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PRE 2010 DOCS� -----�'�^.--- ��-;„�.- -��•� -- +mss. City of Fridley, Minn. BUILDING PERMIT Date: ....... ... ' . .... `.'............ . Address ...................................... N® 3527 Builder ...� ..... .... ................. Address....... ..................................... LOCATION O)BUILDING No. . . /. Street ... ... .... .......... .. Part of Lot . ............. ....:....... off- ��. Lot .. a� ...... Block ....... ........ on or Sub -Division ............. ... f: � ... .. ... Corner Lot ............ Inside Lot X......... Setback 3..,1.710. .. Sideyard .L.0.':� ............... DESCRIPTION OF BUILDING To be Used ...... Front 7. �' Depth: • e Height �� Sq. Ft.ldtr Cu. Ft. Front ........ Depth ........ Height �%�. Sq. Ft......... Cu. Ft. ........ Type of Construction ................... Bst. Cost/07, 9�.�. 000.' To be Completed .............. .. In consideration of the issuance to me of a permit to construct therbrAhsribed above, I agree to do the proposed work in accordance with the description above set forthpliance with all provisions of ordinances of the city of Fridley. ............................ In consideration of the payment of a fee of $..'�:., permit is hereby granted to ................... ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any the provisions of said ordinances. ...I ... B g Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiringmbing, gas heating, sewer or water. Be sure to see the Building Inspector forseparate permits for these Items. City of ]Fridley, Minn. BU11DING PERMITN° 5695 Date: _ ""_ 1 Owner: ' Builder )/1 Z v a�ov— Address _ _ .___. _ _ Address L®CATI®p F BUILDING No. 'It _ Street ' _ C — _ Part of Lot Lot _ Block '� Addition or Sub -Diodon _ Corner Lot Inside Lot h J*tback Sideyard— Sewer Elevation __ __ _ _ Foundation Elevation DESCRIPTION OF BUILDING Tco, as: « Front DepthHeightA$C_ Sq. Ft. Cu. Ft. Frot Depth Height Sq. Ft. _ Cu. Ft. Type of ConstructionEst: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. 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances .---% _ ..,'' Building Inspector NOTICES This permit does not cover the construction, .installation for, wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. Z �, ® Street ` Part of Lot _ Lot Q=, BlockAddition or Subdivisio Corner Lot Inside Lot Setback side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To ben used as Type of Construct To be Completed DESCRIPTION OF BUILDING Height ' Sq. Ft. Cu. Ft. FrontDepth Height Sq. Ft. Cu. Ft. M i mated Cos t 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 ruling of the Department o.f Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct.4 (schedule Fee Costs can be found on the ifeirerifevSide) 2 �� 3 9ITY OF FRIDLEY INSPECTION DIV. §431 Vniveralty Ave NE Effective On January 1, 1991 Fridley, MN €5432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 20.00 $ Gas Piping (Needed with new furnace) $10.00 $ Gas Range $10.00 $ Gas Dryer $10.00 $ *Air Conditioning - All Sizes $10.00 $�® All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work CommerciaUlndustdal 1 % of Value of Appliance or Work State Surcharge TOTAL FEE JOB ADDRESS 6 !2�3 �' = A, 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in thisa plication are true and correct. J Ct-N-4P ,199y - OWN BUILDING USED AS'17 `- ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load .50 Bumer Trade Name Size No. BTU HP EDR MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION 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. HEATING COMPANY_ A� Signed BLTel Tel No. Approved By / r Rough -in Date Final Date l ' l " � 4-1 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) 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 Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE RDMT.F.V MV S4dZ7 PERMIT 1 ,O.: 2004-00356 DATE ISSUED: 03/18/2004 572-3604 FAX: (763) 571-1287 ADDRESS 6730 QUINCY ST NE PIN 143024140008 LEGAL DESC BROOKVIEW TERRACE LOT 2 BLOCK 4 PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 5,000.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE 10 WINDOWS WITHIN EXISTING OPENINGS STATE LICENSED CONTRACTOR 1 APPLICANT WINDOWS AMERICA OF MN INC (20248265 559 SHOREVIEW PARK R SHOREVIEW, MN 55126- (651) 203-0149 CU:' 01:7 YOUNG MICHAEL J & DEBORAH A 6730 QUINCY 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 worts 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 constgruction or the performance of construction. ADDIS Date BUILDING PERMIT FEE 111.25 FIRE SURCHARGE 5.00 STATE SURCHARGE, VALUE 2.50 LICENSE SURCHARGE 5.00 TOTAL 123.75 PAID WITH CHECK # 9091 ow. Ino" gal Cards 1,I� 8 Malled `veer To Post SEPARATE PERMITS REQUIRED FOR WQRK OTHER THAN DESCRIBED ABOVE. NEW [ j CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND.R-2 BUILDING PERMIT APPLICATION Effective 1/1/2003 (763) 572-3604 Bldg Insp (763) 5714 287 Fax oil Construction Address: Legal Description: - Tel.#��-` Owner Name & Address: MN LICENSE Contractor Address:tV Tel. #-&5 L — ZD ss/a� 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 WidthHeight Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type'U11 �f' stimated Cost: Driveway CUff Cut Width Needed: Ft. + 6 Ft = Ft x $ _ J APPLICANT: Tel. # DATE. l Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ - S'n $.50/$1,000 Valuation SAC Charge $ $ $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) License Surcharge Curb Cut Escrow ____,5j00 $ 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 ... _........... � .... . � �) �� a :� ..... ;zT1P�� ........... _ ... M ........_ _ ..._ . ATIONS: sueiEtT P NO. City of Fridley 27969 AT THE TOP OF THE TWINS BUILDING PERMIT e• • _ COMMUNITY DEVELOPMENT DIV. �: ----- r � PROTECTIVE INSPECTION SEC. �V 1 CJ NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 9/25/98 % 10B ADDRESS 6730 Quincy Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2 4 Brookview Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Young 571-6689 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wright HOme Improvement 4735 Norwood Ln Plymouth 54559-4250 20035829 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 )a REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 20 S 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 OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS 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 1714 .86 DOES NOT PRESUME TO GIVE AUTHORIT TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVIS1 S OF ANY OTHER ST TE O LOCAL LAW REGULATING CON- STRLION QF HE FORMA E F CONSTRUCTION 56.75 Fire SC 1.71 PLAN CHECK FEE TOTAL FEE License SC $5.00 64.32 SIGN4 TURF OF CON'RACTOR AUTHORIZED AGENT' IDATEI WHEN PROPERLY IDATEP THIS IS YOUR PERMIT BLDG '/,SP TIAT SIGNATURE OF OW NER pF OW ER BUILDERI I ATEI - ' NEW ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 6 ` 3 a 1 Legal Description: hC'/ ST 4�7. Effective 1 / 1 /98 Owner Name & Address: Ark'e your'Tel. #7l Contractor: 4/L47-qae �eINI� MN LICENSE #200�,r�o�1 Address: Gf 7 3 � � v �� 01 p/Vd1.0.-i1. Tel. # 5-)1— LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF B1PROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Driveway Curb Cut Width Needed: DATE: - � -1 APPLICANT: Estimated Cost: $ / -//Y (Fee Schedule on Back) Tel. # Permit Fee $ 9s- Fee Schedule on Reverse Side Fire Surcharge $ /. '7( .001 of Permit Valuation (1/10th%) State Surcharge $ 5 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S U® $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 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 571-36U4 VAX: 176315"11-IZ57 ADDRESS : 6730 QUINCY ST NE PIN : 143024140008 LEGAL DESC : BROOKVIEW TERRACE : LOT 2 BLOCK 4 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-00136 �, 3 J� DATE ISSUED: 01/28/2004 VALUATION 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 REPLACE FURNACE (WARM AIR, HEIL, 50,000 BTU) VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS APPLICANT ROYALTON HEATING & COOLING 4120 85 AVE N BROOKLYN PARK, MN 55443 (763)424-8333 L alg p1.7 YOUNG MICHAEL J & DEBORAH A 6730 QUINCY ST NE FRIDLEY, MN 55432 0 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 L V9�� Bldg Insp D HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 30.00 GAS DRYER FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 30.50 PAID WITH CHECK # 39580 CRDAD ATR T)RRTATTQ 1D1r7(1TTTT?RTl TCM? Wr)IDY nTT-TRR TT -TART TWW'RTRFTI ARCIVR CITY OF FRiDLEY INSPE �;l Q J DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3504 REFRIGERATION AND AIR COND17I!ONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work. Burner - AJso Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer "Air Conditioning - All Sizes Al! OthersiRepaim & Alterations (UST ON BALK) 1%, of Value of Appliance or Work Commerciallindustrial 1.25y� of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE REINSPECTION FEE $47.00/Hr "Air Conditioners can ncA be placed it a side yard without written permission from adjoining property owner. TOTAL b $ .5-0 Effective On January 1. 2002 JOB ADDRESS &Z30 6t- )Ue_ OWNER_L� BUILDING USED AS ESTIMATED COST _ PERMIT No. e � jka No. of Heating Units_ Circle One (S;cam) (l lot Water) rry Air) Trade: Narne. / i r _ Size No. 'foo _ BTU 000 HP . EDR_ep;- FueI, Tata! Connected Load Burner Trade Name Size No. BTU--- — HP -- _ EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do afi 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. ROyALTON HEATIN 100LINT�,t/-o� HEATING CO _ 4120 - 85th AVENUE m.. -- Signed.--_— A 5 443 �R 763-424-8333 Signed . -- _ _ — _— TEL # _ _-_— TAX # -4 Appro.,M By. Rough -In Date _.__ Final Date evvR Pricdout certified by ACOA to most all requirements of Mimual 7 Form TOTRL P.05 hMMALl:7M ALLUMIr, W1114vr0 1 NmeoiRwas Entire Hoose first floor second floor 2 Rturning FL Exposed Well 260.0 R. 130.0 Ft. 130.0 Ft Ft. 3 Rooth Dimensions, FL 0, 0 t. 25. 0 x 40.0 ft 25.0 x 40.0 Pt x l?t, 4 Ceiings.Ft Can&Opftfl 8.0 d 8.0 heat/cool 8.0 heat/cool TYPE OF Cal HIM Area Bttuh Am Bah Am Bra Arca Btuh MOOSURE NO. Me Gig TAntth Rtg Qg Length t;itg Cis Length Fitg Cg Length Htg Clg 5 Cross 1 UP 6,3 1.1 20eO rrrr 8808 1040 +*a apse 104 err* *rrm s«ae *art Exposed b 121 6.6 1.8 260 torr some 260 •r«► wort a tore *040 rrrr rsor Walls and 0 125 0.9 1.8 680 rrrr rare 650 rrrr Marr a rrrr 0480 «s*r rrr► Pstidans d 0.0 0.0 0 boom *eo0 D 440r rrrr 00or ower roar rrrr 0 0.0 0.0 0 rrrr bora 0 **rr a*aro s**O rrrr rrt*e f 0.0 0,0 0 wore *boo 0 so"rrrr cora 0*44 rrr• rrrr 6 Windowland 1 2A 42.8 eo 220 940 a00* 110 4703 **0t 110 4703 0808 boor Glass Doors b 0.0 so D a rrrr 0 a 0 0 foe" rrtt Hem 0 0.0 00 0 0 ream O 0 rear 0 0«*« ma► d 0.0 a0 0 0 oOre 0 0 soba 0 0*0o rorr e O.D ro 0 0 err• 0 0 rers 0 •««• arrr P D.0 ar 0 0 arrr D 0 rOrO0 0roao Ores 7 Windows and Nordt 31.0 60 rr*0 1860 30 "*** 930 30 0009 830 t4*O Glass Doors NBNW 0.0 0 O040 0 0 4*0* 0 0 or«* 0 **** Gaoling, E(W 99.0 80 orOr 112 40 rrrs 3560 40 3560 rrr. SEISW 0.0 0 erre0 0 or4s 0 ►►►0 0 -PROW South 41.0 60 rrrr 3840 40 *so* 1920 40 Orrr 1920 rocs Harz 0.0 0 rOO• 0 0 r*4o 0 0 ear• D «ew 8 000 doors a 10E 26.1 6.9 46 1253 32 48 1253 329 0 a0 b 0.0 0.0 0 0 0 0 0 0 0 0 9 Not S 12r 6.3 1.7 1812 11416 2993 882 5557 1457 930 5959 159 Exposed b 12z 6.8 1.8 260 1759 460 260 1755 460 0 0 0 Walls and c l2E 6.61 .6 650 4389 115 650 4388 1133 0 0 0 Parddon8 d 0.0 0.0 0 0 0 0 0 0 0 0 0 0.0 a.0 0 0 0 0 0 0 0 0 f 0.0 0.0 o 0 0 0 0 0 0 10 Callings a 16C 7.9 3.7 1000 7920 3652 0 0 O 1000 792 365 b 0.0 0.0 0 0 0 0 o a a 0 0.0 0.0 0 0 0 0 o a D 11 Floors a 21A 2.2 0.0 1000 2160 0 1000 2160 0 0 b0.0 0.0 0 0 0 0 0 0 0 e 0. 0.0 D 0 0 0 0 0 0 0 0 12 batradon a 79.0 8.8 269 21162 2351 168 12476 1396 110 6696 96 13 Subtotr1whLos-6+8..+11+12 8080 59459 °r*a 8800 32291 *O00 orb* 27167 -Paco rrrr rrrr 14 Duct $tuhLASS 15* 0919 room 15a 4844 rrrr 1 SIN 407E aamo o •084 15 Total Btuh Lossw 13+14 a*ar 68377 ower sore 37134 «Oor Orr* 31243 0000 rr00 r8«« 16 lit Gana: People @ 300 4 0008 1200 4 *ram 1200 0 rrrs w*rr Appl, QD 1200 1 •bar 1200 1 e«oe 1200 0 *°*° rrrr 17 SubtotRSH 748.A2+16 **o* **r4 26156 rrr* ooOo 13s93 8000 00*0 1256 *000 Oar« l8 Duct Stuhown 15 as** 3923 1 arae 2039 15 a°a* 188 o baso 19 Total RSH C ie-(17+19)NPLF 1.00 *0*" 30079 1.00 MjOY 15831 1.06 **** 14449 000* 20 CPM Airltcquired eso« 1609 1609 +ora 874 936 roar 733 773 O*oO Pricdout certified by ACOA to most all requirements of Mimual 7 Form TOTRL P.05 THE BELOW MUST BE FILLED W WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON UEMT jMWX -ONNECTOR AND COME11 IS330 I AIR VERIErP'&MM When f jea=&- me undersigned hereby verirres that the venting has been examined and is free from rust, deterioration, oostructions, and is securely supported and firestopped where required. Yes (y. No( } The venting system is plasticIPVC and meets all current codes and manutacturer spmcations including sizing, lengih, number of elbows and termination. Yes (at 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-GANIA Category I Central Furnace Venting Tables for fan assisted and ri&oal draft appliances. Yes (b4 No ( ) The axheting cornhL= ars air is sized and installed to meet the current codes and manufacturer's spermcations. Yes (y} No' i When required to install�!�tiYyi9 qtr it vvvill be sl: ad and installed to meet the current codes and manufactuWs specifications. Yes (a) No ( ) When incta ti „ygonn�=1 , Me undersigned hereby verifies that it is a Listed assembly and meets the current codes and manufacturer's spermcations. This does include AGA -LAMA Category i Central Furnace Venting Tables for fen assisted and natural draft appliances. Yes W No( j Is the common vent and vent connectors sized and instailed ewectly after an appliance has bow removed from the common vent and vented separately as per current codes. Yes (int No ( I Applianoe 01 Type ® STU Input to Fan Assisted or Nat Appilancer #2 Type BTU Input Fan Assisted or Nat Appliance 03 Type_,,, BTU Input Fan Assisted or Nat Total Appliance- Total Btu Input L 1 Common Vent Type 0 Vent Height]Af7-_ Diarnater inches A.ppik-ance #t Vent Connecjor Height—It Length L ft Diameter � in Type ApplIance 92 Vent Connector Height ft Length It Diameter—in Type Appliance 93 Vent Connector Height fit Length ft Diameter in Type _o 61 0 %�5 x'11 G��it G TON P ,4TING & COOLING HEATING CO: 4120 -,85 a- WGRTI-I ,,II Signed By: [BROOKLYN PAHK, MN 554.43 Date: _ % 2 –07 -3333 5, i('1?ri.. 4120 85TH AVENUE NORTH • BROOKLYN PARK, MINNESOTA 55443 PHONE: (612) 424-8333 • FAX: (612) 424-8651 • E-MAIL: royalton@wavetech.net www.royaltonheating.com NOV-18-1998 13:40 FROM CITY OF FRIDLEY TO 4248651 P.02/02 Remarks: • List ALTRA,'TiC7�1SDe-jRg hone: HEATING CO: Signed By: mate: ROYALTON HEA i INUI & UUVLIIvu 4120 - 35th AVENU NORTH BROOKLYN PARK, N 55443 TOTAL P.02 CHMM A—MUCK V —30-ICATIt]N The undersigned hereby verlfiles that the existing clu nney or stack: 1. Has been carefWly emmined Yes X No i ) .No 2. Is fm from rust or deterioration Yes R ( ) 13. Has no foreign objects lodged within Yes( t;�- r10 { j 4. Is securely supported . Yes V No { ) 5. Meets all ccrrent Code requirements for size and total BTU's connected Yes (' No ye,a�� 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for waterhea Yes { 1 --No ( ) 8. Has combustion air been provided for tet' heater Yes No { } Remarks: • List ALTRA,'TiC7�1SDe-jRg hone: HEATING CO: Signed By: mate: ROYALTON HEA i INUI & UUVLIIvu 4120 - 35th AVENU NORTH BROOKLYN PARK, N 55443 TOTAL P.02 Building BUILDING Permit No.: ' q-0 3 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat MAY 2009 763-502-4977 FAX EFFECTIVE 1-1-09 DATE e5�6 17� YOUR E-MAIL ADDRESS C� 6-6ek J /11; Ie---r— SITE ADDRESS (,0-130 9/ ;l M✓ THIS APPLICANT IS: ❑ OWNERCTOR PROPERTY OWNER/ NAME: AA1 e'T TENANT ADDRESS: -1 so CITY STATE ZIP 5'Y 2- PHONE: :?6,,P5 5 3 �1 CONTRACTOR NAME: SUBMIT A COPY YOUR STATE LICENSE N STATE LICENSE # 9-0 5-7 4e (e�- EXP DATE ® C� AND CERTIFICATE OF ADDRESS: Fs� I q 6—r -F �� lA,'� CITY - STATE IP S INSURANCE PHONE - C FAX -7 �d'4,- PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK JWSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 59C 1 k ' j SIZE OF IMPROVEMENT LENGTH (2 WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: W DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, Vinyl IdS,ffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum d� nm 1. Site Plan/Survey showing the existing structures ❑ Other XFascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ &OXb 0 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks Aavable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicat' r F permit d work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all w w 'c es review and approval of �a s. SIGNATURE OF APPLICANT PRINT NAME / /l` _DATE