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PRE 2010 DOCSSUBJECT IFIERMIT NO. City of Fridley ®1396'7 AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 3/29/77 JOB ADDRESS 1544 West Bavarian Court N.E. 1 LEGAL LOT NO. TRACT OR ADDITION SEE ATTACHED DESCR. TBLOCK 18 1 Innsbruck North Townhouses Plat 4 SHEET 2 PROPERTYOWNER 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 MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential (Alpenhof Design) -T-CLASS OF WORK j NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 26' x 32' Townhouse and a 22' x 21' Garage 9 CHANGE OF USE FROM TO STIPULATIONS WARN e digging CON loyal utilities SEPERATE PERMITS REQUIRED FOR WIRING, 18MoNE - ELECTRIC - CAS Etc. .:HEATING, PLUMBING AND SIGNS: REWRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS 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 27,916 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 $44,770 $22.38 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. $111.66 $375.00 PLAN CHECK FEE TOTAL FEE S27-92 $536.96 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) H N P OP LY VALIDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG )NSP DAT. ' A11111,ICATION FOIL IZL'SIDENT.IAL, ALTEIZATIONP OR ADDITION- BUILDING PEIZ1%1tT CITY OF FIZID1,EY, MINNESOTA OWFNER' S IMME :�Arr,t�,q •leis -s, i0Pu . e0 y. BUILDER: J aA" e.. ADDRESS: 7.Z&& 7.Zj!!-C( Laae ADDRESS: %9p/.r. 1;"7,7. 6-f4.28 NO:. STREET Qua/'%ar, `oae LOT: /8 BLOCK: ` - ® ADDITION: CORNER LOT: INSIDE LOT: Ve"? 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: A/��.��o /p 'Y/.OUSG. Front: 2(40� Depth: 3 Z' Height: Z8' Square Feet: $'-3 Z- Cubic Feet: '2_3 z 94 64s-49 e— Front: Z 2` Depth: Z- If Height : /o Square Feet; "¢b Z- Cubic Feet: 4 (oZ O Type of Construction: ogZood Estimated. Cost: - 4 77 O To Be Completed :64rri. 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: �. % 7 SIGNATURE: (ax"— — (See Reverse Side For Additional Information.) �"3l0.9� CITY OF FRIDLEI'— APP! ICATION FOR PUI,'MBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PL.:}:?.ING FIXTURE RATES: NO. RATE TOTAL Fir =uses �_ x $3.00 $ X7.00 Water x. p $ tic . Fixture, Old O?ening x. $2.00 $ Catch Basin r. $51.00 $ nater ::Cater - to 99.600 B:J Heater � � D ,.,. ,,; x. _ of •.r � j O � :..� v: ; :� v, cY :r, n x $5.00 $ > x. a I I? I "' u c %t 1:;t 3 =-"tures 1 x ;as :lee In�i x $1.00 $ Gas Rrnge to 199,000 BTU x $10.00 $ 1 _ �1- 3rd 1 1 ! I I 4 ! I 4th ! I = r^._t._re Ccn ection Opening Connected with Sewer (x) = ..cw Fixture, Old Gp ening t Water PARTIAL RATE SCHEDULE PL.:}:?.ING FIXTURE RATES: NO. RATE TOTAL Fir =uses �_ x $3.00 $ X7.00 Future _ :.Xture Opening x. $2.00 $ tic . Fixture, Old O?ening x. $2.00 $ Catch Basin r. $51.00 $ nater ::Cater - to 99.600 B:J _� _ $5.00 $ 5.0 160,660 B7,; to 199,000 BTU x. S10.00 eater Sc�tener x $7.00 $ .._w Gr..._n d Run Old Building x $5.00 $ Electric ~later Heater x. $5.00 $ GAS FITTING FEES: 1:;t 3 =-"tures 1 x $3.00 $ 2.0 ;•--di io nal Fii:tures x $1.00 $ Gas Rrnge to 199,000 BTU x $10.00 $ REPAIRS $ ALTE?,TIONS _.rst $100.G0 each add. $100.00 or fraction State Surcharge TOTAL FEE F..E $5.00 $2.00 Job Address /Y Ll Ll 64,) eI_A �� jeen,_� O Ucl�art :•nt of Buildings City of Fridlcy 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 Cees and rulings of the Department of Buildings, and hereby declares that all the facts and rearesentations stated in this aaolication are tr.:e and correct OWNER KIND OF BUILDING AJ(�6C�IICJI ��'L� USED AS TO BE COMPLETED KOUT ESTIMATED COST OLD — NEW 'ILDING PERMIT NO. PERMIT NO. Company e.,„ _ _ _Pje1 d., r I Signed By��'I/ Tel. No. ROUGH INS?. Date FINAL INSP.7- Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 �1 I Y 0i FR1ULLY J -- 3 5-5-0 r APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE �R>CITY WAP -M :SIR: RATE TOTAL F'arn ace Shell & Lluct Work $12.00 $ R eplac -e: of F t:rnace 7.00 $ .-, Repairs & .-,iterations-up.-,iterations-up to $500.00 7.00 $ Re airs & Alterations each add. $500.00 4.00 $ IECr;NICAL h*A&NI AIR: Furnace Shell. & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 $ Remlace=enz of Furnace 7.00 $ Fet'irs & Alterations -.:p to $500.00 7.00 $ Fw=airs & alterations each add. $500.00 4.00 $ OR HOT ii:iTER SYSTEM: :oiler s Lines up to 100,000 BTU $12.00 $ ea:.. 50,0"', BTU 4.00 $ Boiler o :'-yl::p to 100,003 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ AIT- BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ .;.AS BURNER- frcz 100,000 BTU to 199,999 BTU $10.00 S (over 199,999 BTU see Fee Schedule) $ BAS FITTING FEES: 1st 3 Fixtures x $3.00 �[_ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ '.IR CONDITIONING'� �/av��C `' $ J. J FAX HEATING SYSTEMS See Fee Schedule $ l'=X 1 ATING SYSTE.IS $ kI.TERATIONS S, REPAIRS_, $ State Surcharge $ .50 TOTAL FEE $ .7, J' i INSP. REINSPECTION FEE Date (.$10.00) F�aL INS?. 1 - 7- 4� % 7 Late %PPROVAL FOR PBi%'IT d ✓QA XI`IX.L.4 FEE FOR A'M'Y HE.A^aING PERMIT IS $7.50 Job Addreos / �yy �" �JGvr-.✓i �,o� C Department of Buildings City of Fridley Tel. ;?571-3450 The undc;rsigned hereby mares 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 Dcpartment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. 6Fridley, Minn. 7 i �°® ® , 19^ OWNER-- "- r'- / �� s ✓ KIND OF BUILDING USED AS 'b ✓✓ �O / - A TO BE COMPLETED ABOUT ESTIMATED COST ti 3 3,� ® j OLD - UILDING PERMIT NO. PERMIT .40. DESCP.IPTION OF FUPNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. I Trade Name Size No. ��100 > �= �C3 v.�o Capacity Sq. Ft. EDR s BTU :? Total Connected Load 415—_ __ Kind of Fuel �` -% BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company §igned By "O A � ti Tel. No. 1 A ve4-,t� a/�p HLOSS CAL HEATING&AIR CONDITIONING CO. MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Guide Reference 19— 9F1. Construction No. Insulation Windows Doors Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes -No Yes -No F 1. Room Length c Width ®1K Height FI. Room I Length 2 Width /t Height Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area No, Width Height No. of _ of pane of pane lighhts Lineal ft. Area of crack sq. ft. No- W drh of a e Height No. of Lineal ft. Area of pane lights of crack sq. it. YC� 3n :� rICY �[d --yyL n ry4- ~L Ly— 1 cj 2- C- VU � T_r 1 3 Coef Btu Coef Btu Infiltration sir ,�I 22`X _ 3 Infiltration 3s Glass Glass S"� cFri.3 Exp. wall 10'2 Exp. wa l l Net exp. wall 373 4- Z Net exp. wall Int. wall Int. wall Ceiling Ceiling e— F l oor Floor Total Btu. Total Btu. 0 1-11 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 SFI. spy Room Length Width 16 Height r C FIr_,�.,., &j(apI Length 2_G Width Haight Windows an Doors-Crackage and Area Willndows and Width No. of pane I Doors-Crackage and Area Height No. of Lineal ft. Area of pane lights of crack .s7q._ft. Width Height No. of Lineal ft. No. of ane of pane lights of crack p g Area sq. ft. Coed Btu jCoefj Btu Infiltration Infiltration /f 7033 Glass Glass. Exp. wall Exp. wall / Sf Net exp. wall 7 .2' Net exp. wall �� 2 Int. wall Int. wall Ceiling _��j )e%,. 1/4- .3 ®'�- Ceiling Floor Floor ---" Total Btu. 3 2 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 I Fl. L( v %!rl Room I Length % �� Width /t/ Height r FI. V j¢- Room Length 12 Width %J Height Windows and Doors-Crackage and Area - Windows and Width of pane Doors-Crackage and Area Height No. of Lineal ft. Area of pane lights of crack sq. ft. No. I Width Height No. of Lineal ft. Area of pane of pane lights of crack sq,ft. No. Coef Btu Coef Btu Infiltration Y OP ;)-0 Infiltration Glass f u Glass V to Cil Exp. wall Exp, wall 2 2 ec ' (� _Net exp. waI I Cr M Net exp. wall 6 �o 0 v Int. wall Int. wall Ceiling Ceiling _-- Floor Floor �- 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 SUBJECT P City of Fridley 20313_ AT THE TOP OF THE TWINS BUILDING PERMIT r? _pEcemrwO__ _ COMMUNITY DEVELOPMENT DIV. 4e PROTECTIVE INSPECTION SEC. �j 7 ��/p i CITY HALL FRIDLEY 55432 NUMBER REV. GATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/24/90 JOB ADDRESS 1544 West Bavarian Court NeE, 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 18 1 I11nShruck North. Towrihous:es Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Noiand 1544 Wemst Bavarian Court N,E, 571-7584 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Northland Siding & Tasulation 2158 Main Street N.W., Coon Rapids 55433 757-7170 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 ❑ ADDITION O ALTERATION [j REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside.Tmmhouse 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $9., 0Q0 $4.50 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- $1�8 �.0 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. s CHECK FEE TOTAL FEE $112.50 SIGNATURE OF CONT FACTOR OR AUTHORIZED AGENT )DATE) WHEN PROPERLY VA ATED HIEj IS YOUR PERMIT SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI BLDG INSP r•)ATE NEW [ ] Effective 1/1/go ADON [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: t-f1(lea c,�! % 14 A) Legal Description: �7 Owner Name & Address: TI / m lVo /,oyD Tel. # Contractor: "a^-r� 7i Tel. Address: a s -g 1A1,01,1 S r• A4 Lv,, Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AM: Length Width Height Sq. Ft. GUUM' AMM: Length Width Height Sq. Ft. DECK AMM: Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page GATE: `i� �`% %a APPLICANT': 2:° -Tel. # Permit Fee $ 108, 0 o State Surcharge $' SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ l 10, —3's� a co STIPUTATIONS: CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57L-3bU4 VAN: (7b3) ADDRESS : 1544 W BAVARIAN CT NE PIN : 243024440088 LEGAL DESC : INNSBRUCK NO T H PLAT 4 : LOT 18 BLOCK 1 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-00061 DATE ISSUED: 01/16/2004 VALUATION 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 1/2 INCH COPPER AND SHUT-OFF VALVE FOR DRYER # A/C UNITS 0 VALUE OF APPL OR WORK # FURNACES # GAS RANGES APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- (763)757-6202 OWNER THORSON WAYNE L & JOANNE M 733 OAKWOOD DR NEW BRIGHTON, MN 55112 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 regulating construction or the performance of construction. Applicant Date Bldg Insp Date. 0 # GAS DRYERS 0 HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS PIPING FEE GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 628124 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 387 0 25.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 25.50 CIN OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ' JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back)— Gas Piping (Needed with new furnace) $ 10.00 $ OWNER Gas Range $ 10.00 $ / BUILDING USED ASmiy�d1 Gas Dryer $10.Q0 $ c � a) PERMIT NO. ESTIMATED COST 99 7 *Air Conditioning —All Sizes $ 25.00 $ ' DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK 1% of Value of Appliance or Work $ No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel' —Total Connected Load State Surcharge TOTAL FEE 50 MINIMUM FEE FOR' ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU HP EDR ?)L 5, tzl,% //oww v4,/ G1� �ti HEATING COMPANY ✓�� Signed By C om- Tel No..,ol a/ ✓�J Approved By Rough—in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE HIMNEY AND TA K 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 O No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Reing Done HEATING CO: Signed By: Date: N•t 1) _ f6 -7 -7 0 CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, 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 Effective 4/1/2004 APPLICATION FOR POWER PLAN S AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Total $35.00 $ 11Y..0 $10.00 $ $10.00 $ $10.00 $ *Air Conditioning -All Sized $25.00 $ Jo All Qther 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 Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/IndustriaVInstitutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR JOB A[ Owner Building Used As z ESTIMATED COST �J �7� ' PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Uni I Circle One (Steam) (Hot Water) (Warm Air) Trade Name z Size N 4. I _ 6ye BTU HP EDR Fuel 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. $ HEATING $ Signed_ *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 FAX # S Tel#SEDGMCK ��1 �8 I AICA WI �OT!�1atfA1 7 (952) 881-9000 Approved by Rough -in Date Final Date