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PRE 2010 DOCSCity of Fridley, Minn. WELDING PERMIT Date: .... Rt a.?4.0.,79'59................... N® 3985 Owner ....................................... Builder ® ....................................... B9>4$OD Address...................................... Address ............................................. LOCATION OF BUILDING No.. 740 ...... Street ...PA id M.;!;;kM At. .A1........... Part of Lot ............................... rookVieLot . �:�........ Block ...... 5 .......... Addition or Sub -Division ........... T®rra fir ............• ......... Corner Lot ............ Inside Lot ............ Setbacks. .... Sideyard ..................... DESCRIPTION OF BUILDING To be Used as: .. Dwel];�.ug ...... Front �J1.�4N . Depth z . ?".. Heightlg .. Sq. Ft. 18 ... Cu. Ft. 20025 .................... Front ........ Depth ........ Height ........ Sq. ]k ........ Cu. Ft. ........ Type of Construction ................... Fast. Cost..0!9...... To be Completed ................... In consideration of the issuance to me of a permit to construct the building sribed above, I agree to do the proposed work in accordance with the description above set forth an in pliance with all provisions of ordinances of the city of Fridley. ... ... : .............................. In consideration of the payment of a fee of $.!,eVx1:..., 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. ..... ','4. Building Inspector NOTICE: This permit does not cover the construotion, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Buliding Inspector for separate permits for these Items Date: City of Fridley, NUmn. /P 2' � BUILDING PERMIT N® 6432 �Oros--� 'iwo '- W. 0T" BUILDING No. Street _ Part Lot Lot Block r Addition or Sub-Divislon� Corner Lot _ Inside Lot — Setback --?/-) •-;� !_ Sideyard — Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To as: Front 110 Depth .gHeight Sq. Ft. Cu. Ft _ Fro, Depth Height �h sq. Ft. a Cu. Ft. `fi e Type of Construction Fast. Co �� _ 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 all provisions of ordinances of the city of Fridley. A dc 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 crondition 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 dart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings w� dty limits and this permit may be revoked at time�po�n vigh�ion of any of the provisions of said NOTICE: ihb permit don not cover the construction, hutall tion for wiring, plinAing, gas heating, sewer or water. Be sure to see the Building lmpoetor for separate permits for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME Ly 26'XlQ 5 TiiFs c�� BUILDER ADDRESS O�A/t WA14 f%. Mf ADDRESS $,/,-17 c LOCATION OF BUILDING No. Street Part of Lot Lot � Block Addition or Subdivision a -d" t c/"e Corner Lot Inside Lot Setback 3 0 zf ii Side Yard 3 / SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; a&",69(A'e /4G [e' Front � ® Depth 2 Lf Height /0 / Sq._ Ft. Cu. Ft. 1914--r (o Front .2 0 Depth I I Height Z f, Sq. Ft. Cu. Ft. Type of Construction r g .4 /11 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. DATE — J 7 _ 6 3 SIGNATURE_ (schedule of Fee Costs can be found on the Reverse Side). City of Fridley, Minn.. BUILDING PERMIT Date: June 17, 1965 N° '7939 Owner: Bugene Gustafson Builder Dorman. Brandt Address 710 Pandora Dr. Address 9994 Raymond Ave St. Paul LOCATION OF BUILDING No. 740 Street Pandora Dr. Part of Lot Lot 10 Block 5 Addition or Sub-Divisiolprookyiew Terr. 3rd Corner Lot . _ Inside Lot ._ Setback Sideyard Sewer Elevation Poundation Elevation To be Used as: Front Front Type of Construction DESCRIPTION OF BUILDING Depth Height Sq. Ft. Depth Height Sq. Ft — Fat Cost --1100021-- To be Completed Repair storm damage Cu. Ft Cu. Ft In consideration of the issuance to me of a permittp construct the building described above I agree to do the proposed work in accordance with the description abe set forth and in omp�ce with all provisions of ordinances of the city of Fridley. , In consideration of the payment of a fee of 100 permit is hereby granted to Norman Brandt 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 location, construction, alteration, maintenance, repair and moving of buildings within the city limit this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Men Jensen Building, mor NOTICE: TM@ perndt don net cam the condruction, hate bOm for whb& plumbing, gn bandn& nwar or waist. Bo sure to sae the Bnildtng bqm ter for :spam parm(ts for than Marta. OWNER'S ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA �7 ! N, LOCATION OF BUILDING -�� l �l� - 4 /24 1 (I C� !� Street Part of Lot L ADDITION OR SUBDIVISION Corner LotInside 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. C Cu. Ft. Front Depth _Height Sq. Ft. Cu. Ft. Type of Construction'4L cal— Estimated Cos-' / , � 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,aare true and correct. (Schedule of Fee Costs can be found on the Reverse Side). J ld`<j CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES r JOB ADDRESS 74�2 P/el r t D r'&_ Die- IL16 RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $ AQ -0 that all the facts and representations stated in this application are true and correct. 11991 Gas Piping (Needed with new furnace) $10.00 $ �&Clk S® Y) OWNER L Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $ 10.00 $ ESTIMATED COST PERMIT NO. 'Air Conditioning - All Sizes $ 10.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ CommerciaUlndustriM 1 % of Value of Appliance or Work $ State Surcharge $ .50_ TOTAL FEE $.,3 MINIMUM FEE FOR ANY HEATING/COOLINMENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 • Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) (Hot �amWater) AiTrade Name Ali gi4�l't Size No. 3qS'COVOo BTU HP EDR Fuel Total Connected Load S34 Burner Trade Name Size No. BTU HP EDR HEATING COMPAN tA.Y Signed By 1 I Ad — Tel No. ,) /- BLAINE HTG, A/C A ELECT. INC. 13562 CENTRAL AVE. N.E. ANOKA, MN 55304 Approved Rough -in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICAT!9N ON� REPLACEMENT FURNACE 1 1V7 .1 9-� CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (A,) No ( ) 2. Is free from rust or deterioration Yes (6 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 BTUs s Remarks List Alterations Being Done: ELAINE HTG, A/C & ELECT. INC. 13562 CENTRAL AVE. N.E. HEATING COMPANY ANOKA, MN 55304 Signed By Date a SUBJECT Cr ,ty of Fridley M21281 AT THE TOP OF THE TWINS ?-� BUILDING PERMIT RECEIPT N . _____ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 . I NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/14/92 JOB ADDRESS 740 Pandora, Dr NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 5 B.rookview. Terrace 3rd Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jack Larson 740 Pandora Dr NE 5715685 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12 x 12 a Deck 9 CHANGE OF USE FROM TO STIPULATIONS Seenotations on plan, WARNING Before digging call for all utility locations 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $] $, 55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT X105 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $29. 00 sire $.0 $1,11 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $30.66 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIHEN ROP LY VA DA D THIS IS YOUR PERMIT LDG INSP NATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI land Ati nnin9 370Mrssiss SINE ,' ' [arad:inq, . Minnenpa/is Z/,, _..Sailsksiky ENGINEERING, INC. Cry►l Fr.Aluricipn/ Silhot440" y --- En yineers Sur vectors Fcr:— 4 c�estific'ate of su�rve Y R N N . r � • j6 _ i oTFv5 .UT,LlT'j PRA AMPE, EAMMENT' bRO0K-V.I F -W TE P"P Ac CSE - � A .171 1710M 7/%eby c!r ;fy. /bot hits is o Inas and cared represenfahr n of e so"r"t, e& boundo� ies obarr desrr.6ird /mad, and o 'flu local.�on q%// bwld s , ff�treon ,. and ol/ ristb/e awnachn�enfs , i�'any; f i or an said /ond As wrveyed 6y lM t1�Cs • _ aby Lill AS 19.M. SUBURBAN ENCG1NEERINC2, WC. NEW Effective 3/1/92 ADDN CITY OF FRIDLEY ALTER f SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: Y e r P IV, i, 4t,/ a, le - Legal Description: Owner Nam M& j Contractor: �� Address: 7 '� 0 671, LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # S- 71 MN LICENSE # Attach to this application, a Coitificate of Survey of the K with the proposed construction drawn on it to scale. DESCRIPTION OF IN[PROVFJ&ENT Length Width Height Length Width Height Length j ;1- Width- Hgt/Ground 3 Sq. Ft. Sq. Ft. Sq. Ft. I yam/ Corner Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: rn Estimated Cost: $ _71-90 Approx. Completion Date: (Cost on Back) Driveway, Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ 6 DATE APPLICANT, -�6 .cj t Tel. # 7 YCITY USE ONLY - Permit Fee 0 0 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.501$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00. (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary I Not Necessary t I TOTAL STIPULATIONS: VI it ,jr rnluLCl w4 orm%.,mjIV ulv. 5431 University Ave NE Fridley, MN 55432 572-3604 tnecuve un uanuary r, iaa:j APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR .. •�"''• <�,,•�;.(.r•..y.,�', Stories Urinal Shoover�Tra Floor ��`'....Auto Drain Gas Washer mange Water r Gas Basement Floor loo 1 Floor 2 ,.. Floor3 F loon 4 PLUMBING FIXTURE RATES: NO. RATE. TOTAL JOB ADDRESS / ® V� �® V '� �5 Y' New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work In strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin '$7.00 and representations stated In this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $.7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner Water Heater —Electric .$7.00 Water Heater — Gas _� $10.00 Building Used As Gas Range $10.00 Gas Dryer $10.00 Estimated Cost •J O '!—e PERMIT NO. Back Flow Preventer Required ( )Yes () No Type •$5.00 PLUMBINGCOMPANY Reinspection Fee $30.00 SIGNED 6 TEL N0. 3— ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance • Approved Rough—In Date Final Date 4 State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ S� PLUS THE $.50 STATE SURCHARGE SUBJECT RMIT NO. City of Fridley2 6 2 9 8 AT THE TOP OF THE TWINS BUILDING PERMIT'( r � RECEIPT NO. 16 tr -------COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/22/98 108 ADDRESS 740 Pandora Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 5 lBrookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jack Larson 740 Pandora Drive NE 571-5685 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Premium Roofing 6680 Lucia Lane #11, Fridley, MN 55432 571-3973 20097688 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 Q REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 $2,085 $1.04 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $74.75 Fire SC $2.08 PLAN CHECK FEE TOTAL FEE License SC $5. 0 $82.87 SIGNATURE OF CONTRACTOR OR AUTHOR12E0 AGENT IDATEI WHEN ALI DATED THIS IS PERMIT FIR�OPER �V BL �N' eYOR _a ryATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 710 P-4 Legal Description: Owner Name & Address: 9/ -}Gk 1-"f fKO'v Tel. 5 95 Contractor: AE/14/ c1A'N c0l=1'Ve- MN LICENSE #JC2a 76 Address:-, gc) z_uc14 L-A... 1:1// ��PiyL'ry ,A'.1 _s`6)d Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction i drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width HgyGround Sq. Ft. Construction Type: 1&o4:1(16 Estimated Cost: $i_ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: /G Lu_yrJ,-eAz `�IP6_7A�ur�lid Tel. # 7i1I'��%� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763.572.3604 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% of Value of Appliance or Work Effective On January 1, 2001 JOB ADDRESS —I 14 D OWNER Rate TOTAL ll BUILDING USED AS �� l I SCI $ 30.00 $ ESTIMATED COST �� CO PERMIT.NO. A6 V $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. /� BTU H.P EDR $ 25.00 $ 0�5� Fuel Total Connected Load 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 $ m, so Burner Trade Name Size No. BTU HP EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE ELECT.t�INC. AVE. IV.E. Rough -In Date S—'77—D 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 manufacturers specifications. Yes No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturers specifications. Yes } No( i/� 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) - BLAINE HTd. A/C ELECT., INC. 13562 VENTRAL AVE. N.E. HEATING CO: 65304 5 Ll Signed By: en. Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 YAX: (763) 571-1287 ADDRESS 740 PANDORA DR NE PIN 143024110101 LEGAL DESC BROOKVIEW TERRACE 3RD ADD LOT 10 BLOCK 5 PERMIT TYPE ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01770 �a l DATE ISSUED: 10/05/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER LARSON JACK D & JEWEL ANN 740 PANDORA DR 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 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 # 118132 JhPAKA 1 K PPKMI 15 KhQUIXED r UK W UKK U 1 HKK THAN 1 ESUKIBED ABOVE.