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PRE 2010 DOCSSUBJECT City of Fridley 15 AT THE TOP OF THE TWINS � I I L DING PER I DING r DV r LR'v' V RECEIPT N • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV. DATE BY CITY HALL FRIDLEY 55432 L.__.-' '•� 612-571-3450 910-F15 14/28/80 ;PAAPPROVED JOB ADDRESS 6191 Starlite Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 2 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE F. C. Johnson 6191 Starli.te Boulevard N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Brothers Construction 1620 - 3rd Avenue 427-6877 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 X 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd but not 3rd roof. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 $60.0 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER SjTATE OR LOCAL LAW REGULATING CON- $7.50 STRUCTION OR, THE PERFO NC 0 CONSTRUCTION. PLAN CHECK FEE TOTALFEE `� $8.00! SIG ATUREOFCONTRACTO ORAUTHo GENT (DATE) WHEN PROPERLY IDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) BLDG INSP DATE CITY OF FRIDLEY APPLICA'rim FOR RESIDENTIAL BUILDING PERMITS (fleet, Alterations, Auditions, or Repairs) OWNER: ADDRESS: i id - 51/W/e_, 2. 4' TEL NO: BUILDER: S� ADDRESS: j6--ge>>�/��,> �. TEL NO: `% -; ? _ 6• Construction Location STIMT NO: 41 % / STREET: � � ,Ie / I r L JJ / r) c� LOT: BLOCii�C: ADDITION: Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION 9 L Rsx, P_ Front: Square.Feet: Front: Square -Feet: Type of Construction: � f r2 V c> To Be Completed: Depth: Height: Cubic Feet: Depth: Height: Cubic Feet: Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ Alt. A Alt. B SEL REVERSE SIDE OF SHEET The undersigned hereby snakes application for a permit for the %-nrk 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: / / b' v SIGNATURE: Stipulations: vl Pry t r- Q. 31U Tlo :s® Roo 15VIL)JIIVU 1'11(1'1) I 1"L:l: ZA-111:1JULL" SI;('TIOI.1 2. The Tiu;pcctor of ))ui.ldi.n,I s ,;1-0.1., },efc -(' i. t:s:.uirtg pe) -nit for, the erection of ally building or. :;truct:urcz, or. for any addition t.c, aiiy existing building or structure, cir for arty a.l Lerat.i.on or re} airs ,'.o buil.cl.i.nu or :structure, upon aL'plicati.on i:}lerefore, r.cgn.i.r.e the payment by U)c applic.::tnt for :.tic:h permit of fees to the 'vnount herein below set forth and in t.ho )nanner herein provided to -wit: 1))3t COISTPUCTIOt•1: Single i.'a,nily }fomes and Garacics: $4.00/1,000 cubic feet. PLAN CIU"M 25 percent of buildi.r,g pcy.mi.t fee. DIdWAIA'. DLYRI SSXON: (Concrete. Curb Streets Only) ' Alternate A: Removal and replacement of concrete curb and cjutt-er only; Driveway width plus 6 feet- x 4�15e75 hlternatc B: Removal and replacement of concrete curb and gutter and install_ a 3 foot wide approach with 6 inch depth; Driveway width plus G feet x $17.85 ADDITIONAL INIFMMIAT10- For the purpose of computing fees for building permits, the cubical contents of any building or addition, is detea-mined by multiplying the ground area covered from a point sir. (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the Iilain gable of a pitched roof. ror repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 rer each five hundred dollars --($500.00) or fraction thereof in the cost of all proposed work. In -no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. VERIFICATION OF FMIND TION NOTE: Permits "-or construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has beeza constructed will be required before proceeding with the framing. CERT I F I CAT_F. OF QC UPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. CITY OF FRIDLEY Effective Date May 1. 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer RATE TOTAL $ 20.00 $ 10.00 $ $ 10.00 $ 10.00 • Air Conditioning (all sizes) S 10.00 All Others/Repairs and Alterations 10 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work State Surcharge Reinspection Fee ($15.00) Rough Insp. Ste Final Insp. //— Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00• PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written pezaission from adjoining neighbor. Job Address Department of Building* 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. 11571-3450 $ 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ Fridley, Minn. , 19 $ OWNER} �C�lA�\O �S �.� \ \ "& KIND OF BUILDING USED AS $ TO BE COMPLETED ABOUT EST TED COST $ .50 OLD NEW BUILDING PERMIT N0. PERMIT NO. r $ SD DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLAN'rS,, �Stem, Hot Water, Warm Air- No. .. Trade Name Size No. A Q Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By Tel. No. Sia �� •S �n� Fill out back side for stack verification on replacement furnaces ---�7 CHIM14EY 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 connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL RemarksD�-),L-L Company . Signed By Da to SUBJECT PE City of Fridley 2 0 6 3 5 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. _ PROTECTIVE INSPECTION SEC. 11[J o.; CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L •" 612-571-3450 910415 10/18/90 JOB ADD4ESS 6191 Starlite Boulevard N .E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 2 Sylvan Hills Plat 2 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Gary Ettel 6191 Starlite Boulevard N.E. 572-8765 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Asphalt Specialties 2929 Anthony Lane South_, Lakeland, M 55043 781-8871 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 kE.7 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct 261 x 22'• Garage Slab (:Garage, to be built by othersl 9 CHANGE OF USE FROM TO STIPULATIONS Provide frost footing, Provide anchor bolts lj�' spaced 6r on center. Before digging call for all utility locations 4154-4002 REQUIRED DBY LAW 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 $4r500 $2.25 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 OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $63,00 TRU NOR THE ERFORM CE OF NS UCTION. PLAN CHECK FEE TOTAL FEE c.� k'ire $4.50 $69.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGEN T (DATEI WHEN PROPER A AT HIS IS YOUR PERMIT a� �1� AO? 96/ INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE, NEW [ ] Effective 8/16/90 ADEN R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: 6171 '1�4 19a / 4-7 1-34 V /� Iegal Description: Owner Name- & Address: 6 I}r L% F - Hc((- Tel.. # ,'� 70 - FX - Contractor: � � ��(fgC 77 SZAlo#Ati �52L- Tel. # 7�? Address' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LTVn4G AREA: Length Width Height Sq. Ft. GFiRAGE AREA: Tpxrj'h Width Height Sq. Ft. DECK AREA: length�� Width Hgt/Gr=4 Sq. Ft. OMER: l- ` A- -�?.2 Corner Lot [ ] Inside Lot [ ] Ft. Type of Construction: _ Approx. Carnpletion Date: Yd Setback Side Yard Setbacks `i r Estimated Cost: $ SZ) C) Proposed Driveway Width If New iced: 761 . $ $ idth See Back PagG� DATE: 1 a l Ira APPISCANT: L L Tel. Permit Fee $ (O.Ir®G Fire Surr mrge $ Lf ,�S o State Surcharge $ a SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TONAL $ o v sTIMATIONS: / ®� ,`� j P CITY USE C NLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary Pax(J, ,3,- etre b'OP',- NFA [ ] Effective 1/1/91 ADM 1-1 AND I-2 AMER [ ] Building Permit Application Construction address: (.O 1 C ! ZrT Ptn—u,►Ti!, ��Lo" 07. �� legal Description: Ls ` 9 L-oeA �- Sc, c u P� t -j ),41 P I Owner Namoe & `dd4s: PCz-%r �' q: -L- Co I q ► "IAI I CMI a r,fior: 0 LIU AJ (1 -- Attach to this application, a Certificate of Survey of the lot, with the proposed bion drawn an it to scale. Proposed Driveway Width If New Opening Is Desired: Permit Fee n aN of AAM"Jasar , LTVM AM: Length width Height sq. Ft. GRRAM AM: Length °�C� width -L-L, Height sq. Ft. r F A1tEl1: Length width Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ 0 Approx. Ompletion Date: Proposed Driveway Width If New Opening Is Desired: Permit Fee $ 7 11 0 Fine s rdhmw , State Surcharge $ 1 SAC urge $ Driveway Escrow, $ Park Fee $ Sewer Main Oorge $ P�495)f VTFTT 1. MX�M1�. yl - Ft. $ S Width + 6' See Back Page ma. # Fee Schedule en 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 Rqi neeri n agr�en1 Necessary [ ] Not Necessary [ ] 7he Chief Building official shall, before.. issuing periaits for the erection of any building or structure, or for any addition to any eKisting building or stnicture, or for any alteration or repair to any ®fisting' building or structure, upon application therefore, require the payment by the applicant for such: permit of fees to the amount herein below set faith and in the manner herein provided to -wit: $1 to $500 $15 (Minimum Flee is $15 plus surriharge) $501 to $2,000 $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2, 000 $2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fiactian thereof,, to and including $50, 000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, tobnd including $100,000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof EVZVOM DE FdMMM E9C WW (Comte 0 Streets Only) Alternate "A": Pd oval and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. Hermits for cm istructicn will be issued a zi ninum of 24 hours from the time of application to allow for proper review of the proposed structure and of the aonstruaticn site. A Certificate of Survey of the lot, showing the location of the foundation dation once it has it has been constructed will be required before proceeding with the framing. SUBJECT City of Fridley 28337 AT THE TOP OF THE TWINS BUILDING PERMIT" (EEO. ` COMMUNITY DEVELOPMENT DIV. v______ f � � PROTECTIVE INSPECTION SEC. 0 1 � i CITY HALL FRIDLEY 55432 NUMBER REv DATE OF APPROVED Br 612-571-3450 910415 10/21/98 F;GE � 1013 ADDRESS 6191 Starlite Blvd NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 21 2 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Doris Nelson 571-5201 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 Rx REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 23 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 OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 1 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 $1971 $.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 $62.25 Fire S $1.97 PLAN CHECK FEETOTAL FE 65.2 NATURE.OF CON' CTOA OR AUTHORi2ED AGENT tDATTTE,�j(�/ do W—ON PROP RlV AT D T / YO R PERMIT/ �9 S. NATURE OF OW NER�� OWNER BUILDER,i TEi BLD I S NATTEE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: f' Ut NVI tqf; , r111'd 1 fii MA/ Legal Description: Owner Name & Address: wo Nasw Tel. # WZ-5` 1-52-0 Contractor: MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. hyo connL 1/ln A c0 IA JAIJ /AA JI -n 12 o , - -) a 1 /d enc Driveway Curb Cut Width Needed: Estimated Cost: $ l99/ (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ _ $ DATE: .10ZI O,g APPLICANT: �"W'c Tel. #til -5zU STIPULATIONS: CITY USE ONL Permit Fee $ (oa?,-?S- Fee Schedule on Reverse Side Fire Surcharge $ 1 . .001 of Permit Valuation (1/10th%) State Surcharge $ 95 $.50/$1,000 Valuation SAC Charge $ $1000 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 $ -CA U STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Effective On January 1, 20001 RATE SCHEDULE JOB ADDRESS _.(a ( q ( 1 4_� M,' f � -" Residential Rate TOTAL OWNER h�n i ( S K - Furnace Shell and Duct Work, Burner - BUILDING USED AS S Also Replacement Furnace $ 30.00 $ s' (Side Vent - Fill Out Back) ESTIMATED COST�e y' o PERMIT N0. Gas Piping (Needed with new furnace, $ 10.00 $ Gas Range but not replacement) $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER Gas Dryer No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) rY $ 10.00 $ Trade Name I Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs &Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR f Commercial/Industrial 1:.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE $ �-S< representations stated in this application are true and c rrec DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. go am MMM09M, HEATING CO won t"'i'mor 06MEET %woy ' - Rough -In DateFinal DateS�L� COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. 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 () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) 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 ( ) 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 BTU Input Appliance #2 Type BTU Input Appliance #3 Type BTU Input Total Appliances Total Btu Input Common Vent Type Vent Height Appliance #1 Vent Connector Height ft Length ft Appliance #2 Vent Connector Height ft Length ft Appliance #3 Vent Connector Height ft Length ft Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Diameter ._ inches Diameter ;P Type Diameter hype Diameter _ r .�tY We HEATING CO: Signed By: Date: CIiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 August 9, 2000 Doris Nelson 6191 Starlite Blvd. NE Fridley, MN 55432 Re: Final Inspection at 6191 Starlite Blvd. NE Contractor: Standard Heating and Air Conditioning Co. Dear Ms. Nelson: A mechanical permit was issued on April 18, 2000 for the property located at 6191 Starlite Blvd. NE for an air conditioning unit and additional duct work.. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical system. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAT/ESEN Buildi Inspector