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V!Ha of FAdleyq MUM ge BURMING P lv® 5.61 - h Office of WSPECMB OF BUYIMWGS � Owner �_14 Architect Frid'.ey, Minn., * 19 Builder' LOCATION of BIDING ' Street f ? Part of Dot Lot Block—Addition or Sub- Division DESCRIPTION, of BOEING Front Depth Height " stories Iffier ofConstruction �Pf' ' To be used as 00 41- To be, compieted_�&Est7ated Cost +e4 M % Permit is hereby granted C` the building & L ; {� described in the above statemen � This permit is granted upon the express condition that the person to whom It is granted, and his agents, .emplo ees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform all respects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair Lind moving of .buildings within the city limits, and this permit may be revoked at any time upon violation of an of the provisions of said ordinances. spector of Buildings. AGREEMENT AM 8WORAJ STATEMENT In consideration of the issue and delivery.to me by the Inc peptor, of' dings of Fridley of the above permit, %hereby agree to do the proposed work irn accordance with .the description above set'forth and according t® ihe'provisions of the ordinaneei of Fridley, , and, being first duly sworn, I hereby state and say that the facts stated by me and contained ' m the above permit are true as therein stated. Subscribed and sworn to before ine at Fridley, I inne-sota,' day of__ '! O BUILDING PERMIT Village of Fridley, Minn. ♦' Date.,. :........................... Owner ... Builder ................... Address 'y99F: t .... Address ................. ON OF BUILDING No. ..... Street Vit:. . ...... Part of Lot 9 Lot .............. B1ockY ... Additio or Sub -Division ... �t ���•' it Corner Lot ............ Inside Lot ........... Setback Si'deyard ...� i To be Used as: DESCRIPTION OF BUILDING 2542 Front Depth .. Height.... Sq . Ft1!.. Cu. Ft. ........ � , y .... Front ........ Depth ........ Height Sq. Ft. 11 ... Cu. Ft........ . Type of Construction ..... Est. C0 #0,040. .......... To be In consideration of the issuance to me of a permit to construct the building the proposed work in accordance with the description above set forth and in co ordinances of the village of Fridley. a .. X-. &. r In consideration of the payment of a fee of ,$ permit is here granted tc� ... .....::.......... . to construct the building addition as descri ed above. Th g thatthe person to whom it is granted and his agents, employees done around and upon said building, or any part thereof, shall conform in all respe Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and In the village limits and this permit may be revoked at any time upon violation of any ordinances. W19 ,d above, I agree to do with all provisions of ?granted upon workmen, in all work to the ordinances of ring of buildings with - the provisions of said ... Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, blumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 0 ' City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldga. Phone 560-3450 DESCRIPTION OF WORK Locshon / 4,3� Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ o:� x 8� < S �o 7Z Z �d O • F • N WATER HTR. GAS EIEC. Base 3.25 $ 1st 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings Connected with Sewer Cesspool 0 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin .... ....................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ......................... Additional Fixtures .................. Gas Range to 200,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code NO. RATE TOTAL X $1.50 It x .50 $ x 2.00 $ Description ................................................$ TOTAL FEE $ City of Fridley: The undersigned hereby makes application for a permit for 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 e / W 195/ Owner Kind of Building Used as ' To be completed about 6 — -'� / — (./ 6 Estimated Cost, $ ,%1" Old—New. Building Permit No Permit No. Signe By Business Phone No 42'f 2-- ROUGH f'fZ– ROUC3H FINAL C� 42 SUBJECT PER. Cityof Fridley 125'75 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ` 1 . i /--'t CITY HALL FRIDLEY 55432 �•' NUMBER REV. GATE PAGE OF APPROVED BY ---- 612-560-3450 910-F15 6/4/74 / / JOB ADDRESS 1533'Ononda a Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Auditor's Subdivision #129 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Anthdany Bourdeaux 1533 Onondaga Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SAME 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Storage Shed -T-CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK install a 12' x 14' Storage Shed 9 CHANGE OF USE FROM TO STIPULATIONS 1. Building be affixed to a permanent foundation. fSEPERATE PERMITS REQ[lFRED FOR ��,1�IIRING, HEATING, PLUM13ING A140 SIGNS, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Metal 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. $250.00 50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONJC 00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $5.50 IGNATURE OF CONTRAC OR HORIZED AGENT (DATE) HEN PROfjERLY V i ED THIS IS YOUR PI/RMI/• 6 I % l-3 BLDG INSP DA TE SIGNATURE OF OWNEATIF OWNER BUILDER,IDATEI APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF I-!:1 DLLY, '\1I NNES0'FA OWNERIS NAME :&� I UILDER• _ ADDRESS: (UO IL)036C2S�` ADDRESS : S -e_ NO:. L3 3_ STREET • 0 /VQ� J L'c7 -S. Z LOT: _BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD; Applicant attach to this form Two Certificates of Survey of Lot and proposed buildixig location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: J kf—'d Front:Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: 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 stticL accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that i11 the facts and representations stated in this application are true and t ,,rrt-c t . IDATE :`7 S IGNATU (See Reverse Side For Additional Information.) V • n UlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 July 12, 1991 Anthony and Kathleen Bourdeaux 1533 Onondaga Street N.E. Fridley, MN 55432 RE: First Notice of Noncompliance at 1533 Onondaga Street N.E. Dear Mr. and Mrs. Bourdeaux: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent inspection of the property at 1533 Onondaga Street N.E. revealed that not all Code requirements are presently being met. Listed below is an item which does not comply with the City Code: 1. Fridley City Code requires that all vehicles must be currently licensed/street operable and kept on a hard surface parking area, or stored in an enclosed structure. I observed two vehicles (531 CCK, 434 EZE) parked in the rear yard which are not in full compliance with these requirements. Your prompt attention in correcting this situation would greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or about July 29, 1991 to determine compliance. If you have questions or would like to discuss this, please contact me at 572-3595. Thank you for your cooperation! Sincerely, Steven Barg Code Enforcement Officer SB:ls CE -91-271 L SUBJECT City of Fridley 372 9;D45 AT THE TOP OF THE TWINS BUILDING P E R M I T r RECEIPT NO. ------COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. a� r 1 i CITY HALL FRIDLEY 55432 NUMBER REv DATE PAGE OF APPROVED By 763-571-3450 910-F15 7/29/02 JOB ADDRESS 1533 Onondaga Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 Auditor's Subdivision 4129 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kathy Bourdeaux 1533 Onondaga Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO MN Window & Siding Co 5730 Duluth St, Golden Valley, MN 55422 763-545-0545 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20296565 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House & Garage; Soffit & fascia 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. Caulk and flash all exterior openings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ire SC $12.87 STRUCTION OR THE P MANCE OF CONSTRUCTION PLAN CHECK FEETOTALFEE Lice SC $ .00 $247.55 ,-_f-VG-NATURE OF CON'RACTORORAUT.ORIZED AGENT IDATEI W N P ERLY VALID TED THIS IS YOUR PERMIT LOG INSP MATE S-GNATUREOF OWNEROF OWNERSUILDERI IDATEI L NEW (] CITY OF FRIDLEY Effective 1/12002 ADDN (J 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address:/-> Legal Description: Owner Name & Address: ,? Tel. # Contractor. AA/ A �o�� Go MN LICENSE # Address: 7 0 XIO t� Sf ��o% �+� Tel. #. 76,75-5K-65q,<- Attach 63-5K-dSyS 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/G and Sq. Ft OTHER: - C -S / o i rte'- E Construction Type: q Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$ DATE:7 APPLICANT: Tel. # Call (763) 5723604 for Permit Fees if mailing in application or Fax to 763-5714287 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 - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th% $ $.50/$1,000 Valuation $ $1200 per SAC Unit $ $5.00 (State Licensed Resideritial Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ . Fee Determined byEngineering $ Agreement Necessary [ ] Not Necessary [ ] $ � f -)-A STIPULATIONS: w5s CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 MW -Mf 11L! V►,W.aWIXI A a VA -VA ADDRESS : 1533 ONONDAGA ST NE PIN : 123024140022 LEGAL DESC : AUD SUB NO 129 : LOT 4 BLOCK PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMI7NO.: 2004-00860 DATE ISSUED: 06/08/2004 VALUATION : $ 3,600.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, CARRIER, 70,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 # FURNACES # GAS DRYERS APPLICANT RIVER CITY SHEET METAL INC 9928 BLUEBIRD ST NW COON RAPIDS, MN 55433 OWNER BOURDEAUX ANTHONY R & K A 1533 ONONDAGA ST NE FRIDLEY, MN 55432 0 # GAS RANGES 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 worl 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. Ann 'chant *� n Date . Bldg HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 13253 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. I 0 0.00 35.00 0.00 0.00 25.00 0.50 60.50 CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes Q+ �-387-7,A0ay a All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Total $35.00 $ $10.00 $ $10.00 $ $10.00 $ $25.00 $ 9 • Db Commercial/industrial/institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR ESTIMATED COST 300. �' PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units------ _ Circle One (Steam) (Hot Water) "W�a�rTrade Name at�7.� Pty �� =�� �'T�I !Dr%O Size No. BTU 70iv0 HP EDR Fuel�G Total Connected Load Burner Trade Name BTU HP Size No. 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 $ Ste. D 0 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City Tel I 1 FAX # Date S—o2O �4 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 ?j 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 No ( to meet the current codes and manufacturer's specifications. Yes e ) 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 f yGC BTU Input -7010 Fan Assisted or Nat Appliance #2 Type d BTU Input Dd Fan Assisted or Nat 2 Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input 6 \ e #-" C / Common Vent Type Z1460/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 Ir At TCMA"r%k10. /r% --- Ak-1 �C e t GD/D ;M' df/1�6 �S�CJ HEATING CO: Rtvar Signed By: Date: `l ;' Z �t'0 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS 1533 ONONDAGA ST NE PIN 123024140022 LEGAL DESC AUD SUB NO 129 LOT 4 BLOCK PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT �2004-008611, DATE ISSUED: 06/08/2004 VALUATION : $ 700.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER HEATER. # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 1 # GAS DRYERS # GAS RANGES 0 # OF NEW FIXTURES # WATER TRMT APPLIANCES 0 APPLICANT RIVER CITY SHEET METAL 9928 BLUEBIRD ST NW COON RAPIDS, MN 55433- (763)754-2199 OWNER BOURDEAUX ANTHONY R & K A 1533 ONONDAGA 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 worl 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 regqlatipg construction or the performance of construction. Bldg PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 13253 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.50 35.50 CITY OF FRIDLEY INSPECTION DIV. 6431 University -Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 I AS FITTING PERMIT ��IqAPPLICATION FOR PLUMBG ND N A G MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB AD New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas** p $35.00 Gas Range*" $10.00 Gas Dryer"' $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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 corgect. OWNER a5'. 0!5 BUILDIN, DATE: c;2 -sl .2 ESTIMATED COST 70©+ ©o PERMIT NO. / j / PLUMBING COMPANY/- SIGNED OMPANY/SIGNED BY Approved By Rough -In Date TEL NO5' S '�% Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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: Signed By: Date: ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY PERMIT NO.: 2004-00832 6431 UNIVERSITY AVENUE NE � FRIDLEY, MN 55432 DATE ISSUED: 06/03/2004� 572-36U4 tAX: (763)571-1287 1533 ONONDAGA ST NE 123024140022 AUD SUB NO 129 LOT 4 BLOCK ELECTRICAL RESIDENTIAL ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. RECONNECT FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT DEPENDABLE ELECTRIC INC 2619 COON RAPIDS BLVD NW COON RAPIDS, MN 55433 OWNER BOURDEAUX ANTHONY R & K A 1533 ONONDAGA 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 # 28488 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.