PRE 2010 DOCSMECHANICAL WAR.! AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSTEM!:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTU
OIL BURNER- to 3 gal, per hour
each add. 3 gal. per hour
'GAS BURNER- from 100,000 BTU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
GAS FITTING FEES:
$12.00
4.00
7.00
7.00
4.00
$12.00
4.00
7.00
6.00
$10.00
10.00
$10.00
1st 3 Fixtures x S 3.00
Additional Fixtures x $ 1.00
Gas Range to 199,000 BTU x $10.00
AIR CONDITIONING �/�7'}�'✓� �'% ®�
FAX HEATING SYSTEMS See Pee Schedule
VENTILATING SYSTEMS
ALTERATIONS $ REPAIRS
State Surcharge
TOTAL FEE
ROUGH INSP.
Date
FINAL INSP. � -/ -2.. -% ?
Date
APPROVAL FOR PER14IT
REINSPECTION FEE
010.00)
The undersigned hereby makes application for a permit for the work herein
$ / =,4"> j specified agreeing to do ali work in strict accordance with the City Codes
$ and rulings of the Department of Buildings, and hereby declares that all the
S facts and representations stated in this application are true and correct.
$ Fridley, Minn. -� e _ ' 19 z7
OWNER
$ KIND OF BUILDING �i� � e-
$
$ USED AS
S •>
TO BE COMPLETED ABOUT o �s
$ ESTIMATED COST
OLD -(NEW• UILDING PERMIT NO. PERMIT NO. ��3�" ✓
$
$ -�11 6 CIS
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, I arm Air- No.
Trade Name j y I'lc: i'1 Size No. �� !
Capacity Sq. Ft. EDR BTUHP
Total Connected Load '_—) 3- Kind of Fuel-
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company GEO. SEDGWICK HTG.. & AIR CONN CO.
Signed By/ e
Tel. No. � �� '�%
1001 XEI\IIA AVE. SOUTH
MINNEAPOLIS, MN 55416
545-1611
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Job Address �Zil.0 eat
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Department of Buildings
Repairs & Alterations each add. $500.00
4.00
$
City of Fridley
Tel. #571-3450
MECHANICAL WAR.! AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSTEM!:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTU
OIL BURNER- to 3 gal, per hour
each add. 3 gal. per hour
'GAS BURNER- from 100,000 BTU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
GAS FITTING FEES:
$12.00
4.00
7.00
7.00
4.00
$12.00
4.00
7.00
6.00
$10.00
10.00
$10.00
1st 3 Fixtures x S 3.00
Additional Fixtures x $ 1.00
Gas Range to 199,000 BTU x $10.00
AIR CONDITIONING �/�7'}�'✓� �'% ®�
FAX HEATING SYSTEMS See Pee Schedule
VENTILATING SYSTEMS
ALTERATIONS $ REPAIRS
State Surcharge
TOTAL FEE
ROUGH INSP.
Date
FINAL INSP. � -/ -2.. -% ?
Date
APPROVAL FOR PER14IT
REINSPECTION FEE
010.00)
The undersigned hereby makes application for a permit for the work herein
$ / =,4"> j specified agreeing to do ali work in strict accordance with the City Codes
$ and rulings of the Department of Buildings, and hereby declares that all the
S facts and representations stated in this application are true and correct.
$ Fridley, Minn. -� e _ ' 19 z7
OWNER
$ KIND OF BUILDING �i� � e-
$
$ USED AS
S •>
TO BE COMPLETED ABOUT o �s
$ ESTIMATED COST
OLD -(NEW• UILDING PERMIT NO. PERMIT NO. ��3�" ✓
$
$ -�11 6 CIS
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, I arm Air- No.
Trade Name j y I'lc: i'1 Size No. �� !
Capacity Sq. Ft. EDR BTUHP
Total Connected Load '_—) 3- Kind of Fuel-
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company GEO. SEDGWICK HTG.. & AIR CONN CO.
Signed By/ e
Tel. No. � �� '�%
1001 XEI\IIA AVE. SOUTH
MINNEAPOLIS, MN 55416
545-1611
m j4vAav(,l Y/-7-'
HEAT LOSS CALCULATIONS
MINNEAPOLIS, MINN.
r,
Weatherstrips
A.S.H.V.E.
Guide
Reference
19
Construction No.
Insulation
Windows
Doors
Out. Wall
Int. Wall
Ceiling
Roof
Floor
Kind
How Applied
Yes -No
Yes -No
_
FI. Room Length /e Width A) Height
FI.&I�% Room Length �✓ Width /0 Height
Windows
and
Doors-Crackage
and Area
f
dindows and Doors-Crackage and Area
No.
Width
of pane
Height No. of
of pane lights
Lineal ft.
of crack
Area
sq. ft.
No, Witlth
of pane
fel ght
of pane
No. of Lineal ft. Area
tights of crack sq. ft.
/
3 �
3� �
�
3.--
I
�
Coefj
Btu
Coef Btu
Infiltration
y1-7
Infiltration
Ci 1
Glass
¢
��
Q'
Glass
"
Exp. wall !` ,r
Exp. wally -
Net exp. wally
Net exp. wall -
V
Int. wall
Int. wall
Ceiling
Ceiling
Floor 00�
�
Floor Wo
1-3
9/ 2
Total Btu.
�
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1. ,��� Room Length 1 Width
/ Height
Fl Room I Length Width
�s
Height
Windows and Doors-Crackage and Area
`
Vilin6ows and Doors-Crackage and Area
�'
No. Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
No Width Height No. of Lineal ft.
of pane of pane lights of crack
Area
sq. ft.
I I
Coef Btu
--
Coef
Btu
Infiltration
Infiltration
Glass
_—
Glass
I
Exp. wall �-
- -
---
-- ----
Exp. wall
Net exp wail
Int, wall - ---
Ceiling I
Floor `7 /
total Btu.
Required sq. ft. E.D.R. or sq. ins W.A. Leader area
Net exp. wall ---
1/
.,
Int. wall _�--
Ceiling ---"
---- -
Floor ✓ ��
�J
,-
Total Btu.
a
Required sq. ft. E.D.R. or sq, Ins. W.A. Leader area -
Room I Length P 'r
,� ✓� �. I g Width
/. Height
T —
,..-, t
CePfl Btu
Flo¢ �� Room Length. � Width7
V indows and Doors Crackage and Area
r ir:, i f �yht � N„ i T L�r�^at ft. Area
d�. f a-r•,.r- yf ..n ht _� of track_ sq. ft.
I
; -----I .t.-------�Coefi-
Height
Btu- -
Windows and
No. Wirith
v1 pane
Doors-Crackage and Area
No of Of
of cane lights of crn�k `q. h.
f vane
Infiltratiot1 ;
Infiltration
Glass
Exp. walI
Net exp. wall I
it,,. wall
Celi:nyFlooryf�
Plot -
lourTotal
Glass
- -
_-
Exp. wall
Net exp. wall
Int. wall
�—
Ceiling� tJ
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Total Btu. (
'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
a-4trA A av�� }
HEAT LOSS CALCULATIONS ,�
CORM70(ak imn iC a MINNEAPOLIS, MINN. r
Weatherstrips A.S. H. V. E. Construction No. Insulation
Windows Doors GuideOut. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Reference
Yes -No Yes -No 19
Ft.i I Hyy Room Length Width Height FI. Room Length Width Height
Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area
No. Width Height No. of Lineal ft. Area
_ of pane of pane + lights of crack sq. ft. No. Width Hwght No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
w,
Coef
Btu
Coef
Btu
InfiItration
y
F,
Infiltration
Glass
Glass
Exp. wall
Exp. wall
Net exp. wall
Net exp, wall
Int. wall
Int, wall
Ceiling,
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl, i r Room Length / Width®
Height
FI. Room Length Width
Height
Window and Doors-Crackage and Area
f14`�SEd��
Windows and Doors-Crackage and Area
No.
Width
of pane
Height No. of
of p ne lights
Lineal ft.
of crack
Area
sq. ft.
Width H i tit
No. q No. of Lineal ft,
of pane of lights
Area
ft.
A
�3
��"
pane of crack
sq.
f
Coef
Btu
Coef Btu
Infiltration
o�
Q2-'- 4?-
Infiltration I p
- 1
7 I ��
l
Glass
Glass
_-. ____ _--�•,_--
Exp, wall
-- ----- �r
NPT exp. wall
Int. wall!
Ceiling
_ ..
Floor
®r.
0
Exp. wall----
��
s
0,4
Net ex wall I --
p' —.
---' ---
Int. wall
�
Ceiling ®� tZ
� ` �
Floor
-
-
- __
-- --'-
Total Btu.
_
I iota l Btu. S5
Required sq. ft. E.D.R, or sq. iris. t', ,A. Leader area
Required sq. ft. E.D.R. or sq. in W,
. A, Leader area
FI. �/ 1 j Room Length w Width Height
Fi. Rnorn I Length Width
Windows and Doors-Crackage and Area
------- _ _. --r--""--
No d,: ;:u, +r•: G,�, T N i>t L,nF'rti ft�..4,ea
�- ---; - - g
qft.
of ;13r1" I ' Uin ht5 r} cr]CkL2-f-
i I
t
—c'-fi
Height
Windows and Doors--Crackage and Area
No. W.din Height
g. Ne. ,. Lineal ft. Asea
of pane I of pane lights of crack sq. ft.
_
coef; Btu
— a t� -'
Infiltration
—--
Glass
-- -- -I -
Exp. wall i --�-- ----
Net exp. wa l l �_ ... �- - ----
�— -�----_.� -
Inf,!tration i
— -- - -- -- t —�-
Glass �------ 1
------------_ -_-- ----
Exp. wall i I
- - -- - -- ---- - - -- - - ---- f
Net exp. wall
i
Int. wall !
j I
Int. wall
Ce i 1, ng ----
_ - �� _Ij� c
�. -- --- - --- --
Ceihr)c
Floor
FI or
nor
Total Btu.
Total Btu.
Required sq. f . E.D.R. or sq. ins. W.A, Leader area
a
Required so. ft. F.D.P. or sc.-ins. W, -A. Leader area
i
SUBJECT
IT
City of Fridley
141
® 14553
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT
o.
COMMUNITY DEVELOPMENT DIV,
d
1 PROTECTIVE INSPECTION SEC.
1
2—
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
112/30/77
JOB ADDRESS 1515 Trapp Court N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
it 3
6
Innsbruck Villages
SHEET
2 PROPERTY OWNER MAILADDRESS
ZIP PHONE
Darrel A. Farr Development Corp. 7286 - 72nd Lane North 560-8110
3 CONTRACTOR MAILADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Res iden tial
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 27' x 29' Townhouse and a 21' x 22' Garage
(Matterhorn)
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMIT_ S ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-1
796+462
20,200 Total
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$25,795
$12.90
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.
$80.80
$375.00
PLAN CHECK FEE
TOTAL FEE
488.90
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
P PE Y V IDATED THIS IS YOUR P RMI
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE)
BLDG I SP
D E
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER; iQ�L ,�(. F,41 :PEVEZaPMENT BUILDER:- g ?EL A.,r-AFR ZMVELOP MEMT
Address: %8 (c ` %nCQ �. ne ,
`I hn .
Address:
Tel. No .:.'9AD -8t 10 1.
No.: 1J516 Street: `%R,*FF (Otlirr
LOT: BLOCK: 4 ADDITION:
CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS:
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:
tJGlI��S�, Front:
�'J' Depth:
��° Height: 11.?Q
Square
Feet: � Cubic Feet:
Front:
` Depth:
�,a?' Height: /®' 7o 7,q L
Square
Feet: Cubic Feet:
A
Type of Construction: (�("�)�
Aa%1 ��
Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: 1111®17 7 SIGNATURE:
Stipulations:
go i�kav
Cwo
9®
() ® 'S
Y
4 �3v.IL W. , ..g. RtI-T -F
� be or �l; sun e is or th ` e .ec
! � N ?�. �J f�?`-Ingpe to'r of B�iil ings ha- 1, j F § ' g p t� l n
i rhucture, i�r lfori an alio# tp an tl ui- di -r- ct�
'any bui I d ng, or,
or o ati o36 .exist t. d ture, 11ori a 1 ca to
jtheirePor riequ re !e payor it by, appllcan o I e s o t he am un
el I. I
he,.belos�: �. _ .thy -m nrae°r�--�a-��id�- �---�i•---.---
iS'I) 25i in` l� Family phi "m acl Gar4ge$ : ' $�r
;p i
.� _ _ _..1 E_ pe .ce rt _ pf - bui! -fie i -fa -� -
i _ D U� Y EP�RESiS2O I -_ i__ _ ;_ _
RIVE A ( : !(Concrete Cub �StrT et 01
ltlernnote_�:I oval �ndl re em t of co cr to icu�b d '
roialy i�r I , 4- -i—]IL v
ate B: 2c iv l ire lac m n�'!'of Ic n �t Icu b_
gut -ter aiid ns alb. a 3 oaf wide appppro4ch }wj -
y ,.
i
f! co puts g ff r }iil in ' ,fit t e ublca c Int nt o a
} u,��,,�ding r add' ti n, isl eltermin d ul ip yizhg 1 gr un a ea co er d ro a
e� -' I f - rrt--or tYz -c 3 --- -� -
i
I I iave`r g ig�ts of th' la e s arf ce or toI th� air r he�jgh!� o a oo e_q.
4 es maa n gab e. f 0' j
c //
- i _ _—� Y
` Fo re ,rs r It ra lois �o xi t' g $tr cti_r._e t e ee sh 11 e ja q r,• e
;cif- 3 . 0 per ea h i B h' nd' edldo la $5 0. 0) I or fr c on there f n c
o`�. ase sha'I t i . Fe ' ch ~� , y permit s et fo th lin Se tin bd ab ,
I
TION
i- - -- } 1__ 1 7-7
! . i r�coin - _ � 31i -w Tl s + u f� 4 - ouris- ro tl e � im
- _ ! ! p -r
' on) t }
i I "-mon;
E as be' en on ofc ? Y!/ber 2 4._. k� enc t i o t°Is n_ o n i
_-
p } � } �:qu"
I � - - --- -
_ - $ ...r
I f >
-ie titin -for a -L'erif#�a - cc'-'azc__ Ib.....__
t y l sh Il e Image en )- ay p o` t the i
! this'dc���Yi as4y�rct a_j
1 sal s u tu'e shall jot °beYusid r c pl d until C rt'fiat o O cu as
-- - I ---bee i -i l�-scied l I -•f- + -- �__- � --
_I
i � t
°
!
} :
I
---- -- 71. +
_+.__
I
1 4
• W I r • OF FRID, EV .
APPLICATION FOR PLUMBING AND GAS FITTING PEFMIT
PARTIAL RATE SCHEDULE
e+ •
NO.
RATE
TOTAL
a
x
a
u
x
X
e
New Fixture, Old Opening
Water
rt
n
x
. - x
$ .--
w
+
_L x
$5.00
100.000 BTU to 199,000 BTU
a
$
Water Softener
x
Heater
•uiOv+.
J a+
J
0
.
7
.0b�
-+
J'G°•'
C
.o.er •
C7
0
,1',
.0
L
C
0
W
O
4 C
U M
0
O .0V;
tJ
• R
�Nl•
�N(
►O71
$�
A3ditiozal Fixtures
x
IA
$ �-
$10.00
$ i�
ae
fC
First $100.00
$5.00
$
each add. $100.00.or fractL6n
$2.00
lea
Stata Surcharga
$ 50
TOTAL FEE
.
•
�
l
3rd
(R) - Future Connection Opening
Connected with Sewer
{•) - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
2.`=ber Fixtures
x
$3.00
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
• Catch Basin
. - x
MOO •
$ .--
Eater Heater - to 99,000 BTU
_L x
$5.00
100.000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$ ^�
Now Ground kin Old Building
x
$5.00
$
Electric beater Heater
x
$5.00
$ ��
GAS FITTING FEES:
1st 3 fixtures
�� x
'$3.00
$�
A3ditiozal Fixtures
x
$1.00
$ �-
Gas Range to 199,000 BTU
S
$10.00
$ i�
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00.or fractL6n
$2.00
$
Stata Surcharga
$ 50
TOTAL FEE
REINSPECTION FEE.
(Sin.oni
Job Address 1515
Department of Buildings.
City of Fridley f
Tel. $571-3450 3
The undersigned hereby makes application for a Permit for the vork hereiz.I
specified agreeing to do all work in strict accordance with the City Cedes!
and rulings of the Department of Buildings, and hereby declares that all g
the facts and representations stated in this application are true and corm
T Fridley, Mn. , 19
i
OWNER ,/ /^ -a-AAd L�_11
KIND OF BUILDING WOo C1 1� rtie
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST 1
OLD - NEW BUILDING PERMIT N0. PERMIT NO.
Company Q.
Signed By - R c a. - (�1.
Tel. No. _ Vo?5—Yl
ROUGH INSP,
Data
• o ,
FINAL INSP.
Date
APPROVAL FOR PERMIT �
MINIMUM FEE FOR ANY PLUMBING PERMIT ZS $7.50 pyyS .$.50 STATE 30=M=v
4
97-8ta-116051 CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00 •
$
A
x
$5.00
$
Water Heater - to 99,000 BTU
x
i4
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
Water
of
u
r°i
e
x
$5.00
$
ro
x
m
a
GAS FITTING FEES:
4j
a
w
tP
x
Heater
$
Additional Fixtures
.-�
$1.00
m
Gas Range to 199,000 BTU
H
.5 g
$
,p k
fa
G7
•.r'i
[ C
2t
U M
O 40
U
Ql
.c
:341
g
(A
"U
a
m
ow
t
14 o
UU)i
Ume43
O
U
c
as
lec
1st
2nd
3rd
4 tz
(R) s Future Connection Opening
Connected with Sewer
- New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00 •
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Pun Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
•$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
P.EPAIRS & ALTERATIONS
First $100.00 $5.00 0$
each add. $100.00 or fraction $2.00 $
State Surcharge $ .50
TOTAL FEE $ 10- 0
pv9;s^,pE"T7�"i
Job Address 1515 Train) Co urt
Department of Buildings
City of Fridley
Tel. #571-3450
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, Mn. 6-5-78 , 19
OWNER FARR
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 6-12-78
ESTIMATED COST
OLD - NEW BUILDING PERMIT N0. PERMIT NO. r)
Company�9�y
Signed By MI1� NEGASC®
Tel. No.
ROUGH INSP.
Date
FINAL INSP. q ' o
Date
APPROVAL FOR PERMIT <�
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS ,4.50 STATS BURCMUM
GEO. SEDGWICK HTG. & AIR GOND. CO. 7 ®,2AV7.0;;"
HOUSE HEATING TEST RECORD
ADDRESS �� CITY
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED B !C-
Electrical Work By Gas Line By
TYPE OF HEAT GA_ FA ' HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE
Serial
INPUT
Form 235
MAKE OF BURNER _
Model
Max. BTU Rating —
MAKE OF FURNACE
Model
Vent Size �0
KIND OF LIN911 SIZE ONE
Draft Hood Regulator
Filters Size Nyhber d
Chimney Location Inside Outside
Chimney Construction
Smoke Bomb Wiring —/
Draft j4p/25- Test Tag <'
Door Pressure Lighting Inst.
Date Tested -
Company Testing
Name.of Tester
CONTROLS
THERMO T T
Heat Plug
Valve
Limit Z,
Limit Setting
Fan Setting
Pilot Type/
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
Pressure -3 `s
Percent CO2
Input CFH 8Q0
Percent 02
Stack Temp. 11M Percent CO
Form 235
MAKE OF BURNER _
Model
Max. BTU Rating —
MAKE OF FURNACE
Model
Vent Size �0
KIND OF LIN911 SIZE ONE
Draft Hood Regulator
Filters Size Nyhber d
Chimney Location Inside Outside
Chimney Construction
Smoke Bomb Wiring —/
Draft j4p/25- Test Tag <'
Door Pressure Lighting Inst.
Date Tested -
Company Testing
Name.of Tester
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571-3450
V June 6, 1978
Darrel A. Farr Development Corp.
7286 - 72nd Lane North
Minneapolis, MN 55428
Re: Final Inspection at 1515 Trapp Court N.E.
Dear Sirs:
A final inspection was made on June 2, 1978 of the above address and
the following items were noted which must be completed before th-e
structure can be finaled out;
1. Provide a hard surface driveway by August 30, 1978.
2. Provide sod in the front and side yards by August 30, 1978.
3. Complete the garage by June 20, 1978.
4. have water meter sealed by June 20, 1978.
We will expect the above items to be completed by the scheduled dates
when reinspections will be made to determine compliance. If you have
any questions on the above items, please contact me at 571-3450.
Si
eye
ION HOLDEN
Building Inspector
RH/mh
City of Fridley
SuBJECT
qtRMIT NO.
'?49 j9
AT THE TOP OF THE TWINS
r
BUILDING PERMIT(
EIPT N
'
� • COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
I �
� 1
i
l ; CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PnGE OF
APPROVED BY
----
L 612-571-3450
910-F15
3/28/97
JOB ADDRESS See Below - Multiple Buildings
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Columbus Exteriors Inc 2131 111 Ln, Coon Rapids MN 55433 868-9195 3509
A ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Townhouse Buildings
7 CLASS OF WORK
O NEW ❑ ADDITION 0 ALTERATION REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Reside 11 Buildings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Install building wrap and have inspection of same unless manufacturer"E
specifications state it is not required.
5600,5602,5604,5606 North Innsbruck Ct; 1511,1513,1515,1517 North Innsbr k Dr;
1510,1512,1514,1516 Trapp Ct; 1531,1533,1535,1537 Trapp Ct; 1511,1513 515!1517
Trapp Ct; 5610,5612,5614,5616 W Bavarian Pass; 5621,5623,5625,5627 W Bavarian Pass;
5631,5633,5635,5637 W Bavarian Pass; 5651,5653,5655,5657 W Bavarian Pass; 5680,
5682,5684,5686 West Bavarian Pass; 5691,5693,5695,5697 West Bavarian Pass
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
AUT"ORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR N:ORK 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
$232,000
I $116.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE SAC CHARGE
PRO'::SIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STR,CTiON OR THE PERFORMANCE OF CONSTRUCTION
$1,547.25 Fire SC $232.00
PLAN CHECK FEE-.>
_ Ar>
_ -
Lie S $5.00
$1,900.25
.
11HA(-!�'iH ()H 4ifT NCIH11,J AIiENI i()A'Er
V (DATED THIS IS YOUR PERMIT
�PERLY
�j4H
,DA'F
.r 11
SUBJECT
PERMIT NO.
City of Fridley
26225
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT
COMMUNITY DEVELOPMENT DIV.
U
PROTECTIVE INSPECTION SEC.
`�
{ CITY HALL FRIDLEY 55132
NUMBER
REV
DATEPAGE
OF
APPROVED BY
612-571-3450
910-F15
6/12/98
JOB ADDRESS ( See Below ) 21 Various Addresses
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Various
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Innsbruck North Townhouse Association
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Stock Roofing Inc 289 Liberty Street
780-3561 3112
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 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof (147 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
ADDRESSES: 5600, 5602 604, 5622, 5624 North Innsbruck
Court NE
1513, 1515, 1517, 1523, 1525, 1527, 1531, 1533,
1535 & 1537 Trapp Court
5633, 5635, 5673, 5675, 5693, 5695 West Bavarian Pass
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
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
21
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
$12,259
$6.12
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
PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON -
$199.75
Fire SC $12.25
TION OR THE PE OR ANCE OF CONSTRUCTION
.
PLAN CHECK FEE
EE
TOT7$223.12
ie - �'-'9�
Licen
$5.00
SIGNATURE OF OF CONTRACTOR OR AUTHORIZED AGENT AUTHORIZED AGENT MATEI
N p P
V IDATED T IS I$ YO YO PERMIT
DATE
SIGNATURE OF OWNER OF OWNER BUILDERI IOATEI
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
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
JOB ADD
OWN
Rate TOTAL
$ 30.00 $
$ 10.00 $
$ 10.00 $
$ 10.00 $
$ 25.00
State Surcharge
TOTAL FEE
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.
$ .50
$b
BUIL
Effective On January 1, 2000
ESTIMATED COST q% DO - y (' PERMIT N0. 61 -
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating
nits Circle One (Steam) (Hot Water ( ar r)
Trade Name Size No. 59 %Q-1 U
BTU % 0i0trO HP EDR
Fuel M lE - %res 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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
;LFzi 4iTCa. A/C a ELECTDATE '
1 "2 CENTRAL A.V. �.
HEATIN 0 NOKA, MN 553041
Signed TEL #
Approved By Rough -in Date Final Date �� �
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 U No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
Yes ti1A 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( )
LP
Appliance #1 Type R UOW BTU Input LlN b an sisted or Nat �i G
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)
1U NE HTG. A/C & ELECT. IN
62 CENTRAL AVE N.C.
HEATING CO: ANOKA, MN 553
Signed By: Date: Z ✓� `1
CITY OF FRIDLEY INSPECTION DIMSION
6431 university Ave NE
Fridley, MN 554.32 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, Vl
572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs &Alterations (LIST'ON BACK)
1% of Value of Appliance or Work
Cornmerc i a l /Industria l
1.25% of Value of Appliance or Work
JOB AODRESS 1515 TRAPP CRT
Effective On January 1, 2000
OWNER ANTHONYIWOINIAK 612-571-3281
Rate TOTAL
BUILDING USED
$ 30.00 $ 3D' L
ESTIMATED COST � PERMIT N{1
$10.00
$
$10.00
$
$10.00
$
$ 25.00
$-a5. OD
HP £DR
$
-Total Connected Load_
,n
State Surcharge
TOTAL FEE
�j �� �1 � '. f 1 f �l . ��. ll . ♦:.'.Ill
1 .A y
REINSPECTION FEE $47.00/Hr
No. of
Trade
Burner Trade Na
The undersigned rebi makes application for a permit for the work herein
specified agreeing to dirall work in strict accordance with the City Codes an
rulings of the Building livision, and hereby declares that all the facts and
representations stated i this application are true and correct.
DATE
HEATING CO RON I MECHANICAL INC.
Signed'
*Air Conditioners can not be placed in a side yard without Approved ByARough-in Date
written permission from adjoining property owner.
TEL# 952-445-8585
Final DateL1/
0
m
w
0
® 28 6ML4
�
Circle One (Steam) (Hot Water�armSize
No. ilk 14
HP £DR
0
-n
-Total Connected Load_
,n
0
Size No.
F
s HP EDR
The undersigned rebi makes application for a permit for the work herein
specified agreeing to dirall work in strict accordance with the City Codes an
rulings of the Building livision, and hereby declares that all the facts and
representations stated i this application are true and correct.
DATE
HEATING CO RON I MECHANICAL INC.
Signed'
*Air Conditioners can not be placed in a side yard without Approved ByARough-in Date
written permission from adjoining property owner.
TEL# 952-445-8585
Final DateL1/
0
m
w
03/07/2000 10:07 6124455053 RONS MECHANICAL PAGE 02
hvs-
V /
£0 7
90MMON VENT VENT CONNi~CTOR AND COMBUSTION AIR VI;RIFKATION
When replacing an a istinct furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and frrestopped where required. Yes No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifcCations including sizing, langth, number of elbows and termination. Yes( NoX
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 0 No ( )
The existingegambus ion air is sized and installed to meet the current codes
and manufacturers specifications. Yes N No( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturers specifications. Yes y No( )
When Iitallitnn a new venting system, the undersigned hereby verifies that
it Is a listed assembly and meets the current cods and manufoototuurer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes W No( }
Is the common vent and vent connectors sized and installed correctly rafter
an appliance has. been removed from the common vent and vented
separately as per current codes. Yes X No { )
Appilancli Type and Size/Cotnmon y-ROt and Vent ConnegWr Information
Appliance #1 Type -�BTU Input d a Fan Assisted or Not , Awk+—
Appliance #2 Type �, BTU Input _ , onn Fan Assisted or Net Aj!d4,-,-,
Appliance #S Type BTU Input Fan Assisted or Not
�.r�.—
Total Appliances cl , Total Btu Input
Common Vent Type S'' )i Vent Height 10 Diameter ., inches
Appliance #1 Vent Connector Height ,a„it Length -IL-ft Diameter M min Type B- Ve ;
a,' _,
.+
Appliance #2 Vent Connector Height _ ft Length L_ft Diameter 9-"" in Type r-- t%., F
Appliance #3 Vent Connector Height ft Length ft Diameter min Type
ALTERATIONS: (Describe)
HEATING CO:-- 6 r t Q
Signed By: D*te :
i
20ee • d Esessby 01 A31a t N.� JO A113 Wodd LS :9 z QieL-8Z-N)j-r
03/20/2000 11:42 6124455053 RONS MECHANICAL PAGE
%v �iAIX /SSS / r'a.�'P
r'd lel
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing finance, 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 r No( )
The venting system is piasde/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination, Yes () No)O
The undersigned also verifies that the replacement unit is s listed assembly
and meets the current codes and manufacturer's specifications. This does
include A(3A-G MA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances. Yes No( )
The existing_ combustion_aiir is sized and installed to meet the current codes
and manufacturer's spechloations. Yes YY No( )
When required to rr ggil g a" Cgmbustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications, Yes y No( )
When MaUllina 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 1 Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes W 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 00 No ( )
Analfarico Type and Size/Common Vent and MW QqDiriggforfo ation
Appliance #1 Type 9,.,e na ca' BTU Input 0 o Fan Assisted or Nat A!cs#s
Appliance #2 Type Wa.,. Ali *¢t, BTU Input g,P&O Fan Assisted or Not I
Appliance 03 Type BTU Input Fan Assisted or Nat
Total Appliances __ATotal Btu Input r sib
Common Vent Type S"' f1 o A ) Vent Height a ' Diameter, S_. inches
Appliance #1 Vent Connector Height a_L -ft Length _eft Diameter M " in Type ,, jzk— 1- j -
Appliance #2 Vent Connector Heighteft Length _eft Diameter k" In Typeye., 3
Appliance #3 Vent Connector Height ft Length ft Diameter in Type,
nr TERATIONS• fDescribe� �,.•.,.�
HEATING CO: w C04 c
Signed By: Date:— - 66
E0i£0 d £S®SSby C�1 A31a r �ld JO I i O W08J LS :9 Z
m
CITY OF FRIDLEY INSPEG i IUN DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Effective On Jan 1, 2000
MARK NUMBER
OF
FIXTURES TO BE INSTALLED ON EACH FLOOR
Old Opening, New Fixture
I'......'"
Urinal
"
Shower
and rulings of the Building Division, and hereby declares that all the facts
Wash I��`::� :.,<
..�:•.:�t1
�
F loor
rain
>'t:::.:.
�
Auto.
washer
•..�'"•......::::::::
Gas
; .::::::..�`
:. �
Water Heater
Stories
''>"
;Gas
Elec
Basement
$10.00
Owner 1515 TRAPP COURT NORTHEAST
Water Heater -Electric
$ 7.00
- FRIDLEY, 55432
(612)571-32828 1
Water Heater - Gas**
$10.00
Building
Gas Range**
$10.00
Gas Dryer**
$10.00
Floor 1
Back Flow Preventer Required ( )Yes () No
Type
$15.00
PLUMBING COMPANY r
.,
Floor 2
Floor 3
Floor 4
r•aa
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL JOB ADDRESS
New Fixtures
$ 7.00
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 accordance with the city codes
Beer Dispenser
$ 5.00
and rulings of the Building Division, and hereby declares 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
$7.002>/7
20 c
Sump/Receiving Tank
$ 7.00
WOJCIAK, ANTHONEY
Water Treating Appliance
$10.00
Owner 1515 TRAPP COURT NORTHEAST
Water Heater -Electric
$ 7.00
- FRIDLEY, 55432
(612)571-32828 1
Water Heater - Gas**
$10.00
Building
Gas Range**
$10.00
Gas Dryer**
$10.00
r�
Estimated Cost PERMIT NO.
Back Flow Preventer Required ( )Yes () No
Type
$15.00
PLUMBING COMPANY r
.,
Reinspection Fee $47.00/Hr SIGNED BY
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Approved By
State Surcharge $ .50
MINIMUM I
TOTAL FEE $3 •� PLUS THE
TEL N0. GI Z 827 4103`:5
Rough -In Date Final Date
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
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 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: