PRE 2010 DOCSV $ge of Fridley, Mmuo
® 2 4 office of MPECTOROF BUMDINGS
Owner ~- �,_,•
Architect Fridley, Minn.
Builder,
LOCATION OF DZILDIN
F
No, 00 Street Fart of I.ot
Lot Block Addition or Sub -Division '
DESCRIPTION OF BUILDING
Front; Pe th Height " Stories Manner of Constructionh
i
To be used as ��." ;� To be completed Estimated Cosh
tl U11
Permit is hereby ted to "' " ;< � � y, ; F 4: ,� �'o
the building r `. described in the above statement. This permit is granted
upon the express ndition that.0e perso o who it is granted, and his agents, employees and workmen, in all
the work clone in, around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley' Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city 1;1 its, a this permit may be revoked at any time .upon violation of any of the provisions of said
ordinances.
z
7nsnector of Buildings.
AGREEVMNT AND SWORN STATEMM� T
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work': in accordance with the description
above set fort and a
ein stated.
according'to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereb state and say that the facts stated by me and contained in the above permit are
true as ther
Subscribed d. sworn to before ine at Fridley, Minn to this .L
day o .L?. 19
o
00
CITY OF FRIDLEY INSPECTION DIV. (e
6431 University Ave NE p�
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2000
2 + R
PLUMBING FIXTURE RATES: NO. RATE
New Fixtures
Old Opening, New 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
$10.00
$10.00
$15.00
Reinspection Fee`$47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL JOB ADDRESS /00 -T& A -ge-?L L /Vil G
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.
-Owner JA
N
Building Used As
- -Estimated Cost ` PERMIT NO. /
PLUMBING COMPANY_
SIGNED BY- ���� �' TEL N0. / —®
Approved ByRough-In Date Final Date. IN
`�
■Ii\VI■ME■\■ rrr r A �\N Al ■�■IAS\�A//�1l� /1rl1■��T �!� A.AA A
TOTAL FEE $ PLUS THE S.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACKSIDE,
mnw
PLUMBING FIXTURE RATES: NO. RATE
New Fixtures
Old Opening, New 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
$10.00
$10.00
$15.00
Reinspection Fee`$47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL JOB ADDRESS /00 -T& A -ge-?L L /Vil G
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.
-Owner JA
N
Building Used As
- -Estimated Cost ` PERMIT NO. /
PLUMBING COMPANY_
SIGNED BY- ���� �' TEL N0. / —®
Approved ByRough-In Date Final Date. IN
`�
■Ii\VI■ME■\■ rrr r A �\N Al ■�■IAS\�A//�1l� /1rl1■��T �!� A.AA A
TOTAL FEE $ PLUS THE S.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACKSIDE,
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 specfications. 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 ( )
AEpliance Type and Size/Common Vent and Vent Connector Infonnation
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
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)
HEATING CO:
Signed By: Date :
I
FRIDOF
LEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
June 29, 2001
Ms. Jan Donohue
100 Talmadge Way NE
Fridley, MN 55432
Re: Final Inspection at 100 Talmadge Way NE
Contractor: KCJ - Mr. Rooter
Dear Ms. Donohue: -
A plumbing permit was issued on February 16, 2000 to install a water heater at your address.
According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted
on the plumbing authorized by this permit. As of this date, no inspection has been called for.
The permit fee that was paid covers the inspections to make sure the work was completed
according to the Plumbing Code. 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 expired the permit and no
further action will be taken.
To set up the inspection, or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely,
DJ/mh