : `� � � � � x° `' � � � 1''� � � # �y �*r iti .� °+C �� Y� � .� .� � . �.�. �. ;�,. t`e •� �i � �„�, -�`� �i. � � ..?� �.� � �, . �. � .� ' t � : � i y '4:� y '�a. �� e� ' � �, � � ,� � � � � • • � �-: �° "h � r : :�, � A � �• ' �� kA '� .� E�o. �. i.; c�� S .' e. � � i �J' �i.� � ^�- �+.°�� � w ° ",� •6,y,� '�� °e *� � �� ~� ' R . `�, �'�f v� � °t` �Ati . "�s � 4 � � � +.� ?� `t t .?',, `..q' `�� .. � � �� ° :,.� _' .`*µ Y� I -4,.,, ti" :'+�. t + 4, -�"� '°'�• w �9 *� ' �..;t ��'� c � .:,,• °' � � � -�-.. _ti ; : .r y;�' , a`" !� +� . `" _ - � ,y •a --s � .,1 � .� � '�. � � � 5 ._.,��i � �. � �. .�. . � S� � y1�� � i ' � q � 'y1 '� .� � �:i ` _, � r � 45 �� a' ; !t , .�� ���,; , YS s�"'y'1 R ,�^� � � �� � �` t �r ; $ :R ;� � � � �� � � t Y � � YD ����� �o�r�7°e�o� ��� ' �", o � �� �' � � ��� � G � � � �� � �� � �v ��= ��Ti�� � �y � �� ��,� �%C' ���c � o� � % � / � � r � � ��c.c.� �' i" 1 ���� ��� ���°�i�`�. ��� �,�_ � �d..� /v��-, � �° � 2 �y a.a�_ � _ _ �� �� Z ���. . � .� City of Fridley �, 4T TMR TOP OP T11[ TM�IMY � ? rL ---•--� GOMwUNIT1' DEV[601�MENT QIV, � . � � MOTECTIVR D1/1!�CTIpN OpT, l � �. _ � prn �.� siuoi.Rr �M� 1......1`.� �.J iq-bf0'sN0 J ��? e� ner rfi'J��L'�� KT .,�e�i � Con�,ractor � f� Kind of Buildin �.� _- G�oma etion Date � I W t � W � I � II i� I �' �; iw�[CT PLUMBI�r, PER�IIT APPLICATI���J s s � ���od �� �� r� ;r ��� � � %�7�� use � , st3c�te ost � l/ c� — - ��T'��! _ �� Plumbing Fixture Rates: N0. RATE TOTAL �Number Fix turea � x $2.00 � Future Fixtures � x $1.50 �9`-, �� New Fixture-Old Open. � x $1.50 Catch Bastn x $3.25 Water Heater-99,000 BTU +� x $3.00 ��i�� Ground Run Old Bldg. x$3.25 Elec. Water Heater x $2.00 Gas Fitting Faes: lst 3 Fixtures / x $2.00 � Additional Fixtures x $ .75 Gas Range-199,000 BTU x $5.00 Repeira � Alterationa See Deacription: Code State Surchart�e .50 TOTAL FEE $ ��� The undereigned hereby makes application for a permit for Ghe woxk herein specified, agreeing to do all work in strict acco�dance with the City Ordiaances and rulin of the Department of $ui7.di.nge, and hereby declare that a11�th� facts and repreaentations atated in this applicat:ton are true and correct. . �,��E/it,•s[.f� �rl�l/ t . , � '� . City of Fridley ar 7�I¢ TOP or rN[ Twu+Y . r�-------� COMMyNIT� DEVE60PI�ENT OtY, � � MqT�CT1IIR r11�i�T(Qry �/f, � �- - � Cm �W.� s�u06Rr �M4 (`.� `.J N�-bS0-aN0 53-81��-915.51 T PLUMBIiVf, PERPIIT APPLICATIt�id Job Address -- � .�' �-x loA � � 5l�8 N. E. Glencoe St�eet ner Ad ress Gordon Drake Contractor A ress �IfINNEGASC ✓�3 MqRQU Kind of Building Use MPLS, Frame Res. Comp etion Date stimate ost �I�I I I � � � -- W ; 3 d I I � 1 aoNVa I ' � ' evol I I � I � i ,svs� I I I I —� � ----- i •eaa� i•�nNwa m �, 8N19YB IK H�11/] I ;O �' 6Nivaa � Booi� �3 0 �w d �Q V I eaaMO►�S IO q •1NflOd� � d � HN�aal � IA � BAWl � HSYM 9IINI8 iN sani �tw N111I1 �u�M � — •� O � —I �I O w .� — �� ---. (� I I W I � � ( � � I i I � � � � i i y � � � � � %��0 - %S�d2�""-` _ 56 ����� Plumbing Fixture Rates: N0. RATE TOTAL I� ! Number Fixtures x$2 . 00 �_ I� Future Fixtures x $1.50 �� '' New Fixture-Old Open. x $1.50 i f Catch Bastn x $3.25 I i� Water Heater-99,000 BTU x$3.00 'I , Ground Run Old Bldg. x$3.25 iElec. Water Heater x$2.00 i � Gas Fitting Faes: lst 3 Fixtures x $2.00 i - ' Additional Fixtures x $ .75 i �� � 5.� Gas Range-199,000 BTU 1 x$5.00 Repeirs & Alterationa See Deacription; Code State Surcharge �►ass �g"m ���'ch�rge ,50¢ .50 � To� �E $ 5 • 50 !The under�igned hereby makea application for a permit for the work herein specified� agreeing to do all work in strict acco�da,nce w ith the City Ordiaances and rulin� of the Depaztment of �uildi.nge� and hereby declare that a1l�the tacte and repxeeentationa atated in thie c`�"'�'�f/ � an correct. . 'Signatur Date � t t t' � � s 3 > � � N � � � A � [ � � C z e� � � � � � � �� ` � � � r� � � �� °��� m � Q p R��� � � p � � i � � ��r � C" � � �I � N � � � I� � � v � �1.1 a � � � � m �� W � � � ��w� ���n�� S ;� � ��o �5�� �� � � �� �� � � � �. : � � � � � a N o� $ a � � $ ««�. � « I� . e y � c y o C" H � a � O. � � �A � 0 � � M � � G� � N O r � � <� � I ws � w �� �' " �o �` ., � � a E � � 8 � � � � � zppp111 � - M r � c� � � � k � � � � � � x � ~ O N C7 iv r i � w C! � � O �O � �njy � � m�� ✓ �i% � a � f° x � � o N � � ,�, y o� �� � � � � y ��� �� „�o s� °���� � � ? � � � . � � � x �' o � � � � � � ;a� o 0 g'3gg ���.� I , I � i ' I � I � ���� � �� ��� � �a��� ������ 0 0 � � � � � g e m ,� � , �� �� � � ,oa• � . � � g : S � � ' Q � w o� o� w o 8 $ $ � 8 N M � � C � O � o C DC z � o � �. � � � i � � � '° � �, � � � � � A j g ; I � � i I z , � i O I I i I i� � i��� : � x 0 O i I � � r� n w x fD d � N. � 0 \I �� � �ti��� W � � � � � � � � �a�.� � ° ° � � � ~ � � ���� � � � � � a� ag o $ o . g : : w e, a� o � 8 8 8 8 e� I ; y ' F' i I om��' A . c.� �i ���� � M�_ � m E Mo�� o. h �'1 � n o m �' L�°' `.a � �� � .. �, �b o °�' .°', o. �' �..o � m � ���� '. �o�� N ~ # �r ��]� ��y� o��� � � �°'oe+ � � �' M ��p„ ��� a� �� �� : � A M m�� � � o`!� � w � � ��� � � � � . D '� � � 117 � T C T � M � ra 4 � � � � � � � � � � � =� � � � � D w � � D � � � _ .�. �� _ : �_. i -a��r'�:p�;,�`:�`' � :,. -. ,: .. :. � � -. u � � �j.S6. �.. :' . ae ` ���T L�� CAlCULA�°E06+�S � �PARTiYl�1T O� �t�1���Pti�� � Weadierstrips A.S. . Conatrrnct�n Na. - Guide s rs Reference Out. Wall Iat. R►�11 C.eil' Roof }�1 a �ind ' �s o Y o 19— Fl.� 1/ m l.ength /�_Widch r��ei�ht FI.� i�er+ 1 Windowa and ra—�Crat�age and Ares Wiadowa and D�ors�r+ �Vldth He166t No. 4t Bdaeal tt. Areo Wldtn HelgEat No No. ot Dg� o e lighte o! erack q. t¢. No. o p e ot � i/ r� ,�- Coe �tu ������ :"B �a'�' d'���.p _ �°-� ' Insulae�om � .� �9�w A��9� ' aeed �ea oeal ft Area ' eraxk fal. tL In6ltration �' Q� Ynfiltratio� % �'alaas �- � C�l�aam F.�cp. wall � �acp. waDl � Net e:a. wall J / e Net eap �va11 �°t In� wall Ceiliag Floor T@tal �tu. � .w� � _ Itequired aq. f� E.D.R. or aq. iaa. �I.A. adee are� FI.` /�'' m 0 l.efl�tle �'tdih eu 1�uj�awa aad D�re—�Craelcags aad �a Wid h efR Na o Llnaal t6. Aees Na ot oaee ot � �imhts ot eraoie sa.,1t. C.�su _.�,,;.r,. �� � i'11tt et�p. � In..._�' �_ :. Ce�ina Required a k. I F1. �i+ Winc�+rs aad wieeh � Na of psn* e G,laas E,��a. wall : Alat e�cp. waq Int. wall Ce�ing I°loor � � or aq. ins. W�i. der aroca �m � L�nga6 V�I'ttlth �„ —Craeleage and Area to�. �eu Cei�ing � �,� �-�- Floor Toeal �tu. i�eqeaired aq. ft. E.D.ti. or aq. ie�a. WA. �r aaes F7.1 i Room I�.eogth G° �adeh e Ro 1V'ucdowe a� i3oora-�rae�agt asd Area �laeh Helsbe No. ot L1Rea1 t6. Arms w.. ni nan. ef eane . IlrBte o[ aTYC4 �. I& B� (_ _ laf�itracion . '°��° � Glssa �p. w8u ° ,� Net e:p. waD I�t. wall � Ceiling � Flooe �� �.»��:: __ i�l���� �� ;: �,� y Ia�6ltratioa � Glaas �° e�.,��u '�, � Alet eap. waD Int wa11 Ceilin�� � Floor �I��'/` �� � ;�.�,,: ''�a+;�:� � � . � ' �.�;, r ���•� sq. inm. VVA. a�r area W. :racka�e and Aren f;� +�.n.:�.,�• ' ��.�' �. .�:s.�+-� ���.. x-'°rrt�?- � � . . __� L 6'���i10 '1ir'��i� 'brf���.�f�a�J���� li��lYRi���� �� �5��9'91��N'��'R`r.:�� 4' �Bi'n.laa~Q �VYB�i�fi'aso_,^. VVeatheratrips A.S.H.V. . I Construction No. Inaulaci��z C,uide ^-"" ' ows I Doors Reference I Out. �/all Int. Wall Ceil�ag Roof oor I�ind How Applsed t'es No � Y No 19_— ° ' -= ' _-? , . F],� . Length �•�Wirlth � �I-leight ;, � •Ft,� °�=�� . en L.ength ;�.%� 1Vidth �iei�he`Y� Windows and Doors—Crackage and Area � Windows and Doors--Cracicage and Area r/�' tVldth He�ght No. of Llneal tt. Area . �'fdth Height No. oI Llneal tt. Are� d .�� No. r t Ca oS P e llB ts �f crack e9 tt. ' � I Na_ ot Gan ot pane tlBhte o[ ack e,f �> �^-���� �: f , `�% _ Ij --� _� :o, , i d�- e � � ls c9�J F �.� • ___� if i� _y__`�!-.l r P � � i,✓ Infiltration � �'" �° '�'� � � � -., Glass � ^�? � � i F�cp, wall Nec e:p. wall � Int. wall Ceiling - --�°-� Floor Total Btu. Required sq. ft. E.D.R. or eq. ina. W.A. Leader area Fl,� Room � Leagth Width I-leight Windows a� Dooro--Crackage and Area Wid h Helght No. ot Llnea! [t. Area No. o[ Dane ot Oane 11{hte of crack rq. fl. ��•"°w .t . � e M�..� a" . �88i `�°� FSPe WB�I - Net e:p. wall Ine. wall Ceiling Floor �'otal Btu. Required sq. ft. E.D.R. or aq. ins. W.A. l.ea�r area Fl. Room � Leag�h Widch Windows and Doors—Cracl�age and Area Width He1Bht No. ot Llneal tt. Area No. ot oans ot Dane 11BAte ot crsck aq. it. � Inhltratioa C.laas Exp. wall Net eap. waQ Int. wall Ceiling Nloor Total Btu. �� � � _ �%�e..��.;�.. �'� _ �. � . _ . _�:_�:,�.. � .. Dtu Btu I 1 1n61tration Glaa� __T Expo wall �� �-- �-°'' o'�, - ! � Net eap. wall Int. wall _ � � t '�' � "� ," '�.�' !'?°'-. J --� Ceiling Floor /• � �s Total &u. Required sq. f4. E.D.R. or aq. ina. W.A. Leader aeea FI.I " Room I L•�a6th Width Ro Windows and Doors—Gaeltage and Atea Wldth ilef�ht No. ot Llneal tt. Aroa No. oY pane o[ Dan� ll�dts _ot crack aQ. tt, �A�1�lC8:lOI1 � �888 Esp. well Net ezp. weil dnt. wall Ceiling Floor Toeal Btu. Requued aq. f� E.D.R. or eq. ioia. W.A. Leader aaea Fl.� Raom I L.eagth Widt6 Windowm and Doora--Cr�slcage aad Area Width Aeleht No. o[ Llneal tt. Area No. ot pane ot Dane 116hts ot crack ra. tf. Bt{I 1n61taatioa Glase F.up. wall Net ezp. wall Int. wall Ceiling � Floor Tota1 Bta. R«�u+re��: !t. E.D.R. or sA. i�. wA. t.eader uea =��; -, � � -i 2 9 � � � � 00 rn -o O � � � � rn � 0 z 0 �' � v -� � � � � � � �% (� c� G�-- ° � � � C � � � �y , �0 �� � � � � , • �•�� o�� �� Cm ��� N ��Zc`� � � � � �� � n� �n � � � � � �D F � � � � � � � FROM CITY OF FRIIILEY TO ur � uu "" v � .��������� �_� ��►� m ��� � �����-� �.� .�-�������5. ����� _� � � �p � � ca �9' � � �► � � w � �' � d -+ �n : � aa ar � � � , � `� E � ... � N .�. v ' � p � i ` � � I 11 4 I 1 ) II II � ������������ c�i� O O O `a C? :� -•1 �{ :.f (s� � -•1 � o�r�oo`c���°cao°�o b N � � z �. � � �\ �� 0 s 3 � � �� r�- � � � ,� -c � � m � � � � I � � � _ � � a �.► � �I V - � � � r � � � � � � � rn � � �.� � m a � r �. � � � .� a ���� � �°��� � � m �. � � � �'��� �. � �°�� ���� �' � � � - '!,i ���� ��� cu ,¢ 0 c3ss�aa � ° � . � � a �' � o � m � �,� � � Q � � � � � � � � �� 6513F�1.s.s� r. ul� eic - ., � ,r. :1, "'� � i � �4 • �� � �� � � `� � � �• v �'2' ��� �� � 0 z � � � �� ��� ��b ��� , ��� ��� � �� � ���� ���a � ���z � ti� � � � �� s, �oq�o� ���� � ' �� _ � �. ; v � �, � �� � �� � �� g ��� � �S � � � � m O n � � 0 � 70 6513651332 P.�� ° APR-04-2003 12�13 FROM CITY dF FRIDLEY �� 'rHE BELOW MUST B� FlLLED 9N Vd1-1�N REPLACiNG FUEL BURNMG APPtJANC�S OR THE APpLICATtON Wt1.L BE R�TURN�D � � � , .� . ,.�, � . : : � • . ��r < < . � � ,��: �� � r s��l h�,�����•;�:,�•�.-.�...r - - — wh�, �� w,a�r��9nea here�y ��s tn�t �,e ven�ing has been �xamfned and is free from Cus� detedoration, tibs�c�ions, and {s sewrely supporf�d �rtd flrestopped wher� requirad. Yes () No { i 7he ven�r�g system is pla�tic/PVC and rn�ets all c�rrerit t�odes and manufactur+�r speafications induding si�ing, length, number of eibows and t�rmfia4an. Yes () ido () The undersYgned ek�o v��s that the repl�c�mertt unit is a listed a�sembly and meets the ament �des and manufacturers speciflc�tions. This does inr�ude AGA-G�W4 C�+9�ry I Ceniral Fumace Ver�ing Tab#e� for �an �ssisted artd natural drafk appAances. 'fhe �.�aiC is si�ed �nd instaqed to meet �e current cades and manuff�c�rer's sp�flcations. When required to w11I be sizad �nd insfaded � me�t ti�e currer� codes �nd manc�rer's spea��ations. Y�s ( ) No ( ) Yes ( } No ( ) Yes ( ) Ido ( ) �- � the under�ign�! hereby veti�es thet it is a�ted assembly and meets the current codes and manufact�uers speaft,�iions. 'rhis does Incl�de ACiA�GAMA Cate9ary I Cen�ai Fu�nacQ Ver�rtg Tables for i�t assisted and natur�l draft applianc�s. Y� () WQ () ls the aommor� vent and vent cx�nnector� sized and 'mstalied con�ct(y after an �pplianc.� has been removed from the c�mmon v�nt and vented Yes No separatety a� per currer�t co�es. () () ��• . � M���,;v:=-�.�r.a�_Jr��,._.._�_ �� a . _ - �� _._� � - �1 . � � ' N. • � �11• u� : � • 1 Appl�nc� #17ype BTU Input „_ Fan �►ssi�ted or Ne�t � qppli�nce #2 Type -- BTU lnput _____�r____ F�n Assisted or Nat � q�p���� ��ypp �TU Input ___,_,_ Far► Assisfed or Nat _ 7ota►1 Appliances � Tot� Btu Input �. Cflmmon Vent Type V�r�t Heigh# ,.,,,,� Diameter inches Appli�ance #7 Vent Connectar Height,_ft Length tt Diameter� Type _, Apptifance #2 Veni Ccsnrtectar Hei�hht � ft Length ft Di�meter ^in T�Ipe ,i Appl't�nce #3 Vent Corm�cr H�igh# ft Lengtf► _, ft Diameter �En TYPB �... = y - � ��• � �.� . rl•,- H�►TtNG CO: - - s;�,sa �y: a� : TOTRL P.02 � _ CIIYOF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 Apri120, 2004 Ms. Michele Dunlap 548 Glencoe Street NE Fridley, MN 55432 Re: Final Inspection at 548 Glencoe Street NE Contractor: H P Pipeworks Dear Ms. Dunlap: A plumbing permit was issued on July 28, 2003 to install a water heater at your address. A final inspection on August 15, 2003 noted the following items which need to be conected: 1. Provide combustion air to any fuel buming appliance. 2. Provide approved gas valve for water heater. 3. Provide minunum 3 screws per joint. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this pemut. As of tliis date the reinspection has not been requested. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further acrion. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. 3 o� � 5 04 � 0 � f � a � 0 C) � � m � m � 0 Z m m � O °o x � � � O � 01 r � N � C m 3, w m 3 !� � � c ° 3 °� -n � m � m � °� n o� O � 3 0 1 � o oi � �C � � C O N � B� N � � �� � � N a 'p 3 ° _ `°3�� � � � � '� � N � � .o � ���° 0 < o � � � O � � W O 'L.* oa � � o -• u � � �' C � � °—' o o � � � o � O�. 0 � °. � � � N � v � � a � � � ma � N�p N � N � v � m � N � oa z � � � � ?1 m � � � � � N � � -� � N � (D o vi � � t°'D � N � d 3 � � � � �. Q. � ° v � `� o � � � � R� � A x v � r � � � � � � ,cNn o 0 0 ,c�"�r� � 0 0 0 0 0 0 0 0 0 0 � � v+ � � � � � �. ' � ' � w -i . � �'i , � d 0 z � � a m m c � � � a a m � � � � rn m � � a �c° o � _. a lD � O � � � � � � �. O N .� � �� N _ � ; v Q � � � m°;� rn � -h � a o < � Q. v � � m � � N � � .. -" �. �, o °: m � n� n m r' � o � o � � m m N N � � W � � W � � 1c3 m �a°� � � m z � �°' �; a � � `D c z m r; N �N _ � m � o r� �� � � � � = o o �° �D � � � � � '+ � m v a � 0 � _ a o r. m � � � m o ' o� 3 D 3 -� V � W � a D � ma v � o °' � � -� m � � � z 0 f � m � ���� w °' cn ,� �' � z � 'Oi7 � � a 70 �,N,° � a �� rn � � � C �1 r= '� v � z � � 'Zw VI � C7 �.' 0 Z � D m 'v � r � � �:: �. =�1 '� °zo a� vo a� � m � � W 0 'G v Z � m � —i � � � O t� Z z � v � � � � �"� Z m � �� � C) �ZO � °z � m � < �0 rn m � Z _-I � O Z � m �. � � N O O � � � � Q ��n W FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTfON AIR VERIFICATION When replacin� an existinct furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and flrestopped where required. Yes ( No () The venting system is plastic/PVC and meets all current codes and manufacturer specfications including sizing, length, number of elbows and termination. 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 Fumace Venting Tables for fan assisted and natural draft appliances. The existins� combustion air is sized and installed to meet the current codes and manufacturer's spec�cations. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's spec�cations. Yes ( � No ( ) Yes (� No ( ) Yes ( ) No ( ) When insta�llih� a ne�t vet�tins� sv�tem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's spe�cations. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () 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. No ( ) Yes (�,� No i ) Appliance Tvpe and Size/Common Vent and Vent Connector Inforrmation Appliance #1 Type � �- BTU Input �O �O � � � � Fan Assisted or Nat � Appliance #2 Type t,�T�'l.i ti-- �►V BTU Input 0 0� Fan Assisted or Nat n,A� Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Tatal Btu Input �_ o�� _ _ Common Vent Type ���-n� � Vent Height a2S� Diameter �J inches Appliance #1 Vent Connector Height � Sft Length � ft Appliance #2 Vent Connector Height .3 ft Length �'' ft Appliance #3 Vent Connector Height ft Length ft ALTERATIONS: (Describel ���LC `� C-e.� �� Diameter `f- in Diameter �in Diameter in �- .�� � Type ��%� 3� Type � � Type HEATING CO: ���n,1 � ,�'n `['1"TG- � ��L- Signed By: Date : �� � - � �