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PRE 2010 DOCSVillage o3l" FrPldl y-9. Mhm. fflj'� N? 323 Office of INSPECTOR OF BUHI)INGS Owner Architect Fridley, Bullder—�'i. LOCATION OF BUILD1NG No Street —Part Lot Block Addition or Sub -Division DESCRIPTION OF, BUILDING Front–11'-- Depth 1�eight–K/-f Stories Manner of Construe To be used To be completer, / 7�1 Cc 19 x ' / Permit is hereby granted the building described in the above statement. This permit is granted upon. the express condition that the Gerson to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof,. shall confa nn in all respects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maintenance, re] iair and moving of buildings within the city limits, and this permit may be revoked at any time upon• violation i if any of the provisions of said ordinances. i2l, spector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector f Buildings of Fridley Of the above permit, I hereby agree to do the proposed work in accord nee with the description above set forth and according to the provisions of the ordinances of n idley, and, being first duly sworn, I hereby state and say that the facts stated by me and lcontain d in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, Minnesota, J, �' '' day A D. 19�--'/. . J� City of Fridley Application for Plum ing and Gas Fitting Peennit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location ° �" V `tl ` " ,/p pp NN j��y W Vl V! Z_ {� vll a} yZ a N aH °QCaZ (�jZ ~ W Oy n yU' `a Z Z Z ` ; WATER HTR. p " K ` °' G a (90 i N GAS ELEC. Base 1st 2nd - 3rd 4th • Future Connection aiiakings Connected with I Sewer � � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg. ............ NO. RATE TOTAL — x $1.50 $ — x 1.20 $ x 1.00 $ — x 3.25 $ — x 2.00 $ — x 3.25 $ �� GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ............................................. TOTAL FEE $ City of Fridley: The undersigned hereby .makes application for a permit for the work here! specified, agreeing to do an work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. �yFridley, Minns 19� Owner Aa"'s 7L Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. c::P, _C1 6 Signed -6� By f CCS k�2d'� Business Phone No - ROUGH FINAL az 2M . City of Fridley Application for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin .... ....................... Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ NO. RATE TOTAL — x $1.50 $ — x 1.20 $ — x 1.00 $ — x 3.25 $ — x $ — x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ........................................ TOTAL FEE $ 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 Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. dley, Kind of Building Used as To be completed " Estimated Cost, Old—New. Build ROUGH FINAL Business Phone No -j y u! Z R • N WATER HTR. GAS ELEC. <i O v1 Base 1st 2nd 3rd _ 4th • Future Connection Openings Connected with New Fixture, Old Openings I Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin .... ....................... Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ NO. RATE TOTAL — x $1.50 $ — x 1.20 $ — x 1.00 $ — x 3.25 $ — x $ — x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ........................................ TOTAL FEE $ 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 Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. dley, Kind of Building Used as To be completed " Estimated Cost, Old—New. Build ROUGH FINAL Business Phone No 0'Q Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECIL WARM AIA Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............. 5.00 $ �® Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 6° 00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ -q^6® Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule TOTAL FEE $ ®® Dept. of Bldgs. Phone 560-3450 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn ./"�� � 19 Owner ; Kind of Used as To be completed about 16- %9P4 Estimated Cost, $ Old New. Building Permit No. Permit No. ftf,Z(L_ DESCRIPTION OF WORK HEATING or POWER P14ANTS_Steam, Hot Water, Warm Air—No Trade Nam 24Size No. �f1 ez Capacity 1®7- 600 Sq. Ft. E.D.R BTU H.P. Total Connected LoaKind of Fuel A BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe By wO` , 42 Business Phone No 2D16a SUBJECT - _ City of Fridley 2099 3 AT THE TOP OF THE TWINS I I IL ®I N G P E R M I j BUILDING Ir� �,J RECEIPT N L. e COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. / rZ-q � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/8/91 JOB ADDRESS 1626 Rice Creek Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 Aud. Sub.. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fallinsten 1626 Rice Creek Road NE 540-4411 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Siding & Remodeling 50.3 Andall St, Lino Lakes, MN 55014 780-9799 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK CR NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 161 x 12 i. Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, &out, Ot . A- R- Before digging call for all utility locations SEPARATE PERMITS REQUIRED - 454-0002 WIRING, HEATING, PLUMBING AND -SIGNS, REQUIRED BY LAND 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 BO 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®� $1,4506 ® $.73 1.619 WITH WHETHER PECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT P ESU TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE P ISI OF AN OTHER STATE OR LOCAL LAW REGULATING CON- OF CONSTRUCTION. $35.00 Fire SSC $1.4511 S RUCTIO R THE PERFORMANCE PLAN CHECK FEE TOTAL FEE $37.18��"�' IGNATURE FCONiRACT OR AUTHORIZED AGENT (DATE) V HEN PROPERLY VAL TED YOUR PERMIT r/IS ;yTHIS SiGNATURE OF OWNERIIF OWNER BUILDER) IDATEI BLDG INSP 1ATE 2D16a ADDN [ ] ALTER [ ] bion Address: i Legal Descr'iptian: Owner Name & Address: rn r .v - Cont aG'timy: irlicweb k -J-*^ LTVIM Atm,: GUMM Ata: AM: on=: Effective 1,/1/91 R-1 AND R-2 Building Permit Applicatim PAS �4n Tel. # ®-- `✓�/ / t Tel. # M —175�j Attach to this application, a Oertificate of Survey of the lot, with the proposed pian drawn an it to scale. n:BQZIPI'= OF -nave ANT length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Width Hgt/Crn-d 30 q Sq. Ft. I q I q"L )c `) e Ub C. 14s I. L- Cbrner Int [ ] Inside Lot M Ft. Yd Setback ® Side Yard Setbacks g% Type of Omstructicn: R Estimated Dost: $ Approx. Ompletion Date: Ir^9 ®� P Prcposed Driveway Width If New Desired: Ft. $ $ Width + 6' See Back Page DATE: i ( APPLICANT: S Tel. 9'755 Permit Fee $ Fire Surcharge Mate Surcharge SAC Charge $ Mriveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ '7 1. Pee Sc herh:le an iaeverse Side .001 x Permit Valuation (1/10th $) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by MVi raw ng NAY [ ] Not Necessary [ ] . . *4V I� lo)e 7., 3�d CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR JOB ADDRESS UrInal- Shower Wash Tray Old Opening, New Fixture Floor. Auto.Gas �imljw Water Heater Drain Washer R an e 9 F 4 Gas Slec Stor Basement Floor 1 $5.00 and rulings of the Building uIlding Division, and hereby de .clares that all the facts Blow Off Basin $7.00 Floor 2 Catch Basin $7.00 Rain Water Leader Floor 3 Sump/Receiving Tank $7.00 '1996 Floor 4 $10.00 Owner Water Heater —Electric, $7.00 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $7.00 f-oo 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 I accordance with the city codes Beer Dispenser $5.00 and rulings of the Building uIlding Division, and hereby de .clares 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 '1996 Water Treatln�g 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 PERMIT NO. Back Flow Preve nter Required )Yes O No Type $15.00 PLUMBING COMPANYYn /��r�i ^ Reinspection Fee $42.00/Hr S 10 N ED By TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough—In Date Final Date State Surcharge $ .50 MINIMUM FEEL ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 80 INCHES. I Y SUBJECT P City ®f Fridley ` 30982 AT THE TOP OF THE TWINS BUILDING PERMIT i o r � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. %- CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L J` 612-571-3450 910-F15 5/25100 JOB ADDRESS 1626 Rice Creek Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 7 Auditor's Sub. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lamoine Follingstad 1626 Rice Creek Road NE 571-9701 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Quarve Contracting 8427 Center Dr NE, Spring Lake Park, MN 55432 785-1472 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 O NEW O ADDITION O ALTERATION Cj REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof House (15 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. Overpayment of $84.93 being held by cashier. Either apply to next permit or come into City Hall to receive. 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $1,311 $.66 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 PLAN CHECK FEE T AL FEE Licens C $5 , $57.92 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iOATEi HE PROP Y VAL D THIS IS YOUR PERMIT BLOG -NSP ` gArE S-GNATU E OF OWNERaF OWNER BUILDERS iDATE, I Y NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION oj1 �6 Construction Address: X 'c6 e!5�-e-elz ,Al �J Legal Description: Owner Name && Address: Av wo,�te r��l��_c i�� Tel. # 7/-e�"%a / Contractor: MNN��LICENSE # ®/ 4.� /Cc Tel. # v 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 I Width Hgt/Ground Sq. Ft OTHER: Construction Type: Estimated ost: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY - Call (763)2-3604 for Permit Fees if mailing In application %6 Permit Fee ����✓�$ ® Fee Schedule on Reverse Side 5 (9 ici Fire Surcharge/ 31 $ .001 of Permit Valuation (1/10th%) y 3 State Surcharge -GG$ $.50/$1,000 Valuation "(0(0 SAC Charge 0 $1100 per SAC Unit License Surcharge $ 15. 6-Q $5.00 (State Licensed Residential Contractors) 5, O 0 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 $ 1 O l � Z r(� STIPULATIONS: �04 0,00 Building WATER AND SEWER Permit No.: 0 .-o Inspections PERMIT APPLICATION Received By;;!�� 763-572-3604 CITY OF FRIDLEY Dat : A 20 763-502-4977 fax EFFECTIVE 1/1/09 APPLICTATION DATE:'' ' DOl YOUR E-MAIL ADDRESS: THIS APPLICANT ISII: 0 OWNER CONTRACTOR _ JOB ADDRESS: NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: LrreA4, OWNER/ TENANT ADDRESS: � lgZb �.:�.e, Cyee � Q�. iJ.� CITY �� � (2, STATE Vt3 ZIP:S5-Zf 32— PHONE: e3< CONTRACTOR, NAME: o -L. �n (_e,✓v :a C� o�,� wo SUBMITA COPY OF YOURSTATE ADDRESS: I S `� (=1 ° au-" CITY STATEZiP WITH PHONE CELL PHONE: -e3- Zgi&' Z -L, APPLICATION STATE LIC #QTY, lStJ 1 - M STATE BOND: EXP DATE:__ 1 3I - Z>1 PERMIT TYPE Pair���f� l f ❑ SEWER CONNECTION PERMIT $50 pit �(l ✓15 �I Vt�i ❑ WATER CONNECTION PERMIT $50 +VA 0, (OVA 10 �WATE EWE LINE REPAIR $40 LP ❑ ADD STATE SURCHARGE $.50 ❑ SAC CHARGE @ $2000 = 0 , OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but only an application fora permit and work is not to start without a permit. SIGNATURE OF APPLICANT PRINT NAME:y �L+ e� DATE: 3 - (Q - p q APPROVED BY: DAT . -7'11-0 _ COPY GIVEN TO: D ILITY BILLING (only if new meter) PUBLIC WORKS ftjNGINEERING City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 111 Building i CHANICA�, Permit No.: I f Imo` Inspections RESIDENTIAL APPLICATION Received By:` 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 7-1-2010 DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER )QCONTRACTOR PROPERTY NAME: L®, L $ %, ro 1 (a —, S s t A,% C �L� e �` TY FSTATE�ZIP6 �i33_ ADDRESS: i (-a CI OWNER/ TENANT PHONE: 143 - S-71 - q -7 o 1 CONTRACTOR COMPANY NAME: 12, CL `� arj, tI CONTACT PERSON: 0 go SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: W t, H& NJ C CITY FK-I oSTATE"-J ZIP-,;,TV, ib APPLICATION PHONE -7 63 -T ca 1 1. 1 FAX PERNUT TYPE 'WSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW -,T�-REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK J,-NB34A tc -1 r cb ()evi FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK. Equipment Installed MFG: (2,A-e-tic- MODEL: SIZEBTU c%Tyi MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE✓BTU A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 CHRVINEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 fi 3 �t M .�hp Ei'+a a<" °,��:F �.�, k � E�h k k� � � � ��,t � l��j 'k $ J �3 iV ,� � y' 'rha"� �. $�. �� �,s "`a✓ �Lpv� � �/ .p( ��' ' � � _ h i t `H"' ��u.� ml�� � �� �•'�«� '�R �.. y. x E xo�c, s °g f _ t�w^'�k' b ���k pis � `f"79.. � � t;✓ �yzpp��yy'p ' a"� �.. �i'`yU �3. _''°t , � _:, �. �, �e � � : ("i. i -i - r q a+.> S `z. �' g..; , �kl �:, �i��Tki��:'T 4'�����R J �37�r6 5� '. 'u I�Yiji "X� f�� dk!. S�„ 2 'E r.� dv'' � �4✓ib* ��.,, � ,� k���22 '-. U � ✓ �� i ` `s�� �i� } � �'' �'"iii�lii� £.1>�F�R 1'ih�C ,�`�� �, s� s�:��a� bow' �j` �`s r':. �' � i� .�'�.: 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 application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT C PRINT NAME 0 t-% e dfs �ti,nDATE APPROVAL INSPECTORS SIGNATURE DATE !k qty jy 7 �d��.. City ®f Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, NIN 55432 763-572-3604 FAX: 763-502-4977