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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.