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AF - 46675City of Fridley AT THE TOP OF THE TWINS i � � � � • COMMUNITY DEVELOPMENT DIV. � j L ������� � � PROTECTIVE INSPECTION SEC. 1 � � � i"'1 � CITY HALL FRIDLE� 55432 1•��'� � ,•� 612-580-3454 SUBJECT BU ILDING PERMIT NUMBER REV. DATE PAGE OF 910-F15 7/25/77 � � JOB ADDRESS 1291 Hill Wind Road N.E. 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION DESCR. EB,St �.00 � Of IA't 2� A11C1. S'UI?. #94 2 PROPERTY OWNER MAIL ADDRESS David Betcher 3 CONTRACTOR MAILADDRESS Gary M. Gorh$m Construction 905Q Collins Drive, Anoka 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADDRESS 8 USE OF BUILDING Residential 7 CLASS OF WORK X NEW ZIP ZIP ZIP ZIP � 14235 RECEIPT N i%���G APPROVED BY SEE ATTACHED SHEET PHONE LICENSE NO. 421-0998 PHONE LICENSE NO. PHONE LICENSE NO. ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 68' x 44' �velling and a 24' x 24' Garage SEPERA�T� PERMiTS REt�U�REa FQR i�VtR�we 9 CHANGE QF USE FROM uc ����, �% ����� aN� TJIG�Ss �i{./� • � STIPULATIONS Provide a ha.rd surface driveHray. Provide a verifying survey before capping. Provide sod in i•he front and side yards. Provide louvered d�r or window in utility area. Provide exhaust fan for utility area. if window not installed. SEWER LOCATION: (Approx. 13' Deep Inc].uding riser) 37' West of Manhole (Inv. 952.54) WYE ELEV: 952.69 + 3.00 Riser = 955.69 TOP OF FOOTING 959.19 Minunum WATER LOC�,TION: 13' West of Sewer Service 51' N.W. of Ma.nhole DRIVEWAY DEPRESSION COST: N/A Existing Bit. Curbing. ��'�� 7'HE CITY OF F�IDLEY pOES NOT GUARANTEE TME ��� �j Ut11�t�ES O�CCURACY 4� tJtIUtY LOCATIONS AND EL�VVAitGP:g. Before di�in8 �� :� DnrA rs FOR i��O�tiON Pu�os�s o�+�Y �n�3 iELEPNO�a� •�tEC�RiC • GAS Etc. FE2SONS U�NG IT SHOULD YEIHFY tNi INFpRAAA'ilph ��Q�IR�p gY i���dy ON iHE SfTE TYPE OFCONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCl FLdICU THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING AUTHORIZED IS NOT COMMENCED WITHIN 80 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. UNI1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING T#iIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $46,410 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOGAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S�-4�-.76 PLAN CHECK FEI � �� -�%� SO. STALLS ,�''� � �✓ �� � ` � $ 3 5 . 44 SIGNATUREOF ONTRACTORORAUTHORIZEDAGENT IDATEI � WHEN PR�PEI � �y C.� � � '`F---'K B ` CU. FT. 76 35 440 JFFSTfiEET PARKING IGARAGES SURTAX $23.20 SAC CHARGE $375.00 TOTALFEE $573.40 D THIS IS YOUR PERMIT 7 -� � -`7 6ERALD T. COYI� 30D BRIiNSN/I�i4 AV@ S. 6OLD�d VALI.EY. MINN. MINN. REG, NO. �74! iNau�a��. -- �uaicuu. cot��ottiwi. — TOPQ(�RAPHICAL CI'fY IOTS — PLATfINC 30RHAM C QN STRtlC'T I ON !!iT SUl�1/EY�S C�A�ifY '��";' a � „�"�" �D 8����� BROOKLYN PARK, MINN. MINN. REG. PIO. 6T43 �'�D Ol�i 6►n OD 61'�i'� (� IUDIliBYdT� �� �� Ltca��sp � oaoII��iCS o� f�rY os f�xi�►�Lts IN1A01l� NO 57�7 W. BroadreY 5�3-992i F. �. N�. blinas�spolii, Mianesote S54Y8 �� �a � �� � ���r� Qj*��� � — OC•t�IOT IRON r — /OG. G�✓ -- — _ I � ioa.o i � I��► '.� �� il �� ��� � � Tk� e r^,as� 100. Ci0 f eet of � Lot 2, Auditc+r's Subdiv3.5 ° a► No. 9k, A�ok� C4unty, Minn esota. r5± � 1 1 -... r��,,�a ' ��r�,`',�='�. � �. ��'=���� � '-3,._. B' �' � .�1 �a � � �l 1� ' � V`v �� ��� � � ! I __ � v � --�.�SE"� �j/� '� -- �.� �4- _ _ - � � � '�--_ ��'� V�- ��°�-e-,..._ Zil/ 7-� �`-�-.�'--�yi � C �t�°,�,�r� ~`-°.�. '`�' `�' �,,q %- '�' �'. � � ��'�,.� �/�, �``�'°_`�-� � �� W� ha�bry► t�i�j► fhat thb b e hw eed wnacr espres�af�tIon ,r ` ai •� oi ii�s ba�ndaria of Hn ebow dascdMd �nol ead r� Na {ecsHwa� af �il bxdlaU�g� �d$ v� �nsra�mte►fi, ii �a�r. ` x from w oa wid l�ud. ��%� �� � � � 5��1� � �1�1�i5t �q 7� � , ,��i� �. � 3�URYEYB COD�PiA1�T7� ��� �! CITY Of= f=j�I]�:.L'f , , � � �� ' APPI_ICI�TIOf�1 FOR RESIllC�'TIAL LUILDING PERI�7ITS � ( rJ���, �LTL= it/1T I GPJS, nDD I T I U(d�, UR RE PA I RS ) OP;tJL•'R: �'�,�� r,:� ,�c ���1 r� PuILUL•'It: '�i c� '- .� � �r�.,� ,� Address: Address: ;�.�� ��%��«„� �E_ �ne�''.,,. Tel . Np . '�� �/` - <�� ��' ,II �����"� , Na. ; � � � � Street : 7�OT• BIACY.: ADDITIO� r���„ /,/�. �l'=f COI2IIER LOT: I2�SIDE LOT: � SETBACK: ���� SID�YARDS: �'? r Applicant attach 'to this form �ao Certiiicates of Survey of Lot and proposed - building location drawn on these Certificates. ' DESCRI PTION OF BUI LDI NG -� To Be Used As: P y r ; •.v� r .>R , �,�. Front: � .� Depth: ��`� Height: �S° -�--- - Square Feet: _!���Cu c Feet: � f �o �� � �� - ��nt: �°� Depth: � Height: � Square Feet: � � �C'(ibic Feet: � � � � Estimated Cost�$ ��•�---- Type of Construction : I,� � ti � ��� ��.. ^- �'� � d , � 7.b Be Completed: /? -- °v' -�� Alt. A� Alt. B s Proposed Driveway Width If New Opening Is Desired �'� $ $ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional information. DATE: 7°/u -�7 SIGNATURE: ,,J �`'�'�' �-�'°'/� r,. ° � ��/�� �G Stipulataons: �Re.t,�=.Q,� , , �od�. bv �,?�;.�,,� �%re t� � �y' a+�,�, �..�.�.7_ a. ��,�:-�1 � , �-�'�" ��y � � �,,,��c . 3, � .,, �o������� �,. " _ �'u� � "�--'7 � : 3 �°� !/y �3-�� � ��� � �3�,55 �4 LSUII_1J11'�C7 I'::tr;'{; 1 :jGC 7l.11f_UULt_ SECTJOI•d ?.. 'Phe I»sF�c.ctor o£ I:ui_lcli.�,ys: ::hall, k,c.fe�rc� ��;suiny {."'��n:it�s i'or 211e r_�recLic7i� C�f i111�1 }�U)�.(�I:1iJ (�1" 1�i:L�UC:t.;;f.(•� r�l" 1C)7.' �:llj� �1(��il�'.JCiT'i !C� l�lll� l'i:l';tilil�J ��121.�_(a1:1'f bY :_tYll!:il1Yt'o c�r ivr rairy ril.��_�r.iLicin or. r.c�prxir.:; lo air, �: i:;l.inc3 l�u�J.c;i.nc� c,r :�iru<.tur.e, u�,uri aJ�}�]i�::,�t-ics:� thr_r.ef.ur.�, rcc�uir.e ttie 1}ay�nc:�r�t 1�� tl,e �,Flj,li.�•:���� Z:ur sur.:i j.urm_iL of f:ces to Lhe an�utzt�t hcr.c�ir, }�clow sci L�rLt� atiu in L}�c rna.i�,�.n c���ei.n F%r.oviuccl tu-wiL-: ?.i.�•J CUII�TRUCTIOtd: Sin�31c P'�mi�.;� Flom��s anii Gar.ages: $4.00/.l,UUU cubiC fcet-. PLI�Id CIII:CY.: 25 I�crcent of. }�uilding t�crin�.t ice. DR?VLt�7AY llEPRI:SS]:UI1: (Cvncrci:r� Curb Str_cet� Only) Altcriir�i_� T,: Remov<il anci ri���lt3cement of concrete curb and gutter only; Uriveway width j�lus 6 feet x$11.75 Altrrnate B: Rcrnoval and re��lac��ment of concrete cur.b and gutter and install a 3 fc�ot wide approach with F, inch depth; Lrivcway width plus 6 fec� x; l�.y�� ADDI T IOP,AL I f�F�'•1AT I ON For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by r.?ultiplying the ground area covered from a point sir. (6) inches below the floor Zine of the base,-nent or the cellar to the average heigr.ts 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 ar_ existing structure, the fee shall be at the rate of $3.00 ner each five hundred dollars ($5a0.00) or fract?on thereof in the cost of all proposed work. In no case shall the fee char�ed for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcliarge. . �(ERIFICATION OF FOUNDATIQ(� NaTE: Perm�_ts �or construction will be issued a minimum of 24 hours from the ti.me of application to allow for proper revie�a of the proposed structure and of the construction site. A Certificate of Survey of the Zot, sho�ving the location of the foundation once it has been constructea will be required before p�oc�edir,g with the framing. CtRTIFICATE OF OCCUPANCY Application for a Certificate of Occugancy shall be made ten (1G) days prior to the use or accupancy of any sti-ucture for which a buildang permit lias been issued; and said struc;ture shall not be used or occupied until a Certificute of Occupancy has been issued. � � � r , - ., , �, _ 1 � ' I ` i � ..� � � l � 9 / � ,c,ve��c�, /�c�'�Q..�. �.- ,y� ' � � � ��, � ' „ , t' .. 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'Y Q LL tf 9 a o ' '= � Closets s �Urinals x � • c � Bath �bs n � � � easins � ►�+ Q' � -s° a S�7fiC3 ,� !` � Wash Trays a W - Drinkinq `4 w ' ' ' Fountains -d � showers � � Floor Dr '\ � � �� catch o f, Basins m ` Automatic a \ %�� Washer E �,r V ,% Gas Appl. M3.SC. F�Xt M. x m � � �,�'-_ �°`' ' � Gas Panqe cr E �S n Other � m cxo � � �i � n � � � g � � t� ►� n0 N M� bf t�' � M H Vl r H � M d � � � ro °r� � � gH o � � K � �� M J � � O • � O � � . } � p' n a� :"� .� ro d' W G M� at O� W � r�►� tnM� %� ao. i-�'-�� � � `Aw m aao m ai°�nc�o w o� M' rt to � �C � b �a w r � � � � � � � o +Wi a►mro� f0 ��m �p� � � Y 0 E m MX�- ���.� p a��� ►-am a • R w ►��- O ' 7 f0 A � N 'p� � ►e A� �7 Q M b ao D� t�"i r�t mx �NNyy ' O � � � � } 0+ f�Di R O n° ,,�; t�o r�►t � � � � � � �a pn� � rn�{. � �� b K `C iM1' g � 3 � ��; r � � � . rt � a 'Q '9 1"' A � "'1 � z 'tf - O � �Q � � 3 � bd ^C � O n � z a � c� •-• a cj � � � � c� . � m • - . � -i • 0 sue�eeT p . City of Fridley 2 9 8 4 8 AT TME TOP OF TME TWINS g U I L D I N G P E R M I T� r ; � RE O. � `y _.���_ COMMUNITY OEVEIOPMENT OIV. '/� ^ � r � � PtiOTECTIVE INSPECTION SEC. '�� 6� � � . , 1 � /"'1 � CITY NALL FRIDLE� SS13P NUMB@ii REV D�TE PAGE Oi ApPROVED BY �.---� • •,� 612-571-3450 910-Ft5 7/9/99 / / JOB AODRESS 1291 Hi 11 ldi nd Road N t LEGAL LOT NQ�' lOO � BIOCK TFiACT OR ADDITION SEE ATTACHED oescR. Audi tor' s Subdi vi s i on 9� SNEET � PiiOPEfiTY O E MAIL ADOR�S$ 21P PMONE You - Chii Minh 3 CONTiiACTOR MAIL ADDRESS 21P PMONE LICENSE NO Shin le Creek Const. 8108 415th St 4 AqCHITECT OR OESIGNER MAI� AOORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATIpN X� REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Rero hou - 9 CHANCiE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Buildi�ng Code. TVPE OF CONST. OCCUPANCY (�ROUP OCCUPANC� LOAO SEPARATE PERMITS ARE REOUIREO fOR ELECTRICAL, PIUMB�NG. NEATING. VENTILATING OR AIR CONOITIONING. TNIS PERMIT BECOMES NULL AND VOID IF WORK Oii CONSTRUCTION 20NING SO. FT CU FT. AUTHORIZEO IS NOT COMMENCED V�1ITNIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 DAYS A7 ANV TIME AFTEii WORK IS COMMENCED. NO DWIG. UNITS OFFSTREET PARKING I HEREBY CEiiTIFV THAT 1 MAVE READ AND EXAMINEO THIS APPLICATION STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION SURTAX ANO ORDINANCES GOVEflNING THIS TYPE OF WQRK WI�L BE COMP�IEO $2709 WITH WHETHER SPECIFIED MEREIN OR NOT. TNE GRANTING OF A PERMIT �1.3rJ DOES NOT PRESUME TO GiVE AUTMOFITY TO VIOLATE OR CANCEL TNE pEqMl7 fEE SAC CMARGE PROVISIONS OF ANY OTMER STATE OR IOCAI lAW REGULATING CON- STRUCTION OR THE PERFOAMANCE OF CONSTRUCTION �H3.2'rJ Fi re SC $2.71 � PLAN CHECK fEE TOTAL FEE � � —� ' ense SC $5.00 92.31 �GN4TUA CON'AACTOpOAAUTNOp�ZED4GENT �04iEi WME pR PERLV VA IDATED THIS IS VOUR PERMIT � /�-� S�GNATU�7E O� OWNEp��f pwNEp BW�DEA� �O�TE� � BLOG �h5o �i�tE � �w [ l ADDN ALTER Effective 5/10/99 [ ] CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII.DING PERNIIT APPLICATION 1�� �� �� � �� Construction Address: ,�,� � j �� � ( � � � � � .Q � Legal Description: Owner Name & Address: �C� c, - C�'� i VV1r►► ��� Tel. # G I�� S'3 �' � l 1$ Contractor: ��� �e C!' �e-e l� CC,� .� �- , MN LICENSE #� GU s G 6 3 g Address: LIVING AREA: GARAGE AREA: DECB AREA: OTI�R: _ `( ( ) ''I-1� 5'f' � Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length DESCRIPTION OF IlVIPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Wic�th Hgt/Ground Sq. Ft. r _ � ' v �' � �- � �%9 Construction Type: �of� U�' �i�6 �3°� ���� S Estimated Cost: $ � Driveway Curb Girt Width Needed: Ft. + 6 Ft = Ft x$ _$ . ' DATE: 7 - � APPLICANT: � !�-•- � Tel. # � 1 a '3 � 6 "/ 6 y `% Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �.� �s � �. �/ $ �- .�� $ � .�.-D � $ $ $ $ $ aJ � CITY USE ONLY Fee Schedule on Reverse Side .(?Ol of Penmit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A° or Alt. "B" Above $450.04 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUII.,DING 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 $50� to $2,000 $2,�1 to $25,000 $25,OOlto $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,0� $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fracrion thereof, to and including $25,000 $391.25 for first $25,O4U plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,0(� $3,233.75 for the first $5(�,000 plus $4.75 for each additional $1, 000 or fraction thereof, to and including $1, 000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additiona.l $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�ub Streets Only) .Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. 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 $23.25. VERITICATION OF FOUNDATION Pemuts 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 co�tructed will be required before proceeding with the framing. 1 � rn ��a � t7 � a� m � o �° ' ti, � Z o' � � � � � � � G � � • � � o �, °� � o o, .� \ �• A � 0� � � � � � a c► ca �Q 0 � � � w � :� s 0 c .t O � - D � � � � � m � �r, s�i � cc � � �Q w 0--+ O � � � � °, �. � ` � � � D� b � � � � � -c � 0 � � � � � '� �•� � � � � � �. � �� N � C3l � aQ tA �3 � iD � o„' � €� d� � °•� � � �Q �1 �' � � � � � � � � � � fll �'�' s�� $ � � � o y � � JC � = � � O . � � � � � � �. � � � � � t� Sl ii °� � � � � � � c o► a °' � � r� N � � � � � � r� �, � .� �o .�. � -� � � �� ;� -� � � ���� �� � � � � � � �, �' � y � f16 � � � _ �� °. � < `� -� � � � � � � �. 4s' � � � � � � :� � � � � N �i i � -� O � � c�a d; .e, � � � e,a o � � � e�. � � � � � D � � m � Dc � �e +� O � �. � ��.�w � � zi, �n c� � � e�va oQCQUm�d i7° ^ < � � °w�.�.� N � � � � � Q � � � � � — C ��—,���:: a� � � W`� o � � f�9 7C' �' v � � � ..�i � � � � � � -� �3a 6�i i�3 ,B�Ba O O o p � b �° � O $ °► o � �l � �a � dfD f�► O i { r CW a � � � 41 {). (D � Sy � � �S7 � N � � � �� +� � f1 � f � W � � �C�� �g � � � � � � � C � t a � � �� C �° � � � � � o � � � � Q � !/� cD � � � I�rnz� i� � � � � � � � : � � I � �+ 3 � � ' � � \ J � � � "'� 0 0 � � � 'i0 tT1 :O � --1 z O � , 1 00 C r= 0 � � C N f�'1 � 'f� � � 1 N r=A � c � � w V+ 't! q�1;� v '� �P � '+� 4u � '"'`T� � � � ��•-„ Z�� V� �. � � `�' M w<� N � y Z .� mm � z v c N D 0 'O Z 'O r �� �O G� � �O �� O� � � "- D � �� �N vZ .� v �, o s �Z Z -1 a �z °v �� � � A � N � / ��.. � � O � � � � � � � �a� �r fr ��. , � �'� � �, � e � O 3 � �• 0 � � �HIMNEY AND STACK VERIFICATION The undersigned hereby verifes chat the existin� chimney or st�cl�: �. kias been carefu�iy �x�mined Yes () No () 2. Is free from rust �r dete�aoracior� Yes {) No (} �. �ias no f�r�igr� ob�ects lod�ed vaitd�ie� Yes () No () 4, Is securely supporced �es () No () 5. 1�Ieets ali curr€r.t Code aequ�rements f�r si�e , and total �iU's connec�� 3fes () No () 6 I�as total h�ating �i'i1's �� AHt o�er �3Ti1's TO�'AY. �'TLJ's 7• Has a liner been provided for water heater �. �as cambustioa� aar been pr�vided for w�ter heater Remarks: �__�1�� o - ` ('�> � .A, I,isC ALaERp►TIONS Being Y)one• gIEATINC �O: �ign�d �ye Datea Yes()No() Yes()No() , ^ \=z ,-� *,� J _ _ CITYOF FR[DLEY '� � FRIDLEY MLJNICIPAL CENTER • 6431 UMVERSTfY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 1, 2�2 Mr. Tom Kim 1291 Hillwind Road NE Fridley, MN 55432 Re: Final Inspection at 1291 Hillwind Road NE Contractor: Dave's Appliance Heating & Air Dear Mr. Kim: A mechanical permit was issued on August 10, 20(?0 to replace an "A" coil at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this permit. As of this date, no inspecrion has been called for. The pemut fee that was paid covers the inspection to make sure the work was completed according to the Codes. 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" and no further action will be ta.ken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, / ,..!: /,r� ,.i _ � Y_''i"' � - . : �.I` � �' � DJ/mh � � O r � � �' � o W �' a �, � � $ C►� -°o m m �' O � � � � . � ' � � � m° � �� a � 0 z 0 z � m '� C�') m � m � � c � v � m a a 0 � Q ,�- � 0 � � _ v � m ?1 � � v � m Z � -o rn � O z m m � i3l O O \ 2 O � � X � n fl O � N r � � � rn � a� ua c� � !� � N �• U7 0 c o m �' �� � °� O � o �, O 01 � � O n A, � �� Q. �y-' � � �v �� ,� � N n � • o — 'd �, � p � s � � < m v � �D '� rn m � � p � �- '� D N N s �: � � m o ai � u ° � � N � Q4 � � O fD y � � m o.: o cn N � � r ,� � v o � o �.. � N o v °, � � 0 � � O a Q. _ � va � N G) � N � m 1 � n� N � � � � � G) T � N O � y 'O � � (p g � N � Z ,(�. � . �.. � �� "t7 �� Cl. -n � � � � � � _� '�` � � O N � 'a EA �' � � N R° N � NF� la i� U1 O O O O O O O tt� W U1 O � � � � � � � � � � � � �_ � � � O � a �J � 2 � z/-� sl/ � O,�D W = .W--{ � �k C � N C Q�„ -Oi, rn � _ 1 � ��'! � �� � z � � °O n m � � a _ � � � �= o �� � � � � N m m v Q � n�,' a. _ m � o 0 m � � � v Z � � � D 1 � � V � � � � v 0 � � � -o m � � _� z 0 W C o. 5 � � � a � � � n Q. � � � � � w z < O 1 � O Ut u�, 'TI � ` � ��� � � N � v �l' �x � m� � (w37 C � � � v � �� � -v m � O � D z m 'o � r In ,� m � -�'-I � Z �a z =o vo A� � � � W � '0. v Z � � v� � �� Q � Z: � � � � ` � � � m z �.�� � ao � Z O v � v� "�` � rn m � � � Z � � � � � S � Q `m � � � N � O Q � �� ����� J�2�i/ �>/l�o�d /'� THE BELOWaMUST BE FILLED IN WHEN REPLA�ING �`IJEL BURNING APPLIAhICES OR THE APPUG'�TION WILL BE RETURNED •u�i�� � I � •►► �•: �►� •1�� ���t � : I : •► _ ;' ._ When � �n acing an _�ric�ing;-f�rance, the undersigned her�by verifies that the :: . �- venting has ;6een ex�rriined.�nct is free from rust, dete'rioration; obstructions, .' and is securely supported.and firestopped wf�ere required. �� � Yes No ('� _ . �� - The venting system is plastiGPVC and meets all current codes and manufacturer specifications including s'izing, len�, number of elbows and termination. The unde�signed also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAl1�A Categary I Cen�al Fumace Venting Tables for fan assisted and natural draft appliances. The pY�e �e►„e���en a�r is sized and instalied to meet the current codes and manufacturer's specifications. . When required to in�an a n vu �me �etien air�,it wi1l be sized and installed to meet the current codes and manufacturer's specifications. When in�� a new ��ntine evc+ m, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufactwrer'� specifications. This does ir�dude AGA-GAMA Category I Central Fumace Ven6ng Tables fof fan assisted and natural draft appliances. 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 ( ) �'°` Yes �j No ( ) Ye�� )11) �i Yes `�c) No ( ) Yes ( ) No ( } � Fl Yes�No( ) �! � • . � h' � ' . � � - • 11. 11 • � - � . 1 �• ' �1 • � / - M • � � L11 . • � Appliance #1 Type _�.r �� � s- BTU Input g�� Fan Assisted or Nat �1 �� Appliance #2 Type ����.c M.-E-� BTU Input � -o� Fan Assisted or Nat _ d�1 �--�- Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type ���n� Vent Height t� ti����iameter� inches - Appliance #1 Vent Connector Height ,�,ft Length ,�ft Diameter �_in Type eJ ��� - Appliance #2 Vent Connector Height �ft Length �ft Diameter �in Type i��e�'� Appliance #3 Vent Connector Height ft Length ft Diameter in Type A1 TFR,4TI(7I�S� (D e ri 1 _ HEATING CO: Signed �►t�o a �nt c��moNa�a uc 881-9000 • ��1- 7 9f`