Loading...
PRE 2010 DOCSCity ®f Fridley, Minn.. BUILDING PERMITN° s Date; ZooOwner: ,v Builder "— --� if Address _._ ___ Address 20CATION F B ® NG NO. Street ,% w .I' f Lot Lot ....._...,w.._........... Block e —._-Addition or Sub—Divi—alk" Corner Lot __ _ _ Inside Lot _ � � _-__- Setback AL5-__ Sideyard - ._.. Sewer Elevation _ _ _ _ Foundation Elevation DESCRIPTION ` OF BIIILDINQ , To Used Of, Front pth Height` Sq. Fi.,, Cu. Ft' _ Fro Depth ;, Height ' Sq. Ft. Cu. Ft. _ Type of .Construction Est. Cost, To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance wish all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ ,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 granted and 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 yvithia the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinar:ces. - Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, laWmhing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. 4' - APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name � �" ,� Jf�✓S�/l, Builder „� �%� ,� 5� i�_ _ r- d ALE Address /aL.�/ry�i'F�i,��'� AX Address V462 ::PAJM LrJe)JtZ AVE, LOCATION OF BUILDING No. Street .a/a % Part of Lot Lot L Block 2. Addition or Subdivision =EXW5.i_J?_(J� >V29 Corner Lot Inside Lot Setback ,!� Side -Yard �� SEWER ELEVATION FOUNDATION ELEVATION -- Applicant -attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: S [L � LF_I wcF,=Y Front_j�Co Depth 2Er�_____Height Sq. Ft. /& " Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction �� Estimated Cost. 9 z To be Completed 7j 0 U 3.r) 9' 7 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. � a c),ljs-r ee r� DATE 3, i Y6 / SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) Mr. George Boomer 1440 Windemere N.E. Fridley, Minnesota Re: Swimming Pool September 13, 1969 1. International diatomite filter, 37 square feet of filter area. Figuring 2 per square foot, it would be 75 g.p.m. 2. 870 square Peet of surface area. 2 skimmers. 3. Two inlets and a main drain. 4. No chlorinator - hand feed. 5. Safety ledge - about one foot. Sanitarian will not endorse such construction. 6. 2 lites - one on either side - ground fault intersurpter is recommended. 7. Provide an open gap fill pipe or vacuum breaker on hose.bulb. This is required. 8. No sewer lines within -50 feet of vacuum lines. Rodney Billman- Contractor 00, . . . . . . . . . . . . . . . . . '000, -.00- City of Fridley Application for Plumbing and Gas Pitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures �i iii Number Fixtures ....... .............. a6i� $ �• a 3F o� New Fixture Old Opening .............. QN LLc =� � <3 (9 °d w �z t94a UN' ? �a (70 • F • N WATER HTR. GAS ELEC. Base GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �x $1.50 $—Z Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd _ 4th Future Connection Openings • New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIBTU RATES: NO. RATE TOTAL Number Fixtures ....... .............. CA x $1.50 $ �• Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ P d New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �x $1.50 $—Z Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS --Refer to Code Description ................................................$ TOTAL FEE $g136 Dept. of Bldgs. Phone SII 4-7470 ` Location--'Lqyy Cy 9 1i o %x 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 Ordinance and ruling of the Department of Buildings, and hereby declares that all the faci and representations stated in this application are true and correct. Fridley, .Minn OGt T y 1W Owner /LS -C/,24 Kind of Building EtC,4f07 le - Used Used as�„-r�- J� To be completed about " r � Estimated Cost, $ 00 Old—New. Building Permit No G Permit No. Signe ROUGH FINAL By Business Phone Application for Power Plants and: Hemming, Cooling, Ventilation, le1higeralion and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 It Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ 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 ...... Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... Each add. 200 sq. ft. EDR Steam ....................... Each add. 320 sq. ft. EDR Hot Water .................. Dept. of Bldgs. Phone SII 4-7470 Locatio*+ 1440 Windomere Dr. 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. Fridley, M,_nn 11-9 19 61 8.00 $ 8.00 2.00 $ _ Owner RiehyLrri Hir n1i Mdi'. 13300 1 5.00 $ Kind of Building 5.00 $ Res 2.50 $ Used as To be completed about 12-9-61 8.00 $ 8.00 $ 2.50 $ 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 $_-- GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ 1050 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 $ 14.50 ROUGH— OUGH FINAL— FINAL Estimated Estimated Cost, $ 450.00 Old—New. Building Permit No. Permit N DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No L Trade Name Westinghouse Size No GUE-125 Capacity Sq. Ft. E.D.R BTU—J.2,% H.P. Total. Connected Load 62.838 Kind of Fuel Gas BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed FRED VOGT & Co. HEA d 9NO A AIR CONDITIONING By 6530 e St. 9-6767 St.IWuis Park, Minnesota 4 z 9M 7-59 Business Phone .�...,.�-__ It HEAT LOSS CALCULATION CA" j k � o O� 'BUILDIM"S ���` �� � N". Weatherstrips AGuide Referedce 1COCEI Construction No. Infi*atioa e Windows Dors Out. Wa11 It. Mall Ceiling Roof Floor Kind Exp. wan F1. Room L,eng Width ,Z ffeight Fl.l i Windows and Doers—Crackage and Area Width eight No. of Linealft . Area Now or pane of pane lighta of track sq. ft. 0,1 I Ceiling r4ar Windows and Doers --Cr+ Width Height No No. of pane of pane lig' Toth Btu. Required sq. k. E.D.R. or sq. ices. W.A. Leader arra Coef. Btu Rom I lAngt6 Width Infiltration Gloss A-0 Ezp. wall 4f tto -V !' width Noo at nne Titration Glass Exp. wall o Net exp. wall Int. wall / I a C C jl�' Net exp. wall ® Int. wall Ceiling 16 A-7 Cding,,�S Floor Floor Total Btu. �. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Roo® f Length ZI Width Height Windom and Doors•--Crackage and Area Idt el`AI No. of Llnoa! et Area No. of Sane ne pane it.Ale oe eracY Not esp. wan Int. wall tip Ceiling Floor Total Btu. Y Required sq. ft. E.D.R. or sat. ins. W.A. Leader area Total Btu. Iexcaulati®n How Required sq. ft. E.D.R. or sq. ins. W.A. Leader ama / ® FLl I Length 'Z Width Windows and Doom—Crackap and Area 'aYldtk e1Qbt No. of Lineal ft. Area No. of pane of pone tights of crack e@. ft. Infiltration ® — Glou p 1COCEI Btu Infi*atioa e 3b 7 A- y.. Glass SQ– Floor Exp. wan Not exp. wall Int. wall Ceiling r4ar Floor Toth Btu. Required sq. k. E.D.R. or sq. ices. W.A. Leader arra F1 Rom I lAngt6 Width Wils�ws aPrd nl- Gackage and Area width Noo at nne eight No. of Lineal ft. Area of pans 11 to oratR . ft. / I a C C jl�' ® ! Zo®S. 9 Coef. Btu Ife5leratil� � Glass .i® Not esp. wan Int. wall tip Ceiling Floor Total Btu. Y Required sq. ft. E.D.R. or sat. ins. W.A. Leader area Total Btu. Iexcaulati®n How Required sq. ft. E.D.R. or sq. ins. W.A. Leader ama / ® FLl I Length 'Z Width Windows and Doom—Crackap and Area 'aYldtk e1Qbt No. of Lineal ft. Area No. of pane of pone tights of crack e@. ft. Infiltration ® — Glou p Esp. wan Net eV. TftI e Int. wall Ceiling Floor R eq. ft. E.D.R. w sq. ids. W.A. Leader area F7. Ro" I Langth Z4L Width Windom and Dooms Zrackage and Area idth elg t No. oe Intal ft. Area No. of Naso of peas IlgAts of crack in. et. M9 A,. I I I I I I Coef.l &ae Inkltration Glass Exp. wan 2– Wet exp. wall Int. swell Ceilin Floor Required eq. ft. E.D.R. or sq. ins. WA. Leader area I -pp • . HEAT L. CALCULATIONS 8��.3-4�t\ 11Wa� � �f 1 OF BUILDINGS a dYlLl"�1�. Weatherstrips A..H.W.E. _ ^Ccc nstruction No. _ I Insulation G 'de ut Windows Doors Refereaee Out. Mall Int. Wall Ceiling Roof Floor - Kind I $®w Yew es—No 19— FLI jggdA Room Length ZZ Width / Height F1.1 Room I Length Width Windows and ®oars—Crackage and Area Windows and Doors---Crackage and Area Width Height No. of Lineal ft. Area Width Height No. of Llnoal ft. Area Igo. of pane of pane lights or crack sq. ft. No. of pane of Pane lights of crack sq. ft. ® Coefil Btu Infiltration 9 - Maas ® A E:p. wall 3 a Net exp. wall Int. wall Ceiling ,> Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room Lengthf,2- Width Height Windows and Doo—Crackage and Area Idtla Height No. of Llnoal Lt. Area Ne of pans st pafle lights of crack nq. ft. Int. wall Ceiling Floor Total Btu. - - -- :.equired sq. ft. E.D.R. or sq. ins. W.A. Leader area -;_,- Clan -- Exp. wall �'. Net elp. wall Floor Total Btu. P7_I Rnom I Lenath Width Height Windows and Doors—Crackae and Area No. Coef. Btu Detfilteatiora Glass 41 Sol Exp. wall /..2 26.. Net exp. wall Int. wall Ceiling P/47 a -- Floor Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Loader are L=4 F1.1 Room I Length JS Width -4. ' t ,6 Windows and yrs—Crackage and Area width No. of pane Height of pane No. of lights Lineal It. Area –of -crack sq. ft. Coef. Btu Infiltration Masa Exp. wall Coef-I Btu Net exp. wall Int. wan Ceiling Glass Coef. Btu Infiltration 1� y Glass Int. wall Exp. wall 4 Ceiling Net exp. wall--°— Floor Int. wall Ceiling Floor Total Btu. - - -- :.equired sq. ft. E.D.R. or sq. ins. W.A. Leader area -;_,- Clan -- Exp. wall �'. Net elp. wall Floor Total Btu. P7_I Rnom I Lenath Width Height Windows and Doors—Crackae and Area No. Width Height No. or Lineal ft. of pane of pane lights of crack Area sq. ft. Lineal ft. Area of crack sq. ft. Coef. Btu Infiltration Masa Exp. wall Coef-I Btu Net exp. wall Int. wan Ceiling Glass Floor Exp. wall Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area F1_I Ratm I L&nmth Width Heitht !endows and Do m—Zrackage and Area No. Width of pane Height No. of of pane lights Lineal ft. Area of crack sq. ft. Coef-I Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley, Minn. BUILDING PERMIT Date: Sept. 8, 1969 Owner: Geo. Boomer Builder Address 1440 Windemere Drive Address No. 1440 Street Lot — I _ -- Block 2 Rodney Billman Inc. 151 Silver Lake Road LOCATION OF BUILDING Windemere Drive Part of Lot Corner Lot _ x Inside Lot Sewer Elevation Addition or Sub-Divisior Setback Innsbruck 2nd Addn. Sideyard Foundation Elevation DESCRIPTION OF BUILDING N9 10395 To be Used as: Swimming Pool Front _37Depth 48' Height 81 Sq. Ft. Cu. Ft. & Enclosure Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost — $16, 000.00 _ To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work In accordance with the description above set forth-quadIn compliange with all provisions of ordinances of the city of Fridley. j In consideration of the payment of a fee of $_6l .521 V Rodney Billman, Inc. ___, 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 granted and 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. p Building Inspector NOTICE: 'fids permh does not cover the Construction, Installation for whine, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S BUILDER ADDRESSe r ADDRESS��,�— G� iP. NO.e t STREET LOT I...? /'BLOCK LOCATION OF BUILDING OR SUBDIVISION CORNER LOT 6111- INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING 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: mmi 10 C' PovLL Front . Depth — Height EN Square feet Cubic Feet Front Depth Height Square feet Cubic Feet Type of Construction Estimated Cost To Be Completed oe 09e 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. (Schedule of Fee Costs can be found on the Reverse Ade.) G - � i Sept. 31 /969 citq of 9aidlel 6431 Un iue,&4 t y Ave„ N. £„ Rimnewta U1421 Cew re . Rodney &UwA, 9w, ha4, .o n f o&aed im of t& -,&t intent to aomttuct a poot adc tion to the home o f At. & &A, �aeo&qe lgooewe& at 1440 Gtacie,t mane. Jhe ptan7, out"d to rye meet with my app woa), -Se-b1: � 44J` "4�� &,.i V,buec,,Xewi4 PERMIT for Power Plants and Keating. Cool® ing. ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Heating Plants ru-A wLAA t,4 2 to be ltered—repaired Make E A ei4 l E L_E' ne / ^ LL4e 65 �, ,Size / - L c4 16-5, , Oil fired ; Coal f<red ; Gas fired__!Z_; Gas Wri 71T Approved by. 9 Final Inspection Date , 19_ Inspector /,147 5Ca/9 9 Permit N° - 4658 Fee $ 34, ®ta Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. ::74 Owner l) t -V L +iy1 ►rl Location /4410 G011126E_m e Kind of Building Fk9A M , How Occupied L w t L.f- t Yo Co Work to be Commenced—, 19 To be Completed E6 6 45' ,19%® Estimated Cost, $ /900 -06 Old Building Permit No Permission is hereby granted to aie= install—erect—use the material and devices described in the above statement. This permit is granted upon t express condition that the person to w it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentio d shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications et forth in the approved application for this permit on file in the office of the Inspector of Buildings. 4 � , Inspector of Buildings .11�42 2M I1-67 V ° GEORGE E. HOPKINS - Registered Land Surveyor and civil Ein gerPhne SO. 1-8856 10701 Nicollet Avnue South Minneapolis 20, Minn. FLAT oil SUMV37 Scale I inch 4 feet PROPERTY OF Rodney BilIM29 L04 1, Block 7., INNSKUCK IND ADDITION /1/0 A Described as denofes iron monument-. 0: This survey was made and a cer}lfic3te prepared Tor Rodney Gillman for }he purpose of showiq Ike, boundaries of }he 14 and easements. There are no encroachrne,45- V CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL RATE Furnace Shell and Duct Work, Burner $ 20.00 Gas Piping �� $ 10.00 (piping need with new nace) 7 Gas Range $ 10.00 Gas Dryer $ 10.00 Air Conditioning (all sizes) $ 10.00 All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work State Surcharge TOTAL PEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. ; Date � e Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE E active Aug. 1, 1981 TOTAL Job Address /& r% $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ ?0, 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, Minn. f , 19 !� OWNER $ $ .50 Attach stack verification form with replacement furnace permits KIND OF BUILDING USED AS�� TO•BE COMPLETED ABOUT ESTIMATED COST (LD NEW BUILDING PERMIT NO. PERMIT NO. % BEATING or POWER PLANTS, Steam, Bot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU NP Company Signed By ��✓id(f% Tel. No. �� � ! — KJ T 191 CITY OF FRIDLEY INSPECTION DIV, Effective On March 1, 1996 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 / `/-AQ 6J i e eo 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) r �,�. Gas Piping (Needed with new furnace) $ 10,00 $_ 1996 OWNER, �G2� L C( -e C14 IL cr Gas Range $ 10.00 $ ,n BUILDING USED AS �✓�-� �-�� �- (,, Gas Dryer $ 10.00 $ ESTIMATED COST J�c+uu m PERMIT N0._ Q ' *Air Conditioning -All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND 08 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 Ai Trade Name d'fG9 Size No, A-IteS! Commercial/industrial BTU_Lh-5� y J HP EDR 1.25% of Value of Appliance or Work $ FTotal Connected Load State Surcharge 50 Burner Trade Name Size No, TOTAL FEE $ 3a -s� BTU HP EDR HEATING COMPANY_ �� �� �� IL 716, MINIMUM FEE FOR ANYHENTIIVG/CQOLIPJGIVENTIL.ATION .�,�,,�� REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed 8y ` �, CJ Tei No. `!°-w � 5-Y PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Rough--In Date Final Date Approved +SIDEOn "Air Conditioners can not be placed in a side yard without FILL OUT BACKTACKVERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CSI MNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (-J'No ( ) 2. Is free from rust or deterioration Yes ("---No ( ) 3. Has no foreign objects lodged within Yes ('-I'No ( ) 4. Is securely supported Yes (t-J'No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (C-Y'No ( ) 6 Has total heating BTU's of Jct o, c90 v All other BTU's �v TOTAL BTU's 1 7. Has a liner been provided for water heater Yes () No { 8. Has combustion air been provided for water heater Yes ((4/No ( ) Remarks: All HEATING CO: Signed By: Date: 7 0 �� i� ge 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 Rate TOTAL Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 $' (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, $ 10.00 $ to. but not replacement) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ *Air Conditioning• All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Cf alk_aoll Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge $ .50 TOTAL FEE $ / . S 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 May 10, 1999 JOB ADDRESS /L/0 u_,)jr)d I _wL dk-. ' OWNER d VI r l 6 BUILDING USED AS B' l ESTIMATED COST O 111 D`D o -U PERMIT NO. O 33 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating U its ' Circle One (Steam) (Hot Water) ) Trade Name 7'l®'- U,#Ai j- Size No. SF -r- v00 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are*true and correct. P,LAINE HTG. A. C ELECT., Q562 CE14TRALAVE. HEATIN 0 AN KA ."l Signed DATE I/ Approved B Rough -In Date Final Date Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHIMNEY 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'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 Being Done: HEATING CO: Signed By: Date: