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City of. Fridley, Mires- 3 �° 6431 University Ave. N. E., M.mneapolis, Minn. 55432 BUILDING PERMIT pymer; LTi egnans Tncnrporated Builder Sate ,Address 5901 Brooklyn Boulevard Address. Same '52 - ®2S3 11To 5 8 Street West Bavarian Pass _ Part of Lot Loi 2 Block - 11 —Addition or Sub -Division _ Innsbruck North Tnhs . Site Corner Lot Inside Lot r X_ Setback — Sideyard Bower Elevation Foundation Elevation In%iv?duaf as. T Front __241 Depth 40 , Height 2.01 Sq. Ft -9601 Cu. Ft-1q,2.DO I Garage Front 201 Depth _22' _ Height 10, Sq. Ft _.4401 Cu. Ft 4; 4001 Type of Construction -Wnn d 'Frame Est. Cost _$1Z,Z3$.40 _ To be Completed.Zan. 5s 1972,.. Stipulations: Provide 10 foot wide plato at elevation 857 for future walk around the lake. All parking lot and street grades must be greater than .6%. Area to be platted and filed before OJ¢JgAAYJ occupancy of units. In consideration of the issuance to me of a permit to construct the building described above, I agree to do ft proposed work in accordance with the description aboveset fo and in compli ce with all provisions of Ord�hances of the city of Fridley. R_87 State Surcharge in, consideration of the payment of a fee of $ 44- 00 _, 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 grantedand 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 n� city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordin Building Inspector HANK MUNICH NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. ("E" Unit) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: y I EWCON INr— BUILDER: VIFWCnU. iNr - NO:, 5518 STREET: West Bavarian Pass LOT: 2 BLOCK: 11 ADDITION: Innsbruck North Townhouse site CORNER LOT: INSIDE LOT: X SETBACK: -- SIDEYARD: -- Applicant attach to this form Two Certificates of Sury Z of Lot and proposed building location drawn on these Certificates DESCRIPTION OF BUILDING To Be Used As: Individual Townhouse unit Front: 24' Depth: l 40' Height: 20' 1600 Square Feet:, Cubic Feet: 19,200 , 1 Garage Front: 20' Depth: 22' Height; 10' 119 zt) Square Feet; 440 Cubic Feet: 4,400 c _ u ��' StA-j-6 Type of Construction: wood frame Estimated Cost: To Be Completed: 15, January, 1972 1,9,2-0-6 ff- eG q �) /-/y 01-0 5_.3 4 d(D 7-0r • CU, Fr The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of tLLLdings, and hereby declares that all the facts and representat s st ed int p io are true and correct® DATE: ---.10/1317] SIGNATURE: (See Reverse Side For Additional Information.) I ski; ��r�c•�� — � �� r ' ! �3�_ 1.36,00 of 36 ( C2®® { (713Sc�dt • � r� �� �� � �tJlr.�..'�"�� orf �, �` -I �} c � �•"'�---'------'----'r----_.�-".__---'-----'•--�------'-_-.,7.._--�--_._.--- ---ter-"- �.r _.-..-..-_----_-.'_'----- � .. Application for Power Plants and Heating, Cooling, Ventilation. ReMgeralion and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 GRAVITY WARM AIR: RATE TOTAL Location 5518 W. Bavarian Pass Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace............................. 5.00 $ City of Fridley: The undersigned hereby makes application for a permit for the work herein Repairs & Alterations—up to $500.00 .................. 5.00 $ specified, agreeing to do all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. 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 Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... 8.00 $ Furnace Shell & Line—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 $ X GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 $ 2®00 Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ a 7+50 ROUGH FINAL 60 - �? - 7 (-/ Fridley, Minn December 13 1971 , 19 Owner Viewcon, Inc. Kind of Building Frame Used as Residence To be completed about Jamuary, 1972 Estimated Cost, $ Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No _ 1 Trade Name Br FINt Size No. 393-80 Capacity Sq. Ft. E.D.R 80 t 000 BTU H.P Total Connected Load 45,300 Kind of Fuel Nat. g&S BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU HY (REMARKS -OVER) Signed Advanced Htg. & Air Comds, Inc. 42 Business Phone No -786-4881 10.00 8.00 $ 2.00 $ 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... 8.00 $ Furnace Shell & Line—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 $ X GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 $ 2®00 Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ a 7+50 ROUGH FINAL 60 - �? - 7 (-/ Fridley, Minn December 13 1971 , 19 Owner Viewcon, Inc. Kind of Building Frame Used as Residence To be completed about Jamuary, 1972 Estimated Cost, $ Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No _ 1 Trade Name Br FINt Size No. 393-80 Capacity Sq. Ft. E.D.R 80 t 000 BTU H.P Total Connected Load 45,300 Kind of Fuel Nat. g&S BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU HY (REMARKS -OVER) Signed Advanced Htg. & Air Comds, Inc. 42 Business Phone No -786-4881 City of Fridley APP licarion for Phsmbin and Gas Cs*Wn Permit 9 9 Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TO AL Number Fixtures ....... .............. (3 f$! x $2.00 $ /0 - Future Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... ..................... I- $ �8�z x $3.00 $ o� New Ground Run Old Bldg. ............ x $3.25 aZ o5�x Electric Water Heater ' U' i 0 O s F s N WATER HTR. GAS ELEC. Base $--2. 00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st p gy 2nd 3rd 4th ` Future Connection Openings �e New Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TO AL Number Fixtures ....... .............. (3 f$! x $2.00 $ /0 - Future Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... ..................... x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ 3,16 New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $--2. 00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code , Description ................................................$ TOTAL FEE $ vP City of Fridley: The undersigned hereby .makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application true and correct. Mi Fridley, nn/(� Owner Kind of Buildingmz�cad) Used as To be completed about - � n�'A z f q % Estimated Cost, $ 4 Old ew. Building Permit No Permit No. Signed zm" By Business Phone No. ROUG ��Q , FINAL V `� ,o Application for Power Plants and HeathM age Ye ns Refilpiam a mnd Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .. $10.00 $ Replacement of Furnace .... . ..... 6.00 $ Repairs & Alterations—up to $500.00 6.00 $__ Repairs & Alterations each add. $500.00 3.00 $—__ NECH. WARM AIA Furnace Shell & Duct Work to 120,000 BTU ... .... ..$10.00 $ each add. 60,000 BTU .................... .. 3.00 ; Replacement of Furnace 6.00 $- Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3,00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. _ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3.00 $ , Each add. 320 sq. ft. EDR Hot Water 3.00 $_._ OIL BURNER—to 3 gal. per hour 6,00 $ _ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 189,000 BTu) ..... ... 5.00 $ over 199,000 BTU Ser Fee Schedule GAS FITTING PEE& NO RATE TOTAL 1st 3 Fixtures x$ 10 $ Additional Fixtures x .75 $ Gas Range to 199,0(0 zt 5-00 g_ TAX HEATING SYSTM SYSTEM ROUGH (SURCHARGE $ illUlil, Dept. of qL >lhmw seo-SM .� 35iA Ss�q? ss�o, ssa6. Sso,�., 5s: 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. 9 % Fridley, Minn_ C4/ !A Owner Kind of Building ._ Used as To be completed about _— Estimated Cost, Old—New. Building Permit No. Permit No. ABATING or POHot Water, Warm Air—No Trade Name She Nn_ Capacity Sq. Ft. E.D.R BTU II,p. Total Connected load land of et BURNER — TradeNamp Size No Capacity Sq. Ft. E.D.R BTU (REMARKS -OYER) . City of Fridley: The undersigned hereby makes application for a permit for the work herei, specified. agreeing to do all work in strict accordance with the City Ordinance and haling of the Department of Buildings, and hereby declares that all the tact and representations stated in this application are true and correct Fridley, Minas24t� I)'s 1972 OWner Darrell Farr Dev© Co© Kind of Building frame Used as residence To be completed about qto I&P 1972 PARTIAL RATE SCHEDULE Estimated Cost, $ 10.00 PLUMBINGFI�[TiTRE l3kTESs NO. RATE TOTAL ®lei New. Building Permit No. p'i°b t , '� J 'r=i Number Fixtures ................ x $2.06 ; Signed MINNEUAbUU Future Fixture Opening .... o ...... x $1.50 New Fixture Old Opening .......... x $1.50 ; Catch Basin ............. ®®. ®... x $3.25 ; Water )Neater !gyp to 99.000 BTU).... x $3.00 ; New Ground Rua Old Bldg.... . ®... x $3.26 $ Itoulo - Electric Water Heater .............. a $2.00 $ FINJttt, 9- �- d Sl GAS FITTING TEESs NO. RATE TOTAL lot 3Fixtures ....•••••••••.• :•• 1 x$2.00 ; 2.00 Additional Fiat r s ............... x $$QW .7766 $ Vas RaWe to 19$,000 BTU . s e.. o ....o. x � 5. s 3.00 (l) lite lie ` State Surcharge $ .50 REPAIRSy.& ALTE TIO fer to _ Description O 0 . . . . . O . p O.O P 0 .. O A. • . . . ..... . ... ...• . 7 TAL YKE 5-5o By Business Phune No SUBJECT PE. IT NO. City ®f Fridley AT THE TOP OF THE TWINS ? BUILDING PERMIT 22512 RECEIPT NO COMMUNITY DEVELOPMENT DIV. v------ r PROTECTIVE INSPECTION SEC. xj I I NUMBER REV. DATE PAGE OF APPROVED BY i CITY HALL FRIDLEV 55432 612-571-3450 910-F15 5/18/94 JOB ADDRESS 5518 West Bavarian Pass NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED, DESCR. 2 11 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dicks Fire & Storm 864 19 Ave SE, Minneapolis MN 5781-6170 24RI 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 ❑X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Garage (Tear-off); Install gutters 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 $2,109 $1.06 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- $54.00 Fire SC $2.11 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $62.17 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHENAID7V LIDATED THIS IS YOUR PERMITin �qJ SLOG -NSP- SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ I Effective 1/ 1/94 ADDN CITY OF FRIDLEY ALTER (( SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application"/$a Construction Address: 5 518 - West Bavarian Pass -- -- Legal Description: Owner Name & Address: Contractor: Dicks Fire and Storm Tel. # MN LICENSE # 2491 Address: 864 - 19th Ave. S.E., Mp1s., Mn._ 55414 Tel. # 781-6170 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Remove and replace roofing on garage TnGta11 utters - Comer Lot [ ] Inside Lot [) Ft. Yd Setback Side Yard Setbacks Type of Construction: Roof i n g /gutters Estimated Cost: $_ 2,109.00 Approx. Completion Date: STIPULATIONS: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 5115/94' APPLICANT: Dicks Fire and Storm Tel. # 78 -61 70 CITY USE ONLY Permit Fee $ 00 Fee Schedule on Reverse Side Fire Surcharge $ ► ( .001 of Permit Valuation (1/10th%) f� State Surcharge $ $.50/$1,000 Valuation k^ SAC Charge $ $800 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 [ ] 1-7 TOTAL $ STIPULATIONS: SUBJECT 031043 City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT COMMUNITY DEVELOPMENT DIV. qr PROTECTIVE INSPECTION SEC. ��� 1 r NUMBER REV DATE GAGE OF APPROVED BY I 7.��--1 : CITY HALL FRIDLEY U432 I�--- %'' 612-571-3450 910415 6/8/00 JOB ADDRESS 5502, 06,10,14,18, 22 W. Bavarian Pass I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DES CR: 1-6 11 linnsbruck North Townhouse Site SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Innsbruck.Townhome Association 651-224-5482 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Garlock -French Roofing Corp. 2301 E. 25th St..•Mpls., MN 55406 612-722-7129 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 00001423 S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING 'Residential ,J,, CLASS OF WORK O NEW O ADDITION O ALTERATION )p REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof Building 8 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Permit Inspection Cards Will Be Mailed To Homeowner To Post 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 6 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 $16,674.56 $8.33 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $279.25 Fire SC $16.67 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE 304.25 SIGNATURE OF CONTRACTOROR AUTHORIZED AGENT IOATEt �NPR P VALI AT D THIS IS OU��MIT OLO. r�afE S-GNATURE Of OWNEROF OWNER BUILDERI iDATEI CITY OF FRIDLEY INSPECTION 6431 University Ave NE Fridley, MN 55432 572.3604 RATE SCHEDULE DIViSION APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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 Rate $ 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. Effective On January 1, 2000 JOB ADDRESS 55I b L.y. &VariCt►7 &.55 OWNER Pq14U-P— TOTAL I� BUILDING USED AS $� vo ESTIMATED COST PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE HEATING CO Signed (-f2dn/eiz TEL # P1 Approved By Rough -In Date Final Date ll -ii�du 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 (A 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 OC) No ( } Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 TypeBTU Input Fan Assisted or Nat Am Appliance #2 Type BTU Input ®o Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances z.- Total Btu Input Common Vent Type Vent Height 222 Diameter 4 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: ``/UePe / Signed By: Date : !Ko Building $ BUILDING See Back Page for Fee Schedule Permit No.: Inspections RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572=3604 .001 times the total job valuation CITY OF FRIDLEY $ Date Rec'd: 6 DATE a ,6 YOUR E-MAIL ADDRESS eL 5c/I ✓� b �(� L® SITE ADDRESS X ,ter 4 cra SAC Charge THIS APPLICANT IS: ❑ OWNER IICONTRACTOR $1675 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: TENANT Erosion Control $ ADDRESS: CITY STATE ZIP $ PHONE: Fee Determined by Engineering CONTRACTOR NAME: ®. SUBhGT A COPY OF STATE LICENSE # g�,� J f;7� EXP DATE 1-31-62 $ YOUR STATE LICENSE ADDRESS: CITY 4 ,0 ( I1JL STA IP WITH APPLICATION PHONE FAX PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED 0 WINDOWS 0 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK WSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW P ADDITION ❑ MAINTENANCE/REPAIR MODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT ®(, Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. 3. Proposed floor plan List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, AING inyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USINTHE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 1b 0 0 6 OCCUPANCY TYPE Permit Fee $ . j See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ Le. .001 times the total job valuation Surcharge $ 3 . (j .0005 x Permit Valuation Minimum $.50 License Surcharge $ '7i -try $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks vavable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w ' h e uire review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 1 V���pf.lfr1 DATE