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PRE 2010 DOCSI VTge Fridley, Minn.. DING PERMIT Date: ...... ....).�:t.. . Owner...............................�....... A Address ........................... ...... Lc9 L ®9 No. ............. .Street ..:.. Lot .... Ag .... Block ..... / . Corner Lot Inside Lor,.. I T® 1466 Builder.......... .. ........................ .a.,ra. Address ..... ...'ted.`: /� . • ta�.�.. 7 z.. . C�4TION OF BUILDING�. iPart of Lot .. "0— Addition or Sub-Divisio......�e� :...... ........... ... Setback ..''� .... fSideyard .. '� ' ' . DE 'CRIPTION OF BUILDING To be U��rrssee as: . j� vl /. q. .. Front 1! .. De th .. �Z.'.7 Hei ht . f :°S S Ft. ........ Cu. Ft. ........ p g 4 ................ .... Front .. Depth ..... Height ........ Sq. Ft. . Cu. Ft. ........ Type of Construction !' ®dam .....I Est. Cost .......... To be Completed .................. X04 4 16 Ae �11 In consideration of the issuance to • e of a permit to construct the building described above, I agree to do the proposed work. in accordance with t a description above set forth andi1a compliance with all provisions of ordinances of the village of Fridley. s" � 0 ' In consideration of the payment of fee of $.5... .., permit is hereby granted to ... .. 3 ..................... to constru the building or addition as described above. This permit is granted upon the express condition that the person t whom it is granted and his agents, employees and workmen, 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, ction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit ma be revoked at any time upon violation of any of the provisions of said ordinances. . ..... . . ........... .. . Building Inspector, NOTICE: This permit does not cover the onstructlon, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to se uilding Inspector for separate Hermits f ese Items. 'n 'F MrCiradlfle*L", S79owa md Do ?mmace Shell & Dad 77�A_, 410.60 Replacement of Ywwee 6.00 Repairs & 6.00 Ropairz & Altrz—Bations L-zch 3co 4__ - - MAME 2UM 7-urdnam shell & Duct work to 120,00 BTU =eh add. so, = VM ..... Replacement Of Furnace Repairs & Alterations --up to SM.00 YL -pairs & Alterations each add. $M.00 .Swao $._ gwo &00 &00 J4 or HOT WATM SYSTME mace Shell & Lines—to 400 zq. ft. MDR Steam $10.00 $ _77'urnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 Each add. 200 sq. ft. EDR Steam 3.0n Mach add. 320 sq. ft. EDR Hot Water 3.00 $- 1 t. Dopt. of RM95. Man"D City of VWdfty: NJ The undersio, cd hereby malzes applicalfta 2Ey a permit far 224 work hereby specified, &Ezee ng to do nil work i�j strict agcarr3ance With the Ci Y ordhamcca and mlinLv of the Department of Buildings, Ad hei-e-Ioy ds-clroe,; Vint a13 ttje and representations stated in this application are tnya and acmye-cl_ Tridle I f, n— ?ft r / _ Owner af��_ Kind of Building ____ Used as To be completed about 0 Estimated Cost, Building Pei "it NO. Permit No.--., OIL DURFER—to 3 gal. per hour over 3 gal. per hour—See Fee Schedule 6.OD 3 or POW BRATING . 'M HANTS—suam, not 'Waft<jWarm �;str Nv_ Trade Name &4 Ills_ Sbe GAR AURNIM 4 u to 1%,00 WTU) . d. —0-0 _ over 199,000 VM See Fee fficbe"* Capacity-- Sn. TL ED R C' BTU_ QhW FITTING FEEB. NO RATE TOTAL 1st 3 Fixtures X$ IM $� Total Connected TAnd Kind of Additional IMxtures x .75 EBURNER —Trade Ame Sin No— Gas Range to 190,000 AIR CONDinamma FAN HEATING BTSTM I" I" schedule Capacity Sq. Ira. Zpjt- BTU ..50 VIM ELATING 9TSTZM ALTERATIOM & REPAIRB TOTAL rM ROUGH — I'MAh— BY. Budma FbM@ City of Fridley SUBJECT if?3657 AT THE TOP OF THE TWINS PERMIT BUILDING RE � COMMUNITY DEVELOPMENT DIV. ^ r PROTECTIVE INSPECTION SEC.®j I i ��-�'1,•� CITY HALL FRIDLEY 55432 NUMBERREV. DATE PAGE OF APPROVED BY _-_. 1 812-580-3450 910-F15 7/20/76 JOB ADDRESS 309 Logan Parkway N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 1 Oak Creek Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Shaw 309 Logan Parkway N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E. ls. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Iteroof house and garage 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. 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. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,600 .80 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE P FORMANCE OF CONSTRUCTION. $12.00 00 PLAN CHECK FEE TOTALFEE e 7 ' •-7 4 1 $12.80 SIGNATURE OF CONT(7 R QR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT .Q BLDG INSP 0j -0j-)')- '?-00--n DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) I CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAME:o h' l \Y1y ,4_4J BUILDER: 4, , L ?'o J � . j© /y AS a ,J a ADDRESS: a c Z — )10 9 4 .J ✓ K , ADDRESS: 2-r/2 ce.� 7-0 A � Ad w AIZ, NO • . `3 � STREET: 4, a 0-1/<, '41, 5 N LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Re,Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: Front': Depth: Height: Square Feet; Cubic Feet: //// a e Type of Construction: klj- k,.- s a d, Estimated Cost: $ J 6 Q G. To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict 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. it DATE: Z_ - SIGNATURE: ✓� \ �� (See Reverse Side For Additional Information.) BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings 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 repairs 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: 14EW CONSTRUCTION: Single Family Homes and Garages: $4.00/1000 cubic feet PLAN CHECK: 25 percent of building permit fee. ADDITIONAL INFORMATION For the purpose of computing 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-r-1pairs or alterations to an existing 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 any permit as set forth in Section 2 be less than $7.50. VERIFICATION OF FOUNDATION NOTE: 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 Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate 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 Certificate of Occupancy has been issued. Effective Aug. 1, 1981 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE 'RESIDENTIAL Furnace Shell and Duct Work, Burner Gas Piping (piping needed with new furnace) Gas Range Gas Dryer Air Conditioning (all sizesl All Others/Repairs and Alterations It of Value of Appliance or Work $ COMMERCIAL/INDUSTRIAL it of Value of Appliance or Work $ State Surcharge $ .50 TOTAL 7= S Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit OWNER S KIND OF BUILDING iV USED AS S TO BE COMPLETED ABOUT iii ESTIMATED COST s L-7 4,, O G -- OLD - NEW BUILDING PERMIT NO - DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, not Water, Harm Air- No. Trade Name size No. Capacity Sq. Ft. EDR 87U HP Total Connected Load _ __ Kind of Fuel BURNER - Trade HMO _ Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 company PLUS $.50 STATE SURCHARGE Signe!Ri .fli�lli Attach stack verification fora with replacement furnace permits Minnegasco 4342.5326 Tel.% enue P. 0. Box 1165 y ��°" Minne�l, MN 55440-1165 �30F�6>9�C,A�C® a . RATE TOTAL Job Address C� $ 20.00 $ Department of Buildings, 6431 University Ave. N.E.• Fridley, NN 55432 City of Fridley $_10.00 $ Tel. #571-3450 10.00 $ The undersigned hersby makes application for a permit for the work herein $ specified agreeing to do all work in strict accordance with the City Codes $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the - facts and representations stated in this application are true and correct. j� $ 10.00 $ Fridley, Ninn. All Others/Repairs and Alterations It of Value of Appliance or Work $ COMMERCIAL/INDUSTRIAL it of Value of Appliance or Work $ State Surcharge $ .50 TOTAL 7= S Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit OWNER S KIND OF BUILDING iV USED AS S TO BE COMPLETED ABOUT iii ESTIMATED COST s L-7 4,, O G -- OLD - NEW BUILDING PERMIT NO - DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, not Water, Harm Air- No. Trade Name size No. Capacity Sq. Ft. EDR 87U HP Total Connected Load _ __ Kind of Fuel BURNER - Trade HMO _ Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 company PLUS $.50 STATE SURCHARGE Signe!Ri .fli�lli Attach stack verification fora with replacement furnace permits Minnegasco 4342.5326 Tel.% enue P. 0. Box 1165 y ��°" Minne�l, MN 55440-1165 �30F�6>9�C,A�C® a . CITY OF, FRI DLEY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND STACK VERIFICATION THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION 70/* A`1( 106,4W 'r DATE OWNER SP��, A ADDRESS The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration 3. No foreign objects are lodged within x 4. That it is securely supported, 5. That it meets all current Code requirements 1 for size and total BTU connected Y E. Total Heating BTU /00 d)00 a All Other BTU TOTAL REMARKS hl � f A- l A:lc cv � At u."- I rlu— HEATING PERMIT # SIGNED Licensee by Address Telephone Fridley City License 9 SUBJECTIrr City of Fridley 310 5 0 AT THE TOP OF THE TWINS ? BUILDING PERMIT r RECEIPT NO. : COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC.`�[C/� „ /�- r 1 � 1 i NUMBEpREv DATE PAGE OF APPROVED By = CITY MALL FRIOLEV 55132 612-571-3450 910-F15 6/9/00 JOB ADDRESS 309 Logan Parkway NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 Oak Creek Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert/Agnes Shaw 309 Logan Parkway NE 571-6299 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Reliant Energy-Minnegasco 2309 Snelling Ave S STE A, Minneapolis, MN 20169856 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 321-5238 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION O ALTERATION] REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (30 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,622 $1.31 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER T OR AL LAW REGULATING CON- '&T $83.25 Fire $2.62 RUCTION OR TH P STRUCTION AC PLAN CHECK FEE TOTAL F E e License 5.00 2.18 S,GN4TUAE OF CO 'FIACT Op AUTHORIZED AGENT [DATE, PR PE L IDATE T IS IS/Y IUR WMIITTMJ//�J $,GNATURE OF OW NER .6 OWNER BWLOE R, [DATE, PATE 4:110 #8� IV 9� /8 NEW [ ] Effective 1/1/2000 ADDN (J CITY OF FRIDLEY 612-572-3604 Bldg Insp ALTER [i]' SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 0 Construction Address:®9 ,/.nn�r� ��s�- S� I✓1�®0 Legal Description: 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 Width Hgt/Ground Sq. Ft OTHER: Z=L ow tel- xexp '39. /) _Sa 60 Construction Type: Estimated Cost: $/� Driveway Curb Cut Width Needed:+ 6 Ft = Ft x $ =$ DATE: /—z'—(n APPLICANT: &'`^4"'U-�, Tel. # ': /r& �✓�A� CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Call (612) 572-3604 for Permit Fees if mailing in application $ jI z5 Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ 1, / $.50/$1,000 Valuation $_$1 100 per SAC Unit $ ,S aQ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above 911 $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: $ BUILDING PERNUT 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 $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 fraction thereof, to and including $25,000 $391.25 for first $25,000 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 $500,000 $3,233.75 for the first $500,000 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 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 $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. 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. New Houses Only Q6Y OF FRIDLEY INSPECTION DIViSION 16431 University Ave NE Effective On January 1, 2000 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 30'9 LOS -IW A4u/ AL J .5Y43-2RATE SCHEDULE OWNER_�OxeV' ��•- 02jr'j' Residential Rate Furnace Shell and Duct Work, Burner - TOTAL BUILDING USED AS �LUQL�JK%- Also Replacement Furnace $ 30.00 $ 3 0. 00 (Side Vent - Fill Out Back) ©a crs ESTIMATED COST � l0©— PERMIT NO. J Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of HeatingLI its Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name &a4 P Size No. -ekA BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel-� Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE �®• SO representations stated in this application are true and correct. $ DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed /.t- TEL # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved BRough-In Date Final Date & .3 q A written permission from adjoining property owner. r 301 Logan P Ly W14 COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION en replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications 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 Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No When installing 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 Type 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 BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: , arrt_ Signed By:4WA Date : 301 LO�an P LWI 10 COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION W-menrenracina an existinci �furance, the undersigned hereby verifies that thethe has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. YesNo ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications 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 Furnace Venting Tables for fan assisted and natural draft appliances. Yes pCj No( ) The existing combustion air is sized and installed to meet the current codes manufacturer's specifications. Yes (- No( ) and r When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ` No( ) l When installing 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 J 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 o ( ) �No Armliance Tvae and Size/Common Vent and Vent Connector Information Appliance #1 Type PAA "t orn. a L'e BTU Input 7T Fan Assisted or Nat Appliance #2 Type 1`r BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input I Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height _Z�_ft Length .Z ft Diameter in Type Appliance #2 Vent Connector Heightft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) • W'j i • � � 4 C SUBJECT City of Fridley 33154 AT THE TOP OF THE TWINS P` BUILDING P E R M I T r I NO. • COMMUNITY DEVELOPMENT DIV. 1 ; V ______ r � PROTECTIVE INSPECTION SEC. E NUMBER REV DATE PAGE OF APPROVED BY i A /� -�,j CITY HALL FRIDLEY 55432 1 ---. „ 763-571-3450 910-F15 10/10/02 JOB ADDRESS 309 Logan Parkway NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 Oak Creek Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Shaw 309 Logan Parkway NE 763-571-6299 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Exteriors Inc 8600 Jefferson Hwy, PO Box 266, Osseo, MN 55369 A ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-391-5514 2877 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION 1j REPAIR O MOVE ❑ REMOVE B DESCRIBE WORK Install soffit & fascia 9 CHANGEOFUSEFROM TO STIPULATIONS Install soffit ventilation to meet the State Building Code. ermit Inspection Cards Will Be Malled To Homeowner To Post TYPE OF CONST OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED 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 CERTIFY THAT I HAVE READ AND EXAMINED 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 $231695 $1.35 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $83.25 Fire SC $2.69 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TO,fAL FEE Licen5olSC $5. 1492.29 SIGNATURE OF CON 7 FACTOR OR AUTHORIZED AGENT iDATE, WH PR LY VAL AT D THIS IS YOUR PERMIT/( B OG'N5 GATE S-GNATURE OF OWNER -6 OWNER BWLDE R. iDATE, C NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: '5 % �� Al�Glj Legal Description: Owner Name & Address: Tel. # 76?--fW Contractor:�-�A) MN LICENSE # �7 7 Address: Yg d q ,:(r,0J1 �%� �� eff,, ce �7/0 JC&1 15� Tel. #'%U LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVE Length Width Height Length Width Height _ Length Width Hgt/Grou Construction Type: C%G��2 Estimated Cost: $ 9J– Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �y APPLICANT: �iN Tel. #3W -rl l� Call (763) 5723604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ a.('9 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ J /"Pq X 0 /' x - STIPULATIONS: