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PRE 2010 DOCSCaiy ®i Fridley, jinn. BUILDING PERMIT Dlte� All� /41 Owner: Builder Address _.. _ - ___ .... _.. _ Address _ _--_------ -- LOCATION UILDING No..Street A . A-�Afjl I.... _.._.. ..._...._ P f 4of __._..._._...._ � .....__..��...._,... Lot Block .. Addition or Sub--Divisio • , A!" +C - Corner Lot Inside Lot .. Setback _-i 15J— - Sideyard _ .. Sewer Elevation __ _ _ _ _ _ Foundation Elevation DESCRIPTION OF BUILDING ;0a Used ..� Front Depths Height �r~ Sq. Ft. Cu. Ft.- Front _ Depth _ Height - o Sq. Ft. Cu. Ft. - Type of Construction Est. cost . 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 uponvolat�en ofany of the provisions of said ordinances NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these hems. h.; APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name��(� $ alder, ASS%//4 CIs¢S 2f` Address 5'3e� i ..�`�•d. 5_ 1 �� 4Address LOCATION OF BUILDING No. Street R-/ PP- A V I if ty art of Lot Lot Block Addition or Sub.Div, JP/ k/)f t�� k/ ,�,.�. Corner Lot L-"' Inside Lot Set Back �5� Side -Yard SEWER ELEVATION - FOUNDATION ELEVATION Applicant attach to this form.Certificate of. Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Front Depth Leight 2 Sq. Ft. 19.2,S- Cu. Ft. ) LK "_0 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction ,Efr A & F • Estimated Cost 4 To be completed 41'&__5 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 representa- tions stated in this application are true and correct. : - DATE L SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) Ciiy of Fridley Application fcw Plumbing and Gas Pitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures LOQ&o" '1 pLL - 6 WATER HTR. GAS ELEC. V m Base 1st 2nd _ 3rd 4th * Future Connection Openings Connected with I Sewer E] New .Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ o 0 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $--L-150 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code 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. 4 , 194-1 Z% —_ 10 Owner ° Kind of Building Used as To be completed about Estimated Cost, $ Old ew. g Permit No J-2_Permit No. Signed By v Business Phone No ROUGH FINAL Description ................................................$ TOTAL FEE $% 4 z 2M 7-59 'cation for Power igonts and H . � Apph e�attng, C��ng, Yent�lat�on, Refr�geratton and / Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 GRAVITY WARM AIR: Furnace Shell & Duct Work .......................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .................. Repairs & Alterations each add. $500.00 ............... MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................ . Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM RATE TOTAL 8.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ 8.00 2.00 6 5.00 $ 5.00 $ 2.50 $ Furnace Shell &Trines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell &Trine --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 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ 1*50 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN BEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $14.50 REMARKS: Location 8199 River View Terrace 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, ATinn- April 26' 1961y 195— Owner Joe Xaciaszek 195— Kind of Building Frame 195— Used as Dwelling To be completed about Ju e 1961 Estimated Cost, $ $ 500.00 Old—New. Building Permit No. New rla DESCRIPTION OF WORK BEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No 1 Trade Name DAICO Size Nc�c*H1-00�� Capacity Sq. Ft. E.D.R. 100BTU H.P. Total Connected Load 339195 Kind of Fuel G -1S BURNER — Trade Names Size No Capacity Sq. Ft. E.D.R BTU H.P. Signe B, HEATING COMPANY, INC. 11 POST IM -12-58 BusinggslPWoy 50_,_IA Uta MINNEAPOLIS 9 MINNESOTA D•56 7 9 HEAT L.WS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No. Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Yes—No I Yes—No 19— FI.I 7 Pi ." i. e, Room I Length;7/--a Width e Height i;r II 1 Fl.l Windows an Doors—Crackage a d Area '>'- (0 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. '® Width Coef. l Z) Coef. Btu Infiltration ref. Exp. wall Glass Glass Net exp. wall Exp. wall &C Int. wall Exp. wall L -0 Ceiling Int. wall Int. wall Net exp. wall (A o j '® Z_ Int. wall Floor d Ceiling Ceiling Floor Floor td �� a Total Btu. I c) - Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl.1111 Room I Length Width ® Height Windows and Doors—Crackage and Area '>'- (0 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. area I F1.1 ; v Room I Leng / Width Coef. Btu Infiltration InfiltrationD c� Glass ref. Exp. wall Glass d Net exp. wall Exp. wall &C Int. wall Net exp. wall L -0 Ceiling Int. wall Int. wall Floor (A 01 0 Total Btu. ' Required sq. ft. E.D.R. or sq. ins. W.A. Lead area % m.I 7 M:i Room I Length q _ Width ` e h Height Windows and Doors--Crackage and Area '>'- (0 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. area I F1.1 ; v Room I Leng / Width Coef. Coef.1 Btu InfiltrationD /11--a Glass C -1-0 Glass Exp. wall Glass d Exp. wall Exp. wall &C Int. wall Net exp. wall L -0 10fy Int. wall Int. wall Floor Ceiling ®8 is Ceiling Int. wall !J Floor d Ceiling b Total Btu. 2,lz> Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Ifs MINNEAPOLIS. MINN. Insulation Kind How. Applied Rnom I Lenath -' Width /& Height Windows and Doors—Crackage an Area '>'- (0 Width Height No. of Linea! ft. Area No. of pane of pane lights of crack sq. ft. area I F1.1 ; v Room I Leng / Width Coef. Btu Infiltration Btu /11--a Glass Infiltration o Exp. wall Glass Net exp. wall Exp. wall &C Int. wall T-,2- L -0 Ceiling Int. wall Net exp. wall Floor Ceiling ®8 is Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 0 I �XRnnm I1.math c? Width—j_> Height 7C Windows and Doors—Crackage and Area '>'- (0 Width Height No. 01 Lineal ft. Area No. of pane of pane lights of crack sq. ft. area I F1.1 ; v Room I Leng / Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ZG 1 Coef. Btu Infiltrations Btu Infiltration 0 Glass ® d Exp. wall &C Exp. wall Net exp. wall L -0 ;-O -0 Int. wall Net exp. wall Ceiling ij b 0- 0 Int. wall !J Total Btu. Ceiling Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Floor td �� a Total Btu. '>'- (0 Required sq. ft. E.D.R. or sq. ins. W.A. LvAer area I F1.1 ; v Room I Leng / Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ZG 1 Coef. Btu Infiltration Glass ® d Exp. wall Net exp. wall L -0 ;-O -0 Int. wall Ceiling Floor !J Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Date: br Owner:Ar, 1� City of Fridley, BE=. L BUILDING PERMIT N9 r.58.54 ......----- Builder Address _ LOCATI :r BUILDING No. Street --.- , _ -� :: Part t ----. _� _ Lot _ Block _ Addition or Sub- i n . Corner Lot . �- Inside Lot __ Otback ideyard w - Sewer Elevation __ _ _ _ Foundation Elevation _ DESCRIPTION OF BUILDING ' Fxont01 Depth �� Height ,.._...,. _ Sq. Ft. Cu. Ft. O Fro _ Deptheight Sq. Ft. Cu. Ft. _ _ Type of Construction - Est. cost, �° "` 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. r In consideration of the payment of a fee of $=.—:.._.., permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildin$I within the city limits and this permit may be revoked at any jjpupon violati f any of the provisions of said ordinances. r 1 rT .ra Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to sea the Building Inspector for separate permits for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA o Owner°s Name Builder Address ,Vit/C. Address LOCATION OF BUILDING l � C No. Stree Part of Lot Loa��Block Additi or�Subdivision 0 Corner Lot Inside Lot Setback e -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. ESCRIPTION OF BUILDING To be used as:. ��- ® ® Front ;-- 7� C3 Depth -2- Height Sq, Ft• ------o Cu. Ft. � C� Front Depth Height Sq. Ft. Cu. Ft. Type of ConstructionEstimated 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 A tated in this application are'true and correct. DATE r v� — �� SIGNATURE 'R4 �'6 fz 1 a w is e /b (Schedule of Fee Costs can be found on the Reverse Side). C -57y CPO'*" 8431 UNIVERSITY AVENUE N.E., FRI DLEY, MINNESOTA 55432 TELEPHONE 612)571-3450 OBSTRUCTION: Lot Block Addition Property avner-.'address 17 RECORD OF COMM)NUC.NTIONS: Ito 7UY 2. 3. 4. G. 7. SUB�E�T P City of Fridley 3 14 3 9 AT THE TOP OF THE 'TWINS BUILDING PERMIT iiECEr T NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC- 1 I I CITY HALL FRIDLEY 55432 I ,.j NUMBER REV DATE PAGE OF A0PROVED BY 612-571-3450 910-F1 10/3/00 JOB ADDRESS 8199 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 30,31 R I Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Kennedy 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rosecraft 1743 Margaret St, St Paul, MN 55106 651-771-0634 20094989 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 O NEW O ADDITION O ALTERATION REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (25 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Cole. 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 $2,557 $1.28 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OT R STATE OR OCAL LAW REGULATING CON- $83,25 Fire SC $2.56 UCTION O E PER RMANCE O CONSTRUCTION PLAN CHECK FEE TOTA EE Licen C $5. $ .09 SIGNATUREOF CONTRACTOROR AUTHORIZED AGENT IDATEI EN P OPE LIDATIODXHIS IS YOUR PERMJTZ a Bt-)rgP rJAIRE S,GNATURE 09 OWNER i6 OWNER SUILDERI (DATE, NEW [ l 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 Construction Address: f�5 ICA --A 1Z-1 G►Z � �� C - Legal Description: Owner Name &Address: --�O Tel. #/ I- — - 7 Contractor: MN LICENSE # -?— A 996en 7 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: L_._ Tel. # &S 1 - 77 SS/®l0 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft. Length Width ,Hgt/Ground Sq. Ft. Construction Type:C2 'D -/' '6��- Estimated Cost: $ �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE:D Lod APPLICANT: Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ �� _ �� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $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 BUILDING INSPECTION 6431 UnlyRrsity Ave NE Fri&ey, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes 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 le,,o �'44 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOBADDRESS �1 1 )2Wcal ��/ ' � Fee Total Owner e $35.00 $ afD Building Used As $10.00 $ $10.00 $ $10.00 $ $25.00 $ 7�ks ESTIMATED COT PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units 1 Circle One (Steam) (Hot Water) arm Air Trade Name 2 L Size No. BTU GG HP EDR Fuel Total Connected Load �:J&xU® Burner Trade Name BTU HP Size No. EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/IndustriaVInstitutional and representations stated in this application are true and correct. !'- SER i ➢ � i ! <w State Surcharge $ HEATING CO 744 -Aa ® A -S C j4 r- �. so MAPLE GROVE, MN 55 TOTAL FEE $ Signed Tel # tt REINSPECTION FEE $50.00/HOUR 901CO vFAX # Date + V *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE c41-4 Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 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 ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) 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 ( ) No( ) No ( ) No ( ) 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 `%` A Q BTU Input 9 } GCC' Appliance #2 Type H;� ,O °2— BTU Input Appliance #3 Type BTU Input Total Appliances Total Btu Input Common Vent Type Fan Assisted or Nat Fan Assisted or Nates" Fan Assisted or Nat 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) KA'�s'MER HEff1o'lIG de O� 744d DALLAS COURT NIAPLE GROVE, MN 5W' HEATING CO: 7,620-51�7 Signed By: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1237 ADDRESS : 8199 RIVERVIEW TERRACE NE PIN : 043024140020 LEGAL DESC UNAVAILABLE LOT BLOCK PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT N 2004-00896 DATE ISSUED: 06_/._11—/2-00`44 VALUATION : $ 3,000.00 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. INSTALL A FURNACE (WARM AIR, YORK, 80,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 VALUE OF APPL OR WORK # FURNACES # GAS RANGES APPLICANT KRAEMER HEATING INC 7441 DALLAS COURT MAPLE GROVE, MN 55311 1Jd S' KENNEDY JOHN M 8199 RIVERVIEW TER NE FRIDLEY, MN 55432 1 # GAS DRYERS 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 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 regulat' g struct'on or the performance of construction. Applicant Date j� Bldg Insp Da l HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 3513 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0.00 35.00 0.00 0.00 25.00 0.00 0.50 60.50