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PRE 2010 DOCSi I city of Fridley, Minn. - No MUDING PERMIT Date: ...... f .... ., owner ....... ............................... Builder ...t<.. Address .......I ............................... Address ........ ........... .. LOCATION OF BUILDING No. ....�. Street . .��,. a ...... Part of Lot . ..... .. .. ! .. Lot ...... Block ..:... / . ..... Addition or vision Corner Lot ,...,........ Inside Lot.. ....... Setback .. :., Sideyard � .:............. DESCRIPTION OF BUILDING To be Used as Front pth frac° °eight ...� a eqSq. Ft Front a� Depth ........HeightrSq. Ft......:.. Cu,� ........ Type of Constr on ...... ........ ]Est. Cost.. / o be Completed .. ....... i t In conside on of the issuance to me of a permit to construct the building desribed above,, I gree.. to do the. proposed wok in accordance with the description above set forth and in compliance with all �rnvis'ions of ordinances of th city of Fridley. .. . ... .. ..... In onside tion of the payment of a fee of ; . , sok .st is hereby granted to ... ..... . .. ,. .......... ... . .. ` .. .:. to construct the building or addition as described above. This permit is ted upon the express con on that the person to whom it U granted and -his agents, employees and workmen, in .all work done in,.around ind upon said building, or any part thereof, shall conform in all respects to the :o ces of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving ofbu drags with- in the city limil and this permit may be revolted at any time upon violation of any of the provvh lons of said ordinances. i a hupeeftr u. NOTICE: This pe r it does not *over the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or wa or. Be sure to see the Buildinginspector for separate permits foe these items. I C Application for Power Plants and Heating, Cooring, 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 $ MECH. WARM AIR 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. IDR 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. IDR 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) T '® GAS PIPING (Up to 3 Fixtures) .......................... 1.50 ' (Add 50c each over 3) AIR CONDITIONING FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ Z • 3-2 Dept. of Bldgs. Phone SII 4-7470 ee y - ;;-ll ✓ E: !+ S ��� dam/ 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, 1Vlinn r 195., Owner0 d=S 19 Kindof Building r�' —195— Used as. 'gr //i ^ To be completed about °V S Estimated Cost, $®' Old -I ew)Building Permit No. k-3 DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No ,, / Trade Nampo c ° IV Size No � u D�'Y'Y Capacity Sq. Ft. E.D.R BTU /-y H.P. Total Connected Load -' Iz "2 °$ Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. sign By, ptRFECTION HEATING COMPANY, IrtC- OW IDUMH AVE. SO. -• TA. a-328 11 POST iM-8-m Busines15 8 MINNESOTA D46 -geW?9 HEAT LOSS CALCULATIONS DEPARTMENt OF BUILDINGS Weatherstrips A.S.H.Construction No. - Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Yes—No I. , Yes.—No 19— Room lLength 7F ? Width .Heijzht 7-- IF � Fu -'d 'a"� Windows and Doors—Crackage and Area Width Height No of Lineal fi. Area No. of ane of pane lights of crack sq. ft. a. d Width—,; -o,,4,, Height nr` Coef. 1 Btu Infiltration Coef. Btu Infiltration Glass Glass Exp. wall Glass Exp. wall Net exp. wall J Exp. wall j Int. wall Exp. wall Ceiling Int. wall Net exp. wall Net exp. wall Ceiling Z' Int. wall Int. wall Ceiling —T7 Ceiling Ceiling —:1=L ITa. Floor Floor ./J Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area J F1.1 k. Room I Length -- Width 0 Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. 77- Width—,; -o,,4,, Height nr` Coef. 1 Btu Infiltration Coef. 1 Btu Infiltration Glass Glass Exp. wall Glass Exp. wall Net exp. wall J Exp. wall j Int. wall Exp. wall Ceiling Int. wall ? Net exp. wall Ceiling Int. wall Ceiling —T7 Ceiling —:1=L ITa. Floor ./J Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .41.1 Y - Room I Lenath Width 'T Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. ofpane of pane lights of crack sq. ft. 77- Width—,; -o,,4,, Height nr` Coef. 1 Btu Infiltration Infiltration Infiltration Glass Glass Exp. wall Exp. wall Net exp. wall J Exp. wall Int. wall Ceiling Int. wall ? Floor Ceiling Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS, MM. Insulation Kind How. Applied Windows and Doors--Crackage and Area Width Height No.. of Lineal ft. Area No. of pane of pane lights [ofcrack sq. ft. ader area Width—,; -o,,4,, Height nr` Coef. Btu Infiltration Infiltration Glass Glass Exp. wall 7- 7-Net Exp. wall Netexp. wall Net exp. wall Int. wall ? Ceiling Floor Ceiling —T7 Total Btu. Required sq. E.D.R. or sq. ins. W.A. i FV 'A Room I Lenstth Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ader area Width—,; -o,,4,, Height nr` Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall ? Int. wall Ceiling —T7 Floor —:1=L ITa. Total Btu. Required sq- ft. E.D.R. or sq. itis. W.A. Leader area F1.1 RanmlLenath 4 Width / , Height " Windows and Doors—Crackage and Area Width Height No f Lineal ft. Area No. of pane of pane lights of crack sq. ft. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins.. W.A. Leader area City of Fridley, BUILDING PERMIT Date: April fikx 16, 1968 e7< Mr. James Sanders Builder Young Const. Co. 0 9668 elif 4k Address 169 Riversedge Way _ Address 5832 Morgan Ave. So. No. 169-- street LOCATION OF BUILDING Riversedge Way Lot Block l Corner Lot Inside Lot Sewer Elevation _ Part of Lot - Addition or Sub -Division ___ Riversedge Addn. — Setback -- Sideyard —.. Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 22 ' Depth 22' Height 10' Sq Ft. 484 CU. Ft. 4840 Front Depth Height Sq. Ft. — cu. Ft Type of Construction Frame Est. Cost _ _ 2300.00 __ 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 orth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 7.00 , permit is hereby granted to Young Coast. Co. 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, main repair and moving of buildings within the city limits and this permit may be revoked at any time upon oiation o9my of a provisions of said ordinances. Official` Building NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to sae the Building hupector for separate ponnhs for these hems. APPLICATION FOR BUILDING ' PERMIT CITY OF FFIDLRY, MINN!RFT OWNER ' S NAMES ADDRESS- _ _ �. �' WRESS :,a L. TIQN' BOILDING y STREET ' , _._...�.::._..._._. ..-- LOT BZ,©CB%,�. - _. ADDITION OR SUBDIVISION /f t9, CORNER. LOT INSIDE LOT SE*X" M21—SIDiYARD,,,_ _ SEWER ELEVATION TOP OF FOOTING ..Applicant attachbo.; his ,form, Certificates of Survey of Lot and proposed building locati6 drpin on,these Certificates„ DESdkl'TION Or BUILDING a To Be Used As: ; a Front Square€ feet _g 'Cubic Feet Front Depth Height— Square feetCubic Feet Type of Construction CEstimated Coat,; -'2'3- To Be Completed The undersigned hereby makes application for a permit for the work herein. specified, agreeing to do all work in strict accordance faith the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts ;and representations' stated IU -this application are true and correct, DATE'i�� _ SIGNATURES (Schedule of Fee Costs can be found on the Reverse Side). Piz f r X36 3 i APPLICATION FOR BUILD. PERMIT -ITY OF FR.IDLEY, NINN499TA OWNER i $r NAME' ADDRESS _. _ ._ , �AbDRESS L TION BiJ'tLDING , STREET ---p" a LOT; BI,<?CiG ;.;: ADDITION OR 'SUBDIVISION /' Q-Ve,09AO CORNEA L INSIDE LOTSETB'ACK _ iiDEYMM SEWER ELEVATION TOP OF FOOTI �_... :.`Applicant attach rbo.,ithis • for,a_.Twa Certificates of Survey of Lot an, Imposed builditig location~ 4r4, ons, these. Certificates ,. - J ttc i DBSdB.7 klON OF OBUILDING �a To Be Used As: IRA.:' Froutz.._ .,� DeptB t�• iieights�., Square fteC _ Cubic Feet 's Front Square feetCubic Feet Type of ConstructEstimated Cast: To Be The undersigned hereby makes application for a permit for the work herein. specified, agreeing to do all work in strict accordance tai.th the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the mets iand representations'. epresentations stated 1iu"'this application are true and correct. ,pp - DATE%gr_ SIGNATURE -ui't. _ �' �lw (Schedule of Fee Costs can be found on the teverse Side). k1� ry Pt 3K 3 MA SUBJECT PERMIT NO. City of Fridley 12693 AT THE TOP OF THE TWINS LI I I ®I � I G ❑[ D A A I BUILDING r 1ECEIPT D L ' v �" C R'v, NO. COMMUNITY DEVELOPMENT DIV. L e r PROTECTIVE INSPECTION SEC. � I CITY HALL FRIDLEY 55432 NUMBER REV.,. DATE PAGE OF - APPROVED BY. 612-560-3450 910-F15 8/23/74 JOB ADDRESS 169 Rivers Edge. Way NE. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 River's Edge Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Combs 169 Rivers Edge Way N.E. 3 CONTRACTOR MAILADDRESS 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 ISI REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Re -roof dwelling 9 CHANGE OF USE FROM TO STIPULATIONS SEP"ERATE PERMITS 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. it THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZO G SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R-1 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 $497.00 - 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. $5.00 PLAN CHECK FEE TOTAL FEE $5.50 IATURE OF CO ACTOR OR AUTHORIZED AGENT (DATE) WHEI PR PE Y V THIS IS OUR PERMIT - SED INSP SIGNATUOF OWNER IIF OWNER BUILDER) (DATE) MA APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: 612 oet (a 113 j BUILDER: ADDRESS:- /(a% "(VJC2 A C/a �d ADDRESS : NO:. STREET : J K� /� �( Co �✓/�' LOT : ( BLOCK : / ADDITION : %lJr� /CC� CORNER LOT: INSIDE LOT:'>(� SETBACK,: SIDEYARD: 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: /ice P� -T dja Q � �ATront Square Feet Depth: Height: Cubic Feet: Front: Depth: Height Square Feet; Cubic Feet: 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. DATE: `a T SIGNATURE: zZ (See Reverse Side For Additional Information.) A 1:11M] NCR Comten, Inc. 2700 Snelling Avenue No. St. Paul, Minnesota 55113 (612) 638-7777 November 9, 1983 Board of Appeals City of Fridley 6431 University Avenue Northeast Fridley, Minnesota 55432 Dear Board Members: After a phone conversation with a building inspector, I am writing this letter to voice my extreme frustration in regard to the approval of the variance code, Chapter 205 of the City of Fridley Code, which allowed the construction of a garage two feet from our property line. The building permit, which still is not posted, was issued to Delores Christianson at 173 Riversedge Way. We, at 169 Riversedge Way agreed to let them build, provided they followed certain restrictions. During the past seven years we already have had to put up with such problems as reckless driving in and out of their driveway endangering the safety of our children; excessive noise at 4:00 AM waking the neighborhood; their felling a tree across our concrete driveway, thereby cracking it the. full width (without even an explanation or apology); and piling debris on the side of their house, often partially on our property. Considering the numerous problems already encountered along with how close the garages already are, we felt that allowing any such permit was being extremely generous. Now I find I am the victim of some very hostile actions and words because I want their construction messes cleaned out of Rix side yard. They won't clean it up. Yesterday, while I was asking Ms. Donna Christianson if she would instruct the construction crew not to leave such a mess, Mr. Larry Sorenson, 172 Riversdge Way, came across the street and started yelling how unreasonable and hard to get along with I was, and that 1M side yard is a construction zone. After many other hostile words, he then stated that he would resod any damage. This, however, is not in writing. Incidentally, Mr. Sorenson is also helping in the construction and arranging for any additional construction crews. He also is the only other neighbor who thought the construction was a good idea. I am very concerned for the safety of my children - two four year olds and one eight. The hole for the footings, which is nearly on the lot line, was open for two and a half weeks (including Halloween) with nothing protective around it. When I inquired once as to how soon construction would again start, I was told I was harrassing them. I am cleaning up concrete spills, dirt, rocks, and general debris (including work gloves thrown over my fence into my back yard) from 1M yard every time they work. I feel this letter is my only course of action as any other action to protect my legal rights will only increase the hostility. Before you approve any such variance to a code, please bear this situation in mind. Maybe other people will be spared the frustrations of infringements on their legal rights and the open hostility we have had to suffer. Sincerely, Mrs. G. K. Griebenow 169 Riversedge Way Fridley, Minnesota 55432 CC: Mr. Darrell Clark City Building Inspector suBJE& P City of Fridley 9 94 3 AT THE TOP Of THE TWINS BUILDING PERMIT r � T NO. L'___.__ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. J r � NUMBERREv DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/27/99 JOB ADDRESS 169 River Ede WayNE 1 LEGAL LOT NO. BLOCKTRACT OR ADDITION SEE ATTACHED DIE 7 1 River Ede Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kim Griebenow 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO BARC Industries 17001 Fish Point Rd SE Ste 104 Prior Lake 55372 440-9730 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 )0 REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 18 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 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 $1573 .79 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $57-05 FirHA C $1.57 PLAN CHECK FEE TOT L E Licens 5.0A .41 00, ...Vo S�GNATu FCO AA RORAurHOQiZEDAGENi i0A7E, N THIS R P M P�MPDAT .r r $-GN4 TORE OF OW NER �iF OWNER BUILOERI iDATEI - BOG ASP oV�+�T NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: fig yl,e.�,,,� JSF Owner Name & Address: KyN Cr r'e e bAon Tel. # Contractor: FARC L&(vufr"ej MN LICENSE # 2017861 Address: 17001 's4 AoeA f jf0[ S.F Sv+IN /041 %%°.`ar- �.a /4y /#// S.rV? Tel. # 612 - VYo - 9?Jo Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. _ GARAGE AREA: Length Width Height Sq. Ft. _ DECK AREA: Length Width Hgt/Ground Sq. Ft. _ OTHER: IV Construction Type: c a ICe . X 00-f Estimated Cost: $ 1:kwn Z 15% 3 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: Z12 7 APPLICANT: Tela # 0112 -1/11$ • �'?,,�t3 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: C) CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-36'04 FAX 763-5711.287 Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning-AllSizes 381xa GIaL I Z-1 . Effective 4/1/200,i APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES $35.00 $10.00 $10.00 $10.00 LTO N $25.00 All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater, on work less than $500.00 Commercia flndustrial/lnmMutionai 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Insiitutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR - 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ •50 $-6.D- __56 *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FAX # 6 I Z. '12 4 - 2.01 j Date Tel # 61 L 744 -18 9 ct FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date- Z-111 ate JOB ADDRESS _ _ 165 12 , v 2C..0 G Lia:e Owner, t rn r. Z, 6- s e L—A $� Building Used $ ESTIMATED COST 7 l y O` o PERMIT NO t $ DESCRIPTION OF FURNACE AND BURNER $ # of Heating Units Circle One (Steam) (Hot Water) arm _ oo Trade Name --L &&A a,r o -rc Size No. $-25* BTU 6" eon HP EDR Fuel hi ar _ fj A S 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 $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ •50 $-6.D- __56 *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FAX # 6 I Z. '12 4 - 2.01 j Date Tel # 61 L 744 -18 9 ct FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date- Z-111 ate