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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: ZZ — z " ' 6 e Address N°5017 Builder f Address - - - --- — — -!� LO ION �F BUILDING No. Streetz7A I . Part of t ai Lot .__ Block - , Addition or Sub -Division Corner Lot Inside Lot �� `� Setback —�� Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To Yp Used f A'j4'--r'ZFront . Depth Height Zf Sq. Ft. Cu. Ft./` Front DepthHeight Sq. Ft. Cu. Ft. Type of Construction 39a—Est �41 A & be Completed 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 of ordinances of the city of Fridley. a In consideration of the payment of a fee of $ , permit is hereby granted to— to construct the building or addition as described above. This permit is granted upon the express condition that the person to 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, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any tune upon violation of any of the provisions of said ordinances. r' Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sura to see the Building Inspector for separate permits for these iteme. 4 s APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, KMMSOTA Owners Name Builder Address LOCATION OF BUILDING No. fi"L ! _Street L I)raA -�- Part of Lot Lot Co Block L Addition or Sub.Div. L,�j Corner Lot,_,,,,,,Inaide LotSet Back .S� Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used ass �""`r 10 IcG Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft, Type of Construction Estimated Cost To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true an orrect. I DATE _- ll' 3, SIGNATURE (A Schedule of Fee costa can be found on the Reverse Side. Apptica cion for Power Plants and. Heath% Coating, Ventilation, .Refrigeral�ion and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU, 4-7470 GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ C Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ Replacement of Furnace ............................. §.00 $ Repairs & Alterations—up to $500.00 ................ 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ............. I ......... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 $ Kt Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALikRATIONS & REPAIRS TOTAL $� . ROUGH FINAL City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fri4ley, 11 inn f �` —Ag 119(0-0- Z _ 119 Owner Kind of Building"✓ Used as�� To be completed about d'® Estimated Cost, $ Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or :O;_=aS—SteHot Water,4!fjrm/N'oa7-C-� Trade Name Size Capacity Sq. Ft. E.D.R_ /0e e0a BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Sign By q K.� 4 a ZM 7-59 Business Phone No..�� (REMARKS—OVER) s--/. 936-= HEAT LOSS CALCULA;&S ,(c vcL DEPARTMENT OF BUILDINGS 0 . MINN. Weatherstrips ws �rsA-Uile.E. Construction No. Insulation )yWGuide o. , Reference Out. Wall Int. Wall Floor Ceiling Roof Kind How. Applied o I -!� J�t6 19— 07 r • �• F1.1 Room I Lenath97De31,1 Width /V Heisfht o II / M � Room I Lenath!7-Z`Width e,' Heightg/ Win ows a oors—Crackage and Area 1179 Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. WidthHeight No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. �� 0�-1 �� JA.& { / O! .70 /y Ar. / 176 / J= I 70 ' 42d ® ©7/,® JCoef.j Btu Infiltration /11707 8 'r.3 161 �3a6� Glass �, a // e ---v y.3 �® -,Z) Exp. wall /Q Ceiling Net exp. wall /® e /® Net exp. wall Net exp. wall Ceiling Int. wall 44 /® /�•�� Int. wall Ceiling oe-)O o� Ceiling Ceiling Floor Floor f7®� �— Total Btu. V14,916 / ®'r Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /F1_1 _ Rmm1i.nnoth A19�'W;Jth /// NP.1Qht p'/ Windows a oors—Crackage and Area 1179 Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. Width Height No. of Lineal ft. Area No. ofpane of pane lights] of crackle sq. ft. 9sv rte/ ---74 ✓�. / 176 Coef. Btu Infiltration Coef. Btu Infiltration Glass /11707 8 'r.3 Glass Glass Exp. wall �, a // e ---v Exp. wall / Exp. wall /Q Ceiling Net exp. wall /® e /® Net exp. wall Ceiling Int. wall Int. wall Ceiling oe-)O o� Ceiling Floor Total Btu. Required_ t. M. - or sq. ins. W.A. Leader area I I FUa Room I Lenath Width / /I HeWh-t ,?/ Windo and Doors—Crackage and Area 3 1179 Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. i7 / (- A/15 I 9sv Exp. wall 176 Coef. Btu Infiltration Coef. Btu Infiltration Glass /11707 Floor Exp. wall /o / Glass Exp. wall Net exp. wall Required sq. ft. E.D.R. or sq. his. W.A. Leader area ® o M I - Y & / Exp. wall /Q Ceiling Int. wall /® e /® Net exp. wall Ceiling Int. wall A0,61 oe-)O o� Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 Windows and Doors—Crackage and Area 3 1179 Width Height No. of Lloss. ft. Area No. of pane of panne ilghts of crack sq. ft. --Z 9sv Exp. wall 176 Coef. Btu Infiltration / --7J' Glass Glass Floor Exp. wall /o / Total Btu. Exp. wall Net exp. wall Required sq. ft. E.D.R. or sq. his. W.A. Leader area o M I - Y & Int. wall /Q Ceiling Int. wall /® e /® Floor Ceiling Total Btu. 1 7-1A, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room ( Length // "Width// ° Height �® Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Wane Height lights of crack sq. ft. Infiltration 3 1179 Glass --Z 9sv Exp. wall 176 Net exp. wall Coef. Btu Int. wall Ceiling Glass Floor .50 Total Btu. Exp. wall Required sq. ft. E.D.R. or sq. his. W.A. Leader area o M I - Y & 11 D_—_ 1 r _--►L /— 9W;A.. I— _uo:bi,► Go ---- -- a - Windows andDoors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sQ. ft. Coef. Btu Infiltration s Glass .50 Exp. wall Net exp. wall /Q C..7 1.2 0 Int. wall Ceiling Floor A0,61 oe-)O o� Total Btu. Required sq. h. E.D.R. or sq. ins. W.A. Leader area 1756 e F �v 11.2 ate) HEAT LOSS CALCULATION DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Flo( Yes—No I Yes—No 19_ FIC a o nom Length >i9 Width /� —Height II M_I �i Windows and Doors—Crackage and Area 1Coef.1 ....,a... ro Width Height No. of Lineal f . Area No. of pane of pane Ilghts of crack sq. ft. Oe 9.19.0 / -v— Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. Coef. Btu &0 Exp. wall JCoef.1 Btu Infiltration Infiltration Net exp. wall '99 //7 Glass Ceiling 19 Floor f ��v Exp. wall ISG® Total Btu. Int. wall _ Net exp. wall Ceiling /® Q Int. wall Ceiling 6 ® a Z) Floor Total Btu. Required sp. ft. E.D.R. or sq. ins. W.A. Leader area ,.1 ......... 1 ...c..a.,. " to .. ,...., - 1Coef.1 ....,a... ro Windows and Doors—Crackage and Area g p I / -v— Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. Coef. Btu &0 Exp. wall Glass Coef.1 Btu Infiltration Net exp. wall Int. wall Glass Ceiling Exp. wall Floor Floor Net exp. wall ISG® Total Btu. Int. wall _ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Ceiling /® Floor Total Btu. Required s . or sq. ins. W.A. Leader area F1.1 Room I Lengtha® °Width WQ-ovffand Doors—Crackage and Area Width Height Noal . of Lineft. Area No. _ of pane of pane Ilghte of crack sq. ft. Windows and Width ] No. of pane c Insulation Kind How. Appli om I Lengt S1 Width /0 —Crackage and Area No. of Lineal ft. Area Ilghte of crack sq. ft. P 1Coef.1 Btu Infiltration g p I / -v— Glass Coef. Btu &0 Exp. wall Glass Net exp. wall Net exp. wall Int. wall Int. wall Ceiling --- Floor Floor — gr ISG® Total Btu. IAO. /4 -2 - Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Height Windows and Width ] No. of pane c Insulation Kind How. Appli om I Lengt S1 Width /0 —Crackage and Area No. of Lineal ft. Area Ilghte of crack sq. ft. P /Z 2 /78 Coef. Btu Infiltration / 'U d a/f Glass Coef. Btu &0 Exp. wall Glass Net exp. wall Net exp. wall Int. wall Int. wall Ceiling Floor Floor — gr ISG® Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area IAO. Fl.l Room I Lenstth Width Height Windows and Doors—Crackage and Area Width HeightNo. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ifis. W.A. Leader area F1.1 Room I Length Width Windows and Doors—Crackage and Area Width I Height No. ft of Lineal . Area No. of vane of an. lights of crack ea. it. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Btu City of Fridley, Minn.. BUILDING PERMIT Date: r r Owner: uilder O Address Address N° 5349 LO, TIO OF BUILDING No. streetFV Part of Lot Lot - Block Addition or Sub -Di on Corner Lot _ Inside Lot _ riG�^""aback ideyard Sewer Elevation _ _ _ Fo dation Elevation _ DESCRIPTION OF BUILDING T efl as: Front Depth Height - Sq. Ft Cu. Ft. o Depth _ ._ Hei t Sq. Ft Cu. Ft — Type of Constructio .. ^ Est Cost _--- To be Completed4-11 0 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 of ordinances of the city of Fridley. In consideration of the payment of a fee of $ a I permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to 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, construction, alteration, maintenance, repair and moving of buildings within the city ]imits and this permit may . be revoked at any time upon violation of any of the provisions of said ordinances. .,,�, _ , 4 ••-� NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. r LO, TIO OF BUILDING No. streetFV Part of Lot Lot - Block Addition or Sub -Di on Corner Lot _ Inside Lot _ riG�^""aback ideyard Sewer Elevation _ _ _ Fo dation Elevation _ DESCRIPTION OF BUILDING T efl as: Front Depth Height - Sq. Ft Cu. Ft. o Depth _ ._ Hei t Sq. Ft Cu. Ft — Type of Constructio .. ^ Est Cost _--- To be Completed4-11 0 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 of ordinances of the city of Fridley. In consideration of the payment of a fee of $ a I permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to 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, construction, alteration, maintenance, repair and moving of buildings within the city ]imits and this permit may . be revoked at any time upon violation of any of the provisions of said ordinances. .,,�, _ , 4 ••-� NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILpING PERMIT CITY OF FRIDIZY, MINNESOTA 7 ) Owner's Name Builder n J Address No. LOCATION OF BUILDING 4biL . 7 r_ Part of Lot Lot Block Addition or Subdivision Corner Lot Inside lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUIIDING To be used a"��-`�� n �[ Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings., and hereby declares that all the facts and representations stated in this application are true and correct. /`5� l (A Schedule of Fee Costs can be found on the Reverse Side.) m..4' - .- Appflcatla, for Power Plants and Hoeft Cooling, rendkdon, ReALigerolion and Air Conditioning S"Mm and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ................ .. $10.00 $ Replacement of Furnace 6.00 $ Repairs & Alterations—up to $500.00 6.00 $_ _ Repairs & Alterations each add. $500.00 3.00 $—_— MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ........ ..$10.00 $ each add. 60,000 BTU .................... .. 3.00 ; Replacement of Furnace .. .... .. 6.00 Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 &W $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. tt. EDR Steam $10.00 $. _ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3.00 $ — Each add. 320 sq. ft. EDR Hot Water 3.00 $� OIL BURNER—to 3 gal. per hour 6.00 $ _ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) .. ...... 6.00 $ over 199.000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures .. . ..... x$ zoo $ Additional Fixtures x .75 $ Gas Range to 199,000 s$ 600 $ AIR COUDITIOIft11G $47 FAN HEATING STSTBM See Fee Schedule VE1fTILATING SYSTEM $ ALTERATIONS & REPAIRS ROUGH FINAL 9 ` / % - 7 y - TOTAL FEE $ /'�r 6--Z) Dept. of Bldgs. Phone 6804490 /! City of Fridley: The undersigned 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 of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, (P Owner ,LLIC).-7-7-1 l Kind of Building _- �� 1 o' Used as To be completed about Estimated Cost, $�t� ✓l�_00 Old ew. Building Permit No. Permit No.� P=Cum, WOR>z -- terarm Air—No Trade Name— � Size Ne•G'�'_�a = �ry �'i /' Capacity '�� /rrla��®i �� H.P.. Total Connected Load_ gnd of _ U (REMARKS–OYER) — ams gaze >91� Signed_ %-%� st `��, i cz iBudneas P1 N06— '97 SUBJECT City of Fridley o 1870 AT THE TOP OF THE TWINS BUILDING PERMIT r GFIP_T NO � _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. - '- CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/15/86 JOB ADDRESS Z I LU/�� V P t L �t UODCL 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 1 �, 6th Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE . 7 Q 3 CONTRACTOR MAILZIP PHONE LICENSE NO. �m�AADDRESS 9 P. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATIONREPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK //�� 9 CHANGE OF USE FROM TO STIPULATIONS SEPARAT ERMITS 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT to A 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- /1 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. or� , �1 �6 PLAN CHECK FEE TOTALFEE SIGNATUREOF ONTRACTOR OR AUTHORIZED AGENT (DATE) EN PROPERLY LI T D THIS IS YOUR PERMIT LDG IN SP %-r�-6 DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NE [ ] City of Fridley Effective 4/1/8( ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Legal Description:- --{{-- Com. Ccs `U 1__� 8 Tel. f 577/z ®'0 % Owner Name iAddress : �L Contractor: • 7) 4' P_ -bnP Tel. # -75W Address: %40/ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF TKPROVEMIENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width __ Height Sq. Ft. -_ DECK AREA: Length - Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Type of Construction: Approx. Completion Date: /Lot [�] Ft. Yd. �I Setback - - Side Yard Setback Estimated Cost: $ Alt. A Alt P Proposed Driveway Width If New Opening Is Desired: _ $ $ See Back Page for Explanation l ✓�`G,1��:e DATE: APPLICANT:- T/ ° �� Tel . 4 ��- 75 -YY CITY USE ONLY Permit Fee Plan Check oo ` y Fee Schedule on Reverse Side 25i of Building Permit Fee State Surcharge $.50/$1,000 Valuation SAC Charge $475 per SAC Unit Park Fee r. Fee Determined by Engineering Sewer Hain Charge TOTAL g Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: I 6,0C) r - �' C? � CITY 01- FRIDLEY INSPECTION DIV, K ' Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 1* r Z ` L N ®6 DA, -A/9 . RATE SCHEDULE DULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Fumace $ 20.00 $ Z®. ®n representations stated in this application are true and correct, _ ,1993 Gas Piping (Needed with new furnace) $10.00 $ 1®, �p OWNER D ®4 fit I Gt ®®7°�/ Gas Range $ 10,00 $ BUILDING USED AS ,cam► Gas Dryer $ 10.00 $ ESTIMATED COST � � �0(� � oc PERMIT NO. %�cr *Air Conditioning — AD Sizes $10,00 $ 10. co DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs.& Alterations (LIST ON BACK) I% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Ljtsy .x Xx&6.. -&,) I -Q3't ize No. &0, ® © Commercial/Industrial BTUHP EDR 1% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ 50 Burner Trade Name Size No. BTU HP EDR TOTAL FEEs'40,50 HEATING COMPANY_ AIVSH N SG +#PZ MINIMUM FEE FOR ANY HEATING/COOL.INGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS 115.00 Signed By -*A 717444ok Tel No. 5 3b 0 ®bb i PLUS THE $.50 STATE SURCHARGE V REINSPECTION FEE $30.00 Approved Byald., Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( No ( ) 2.. Is free from rust or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes (X) No ( ) 4. Is securely supported Yes (X) No ( i 5. Meets all current Code requirements for size and total BTU's connected Yes No { ) 6. Has total heating BTU's of All other BTU's , 1 TOTAL BTU' s Remarks :�A5.rA t,I �`�� ? Le NNS �� S F"-CAI List Alterations Being Done: HEATING COMPANY M"54 YOMW6 p�- *,zx (&j Signed By Zd4 X-) ' Date 5 5.� IIOU51: HEATING TE ;T RECORD ADDRCSS APT. _ FLOOR CITYID&—SUDURO_ �- y OCCUPANT D•'� �� C Z3 `� '-! -� OWNER _ 5 f� ---- HEAT LOSS DATE IITG. INST. _ �- INSTALLED U�'_!_S!l„ 6r_-�• SOLD DY.� ��5_ s� '� �� ,�' Electrical Work llyt_ Gas Linc Dy TYPE OF HEAT: CA FA k 11W STEAM- 511ACE 11TR.UNIT 11TR.- OTIIGR • GAS DESIGN CONVERSION 1•i„t;r. CGC�/c fl MAKE OF. BURNM !'y X Model -'-- �• 73 k 3 l 1 Max. BTU Rating; ' Serial . d� rVd; Z or. INPUT- Moilcl - CONTROLS Tl1ERM05TAT _ltcat Plug _ -----vent Size KIND Ox Lzrrr•.n sY7.'�r NONC Vn�.va Limi i Draft llood_ Rcrulator Limit Scttinl? ! d o Piltera; Size 7 bX� .�Numbcr __ Chimney Location: 'Insidc.-Al_Outsidc — Fan Setting �d Pilot Type Chimney Cons truction%.,,, v C — Pilot Make Smoke Bomb Wiring Pilot Model -- Pilot Timing L DraPC Tea t ' Door Prcaaurc LiEhtinE Inst•____.__ L.W. Cut OPE p� cam- Pcrccnt CO2 !O Date Teated / Prcaaurc /� j�� d 1 j�!c`_ Input CFl{ Pcrccnt Off_ 24 • O Company Ica tiny" t `_ '� S 1�9 T �T rr Namc of Tester �'1 � Stack Tcrnp. J Pcrccnt CO i SUBJECT "27041 P City of Fridley AT THE TOP OF THE TWINS P E R BUILDING M I T ( r ` . NO. COMMUNITY DEVELOPMENT DIV. ��j�� ______ r v PROTECTIVE INSPECTION SEC. Z y F . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 j 612-571-3450 910-F15 8/7/98 JOB ADDRESS 1121 L de Dr 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 L ndale Builders 6th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don Collotti571-0437 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Four Seasons Roof & Remodel 7930 University Ave Fridlpy 795-9410 4 ARCHITECT 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 ❑ ADDITION ❑ ALTERATION ERX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 1 Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2585 $1.29 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR ION OR PERFORMANCE OF CONSTRUCTION. 74.75 FireSC 2.58 PLAN CHECK FEE TOT L EE sy7t \ o - Lice C 5 62 SIGNATURE OFC7RACTORORAUTHORIZED AGENT IDATEI ENRPRO&PVALIDA EHI$ I$ Y R PERMSIGNATURE B G IN OATE OF OWNERdF OWNER BUILDERI IDATEI NEW [ ] Effective'.1/1/98 ADDN ALTER [ ] SINGLE FA►MI'i;'AND DUPLEXES;' R=1 AND R-2 0 ' ,+..• a P I J P!,�y •ar!LIC,... QdN _- .a.y�)�y -q'� IF 0114 • , P - f i �` xi . �e, `'r: ��' h; Ai.+7ai'yj•'.*I+ {. ! ri. �. li. t + V {a ' r�Rn"s,F"''9••'e':�r `WP�� Y � f � el.%. ..'.'' ! l�#`�r°Pt}-.;'•S it i�r � ,4{y��?�tc�fFn'�f.7��-r4��i� ';� ConstructionAddress: ;. y , °' iF, �. �• F. �: ; Y? "iiia ,;� .+'t<�^,'..?�<� Legal Description: Owner Name & Address: b6in"n I Qi`f' Contractor: rUur 6ea 5 od-�i .dA&w►�1�1�ria l MN LICENSE :+-fn :address: 7G% 3 d L t U Tel. #: -IqS � gjio Attach 'to this agplicationj; a Certificate of Survey of the lot, with-tli4roposeds'construction.draw4 on1t,to scale. DESCRIPTION, OF V"ROVEMENT ..�'Nr � {.I • 4 J . _.� Rijn I ' LIVINGAREA: Length- Width Height Sq. Ft. ARAGE AREA: Length Width . Height Sq, Ft.' NECK AREA:jngth ',`, , Width - ' Hgt/Ground Sq. Ft. OTHER: �e_ ag Construction Type: Estimated Cost: $ (Fee Schedule, Driveway Curb Cut Width Needed: ° '' Ft'.,: +6 Ft = —Ft'x $ = $ �/JJ J�/q D DATE: • / V A'P LICA 17��/� i I1t y +, y C' �,Fyld�,rY.�O.�"i' r aF r k F�'�'`�c{ �`8,f�1d' �Y •s v � +`� �d s3 .�, t �" .: "t . ,. • �f , , p�+�'r<K dot. . •.ii.� Permit Fee $' " • •gFee Schedule on Reverse Side Fire Surcharge $ � tl`" 1s of:Pemu Valuation (1/10th%). State Surcharge $ t`$50/$OOO Valuation 000 SAC Charge i per, SAC Unit. $ + s� ,$11,4 '® '�r„�hF License Surcharge $$500,(StatLiconic4t Restden '$ '�°. h h 'r , L"[..' ,tv �ri it°PI��•,�'. .: Driveway Escrow Pr ryas i�J.1'A'"nor A7t:: B Above , �%it � a. cq�:ae �'Z .•P si tty� a�,r 4�1=C M,r .�. Erosion ControlOQ�C�o erv�tion x etw ,n9VCt S Park Fee $ `` dee Detemned by Engineering;.. i � ` l - 4. b ':., ,,..- ., ,':ri f;+. K3, •�•� w �1.�„ I ,!N{f�t4; �xi *,.'':' '. Sewer Mam 'Charge. ` $ i ;s�`°Agreement :Necessary [.] Not. Necessar 4•,. ..5,.i..• pj`'; .. s:.�,. ....'.+s p�;x � r� LT."kt •ti � 1:.rpLw �� STIPULATIONS a a rte �r� �� 9 r �zti�} P e � � �K 'rJ+p3 ��• "r �� ' .'� ?' �• �CR� y� � �x'�-P ��+.';+ `� �` 4'� y.c a a C-aFv ',�`'� 'p'�t :, ,,.• ,YYA� ,'",'�i i U a ;,,•.