PRE 2010 DOCSh
VWage of Fpd1e., ` Minn.
0
4295
BUR DING PERMIT
Z."
Date:
02 71
........... Builder
ow .......
...............
.......................
Address .......... ...... ......... ..... .......................
A A
I N F BUILDING�
CAT 0 10
-7 Part
Lot No. Street
.. . ............ ...... .of
Lot Block ..... ...'Addittoi or. Sub-Divitidn ..... .. ..................
corner_ -Lot .......... . Inside Lot . ..... ....... Sideyard ......................
DESCRIPTION OF -BUILDING
To be Used aw
Sq. Ft
Front Depth H htf ......
4CU. Ft. .......
.�A.
I ...................... Front Depth Height ..... �Pq. FL�
_,Cu. n .........
Type of Qonstruction_ . . ........ .......... .......... To � be Coniple
..........
?I
f
In c6usideration. of 'the issuance to tie. of it -Permit' building described,- I agree to-do
�p construct the _
the proposed work In accordance with 1he.description above set forth and in compliance
all pr0VjqjG=, of
ordinances of the village of. Fridley.
. . . . . . . . . . . . . ... . . . . . . . . . . . . .
In consideration of the payment a feeof permit Is hereby grmanted
. . . . . . . . . . .
A ........
construct the building or addition asdiageribed above. This
Is granted upon
the e*Ters condition thaf theperson to whom it is .granted and hls agents, employees; and
M -in ail work
done in, around =& upon said building, or MY part thmeof, - shall confom In all respects
the ordinances', of
Fridley, Minnesota regarding location, construction, altemdon, matntenance,.repalr and mo
of buildings with
in the village limits and this'permit may be revoked at. any time upon violation of any of
provisions of .sald
ordinances.
......
Bulift; Inspector
. . . . . . . . . .
NOTICE:
This permit does not cover 06 construction, Installation or alteration for wiring, plum
ng, gas heating,,
sewer or, water. Be sure; to see � pIldlnd Inspector for. soaraie permit:i for,fl,--), Rem
City of Fridley, Minn.
BUILDING PERMIT N® 3766
Date: ...'��........... J........... .
Owner /.`% /%tel
... ... ..�`il� Builder .............................................
Address...................................... Address .............................................
LOCATION OF BUILDING
//
No. l./� qy. Street ... ..... Pa*Side
Lot ...
Lot ..1 �..... Block ..... /........... Addition or Sub -Division
Corner Lot ............ Inside Lot ............ Setback ........... ...........................
DESCRIPTION OF BUILDING
To be U a
.. X46; Front' : Q Depth %: ob Height . / . � v Sq. a7�i , curt. 3�
.................... Front .......: Depth ....
Type of Construction ................... Est. Cosi
..... Sq. Ft......... Cu. Ft. ........
..-.,.. To be Completed ...................
J � // 06W
In consideration of the issuance to me of a permit to construct the building desribed 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 $. ...., 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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. n
........ Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
w
,/ ,,,/ �4_ a �((� �
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name zc, `',Builder
Address l '' Address
CtATIO`N OF BUILDING
No o1 Street Part of. Lot
i `)
Lot/Y_ Block Addition or SUb;Divx
Corner Lot Inside Lot Set Back
Applicant attach•'to. this form Certificate of Stuvey of Lot and proposed
building location,
DESCRIPTION OF BUILDING
To be used as
Fn`.r�t,,._ Depth Height.
Cu
Sq, Ft. �o o ' Fto .
Front ., Depth Height
t
.St'y Q Fl: P CU. Ft
'�`y"e'c ^f COn�tru:;t�.on �____.�_... �.:. Fc+s ��+or1 Cos+, • w �� � �l_.:.�._.. .
To be completed
The undersigned hereby makes application for a permit for the work
herein specifiedi agreeing to do all work in striet'aecordance with the
City Ordinances and: ruling of the Department of Buildings., and hereby -
declares that all the facts and representations stated in thin application
are true and correct,
Date Signature
(k Schedule,;of, -Fee Costs can be found on the •Reverse Side)
i • -
33,;?e-6
City of Fridley, Minn. N° 8718
BUILDING PERMIT
Date: March 18, 1966
Owner: Delbert G. McLain Builder S€me
Address 162. Osborne Road N. E. Address
LOCATION OF BUILDING
No. 1624 Street O borne Road N. E. Part of Lot
Lot 18 _ Block 1 Addition or Sub -Division Spring Take Park–TakAcidA
Corner Lot _ Inside Lot _ Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 16f Depth 241 Height l0 1 Sq. Ft. 384 ca Ft 3 p 840
Front Depth ' Height Sq. Ft Cu. Ft
Type of Construction Est. Cost — _ To 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 21 provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ permit is hereby granted
IZjQQrT4 —U* lvieto construct the building or addition as described above. This permit is granted upon
the express condition that the peon to whom it is granterhisnein, around and upon said building, or any part therFridley, Minnesota location, construction, altthin the citylimitsd permit may be revoked at anye upon violation of any of the provisions of said
ordinaaoaa
ALLEN G. JENSEN Building Inspector
NOTICE
'fids permh don sof sown the senslrusdce, Insinuation for crMh& phrmbino, on hafte, ower or wafer. Be sun to sa
iia BuUdbre hnpeatar for asperafe permit for these haw.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER«v,
�O
ADDRESS _�,,� �-a`�ADDRESS
// LOCATION OF BUILDING
l0
N0. STREET � PART OF LOT
LOT_4_�( _BLOCK ADDITION OR SUBDIVISIO14
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
Front Depth Height
Sq. Ft. Cu. Ft.
Front De th Height—/6—
Sq. Ft. g' 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 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.
(Schedule of Fee Costs can be found on the Reverse Side)..
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY NAPA AIR:
RATE
TOTAL
Furnace Shell & Duct Work
$12.00
$
* Replacement of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$ '
MECHANICAL TtiAR.`.1 AIR:
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
each add. 50,000 BTU
4.00
$
*Replacement of Furnace
7.00
$
Ra_airs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
STEZI OR HOT WATER SYSMI:
Boiler & Lines up to 100,000 BTU
$12.00
$
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
each addn. 50,000 BTU
6.00
$
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ 6
(over 199,999 BTU see Fee Schedule)
$
GAS FITTI?;G FEES:
1st 3 Fixtures x
$ 3.00
$
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEMS See Fee Schedule
$
VENTILATING SYSTEMS
$
ALTERATIONS & REPAIRS
$
State Surcharge
S .50
TOTAL FEE
ROUGH INS?.
yar.e
FINAL INSP. .1- 3 -81
Date
APPROVAL FOR PERMIT
REINSPECTION FEE
(.$10.00)
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
Job Address
Department of Buildings
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.
en
nFridley, 'M An. �� I9
!I Q . � -,n- n S� ,
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT �/!% / % /
ESTIMATED COST
CLD - NEW BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or PMa"-'Z
ANTS, Steam, Hot Wa Warm No.
Trade Name Size No. (�
Capacity Sq. Ft. EDR BTU-&-day
�. d HP
Total Connected Loa / Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
s
Company
ems!
Signed By
Tel. No.
CITY OF FRIDLEY
APPLICATION FOR HEATING REPLACEMENT
CHIMNEY AND STACK VERIFICATION
THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM.
LOCATION DATE
OWNER 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
4. That it is securely supported
5. That it meets all current Code requirements
for size and total BTU connected
6. Total Heating BTU g1� VU
All Other BTU
REMARKS
HEATING PERMIT #
TOTAL F,� d-77
SIGNED 1.
Licensee
by
Address
Telephone -!mal
Fridley City License #
LIN
SUBJECT
PERMIT NO.
City of Fridley
-�
AT THE TOP OF THE TWINS
BUILDING
P E R M I T
r
T NO.
1
�
` s. _—�_�_ _ COMMUNITY DEVELOPMENT DIV,
I PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/4/95
/ /
10B ADDRESS 1624 Osborne Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
18
1
Spring Lake
Park Lakeside SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Delbert Melain 1624 Osborne Road NE
784-6464
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
D & D Home Improvement Inc 7401 Central
Ave NE, Fridley MN 55432 784-7543 4840
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 Ci REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reshingle garage (4.5 Sq) 2nd Layer
9 CHANGEOFUSEFROM
TO
STIPULATIONS
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
$247
$.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-
Fire SC $.25
STRUCT R THE PERFORMANCE OF CONSTRUCTION
$15.00
PLAN CHECK FEE
TOTALFEE
License SC $5.00
1 $20.75
SIGNATURE OFCO CTOR OR AUTHORIZED AGENT 1 ATEI
WHEN PROP
7jBLDG INSP
ALIDA IS YOUR PERMIT
S,14 -O _5
GATE
SIGNATURE OF OWNERoF OWNER BUILDERI IDATEI
LIN
NEW [ ] Effective 1/ 1 /94
ADDN [ ] CITY OF FRI DLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2'��
Building Permit Application
ConstructionAddress: 0z'�Z' 5_246"9 �K , Zeq
Legal Description:
Owner Name & Address: ����� s� �/,�e�e Tel. #
Contractor: D c D Home Improvement, Inc. MNLICENSE# 4840
Address: 7401 Central Avenue NE, Fridley, MN 55432 Tel. # 784-7543
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: S,600 a"�imated Cost: $
Approx. Completion Date: 4%
(Cost on Back)
Driveway Curb Cut idth Needed: Ft. + Ft = Ft x $ _ $
DATE: APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ / . O0
$ , �.2S
$ 0
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / 10th %)
$.50/$1,000 Valuation
$800 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 [ ]
SUBJECT
P..,IF-
City of Fridley
24352
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
--
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
i L����
v PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/11/96
JOB ADDRESS 1624 Osborne Road NE
1 LEGAL
LOT NO.BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
] 8
1
Spring Lake Park Lakeside
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Delbert McLain 1624 Osborne Road NE
784-6464
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
D & D Home Improvement Inc 7401 Central Ave NE, Fridley MN 55432 784-7543
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
4840
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
Reroof House (12 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the 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
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
1
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
$990
$.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 CON-
$34.75
Fire SC $.99
STRUCTIO THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
7
License
SC $5.90,
$41.24
GNA URE OF CONTRACTOR ,D AGENT 1 Ei
HEN PROPERLY
V I �JED THIS IS YOUR PERMIT
IjATE
SIGNATURE OF OWNER OF OWNER BUILDERi iDATEi
NEW [ J Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: 14;� �/ 4!�9'lcleltl e�eelpal
Legal Description:
Owner Name & Address:
Contractor: D & D Home Improvement, Inc MN LICENSE # 4,q 4 n
Address: 7401 Central Ave NE Fridley, MN 55432 Tel. # 784=7543
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:
—
A
k.,,Pstimated Cost: $
Approx. Completion Date:r LC
�® /2e�
�,
.(Cost: on Back)
Driveway Cur t Width Needed.:
Ft. + t = Ft x $ = $
DATE:
APPLICANT:
Tel. # 7!rV-- Y
CITY USE ONLY
Permit Fee
$
�J� ��®
Fee Schedule on Reverse Side
Fire Surcharge
$
19
.001 of Permit Valuation (1/10th%)
State Surcharge
$
n 6ZI
$.50/$1,000 Valuation
SAC Charge
$
$900 per SAC Unit
License Surcharge
$
610
$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:
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION 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,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25/0 of Value of Appliance or Work
JOB ADDRESS�h
Effective On May 10, 1999
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ 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
$ .50 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
Approved Byti- Rough -In Date
DATE
Final DatJ7
OWNERR
Rate
TOTAL
BUILDING USED AS
$ 30.00
$
ESTIMATED COST
PERMIT N0.
$ 10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00
$
No. of Heating Units
Circle One (Steam) (Hot Water) (Warm Air)
$ 10.00
$16,
Trade Name
Size No.
BTU
HP EDR
$ 25.00
$
Fuel
Total Connected Load
Burner Trade Name
Size No.
$
BTU
HP EDR
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ 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
$ .50 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
Approved Byti- Rough -In Date
DATE
Final DatJ7
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
CHIMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or
stack:
L
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:
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ .50
$SS -so
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
sG/si �. n ��;F l
:iiry c�:l�I AFP,k`i
41', 0 'vVEST _A`'KE STREET
HEATING CO __rp�gE���8
Signed / TELA#y�`I
Approved By Rough -In Date Final Date
BACK SIDE MU BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION'AIR VERIFICATION
q
SITY OF FRIDLEY INSPECTION DIVISION
Effective On January 1, 2001
643.1 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND
HEATING, COOLING, VENTILATION,
763.572.3604 REFWGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
OWNER �� 6
Residential
Rate TOTAL
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
30.00 in
BUILDING USED AS Cf -S ca&yc_
__00
$ $
o
(Side Vent - Fill Out Back)
ESTIMATED COST PERMIT NO.
Gas Piping (Needed with new furnace,
$ 10.00 $
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range
$ 10.00 $
No. of Heating Units Circle One (Steam) (Hot Water) arm r)
Gas Dryer
$ 10.00 $
Trade Name A r( Size No. SRa
BTU f, 6, , 04�n 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
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ .50
$SS -so
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
sG/si �. n ��;F l
:iiry c�:l�I AFP,k`i
41', 0 'vVEST _A`'KE STREET
HEATING CO __rp�gE���8
Signed / TELA#y�`I
Approved By Rough -In Date Final Date
BACK SIDE MU BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION'AIR VERIFICATION
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When 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 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 Type and Size/Common Vent and Verit 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 :
CIiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
November 26, 2001
Mr. Delbert McLain
1624 Osborne Rd NE
Fridley, MN 55432
Re: Final Inspection at 1624 Osborne Rd NE
Contractor: Standard Heating & Air Conditioning
Dear Mr. McLain:
A mechanical permit was issued on September 14, 2001 to install a furnace and an air conditioner
at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. As of this date, no inspection has been called
for.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do not
hear from you within this time to set up the inspection, we will expire the permit and no further
action will be taken.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely,
DAVE JENSEN
Building Inspector
DJ/mh
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FDM IRFS T(-1 RF INCTAI I Fn not Genu M nnQ
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 54)W - -e, dW&31E-1Z
New Fixtures
Old Opening, New Fixture _
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas`*
Gas Range"
Gas Dryer**
Back Flow Preventer Required { )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge $=50
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 puilding Division, and hereby declares that all the facts
.and repro—�n+=fnnc statpd in this application are true and correct.
MCLAIN, DELBERT -y
1624 OSBORNE ROAD �' 23 o `^ 20
FRIDLEY, MN 55432
(763) 784-64.64
Owner_
Building Used As�61�%/lY,
00 Estimated Cost 4n PERMIT NO.
PLUMBING COMPANY PLO AjQ CA
Approved By
TEL NO. A/Z-RZ T -4/® 5�
1�
Rough -In Date Final Date
_ `MINIMUM FEE FOR ANY PLUMBING/ .es PERMIT IS $20'
TOTAL FEE $�/��.� PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
, Mimi i 0
on W -M
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 54)W - -e, dW&31E-1Z
New Fixtures
Old Opening, New Fixture _
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas`*
Gas Range"
Gas Dryer**
Back Flow Preventer Required { )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge $=50
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 puilding Division, and hereby declares that all the facts
.and repro—�n+=fnnc statpd in this application are true and correct.
MCLAIN, DELBERT -y
1624 OSBORNE ROAD �' 23 o `^ 20
FRIDLEY, MN 55432
(763) 784-64.64
Owner_
Building Used As�61�%/lY,
00 Estimated Cost 4n PERMIT NO.
PLUMBING COMPANY PLO AjQ CA
Approved By
TEL NO. A/Z-RZ T -4/® 5�
1�
Rough -In Date Final Date
_ `MINIMUM FEE FOR ANY PLUMBING/ .es PERMIT IS $20'
TOTAL FEE $�/��.� PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When 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 appliancehas been -removed from the common vent and vented.
separately aspen current codes. Yes( ) No ( )
Apoll.ance 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 Cb:
r
Signed By: Date
CITY OF FRIDLEY PERMIT NO.: 2004-00815
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 06/02/2004
572-3604 FAX: (763) 571-1287
ADDRESS 1624 OSBORNE RD NE
PIN 123024110048
LEGAL DESC SPRING LAKE PARK LAKESIDE
LOT 18 BLOCK I
PERMIT TYPE ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. NEW 100 AMP SERVICE.
APPLICANT
AID ELECTRIC CORPORATION
1622 93 IN NE
BLAINE, MN 55449 -
OWNER
MCLAIN DELBERT G & EMMA F
1624 OSBORNE RD NE
FRIDLEY, MN 55432
ELEC AMP SERVICE FEE 30.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 30.50
PAID WITH CHECK # 43038
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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.