PRE 2010 DOCSit
Village ®f Fridley, Mum.
UIL11IN(ir PERXrr
lr ®
15!6
OVice of INSPECTOR OF BUILDINGS
Owner
Front
To be used
k g-& i, I
Permit is hereby granted
Height Stories Mariner of
be completed
— i
j7q
n
the building described in e above statement. This permit is granted
upon the express condition dition that the person to whom it is granted, and 'his agents, employees ' and workmen, in all
the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limits, and this permit may •be revoked at any time .upo�p, violation of any of the provisions of said
ordinances.
NE, Spector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley' of
the above permit, I hereby agree to do the proposed work in accordance with the description`
above set forth and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true as therein stated.
Subscribed and sworn to before me at Fridley,
day of A.D. 191`,1.,
Architect
Fridley, Minn., 18
1
Builder, r k
LOC ON OF BUILDING
,
No. f
Street " e Part of Lot
Lot
Block Addition or Sub -Division
Front
To be used
k g-& i, I
Permit is hereby granted
Height Stories Mariner of
be completed
— i
j7q
n
the building described in e above statement. This permit is granted
upon the express condition dition that the person to whom it is granted, and 'his agents, employees ' and workmen, in all
the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limits, and this permit may •be revoked at any time .upo�p, violation of any of the provisions of said
ordinances.
NE, Spector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley' of
the above permit, I hereby agree to do the proposed work in accordance with the description`
above set forth and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true as therein stated.
Subscribed and sworn to before me at Fridley,
day of A.D. 191`,1.,
a
95
SUBJECT
PE
City of Fridley
27324
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
v _ PROTECTIVE INSPECTION SEC.
73
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
,oj
L 612-571-3450
910-F15
8/20/98
JOB ADDRESS
5841 2 1/2 Street NE
1 LEGAL
LOT NO.
BLOCK TRACT OR ADDITION
SEE ATTACHED
DESCR.
25 26
22 $ de �k$ Pa k
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ron Newland971-716
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Horizon Exteriors LLC 1333 Larc Industrial Blvd Bur890-3900
20019
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 (Rx REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house (12 S Tear-off
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.
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
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
1000
.50
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.
$34.75
Fire SC $1.00
PLAN CHECK FEE
TOT EE
Licens S
5.0
.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
POPE
BLD )NSP
Y ALIDAT THISU�M
r �
riATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
a
95
NEW [ ]
ADDN ;
ALTER
ConstructionAddress :
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION (S -7i -3450
Effective 1/1/98
Legal Description: Y 1
Owner Name & Address: _ Kno q 1. Tel. #
Contractor: HOARIZQ, l gg gR a ' MN LICENSE # R46C2 Y-5
Address: ttc
1335 Larc industrial Blvd Tel. # Frie-39e6
-ulIioVille, Iv11l1 ��]
Attach to this app ic�adion, 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: \,
Construction Type: Estimated Cost: $
(Fee Schedule on Back)_
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: Z g APPLICANT: Lt"—� Tel. # C� �3 �l 00
//Sf
Permit Fee / OC$_
Fire Surcharge A
State Surcharge S"`) -
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge $
TOTAL $
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
...
SUBJECT
of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
,29346
Ir?City
RECEIPT NO.
i L ___-_I, COMMUNITY DEVELOPMENT DIV.
L
f PROTECTIVE INSPECTION SEC
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L J` 612-571-3450
910-F15
4/29/99
JOB ADDRESS
5841 2 1/.2 Street NE
1 LEGAL
LOT N0.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
125,26
I 22
I Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Ronald Newland 5841 2 1/2 Street NE
571-7162
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Sussel Corporation 1852 Como Ave, St Paul, MN
695-0331 1934
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
Q
x NEW ❑ ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Construct a 22' x 28' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Install a hard surface driveway.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
$11,704
$5.85
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
$187.15
Fire C $11.70
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTA F E
�-.;_c
$5.0
09.80:
'�T
SIGNATURE OF CONTRAC OR OR AUTHORIZED AGENT tOATEj
ENP OD
BL NSP
IS ALIOAT HIS I�I�
BATE
S-GNATURE OF OWNEROF OWNER BUILDER, iDATE,
NEW K
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
N
Effective 1/l/99
Legal Description: 1
Owner Name & Address: A d`I ,k l IV � cep l zt_J4 d Tel. #
Contractor: -5 Lc - � �' T� MN LICENSE #
Address: Ic— 01A401U c �' =,r S Tel. # ct
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:
DESCRIPTION OF IldPROVEMENT
Length Width Height
Length 2..2 Width I Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: �, �' P (`rit Ak�,t imated Cost: $� OD
(Fee Schedule on Back)
.Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:L21,Tel. #
TOTAL $_2_01 n o
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$;
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ c.�
$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 [ ]
TOTAL $_2_01 n o
STIPULATIONS:
Mr. &
MW%nald Newland #9434
5841-2 1/2 St. NE
ST. PA!-
?62 - MN 5AVE'.uE h Fridley, Mn 55432
It t Jl555'08H 651571-7162 R 612 333-1515
�:ai Dei.- otior
3 28x22 Det. Allbilt W/Cone.
3/2/99 Dennis Jarnot :E
• al'.:e
-
1�3.
�•= AR's
PCI', -S ON L'
^
OF
_ _cuare :n
- h
kc -By
= 3.0 --
_ gra.- �, nt
Sy _,N ^
-=ckf 3 Oo,-,. -By :.sse
f
1.t..nta - --' Waw -4e.cnt
CC Ks R
t r r
�o c- = ccks --
:c< S z �a C:'_ -Se'
-
- -01_.
14 He,cr: ether -an B"�� --
J
--
_ t
_ I I
1
Ex s-ing garage: Nc-- --_ _ - ----
�etacheC =A—ached T _ _
E ,�
S_= of ex s--ig: x
Ai 1
ft as S
= Zcnverte= to L.& - By ow-er
-emoven 3y• Groner
S-ssel — -
-_...
Ji.s:K Must 3e RemCved By O`Nrter _
i 1 _
Su -.es vis6e - !"Yes C `+o -'
Su~=ey ava able - = Yes C %o
roecial -structims from
Cement man
-- -tj- -
r '
f
ACCESS
Good ❑ Fair ❑ Poor DIRECTION
PURCHASER'S INITIALS:
" , ..4
SUS SEL GARAGES ROOF: GABLE REVERSE GABLE HIP
EAVE OVERHANG:
l Z"
RAKE OVERHANG:
SEAL DOWN SHINGLES WITH PLYWOOD OR
12 WAFERBOARD ROOF SHEATHING AND 15 LB. FELT.
Roof Sheathing `�JZ 0
Seal Down Shingles
Manufactured Trusses / 2" x 4" Triple Top Plate
NOTE:
1) Roof approved by Minnesota State Buliding Dept. as meeting Minnesota State
Code Requirements of 40# snow load.
Hipconsist o" x 6" rafters 2" x 6" cr s 48" O 8"
L-tfl-p rafter pans d er are ssed.
RAFTERS: Trusses @ 24" O.C.
STUDS: 2" x 4" 16" O.C.
WALL SHEATIJING:--
SIDING: �� ` �'� •�
OVERHEAD DOOR HEADER: <Zouble 2" x 12" r 2 -
2"x 4" studs
2" x 6"
Treated Bottom Plate
Sill Sealer 7"�P
1 Row 6" Concrete Blocks
Slab on grade construction approved per Minnesota State Code. Refer to State
Building Code Letter Number 11.
_ _ _ _ _ _ _ _ _ SLAB_ 4'WITH MESH 6..X 6...#10 Gau.e.......-._._._._._._._.-._._._._._._._
Trim
1"x4"
Sub Fascia
Fascia
Soffit
3/4" Cove
2" x 4" Studs
Siding
---71/2" x 7" Anchor Bolt
2" x 4" Treated Bottom Plate
A -
x_10 Grade
Grade
PLOT PLAN
b 7
ADDITION:
A _
>,
TC FORCE AXL BND CSI
1- 2 -3798 0.24 0.75 1.00
2- 3 -3324 0.11 0.72 0.83
3- 4 -3236 0.27 0.61 0.88
4- 5 -3236 0.27 0.61 0.88
5- 6 '-3324 0.11 0.72 0.83
6- 7 -3798 0.24 0.76 1.00
BC FORCE AXL BND CSI
12-11 3522 0.57 0.29 0.86
11-10 2344 0.36 0.26 0.64
10- 9 2344 0.38 0.26 0.64
9- 8 3522 0.57 0.29 0.86
WEB FORCE WEB FORCE
2-11 -708 4- 9 1018
4-11 1018 6- 9 -708
8148 - 1.15
HTM
----WtX7U IRInSC SYSIITIS---
TOP CBDRDSt 2x4 SPF 1650F-1.SC
2x4 SPF #1/#2 (N) 2,3
HOT CHORDSt 2x4 SPF 165OF-1.5C
WEBS: 2x3 SFF STUD (N)
MM LIVE LOAD DEFLEMC21t
L/862 at JOINT # 3
L--0.38" D--0.16" T--0.54"
MZ HORIZCHML DEFLECTION:
T. 0.16"
T
All COMPRESSION Chorda are asstmted to be ........ .....Joint Locations..--.---------
continttottely braced unless noted otherwise. 1)
0- 0- 0
5)
17- 8- 8
9)
18- 4-12
2)
7- 4-14
6)
20- 7- 2
10)
16- 0- 0
3)
10- 3- 8
7)
28- 0- 0
11)
9- 7- 4
4)
14- 0- 0
8)
28- 0- 0
12)
0- 0- 0
14-0-0 11
1 S 6 7
r 4,00 -0 00
5X4
11
4A0 '1A9 JAW
M
2841-0
sq
1690# 3.50" 11 10 1690/ 3.S0"
100 L 28-0-0 J �1-0-0
(R1-010)(' R1'0-10)
EXCEPT A,S SHOWN PLATES ARE TL20 GA TESTED PER ANSUTPI 1-1995 scale = 0.1875
WARNING:
READ ALL NOTES ON THIS SIIEET.
A COPY OF TATS DRAWING
TO BE GIVEN TO ERECTING CONTRACTOR.
BRACING WARNING
DESIGN INFORMATION
Bracing sbowa no this drawing Is out erection bracing wind bracing.
Thu design is for an individual building compo ert and has been bored on Infomta.
portal bracing or timBar bracing which h a part of the building
lien provided by the client. The deai&= disdsimt any responsibi ily for damages
design and aidch most be considered by the buildirt daigoer.
at a moll of Why re incurred inform ilov. epedlicatimv auditor designs
Bracing shave is for lateral surpM of tons+ members only to reduce
f rrdaMd to the buss designer by the client and the correctness or accuracy of
buckling length. Rovisiom rust be trade to anchor lateral bracing
this information as it may relate to a al vdfre project. This Imes hu beau
at ends and qedfied locations determined by the buBdbg designer.
designed In accordance with'TPI.95" and 'NDS -91' to be iecceponted as (art of
Add'dimsl braft of the overall orucmre tray be required.
the building deign by a Building Designer. When revieurd for approval by the
(G•e 1118 91 of TPI). I'm arecific Irons bmdng T-01emrds,
cmad building designer, (Truss hos Insliaae, TPI, 6 located
h eilding desiltner, the design lundiryts ahtwn must be cbecked to be me Civil Be
dela sl.avtt ane Ins ntremrN with the heal bulling sod". (oral climalic records
u 583 D'Omfnio IM-. Madison. WL c-ia 57719).
fre aid or aro., k ds, prof ed arecif"lha- or -pedal -relied bwd-.
TC Live
40.0
psf
TC (lead
7.0
pcf
BC Live
0.0
psf
BC Dead
10.0
Mf
TOTAL
57.0
psf
Designed By: JODY
Checked By:
Date: 6-12-97
LOAD DUR. FAC: 1.15 I Dwg. No:
SPACING: 24.0" Segn: 05.22.97- 8.522
IS
01,
SUBJECT
IT NO.
City of Fridley
295 5 5 1
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RE NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
1
= CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
5/25/99
JOB ADDRESS 5841 2 1/2 Street NE
1 LEGAL
LOT N0.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
25,26
22
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ronald Newland 5841 2 1/2 Street NE
571-7162
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Twin City Exteriors Co Inc 9060 Zachary Lane N, Maple Grove, MN 55369
e ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
425-4737 2535
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
0 NEW 0 ADDITION 0 ALTERATION J] REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
Permit Inspection Cards
Will Be Mailed
76 Homeowner To Post
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 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
'HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 ISTALLS
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
$9'000
$4.50
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.
Fire SC $9.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$167.25
PLAN CHECK FEE
FEE
TOX5.75
Licens $5.00
$
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE.
N 1 OPE ALIDATE HIS IS Y UR PERMIT
BLD INSP
OAiE-!FL- I
SIGNATURE OF OWNER,IF OWNER BUILDER, IDATEI
01,
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:�/
Legal Description:
Owner Namp & Address:)-jl//
Contractor. TWIN CITY EXTERIORS CO. , INC.
Effective 1/1/99
Tel. #-/5Zz/ - 7Z6,2
MN LICENSE # 2 5 3 5
Address: 9060 ZACHARY LANE N MAPLE GROVE, MN 55369 Tel.# 612-425-4737
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
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: / — Estimated Cost: $ q r3nf)
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: - ?d �' APPLICANT: Tel. #612-425-4737
00,
CITY USE ONLY
G�®
Permit Fee S Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1050 per SAC Unit
License Surcharge $ SLQo $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 [ ]
TOTAL $ IkERT5,
STIPULATIONS:
F
CITY OF FRIDLEY INSPECTION DIViSION I
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
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
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.
MR
OWN
Effective On January 1, 2001
I
ESTIMATED COST PERMIT NO. 'V
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.
$&ZIn
//2. C 0 DATE --%—��
w
47a-
Approved
7 -
Approved Bye Rough -In Date Final Date
BACK SIDE MUSTBE FILLED IN ON VENT SIZE, VENT CONNEC-17ORS
AND COMBUSTION AIR VERIFICATION
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 manufacture'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 :
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FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
March 29, 2002
Mr. Ron Newland
594121/2 Street NE
Fridley, MN 55432
Re: Final Inspection at 594121/2 Street NE
Contractor: Airco Heating & Air Conditioning
Dear Mr. Newland:
A mechanical permit was issued on May 25, 2001 to install an air conditioner at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. As of this date the inspection has not
been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DA SEN
Bu- ' g Inspector
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