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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, 'Minn-N° 2207 Y Date Owner Builder ................ Address ......�.........�. . �... Address ... d' .. ............ LOCATION OF BUILDING; No. .Y .. Street ... .. .. 4aoLot ... ..... ........ . ... . . .. ... . ... .... .� Lot ........ .... ., Block .................. Addition or Sub-Division ........................ Corner Lot Inside Lot w........ Setba Sideyard'........ �........... DESCRIPTION OF ILDING To be Used as: .. Front .... Depth .: ... Height ....... Sq. Ft ... Cu. Ft. ........ .. Front .. Depth . Height Sq. Ft. Cu. Ft... .. . Type of Constru � n�. �.. Est Cost .... • To be Completed ................... • .. r In considerati n m of the issuance to me of a permit to construct ;the building described above, I agree to do the proposed wor accordance with the description above set forth and in compliance with all provisions of ordinances of theyillage of Fridley; In consitlerati of the payment of a fee of $......... vqq 4t is hereby granted to ....... ........... ........I , .... to construct the building or addition as described above. This permitis granted upon the express Cond-tion that the person to whom it is granted and his agents, employees and workmen, in all work done in, around d upon said building, or any part thereof, shall conform ii all respects to the ordinances of Fridley, Mill' il peso regarding location, construction, alteration; maintenance, repair and moving of buildings, with- in the village lima and this permit may be revolted at any time oin violation of any of the provisions of said ordinances. F r ,.. .. ... .... .....Building Inspector NOTICE* This ,'perm does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or,'wate Be sure.to seethe Building Inspector for separate permits for these Items. p SUBJECT PERMIT NO. City of Fridley 142 AT THE TOP OF THE TWINS PERMIT • r BUILDING RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. i 1 CITY HALL FRIDLEY 55432 ,`j NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 7/19/77 JOB ADDRESS 4566 A Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Rearrangement of Bl. 13,14,15, Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Chester Schrade 4566 = 231 Street N.E. 3 CONTRACTOR MAIL ADDRESS 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 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK RM Reroof dwelling 9 CHANGE QF USE FROM TO STIPULATIONS Owner agrees that this is second roof and 3rd roof is not allowed. Install 90 lb. roof cool valley or galvanized x000 ridged valley SEPERATE PERMITS REQUIRED FOR WIRING, ttE!'F'iNt�, PI:iINBiI�tC AND SIGNS. 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. AUTHORIZED IS NOT COMMENCED WITHIN 60 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 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. $550 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $7.50 STR 10 OR THE PERFORMA CE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE Q. pyo/ $8.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT a (DATE) WHEN PR PE/RLY VALIDATED THIS IS YOUR PERMIT y( BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DAT LI I Y UI I^KII)LLY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: Address: No. °i G LOT: CORNER LOT: Street: BLOCK: BUILDER: Address: 0 Tel. No. 44 INSIDE LOT: SETBACK: /c� 13i SIDEYARDS: Opt' 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: ® Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: 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: SIGNATURE: Stipulations: r Y f A i t,- " i .J SUBJECT P City ®f Fridley 20991 AT THE TOP OF THE TWINS BUILDING PERMIT � ECEIPT N COMMUNITY DEVELOPMENT DIV. I L° PROTECTIVE INSPECTION SEC. r � , CITY HALL FRIDLEY 55432 NUMBER REY. GATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/7/91 JOB ADDRESS 4566 - 2-2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 SHEET Plymouth Addition 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Larson 4566 - 2i Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Rome Improvement Inc. AVerlUe NE 784-7543 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 ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Install l4k Microlam Ream in.basement 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $800 $.5Q WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $21.00 Fire SC $.80 STRUCTION OR THE PERFORM NCE OF CONSTRUCTION. CH AL E ,30 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN P PERL V I T IS IS YO R WYIT r t INSP r) At E SIGNATURE OF OWNER IIF OWNER BUILDERI (DATEI M [ ] Effective 8/16/90 ADDN [ ] R-1 AND R-2 AIM [ ] Building Permit Application Construction Address: ,, (10 D Vx sf, /VE legal Description: Le, i IN Owner Name & Address: _/-q tsotl Tel. Oontractor: rem en f Address:, %q(2t deh I p Ve - NE Tel. # 17V/ -7S -q-? Attach to this application, a Certificate of Survey of the lot, with the proposed cxnstniction drawn on it to scale. DESCREMC K OF Il l I I MENI W WVM AREA: length Width Height Sq. Ft. @NMW AREA: Length Width Height Sq. Ft. DEM AREA: Length Width Hgt/Cron nd Sq. Ft. OTR: Corner Lot [ ] Inside lot M Ft. Yd Setback Side Yard Setbacks Type of Construction: Mn t,10 Q / q,', cjh W 8 -Estimated Cost: $ Approx. C oopletion Date: /®-/ - 9 Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page HATE: �' � � � � APPLZMU: 2 ' Tel. # /7'9q-722_2 Permit Fee $ �� Fire Surcharge State Surcharge $_ R SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ �O s-riPvr.�Tzo�s: CITY DBE CNLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering A4reement Necessary [ ] Not Necessary [ ] Fqo' 3� �Ay, Soh - qS46 DYX St'N&7 bkb *Oe- rv&P. r7gy-7514 3 tJjta, earn VITSOV) o Rill-, POS �CQa,��.. ��}� pP?h•�,n�. -=v� �'f��',�� -fgVr�i �Y i'v°n'�_ J CY`0 ainni)\ol+"J beAm D1� biOck tt�°tl� dhd I�jX P,S+ � '�� �n1or-Y, Poor�- CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER 410 PLANTS AND HEATING, COOLING, VENTILATION,�� 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 4e�� T> 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, Bumer — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) 12 —1-31 994 -� Gas Piping (Needed with new furnace) $ 10.00 $ N OWNER �' ��� X✓ L .�/� � 0 Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $ 10.00 $ _ ESTIMATED COST >J - PERMIT NO. �� ��A *Air Conditioning — All Sizes $ 10.00 $� 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 ED 1 % of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. TOTAL FEE,��C) BTU HP EDR MINIMUM FEE FOR ANY HEATING/CO OLINGNENTILATION REFRIGERATIONJAIR CONDITIONING PERMIT IS 515.00. PLUS -!H --E$-.50 STATE SURCHARGE RE_.MPECTION FEE $30.00 Air Conditioners can not be placed in a side yard without written permission. from adjoining property owner. HEATING COMPANY/ //fC 0 �/rC 0 ��� Signe Tel No. "7i % Approve Rough—In Date Final Date , J/` `3 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using aside vent furnace. CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the. existing chimney or stack: I. 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 ( } b Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater S. Has combustion air been provided for water heater Remarks: ,List -A-LTER§,T1-0NS-BeiTz-Du7= HEATING CO: Signed By: Date: Yes (} No ( ) Yes() No SUBJECT City of Fridley _ 3 0 3 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIP O. _ COMMUNITY DEVELOPMENT DIV., PROTECTIVE INSPECTION SEC. ply NUMBER REV DATE 7/23/97 PAGE OF APPROVED BY L J` '� CITY HALL FRIDLEY 55432 612-571-3450 910415 JOB ADDRESS 4566 2 1/2 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 2 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry McLaughlin 4566 2 1/2 Street NE 572-8510 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Steven R. Lee Contr. 9465 Irving Ave, Brooklyn Park, MN 55444 424-1198 5758 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 ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must MqM comply with the State Building Code. 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 SO. 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 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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 $1,668 $.83 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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. 7— % PLAN CHECK FEE TOTAL FEE License SC $5.00 $61.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY Vft1IDATED THIS IS YOUR PERMIT SLOG hNSP FATE SIGNATURE OF OWNERI IF OWN ERBUIL DER) IDATEI NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:� Legal Description: '1'- (. r- -19 Owner Name & Address: h Tel. # . —< _ �S Contractor: s�-�.� K �-�-� MN LICENSE # J— 7S� Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length Length Length DESCRIPTION OF IMPROVEMENT Width Height Width Height Width Hgt/Ground 4�"— "')c) f Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: _-c_a �,� y, Estimated Cost: $ 0 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: % -7 //APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULA"CIONS: � Sn CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 5:72-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On May 10;1999 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR <` `�'+r+moi: � •i::<. Uri nal `> Shower ����>`:.. :�t#3�C=>��� Wash Tray .. tt �- :: _ :..:::.:... - Ft��<�: Floor . Dram ;: <>:::; i�`'<r: Auto. s<=� �<>< Gas - �<:�==:;- Washer �� :. Range �` � �� �ilTs�-"�� � Water Heater r: • A•i+i:it Vii::: Stories .(Q..�=. . a:Y:-.xf: � Gas :ilk::_:: Elec Basement Floor 1 xf..• - ii:::: -:ti :-� �:•.:• Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric NO. RATE $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 Water Heater - Gas"* �_ $10.00 Gas Range" $10.00 Gas Dryer" $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance TOTAL State Surcharge $ .50 TOTAL FEE s20.50 JOB ADDRESS SAM F,7 &!5 ©W&)t5L d�6011J 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. MCLAUGHLIN, GERALD 4566 2ND 1/2 STREET NORTHEAST FRIDLEY, MN 55421 O (763)572-8510 Building Used Estimated Cost LI "� PERMIT NO. ` c2e�16 PLUMBING COMPANY SIGNED BY ( ��® TEL N0., J2 ��7- X033 Approved By Rough -In Date Fina! Date—/`3n ' (-) / "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. C17YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 January 18, 2001 Gerald McLaughlin 4566 21/2 Street NE Fridley, MN 55421 Re: Final Inspection at 4566 21/2 Street NE Contractor: Norblom Plumbing Co Dear Mr. McLaughlin: A plumbing permit was issued on October 13, 2000 to install a gas water heater at the above noted address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date no inspection has been called for. The permit fee that was paid covers the inspector's time to check to make sure the water heater was installed correctly, that the State Plumbing Code has been complied with for installation of combustion air for fuel burning appliance, and that the vent has been sized correctly with the correct vent connectors. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Please contact me at (763) 572-3603 if you have any questions concerning this matter. Sincerely, DAGENSEN BuildifA Inspector Effective January 1, 2003 CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 JOB ADDRESS 4 SCO U ;d -;t St ii�C RATE SCHEDULE OWNER cl-� y Residential Rate TOTAL �'►��'-� Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) $ :30.00 - ESTIMATED COST 0QCG. Oc_-�' PERMIT N0. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) 1 Air Gas Dryer $ 10.00 $ arm Trade Name BTU '1101 boo HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs &Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE DATE <�- - ice- (')3 CenterPoint Energy Minnegasco MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING C013562 Central Ave NE, Anoka, MN 55304 REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed763-757=6202 FAX # 763-757-6701 REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard withbut Approved By _ Rough -In Date Final Date written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When ®n��,. an ""'sting finance, the undersigned.hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes X� No and is securely supported and firestopped where required. ( } The venting system is plastictPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (X) No ( ) The'undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and lfspecifications. This ioes include AGA-GAMA Category VentingTabls for fan Yes (X) No ( ) assisted and natural draft appliances. The av stinger o t,i-,ntion air is sized and installed to meet the current codes Yes No ( } and manufacturers specifications. When required to ingdaii it now combustion air_ it will be sized and installed Yes �) NO ( ) to most the current codes and manufacturer's specifications. When Inatallin , the undersigned hereby verifies that it is"a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category ICentral Furnace Yes f) No( ) Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented Yes (X) No ( ) separately as per current codes. �� n T _o _ and Sim /[`nmmnn Vent and Vent rmnnector Information A"PAppliance #1 Type BTU Input �= an Assisted or Nat a' Appliance #2 Type BTU Input Fan ssis ed or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input t Common Vent Type �� i1 -t wj -Vent Height �_ Diameter inches Appliance #1 Vent Connector Height = Length �ft Diameter Lin Type Appliance #2 Vent Connector Height _ ft Length ft Diameter in Type Appliance #3 Vent Connector Height �ft Length �ft Diameter in Type HEATING CO: CenterPoint En ArgyMinn,ngaapn 13562 Central Ave ATE, Anoka, MN 55304 Signed By: Date: . CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE FRIDLEY, MN55432- // ISSUED:12282006 (763)572-3604FAX: (763)502-4977 Permit #2006-02553 4566 2 1/2 ST NE ADDRESS: PIN:263024330103 LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH :LOT 3 BLOCK 2 PERMIT TYPE:ELECTRICAL PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:ENERGY SAVER SWITCH ELECTRICAL PERMIT FEE20.00 APPLICANT STATE SURCHARGE, ELEC FLAT0.50 HUNT ELECTRIC CORPORATION TOTAL 20.50 2300 TERRITORIAL RD Payment(s) ST PAUL, MN 55114- CHECK13628220.50 OWNER HULBERT, JACKIE 4566 2 1/2 ST NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 180 days or if construction or work is suspended or abandoned for a period of 180 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 work 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 ________ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE ISSUED:12/28/2006 FRIDLEY, MN55432- (763)572-3604FAX: (763)502-4977 Permit #2006-02553 4566 2 1/2 ST NE : ADDRESSPERMIT APPLICANT: PIN:263024330103HUNT ELECTRIC CORPORATION LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH2300 TERRITORIAL RD :LOT 3 BLOCK 2ST PAUL, MN 55114- PERMIT TYPE:ELECTRICAL PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:ENERGY SAVER SWITCH BUILDING INSPECTION RECORD 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM INSPECTION TYPEDATEINSPECTORCOMMENTS ELECTRICAL FINAL01/11/07PBOBC INSPECTION COMMENTS: IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT. THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.