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PRE 2010 DOCSCITY OF FRIDLEY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND STACK VERIFICATION THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION 6542 Oakley St. N.E. DATE June 14, 1979 OWNER Ron Bloom ADDRESS 6542 Oakley St. N.E. 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 lodoed within 4. That it is securely supported 5. That it meets all current Code requirements for size and total BTU connected 6. Total Heating BTU 100,000 All Other BTU TOTAL REMARKS HEATING PERMIT # X X X SIGNED ce Licensee by-N-ortheast Sheet Metal Address _4347 Central Ave. N.E. Telephone zgi-9776 Fridley City License 14834 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work * Replacement of Furnace Repairs &. Alterations -up to $500.00 Repairs & Alterations each add. X5500.00 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU *Replace=ent of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500,00 STFAM OR HOT P AaTER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OII. BURNER- to 3 gal. per hour each add. 3 gal. per hour RATE $12,00 7,00 7.00 4.00 $12.00 4.00 7.00 7,00 4.00 $12.00 4.00 7! PQ A•qp TOTAL $7,00" SlQ.pp S }p:qq S GAS BURNER- from 100,000 BTU 1,0 199,jjq STN S}O:qq $ (over 199,999 BTU see Fee Sc}egj4le� S GAS FITTING FEES: 1st 3 Fixtures _j_ x $ I:qq LL. A4ditional Fixtures X $ l:Pp $ Gas Range to 199,QQQ BTU q AIR CONDITIO.NING ao .00 FAX HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS S ALTERATIONS $ REPAIRS $ State Surcharge $ .50 TOTAL FEE $20.50 ,lob .Address 6542 Og4ley St. N.E. Department of BRlldfngs City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. June 14 , 19 7 9 OWNER Ron Bloom KIND PF BUTLDTNG Frame pSNp AS Residential Tp pp. cpMp?,ETpR #.ppHT June 14, 1917 FmTTwpip, cpsT 2475.00 / PR - NM PN}RTNP PTMTT N. FERMTT NO. RESCRTgTTON AF FURNACE/BURNER UEATTNP or j?QWPP,F? ]TS1 A#P_Z le #)RI: timer{ Warm A}r- No. Trade Name Friidrich-Greenbriar Uze No. capacity Sq. Ft. RER BTU 1 00 y0()0 UP Total Connected Load Kind of Fuel na tiiral gas BURNER - Trade Name Size No. ROUGH INSP. REINSPECTION FEE '.Capacity Sq. Ft. EDR BTU HP Date 010.00) We are installing furnace to existing ductwork. FINAL INSP. Company Northpast�Sheet Metal • Date We are also installing a Freidrich Tempo 24,000 BTU air / Signed By to system. APPROVAL FOR PERMIT �� Tel. No. 781-9776 MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE *Attached stack verification form SUBJECT PERMIT NO. of Fridley 1��-2 2 9 ®1 AT THE TOP OF THE TWINS BUILDING PERM1f--�------ Ir?City RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. 1 � PROTECTIVE INSPECTION SEC. �� r Y✓ 1 NUMBER REV GATE PAGE Of APPROVED BY iCITY HALL FRIDLEY 55432 612-571-3450 1910-F15 9/13/94 JOB ADDRESS 6542 Oakley Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8F I Second Revised Auditor's Sub. #21 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald Bloom 6542 Oakley Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO MIlton Johnson Co. 525 Lowry Ave NE M ls. MN 781-9548 2083 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 REPAIR ❑ MOVE ❑ REMOVE R❑ 8 DESCRIBE WORK Reroof House (13 Squares) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State BUilding Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 975 .50 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- $25.00 Fire SC $.98 TRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE License SC $5.00 $31.48 S IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHI PR NSP %LID A D THI IS YOUR ERMIT 9 DATE S.GNATURE OF OWNERIIF OWNER BUILDER) IDATEI NEW [ ] Effective 1/ 1/94 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 49,6 tea. y 41!2 . Legal Description: Owner Name & Address: A,u,4 4A /JLo eq 1.71 Tel. # Contractor: iyj/L 7a �" �'®,t/ Cfl . MN LICENSE # le �3 Address: :�:,-2 o4o!K- Tel. # 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: �F.19c- - it a,,;=7 Estimated Cost: $ �� 1 Approx. Completion Date: 9 - -2y- 9 y� / (Cost on Back) Driveway Curb, Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 9 -/3 - y c l� APPLICANT: - a.� ` Tel. # '% F / - CITY USE ONLY Permit Fee $ DD Fee Schedule on Reverse Side Fire Surcharge $ 96 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ 00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ TOTAL STIPULATIONS: $ 3/. A CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 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 RATE SCHEDULE : The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specfied agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner - 00 rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00.• $ ya representations stated in this application are true and correct. (Side Vent - Fill Out Back) - ,1995 Gas Piping (Needed with new furnace) $10.00 OWNER®� ��Q� �!®6 �' - o Gas Range $10.00 ' • BUILDING USED AS�,�@�� Gas Dryer $10.00 $ ESTIMATED COST ? Q(0 ®® PERMIT NOJ 3 G *Air Conditioning - All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURbIER All Others/Repairs & Alterations (UST ON BACK) I% of Value of Appliance or Work $ No. of l-ieatin Units_ Circle One (Steam) (Hot Water)arm Air) Trade Name Size No. Gi aA � Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $� Fuel —Total Connected Load State Surcharge X50 Burner'Trade Namecxa'-s f' P.,- Size No. &A\ 0a BTU ,�C'�C'��t'�p�` HP EDR TOTAL FEE HEATING COMPANY C Gc-"'A MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION%- REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Sig No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved ByRough-In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SID OR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FUR CE Remarks: HEATING CO: Signed By: Date: CHIMNEY AND STACK VEWFI ATION 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 '( A.No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes y) No ( ) .6 Has total heating BTU's of All other BTU's (C) TOTAL BTU's \ LI ® , 00 i. Has a liner been provided for water heater Yes () No S. Has combustion air been provided for water heater Yes No ( ) Remarks: HEATING CO: Signed By: Date: S�� NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: (�1 Legal Description: Owner Name & Address: �"� ��� e U ��vUt,� C- , Tel. # -76P 3 Contractor: MN LICENSE # Address: Tel. # 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 ® 2— Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: (k o`P 6 a,, r 'C" s -roti Construction Type: w Estimated Cost: $� grin, Driveway Curb Cut Width Needed: Ft. X6 Ft = Ft x $ _ $ DATE. 2 - 2 APPLICANT: v- ® Tel. # LS f Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] TOTAL $ �i� A STIPULATIONS: