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PRE 2010 DOCSlaity of Fridley, Minn. BUILDING PERMIT NA 6575 Date: 2 6 Owner: 00, Builder Address Address _. Lot _ _ --Block I Z Addition or Sub -Division ,�----++ .014, Corner Lot — Inside Lot _ _ Setback , Com____ Sewer Elevation —_ ._._ Foundation Elevation DESCRIPTION OF BUILDING T 'sed name, °, _ Front -' Depth. _ Height „ Sq. Ft. L Com. Ft.; WAO Fran Depth Freight Sq. Ft. Cu. Ft. Type of Construction _ 'Uall in Fit. 45 To be Completed In consideration of the issuance to me of a permit to consft4 the building described above I agree to do the proposed work in accordance with the description above set f rth and in compli ce with a'll provisions of ordinances of the city of Fridley. /� 11 0 r-,, In consideration of the payment of a fee of $ gA L "—� ; permit is hereby granted two 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 7dley, Minnesota hin the dty limiivaaore. NOTICE M porn& dos not eoror the eondmWon, harm Mon for wkb& plumbing, gas hosting, rower or water. so sn a to no the Building Inspector for separate pormits for these home. i APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA A OWNER'S NAME - UILDER ADDRESS ADDRESS LOCATION OF BUILDING No.%� Street Part of Lot LotBlock Addition or Subdivision_(�r� Corner Lot Inside Lot t -----Setback I IV_Side-Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as : AV-'Ii,kC Al Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Type of Construction At Estimated Cu. Ft. Cot 1 60 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 of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicatioe true and correct. DATE 11% (Schedule of Fee Costs can be found on the Reverse Side). ti d F -r e f • Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ 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. IDR 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) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................ x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $_/ 3 ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 Location�- 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. Fridley, dley, Minn Kind of Building / ► Y�1 e-_ Used as To be completed about Estimated Cost, $ Old New. lding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam,Hot Wa Warm Air—No Trade Name 4 7ft—l" 0, CQ -j? � 4 K a/'Qrd Size No.f©i ® ® Capacity Sq. Ft. E.D.R BTU—H.P. Total Connected Load Kind of Fuel A'd / y (� es BURNER — Trade Name �'m �' % o Cct Size No Capacity Sq. Ft. E.D.R BTU H.P. Si e By .OQ« 2M Business Phone No �6 ®a '�� i (REMARKS—OVER) 1 City of Fridley, Minn. BUILDING PERMIT N® 7465 Date: N a 21j 1965 owner: r"/ ! f 1 G a! e Builderfi• - • i • Y dl L6 cl • ■ Address 7-4 Kississim-1 $-to NOE# Address I&it!e Bear Lake- Wizm, LOCATION OF BUILDING No. 748— Street — Masissippi St. N*E. _._. part of Lot Lot _ Block Addition or Sub -Division Corner Lot _ Inside Lot Setback -- Sewer Elevation To be Used as: Sideyard Foundation Elevation DESCRIPTION OF BUILDING Front Depth Height ._ Sq. Ft. Cu. F't. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost _15sO _ __ To be Completed Dwelling — Storm Du age 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 ,�et forth and in compliance with ill provisions of ordinances of the city of Fridley. (I In consideration of the payment of a fee of $0e00 , permit is hereby granted to AWerson CS2fl trs].Qt10n to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, arnund and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the dty ]imits and this permit may be revoked at any time upon violation of aR}► of the provisions of d ordinances. Building inspector NOTICE: This permb don not cover the construction, hutaLtatlon for wlrb& plumbing, gee heaHeg, sewer or water. Be ane to we the Buihltng kqm for for separate peemhs for these hems. J APPLICATION FOR BUILDING PE"112IT CITY OF FRIDLEY,'MINNEESOTA �✓/ � a j OWNER'S NAME�c"'� BUILDER G r D d ADDRESS Z ADDRESS=— LOCATION OF BUILDING No. Streetf, Part of Lot Lot Block Addition or Subdivision"01,04r7t4, Corner Lot Inside Lot* Setback .5-Z) Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. . To be used as; DESCRIPTION OF BUILDING Front DL..th Height Sq. Ft. Front Depth Sq. Ft. Cu. Ft. Height Cu. Ft. Type of Construction jtea, tip. Estimated Cost 0 _�7-c el To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNATURE. -- (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas F'ini'ng Permit DESCRIPTION OF WORK Number. Kind and Location of Fixtures 0,S$� Y F vTg�j Z j 2 O w Z • F • N WATER HTR. GAS ELEC. 3 ;SF, L34 3 t_ c vi '8C t� < 3 (�'� °d (�'� (�9 0 Base 1st 2nd 3rd 4th • Future Connection Openings Connected with * New Fixture, Old Openings Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: RATE TbTAL_ 7_4?­x$1.50 Number Fixtures .................... "r Future Fixture Opening ............. / x 1.20 $_41 - New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ P O d New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............... :.............. x $1.50 $_/ S Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ / TOTAL FEE Dept. of Bldgs. Pkone SU 4-7470 City of Fridley: The undersigned hereby makes application for a permit fbr the work herei 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 fact and representations stated in this application are true and correct. Fridley, Minn 19_ % Owner Kind of Building Used as ,/-►� To be completed about d �® Estimated Cost, $®® Oldew. uilding Permit A Permit No. Signe ROUGH FINAL _QW42 2M By Business Phone No CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas $10.00 Gas Range $10.00 Gas Dryer $10.00 Back Flow Preventer Required ( )Yes () No Type $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge .50 P JOB 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 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. .:5i® z Z"1991 Owner Building Used As® (2 - Estimated Costa °Q PERMIT NO. PLUMBING COMPANY SIGNED BN NO.JS Approved By -OW Rough -In Date Final Date // (0/ �17 <- MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $LJ• �O PLUS THE $.50 STATE SURCHARGE SUBJECT PE-� City of Fridley 6131 ' AT THE TOP OF THE TWINS BUILDING PERMIT Ir? RECEI COMMUNITY DEVELOPMENT DIV. 1 V PROTECTIVE INSPECTION SEC.® r li 1 i ' ` CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/3/98 10B ADDRESS 748 Mississippi Street 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Ortenstone Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Nancy Walker 748 Mississippi St NE 571-3079 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Dahl Builders & Remodelers 451 Maple St NE, Spring Lake Park, MN 55432 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 784-4830 2 050777 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE Cl REMOVE 8 DESCRIBE WORK Construct a 12' x 25' Deck; a14' x 21' Three Season Porch 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. NING Before digging call for ABATE PERMITS REQUIRED `FOR all utility locations "FHNG, HEATING, PLUMBING AND -SIGNS. 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIREO 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 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 $00,365 $5.18 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- Fire SC $10.36 STRUCTION OR THE PERFORMANCE OF ONSTRUCTION. $174.75 A) a4!!2' PLAN CHECK FEE TOTAL FEE - Lice C $40 $195.29 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI HE �P�RYD ED THIS IS YOUR PER 810G, INSP GATE SIGNATURE OF OWNERI)F OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (� BUILDING PERMIT APPLICATION ConstructionAddress: 7_// 9/5� Si4��i��,®f Sr"� Legal Description: Owner Name & Address: �/ll ��� Tel. Contractor: 6a/di Flee eZ3 e MN LICENSE# �4�d54�71 Address • Tel. # 7 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 Width2 Height GARAGE AREA: Length Width Height. DECK AREA: Length i Width � 57 Hgt/Ground OTHER: Sq. Ft.o%L, lJ . Sq. Ft. -77 6.73, ,w Sq. Ft. Construction Type: JP Qfi4 GU IW 4 Estimated Cost: $ .2– 'Q!2-2- (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ ia, 3v Y4 DATE:APPLICANT: Tel. # Permit Fee $ Ph 7� Fire Surcharge $ A A State Surcharge $ c', SAC Charge $ License Surcharge $ I Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ g • 2 % STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreemer* NPrPccanr f 1 Nnt Nececcary f 1 PIT 5.7 rf rcf��orrs�ot F,� 4' 07 SU BURAM' ..' .. .'L "'. 1' ? V2, of 4. 1. r-Ap or Walter's Addition J &a6aj 1/2 osb Sheating 25Year shingle 151b Felt Water & Ice Mem ,,-*` Deck Railin 6" South Elevation Of Porch 1/4 = 1.0' 2- 9 1/2" Microlam Solid Blocking Hand Framed Rafters 16" oc Jai (a) 9X/,) /�� 5' Down to deck a, 21' � � J FLASH OVER ALL EXPOSED EXTERIOR OPENINGS R-25 Insl /Ceiling ,VI. �Roof Vents 1" Al air spaces7e° -----soffit Vents `�- All Openings to be flirHeOL �as Fireplace Doghouse 40, 6X6 Posts Gm Trd Side View of Porch 1/4" = 1'0 House 6' Slider West Side 1/4 =1.0' 4X12' Landing With a steps to 2 nd Level 11 5' off the Ground Soffit & Facia to Match Existing House Floor Framing 14' Double Joists on ends and Front i of 2x91/2" Microlam Beam For Roof Load Lag Bolts Every 16" Jgist hangers -- Top View of deck and Porch 1/4"= 1'0 —� 12' *% 40uw ' 2x12" Joists 16" on Center 3/4" PLY wood Glued and Nailed Double Joists on sides & Front Down t Do eck Down to Patio I- �91�9 Existing patio Double Joists on sides and front I 1 I II 2x10"x12' 1 Green Treated Floor Joists on center 8" Dia ftg l2 p 42" Deep 16" Footings 42" deep on sides /dam" �C 12" in Other Locations 114 Cedar 12x 25 deck o 25' Joist Hangers LL =4 Down t Do eck Down to Patio I- �91�9 Existing patio Double Joists on sides and front I 1 I II 2x10"x12' 1 Green Treated Floor Joists on center 8" Dia ftg l2 p 42" Deep 15 Ib felt Water and ice Barrier 25 year Fiberglass shingle 1/4" ply underneath Wall Section 1/2" = 1.0' IYR " Nand framed rafters 16" on center 12 Ivl microlam Beam >sb sheating Roof ins ceiling solid blocking til poly Inge and Groove Cedar Interior yl Siding Exterior ,onstruction 16" on center )sb walls walls floor r & G plywood Glued and nailed 2 Joists 16" on Center f CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1 1998 6431 University Ave NE Fridley, MN 55432 APPUCA71ON FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work JOB ADDRESS_ 7 `f "t ' s S - f P e `S 1`C''/ k h The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and $ 30.00 $ representations stated in this application are true and correct. $10.00 $� d � � ,1998 OWNER Uj v� L $10.00 $ BUILDING USED AS V $10.00 $ ESTIMATED COST PERMIT N0. /n $ 25.00 $ s L c DESCRIPTION OF FURNACE AND OR BURNER 41 State Surcharge $ .50 TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILA OIT N60' SZ) REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr No. of Heating Units Trade Name BTU Fuel -Circle One (Steam) (Hot Water) (Warm Air) Size No. HP EDR Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY 0t�- h C I �o �, &' k Signed By Approved By *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE written permission from adjoining property owner. REPLACEMENT FUR Tel No. `t 3 6 Rough—In Date Final Date J'/J STACK VERIFICATION ON 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes.() No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: 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 () No ( ) 4. Is securely supported . Yes () No ( ) 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 TOTAL BTU's 7. Has a liner been provided for water heater Yes.() No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: ITY OF FRIDLEY INSPECTION DIVISIONIND of 431 University Ave NE ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, °1. 763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES a. © RATE SCHEDULE r_ N-esidential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range o ~ Gas Dryer "Air Conditioning - All Sizes Rate TOTAL $ 30.00 $- $10.00 $10.00 $ $ 10.00 $ 10.00 $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance.or Work,. W A :ommercial/Industrial 1.25% of Value of Appliance or Work LL LL 0 L) State Surcharge TOTAL FEE 0 r` 71NIMUM FEE' FOR ANY HEATING/COOLING/VENTILATION 1EFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 r? 'LUS THE S.50 STATE SURCHARGE 0111 m !EINSPECTION FEE $47.00/Hr ca m Air Conditioners can not be placed in a side yard withoul iritten permission from adjoining property owner. ti Effective On January 1, 2002 JOB ADDRESS —74 VYI i c iS1 ,2c�T OWNER BUILDING USED AS 'l L ESTIMATED COST PERMIT NO. DI_ _SCR PTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATING CO Signed FAXh_ .Approved By BLAINEam HTG. AVEEM, 1MC. 13562 CENTRAL AVE. N.E. ANOKA, MN 55304 r TEL # Rough -In Date Final Date �� JAN -15-2002 09:32 FROM CITY OF FRIDLEY TO ?5?5?01 P.02i02 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED VVhen rP I:;c inn an exiatinQfuranr_ , 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 ( I 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 -GAMMA Category I Central Fumace Venting Tables for fan. assisted and natural draft appliances. Yes( ) No () . . The existing comhiistion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No() When required" to ina ,aIla new cem>,tjstinn air_ it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When iDsfalling_.a n= venting sUstpm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers 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 Typp and `Zi a/ Common V nt and Vent r-nnntmefnr 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 01 sex - ING 13562 CENTRA AV 04N.E. HEATING CO: � I t Signed By: \ Date TOTAL P. 02 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 571-36U4 FAA: 17631571-1257 ADDRESS : 748 MISSISSIPPI ST NE PIN : 143024410116 LEGAL DESC : ORTENSTONE TERRACE LOT 5 BLOCK 1 PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT NO.: 2004-00721 DATE ISSUED: 05/19/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. # INSPECTIONS 1 APPLICANT ROBBINSDALE ELECTRIC CO 3754 W BROADWAY ROBBINSDALE, MN 55422 OWNER WALTER DAVID A & NANCY A 748 MISSISSIPPI ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 10199 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.