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D SUBJECT PERMIT,O. City of Fridley 91341 AT THE TOP OF THE TWINS PERMIT BUILDING RECEIPT NO. 1 16U -__-_ COMMUNITY DEVELOPMENT DIV. t � PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 3/23/76 JOB ADDRESS 6170 Rice Creek Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 1 Rice Creek Estates 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Briar Homes 8535 Central Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SAME 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING residential. 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 40 x 32 house with 20 x 30 garagETHE CITY OF FRIDLEY DOES NOT G6tARAtjTtE- ACCURACY OF UTILITY LOCATIONS AND ELATI S3, THIS DATA IS FOR I F 9 CHANGE OF USE FROM ESS®{NS USING IT SHOULD VErjFy THE IINF0RMATj0t4 C1 N ,THE SITE, STIPULATIONS Sewer: (Approx. 14' deep) 1. Provide a verification survey. 222' south of M.H. (S. Inv. 908.30) 2`. Provide a hard surface drive. Wye Elevation 909.19 Top of footing 912.50 (Minimum) NO`QCT® ��'�`� w's Water: c�C��®Co����� 11.3' S. of Sewer Service $ Veto � yl SEPERATE PERMITS REQUIRED FOR WIRING, IJ.EATING-t PLUMBING .AND SIGNS: SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. wood frame 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 I1310 f 600 32200 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 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, 39,941 19.97 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT NOT RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 59.57 350.00 STRUCTION OR THE P RMA E OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE 429.54 ATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN PROPERLY L T D THIS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) -IIBLDG INSP OAT ,I • •Kl'j'JrA l.f�11 UAV VUA VLJ.;0 All UA i AI%IJ-, I- Jaa•s�•s. +...•., n • OR ADDITION.BUILDING PERMIT °• CITY OF FRIDLEY, MINNESOTA : \�t 9 BUILVEr.: Z�2tER' s NAt iE t ADDRESS :�+��- Ya\j k ADDRESS: •, % STRBET: 110. •ADDITOI\1:� LOT: �r� BLOC.. • I. _ SIDEYARD: CORIJER LOT: INSIDE LOT: __SETBACK: • s Applicant attach to this fonr� Two Certificates. �f Survey .of Lot and .proposed building location di.•.ivn on these Certificates. DESCRIPTION' OF BUILDING To Be Used As Front: Depth:- •°Height : Square Feet:�, �°Z21' Cubic.Feet: Front : '.� , Deptli : Height: ` S� Square feet; �'�'�' Cubic Feet: 9jrpe of Construction: '�'�'� �'�'►'�� Estimated Cost:_ To Be Completed:ken. The undersigned hereby makes application -fox 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 represent s stated in this application are true and correct. • DATE: � `� -`� �C7 SIGMA •• (see Aeverse Side For Additional. Information.)* , CERTIFICATE OF SURVEY FOR: 8r iar ` Homes ' Irtc: -: 3 , r 128.44 W • 1qt 3 .35 1 7 'ase I 'I 0 LJ Lo a' �•''Utiltt �' W • V -" 126.02 --• '- f� o Deno-i-ez iron monument Revised 4-2-7Gr -lo show -foundaation in-place Description; 'Lot 11, Block 1, RICE CREEK ESTATES 2ND ADDITION, Anoka County, Minn. Z7OWiZ & COuntr I hereby certify that this is a true and correct representation of a survey of Job No. the boundaries of the above described land and of the location of all buildings, 455 Surl✓eyor.4 if any, thereon, and all visible encroachments, if any, from or on said land. Book —Page Land Surveying 0 Site Planning As surveyed by me this 'i•11 day of Sept_ , 197• Civil Engineering 9 F - S>3 8816 70th Av. N. (1.94 at Boone Av. N.) �"� Scale Brooklyn Park, MN 55428 Phone: 533.7340 Minn. Reg. No. 1094 � $ � gem Base PARTIAL RATE SCHEDULE City of Fridley: The undersigned hereby makes application for a permit for the work herei, specified, agreeing to do all work in strict accordance with the City Ordbumce and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application fre true and correct v -N Fridley, W I ,19k Owner Kind of Building sewff [3 0 used as CeSNPOW PLUMBING rIXTURZ RATES- NO. RATE Number Fixtures ................ x $2.06 lTOTAL S0 Future Fixture Opening .... o ...... x $1.50 t New Fixture Olaf Opening . e e ....... x $1.50 i Catch Basin .............. a ..... x $3.25 i Water Beater ''Up to 99.000 BTU) x $3.00 : � �. v o New Ground Run Old Bldg......... x $3.25 $ Electric Wates Heater .............. a szoo $ GAS rITTING FEEM NO. RATE TOTAL �—x.32.00 lot 3Fixtures •..•.•••••••••..•• $ Additional ur s .. . . .. .d. �... e a e s'e x $ Gas Range to 199,000 BTU . s o.... o e ... �$g.75 - x $5.00 $ State Surcharge $ .50 REPAIRS1.S�r,.a�AL TI® er to _ I... iption . . . .... . .. ... © .. e. a e ...► a ....... .�a�/.�a.®.y....m . e p o To be completed about . Estimated Cost, Old—New. Building Permit ROUGH No. g_ Permit Signed By Business Phune No i �tn.e..epgnersnr�ir•s+� �1!!]....rT. i^,7.....�'4.. �...v? orf.+?r^. ^-�?-,n- �ne.r° �1R r.•`..,•• A�f...._ a !� ..�. �'f:'m ma: 7`ar6� •:alit Y or.+tibi et Cr �e. s. 4+ �e,it 8 -r e�w.•� '%t. v✓�s^�'i1a�y �k�. Le Yi�tt NS bbl ady �a:.+�:6 �•m v�94 c6.9 63 t s F9 r +n fir? . �" rT 1^yr.n '• C•-' y n+ { fon r 6'dS8 ycS •a, .. wo♦ L�.en«t.. ` 'i sYa L.a1� Co.+4. aaav b s=35 PARTIAL PATE SCHEDULE GRATM WARM AIA: rziraace S2 -ell cos Duct Work Rep;acern•_r:t of Furnace F.rpa:rc & Al! rat.ors-- up to $500.0o Repairs & A!terat:ors each add. $500.00 =011 W AR14 RIP' rumace Shell & Duct Work to I30.000 BTV each add. RA,000 BTU Replacement o! Furnace RC,•airs & AltP*ati ns—up to $589.00 Repairs & Alterations each add. $500.00 M i a> TOTAL • - v I0.0i1 � 6.00 $ 611* b 3W $ .51000 $ 0.0 00 Vn 3 2:1 6.00 8 6.00 $ 3.0o $ STEAM oz HOT WATER SYSTEM F -mace SheIS & Lines— to r00 sq. ft ?.DR Steam s10.00 $ Furnace Shell & Line—to 640 sq ft. EDR Not Water 1000 S. Each add 207 sq. !t. EPR Steam 3 m $ Each add. 320 sq. ft EDR Hot Water 3.00 S OIL SURNEP.—to 3 gal per hour 6.00 $ over 3 gal. per hour c'ee Fee Schedule GAS BURIPER (up to L99, ,f BTU) 5.00 $ C over 1-9.000 BTU Soe Fee Sehodule GAS F ,LING F rz. NO RAZE TOTAL Ist 3 Fixtures x$ 200 $ �� Additional Fixtures x .75 Gas Range to MWO $$ W* $ A R CGXDMONrNG- rJLV1 F=AT=G M iAM-A V=;TILLT"aII a S'TSTMI . ALTsT71lA1 TO2g3 & FXPAIRS ROUGH State Surcharge .50 S" Foo r*c _1% TOTZL aOr� t. Of B?„rt'r«a. ?3%ocm 5333-14S3 Lam-•t„r. G� ! % �' �/�/,� �-/��� �C ,��tPj%Z���= City of Fridley: The undersigned hereby rnakes application for a ptrmlt for the work ?xere'1 specific -d agrL� irg to do all work in strict accordance with the City Ordina;.ct and ruling of the Depa: trnent of Buildings, and hereby declar^s that an the fac and repr,!sPntati, .0 s'.ated in this appbcation are true and Correct. p Fridley. MAA n -7— Owner/cZA/L / Omr S Kind of Building . ��` 4 /-1 F Used as . /-) 6 C //-°( To he completed about Estimated Cost:, S�/] zro Old—New. Building Permit No Pamit No. (0 6,�23 OF won HEATING or FOVMR PLAINTS -Steam, Hot W& No Trade Name � -TA Size moo- CapacityLr�_S Sq. Fr, Y-D.R BTU— Total TU Total Connected Loyd `-5� (0 Kind of lct BURNER - Time Na a lag &17 -/?e, site Capacity sq. ;fit. ED R- BTU Ez (=*ftAtrxZ-.Donal B'w � E SUBJECT PER2 "08 City ®f Fridley 0 5 AT THE TOP OF THE TWINS BUILDING PERMIT iECEIP COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. / 1 NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/6/91 JOB ADDRESS 6170 Rice Creek Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESAL 11 1 Rice Creek Estates 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerri Crane 6170 Rice Creek Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jansick 6480 Squire Drive NE, Fridley 574-9679 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 AD ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 148 sf Deck; remove existing deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, Before digging call for all utility locations 454.0002 REQUIRED BY LAW SEPARATE PERWTS REQUIRED FOR WIRING, HEATING,, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 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 1 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 $1,100. $.55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS.CM ANY OTHER TATE OR LOCAL LAW REGULATING CON- $27.00 Fire SC $1.10 STRUCTION THE PERFOR ANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ' $28.65 IGN URE OFCONTRACTORO UTNORI2EDAGENT (DATE) WHEN PROPERLY VAL /UT D THISYOUR .PERMIT BLDG INSP TE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI E " [ ] Effective 1/1/91 ADEN [ ] R-1 AND R-2 AMER [ ] Building Permit Applicatim Construction Address: 4r / 70 /V6 %f is e- ('lop. 0 / Legal Description: '/07' // �0// / /�c�i�. /?`e?, 62dc&< SISMt&s �ivro Owner Nene & Address: e;t'er 1. # L; 11" - tor: J'0' 51e/ e- Tel . # g7er -Elm Address: r/i Vrro S 4 ul k P 61 - Attach to this application, a Certificate of Survey of the lot, with the proposed oonsxuctim drawn an it to scale. LIVIIG AREA: length Width Height Sq. Ft. CsLMM AREA: Length Width Height Sq. Ft. DDCR AREA: length Width Hgt/Gr=id Sq. Ft. oTHM:to Move_ ie").57(a tdll�. Corner Lot [ ] Inside lot [ J Ft. Yd Setback Side Yard Setbacks Type of C tics: TpPaarC,O 1/ 64%040 1 Estimated Cost: $ Approx. Completion Date: /%y- Off"® 9 r 1' 0 d Proposed Driveway Width If New Opening Is iced: Ft. $ $ Width + 6' See Back Page DATE: 5_/z 9/ APPUCANT: Tel. # 57`/ PdV Permit Fee $ s% Fire Surge $ 1.10 State &1 r uuVe $ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ 70TAL 1,aW STI RJ=CNS: 1. $ Z8.4r MY USE ONLY Fee ale an Reverse Side .001 x Permit Valuation (1/10th.�) $.50/$1,000 Valuation $650.per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON TACH Fi OOR Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, rNew 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 /C .00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS � � �0 GE CA-xAk- 6/Z The undersigned hereby makes application for a perm it for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. 4r!� Owner la N C R A ,J � Building Used As �0�'� Estimated Cost S5'0.00 PERMIT NO. / J PLUMBING COMPANY ����i ®dE/LAe-,� :✓l/t- PL�(� SIGNED BY te.� �D+� �.._ TEL N0. Approved By Rough -In Date Final Date-� $ .50 ` MINIMUM FEE OR ANY PLUMBING/GAS PERMIT IS $20.00 $ 10.6'a MINIMUM THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. ,11 SUBJECT City of Fridley 2 8 5 3 2 AT THE TOP OF THE TWINS ? BUILDING PERMIT " `572® jxECv.PTw6. v_____ O MUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 3 E _ I "-'-1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/5/98 � JOB ADDRESS 6170 Rice Creek Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11 1 Rice Creek Estates 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Crane 571-7718 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Hall Enter riseso Inc. 56 66 1/2 Way NE F i 1e974-7393 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 JEk ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Addition of a 14' x 16' porch 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan 4 Before digr,,.Ig call for all utility (or:;tions 45 .4 u9? REQUIRED: 3Y [LAW SEPARATE PERMITS ARE REOUIRED 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 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 $13,966 $6.98 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 $212.25 Fire SC $13.97 PLAN CHECK FEETOA FEE Lice 5 0 2 8.20 SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT tDATEP EN R ERM _z? VALID E THIS I�7_:! BLOA iNSP z S III nArE S,GNATURE Of OWNEROF OWNER BUILDERI iDATEi NEW ADDN [ ] CITY OF FRIDLEY��`'� ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION f ConstructionAddress: �o%'70 :Re (2tee & 12 P / Ye 1/1/98 1 1.. Legal Description: G Owner Name & Address: Cc' �(� yU CZ Offel. # 4W 77/F Contractor: LL <�(r I'd�5 �t�C , 'VSE # Address:' 64, //t2- /V All C- ��k I. # 73 Attach to this application, a Cei lot, with the proposed constructi.,.. urawn on it to scale. DESCRIPTION OF IMPROVEMENT '3L LIVING AREA: Length / ® Width %� ® Height Sq. Ft. 422 � 42 3S GARAGE AREA: Length Width Height Sq. Ft. -Eli 7a. YO DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: a `, 1 �® 1^c Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE:0�±19 A- APPLICANT: komqy AqU, PAU– 7 ( bArel. # q --� 3 f Permit Fee $ a /2• 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 ( J J. CITY OF FRIDLEY INSPECTION DIViS10N 6431 University Ave NE Fridley, MN 5.5432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 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°f of Value of Appliance or Work Commercia I/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.0-0 $10.00 s— $10.00 $10.00 $ $10.00 s- $25.00 $25.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AER CONDITIONING PERMIT IS $21110 PLUS THE $ SO STATE SURCHARGE REINSPECTION FEE $47.00/Hr $ .50 $&b� JOB i OWNE BUILDING USED ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE ANDOR BURNER No. of Heatinq Units l Circle One (Steam) (Hot Water) arm Air) Trade Name Size No --.---- BTU 1.i HP EDR Fuel Total 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 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 ttcorrect. DATE ILL,— wA1 FAX # *Air Conditioners can not be placed in a side yard without Approved By ( Rough -In Date Final Date written permission irom adjoining property owner. Gil 1 ni IT RAM SIDE F04 STACK VERIFICATION ON REPLACEMENT FU^NAS THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE AppUCAT10N WILL BE RETURNED wayERIELCATION nnNNECT When , the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration. obstructions, .. Yes" No( } and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer No specifications including sizing, Yesng, length, number of elbows and termination. ( The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and AMA Category 1 Central Furnace Venting cturers cTtabies fa rfanoes include AGA G Yes No ( ) assisted and natural draft appliances. The is sized and Installed to meet the current codes Yes tp4 No( ) and manufacturer's specifications. When required to itis'"'" " now coull "sfiamair; it will be sized and installed Yes( No to meet the current codes and manufacturer's specifications. When jostaftoo yy� the undersigned hereby verifies that -W codes and it is a Iicati assembly This does include AGA-GAMAA Category I Central ral Furnace and meets the cun specifications. Yes () No Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented YesVNo { ) separately as per current codes. Appliance #1 Type 4v-*JASZ -BTU Input �`' � pan Assisted or Nates ce Z e T BTU lnput� Fan Assisted or Nat Appliance # Tye Appliance #3 Type BTU InputFan Assisted or Nat ,,._. Total Appliances Total Btu input i SQ-a�? `� I 1 Z5 Common Vent Type "g- \1Gk'rV - - Vent Height � Diameter._.- inches Appliance #1 Vent Connector Height ,7— ft Length —�7ft Diameterm Type._____— Appliance #2 Vent Connector Height „,,,,_ft Length ft Diameter in Type - ,P2 --Appliance #3 Vent Connector Height ft Length n Diameter in Type_,,,_. AL1EIRATJONS' (0=1 HEATING CO: Signed By: Date: DAVE'S HEATING & AIR INC 1601 37TH AVE NE COL HGTS, MN. 55421 763-781-6901 From: SCOTT ACKERMANN To: Subject: Date prepared: Subject: Urgent X For Your Information Respond Please Comment Other TALKED WITH RON DECEMBER 1, 2003 - 6" CHRVINEYLINER IN GOOD CONDITION. IMPOSSBLE TO CHANGE WITHOUT REMOVING ALL DUCTWORK. RON OKD TO LEAVE 6" CIM'vMYLINER I� UlYOF ' FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 June 15, 2004 Ms. Gem Crane 6170 Rice Creek Drive NE Fridley, MN 55432 Re: Final Inspection at 6170 Rice Creek Drive NE Contractor: Dave's Heating & Air Dear Ms. Crane: A mechanical permit was issued on December 3, 2003 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 the inspection has not been requested. 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 mark the permit "no inspection called for by homeowner after notification" and the permit will be expired. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, DAVEJ Building DJ/mh CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 S71 -36U4 YAX: ( 763) 5"/1-1257 ADDRESS 6170 RICE CREEK DR NE PIN 133024440096 LEGAL DESC RICE CREEK ESTATES 2ND LOT 11 BLOCK 1 PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT NO.: 2004-01106p, 30 DATE ISSUED: 07/13/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT HARD ELECTRIC SOLUTIONS 415 DECATUR AVE N GOLDEN VALLEY, MN 55427 OWNER CRANE JOHN R & GERALDINE R 6170 RICE CREEK DR NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 1397 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 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.