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PRE 2010 DOCSBUILDING INSPECTION DIVISION A0 BUILDING PERMIT REVIEW CHECKLIST AND ROUTE SHEET FILE DATE eFour Sets of Plans; 1 Insp { } 1 Fire { } 1 Plan { } 1 Engr { } DUE DATE S-96,2 ���/� �✓ ADDRESS VA-kd01,a COMPANY NAME { )PLANNING Scott Iii Paul Bolin [ ] Performance Bond cunt: [ IirPark Fee Amount:$ 21,E [ vrSetbacks a,- [-1�az�g©'��yG�ctkeA-toJs�Pe PeG t [v] ���Pu�° [ IkWetlands A" ^`C- [vj Compliance w/ Council StipulatioZs� Jon Haukaas [ ] Grading/Dr ' ge Plan [ ] Conservatio rosion Control Plan [ ] Sewer Later s Required [ ]Water Later Required [ ] Land Alteration ermit Issued [ ]Pond Maintenance ement [ ] Rice Creek WSD Permit e [ ] Easments Required [ ] Inspections RETURN TO RON JULKOWSKI Fee: Fee: Fee: STIPULATIONS: Please Print or Type Clearly SUBJEti P NO. City of Fridley 32327 AT THE TOP OF THE TWINS ? BUILDING PERMIT r : RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. PROTECTIVE E _ � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910415 11/16/01 10B ADDRESS 5702, 5706, 5708, 5710, 5712 4 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2,3,4,5 1 Gateway East Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gateway East Redevelopment ULC 325 Cedar St, St Paul, MN 55101 651-227-6925 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Albrecht Construction Services RR 1, Box 183, Motley, MN 56466 218-352-6807 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5125 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Townhouse Building (5 Units) 7 CLASS OF WORK Ck NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a Townhouse, deck, porch & Garage for 5 Units 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. Park Fee of $3,750.00 paid. SEPARATE PERMITS WARNING REQUIRED FOR: Before digg1ng call for nSIG�M� all utilitl✓ locations PLUMBBIMG`'WIRHEM AND 454-0002 R�EWIRED BY LAW 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 5 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX Fire SC AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $578,605 $349.80 $699.60 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 $4,183.75 $5A750.00 ERFORMAN OF CONSTRUCTION PLAN CHECK FEE �' FEE r 2v/® R'Z983.15 + PF Si NATURE OF CQN'RACTOa OR AUTHORIZED AGE T iDATE, _ K!HE PR VA 04olfZ THIS IS/Y/q^UR PMIT BL , RATE S-GNATURE Of OWNER,IF OWNER BUILDER, iDATE7 Jan. 4. 2001 4:00PM` �" "� '` No "' .6355''P. 2/91 Receig_ X-3. CUMMCM 6 XUvus2jLj L D ZWMM V=K['r APPLIC TICK L. /J fat#' / (��,� S /, �, �j S,C��� �°�t'✓%S' °J��17C1 construction Address 6*70 2/ S7010. I m1 s 712 y r~ S r Aon onig Legal 40 7 3 J ` AI•K tm S 6-6 41,Ar Af, tors 9 -7 8404V b dtfnf ylBsd #*AAA trA aoo!wry . CM A Y "PAy Asir e� l m/e � irwr L A.& owner s Address 3 Z S G c- tS ,A / s r�sT.il pit, /1yN 10942-8 ) Z2 7 wMMACTOR & A=Mw %3 J I AJy 2 AEa S - 4 E!: fAp Ts1O t I � 3 y 9 � ..F'o.Se•.� r' si Lss1�T' si`�,�ovt,� � •a ssi�� . arcdit�ot �C -tea c�G • _, sed.#d,B�� ft9i=00r S .�tS64-. lug .$�7�9 BVILD3M COWTA rCrrON "M OF DORS NeYir U Addition U Alteration -Describe OFC. ARBA: Length Width MSR ARBA.: Lftgth � width OTMM ARBA: Lengtb Width Height /Uf1C7 Sq_ geighe ,; `4,` Sq. Height Sq. k"UM 1iT Tel 0 Date VALVATIONS'O :q.tet. x S Cost/Sq. Ft. m Valuation g ) PeRv-Osr •q. Ft. x 5 Coat/Sq. Ft. a Valuation a§'%8a4s®5 BL -06. .q. Ft. ` x $ Cost/Sq. lit. w Valuation $ ) TOTAL Yaws 77. X/..02 holding DG�e�ES�o NriAL� construction Typa u+ � Woacapaacsr cfr+aup / 3 Ir conditioning KYes []No Fire Protections, Provided ()Yes XBO �mrfarmar►ce Band Amounts . $me Reverse for Schedule ved U Yes q No ?MET Fps permit Fee $ • !Jr See Fee Schedule an Bev eras Side Man Check $ In Rxceas Of Prepaid Amount - See Reverse Side Fixe surcharge .001 x Permit Valuation (1/10th 0) State Surcharge $.50/$1.040 Valuation (See Schad. for > $1 Million) SAC Charger � $ 5 7 S� 5 $1150 per SAC Umit (plans to N9;CC for datesminatgon) Erosion omtrol s . 63 $454.00 Coeserwatsou Plan XevjAw Park Peet-75-rDt,- $ _ 375D.00 Fee Determined By Pagineering Spec. Assseamaeats $ AgreeRNMt gecessary C:I Not Nec"Bary 0 Driveway Recrow $ _ feet x $13.50/foot TOZ'Ylr. ATMCS B=FUYATXMB DEC 21 2001 09:45 FR STOCK LUMBER—EAGM 651 454 1511 TO 7635712992 P.03f05 12/21/01 FRI 08:27 PAX 612 886 1117 rxua JVtaa � Atevaer Bv�s December 20, 2001 Motley Frantzick Stock Building Supply 913 'Yankee Doodle Rd. Eagan, mN 55121 Re: Gateway East Town Homes -university Ave. & 576 St. N. E. Eridicy. MN M-01-1025 Dear Morley' This letter is being sent to verify the adequacy of the 3 pcs. of 1-3/4"%16" 1.9E Microllam LVL in the above referenced project. The 3 pcs. of 1 -3/4"x16 --1.9E Microllem LVL will be adequate for the 2" and 4" diameter holes as shown on the enclosed TJ -Sizing'+" calculation. The calculation can be identified by the follows+$ date and time in the upper left-hand corner. 12/20/2001 4:56.14 PM This analysis is based on information you provided. Any deviation from this infor 600 "I require re-evaluation. we have not reviewed the project plans to deterAline if product application, design loads, and dimensions are correct. An authority familiar with the structure must confirm the validity of the loads and dimensions shown. The calculations apply only to the Ttvs Joist produm 3 pee. of 1-3/4"x16" 1.4E Micro9am LVL, in the above project. Please look for the proper Titus Joist tredemarks when at the project site. Please contact us if you have any questions. Sircerely, . 44*, Frio Roloff North Central Rion Encl. . c. Gary Parshall, Trus Joist North CeM•il Appian • Afi30 W 77'0- StN00 Cria So* • EO' *' MWW*p b663B • Wrons 999.096.1117 I. To® Free m.a99,1427. R&s 9S4•298•i If? DEC 21 2001 08:23 612 B96 1117 PAGE -02 DEC 21 2001 09:45 FR STOCK LUMBER—EAGAN 651 454 1511 TO 4635712992 P.05i05 12/21/Ol FRI 08:27 PAX 612 886 1117 txua 3 Pcs of 1.75" x 16" 1.8E Microllam® LVL MA SW4 614.1 m2al l 4!96:14 PM Page 2 012 BM Cods: 149 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED OPERA R NOTES .The 3 Pa. of 1.3/4"x16" 1.9E Micmilant LVL with the de6ign contnils 60e6fled above will be adequate for the r and 4' Diameter tortes 68 shown in the dMil below. -Any deviation will require funbw anaty6ls. P ROJ EC_T_INRORMATI ON Stock Banding Supply Gateway East Town ttgmes Unlversity Ave. & 57th 5t. N. E Fridley. MN M -01 -IMS t 4"d�a�ai+trl,oi� , L I 3pcs.4 1;4'x 16"M!crollun LYL INFOR Trus J019t Eric RoloN 4530 Wa6t 77th street, suits 2D0, Edina, MN 55435 1-800-43&1427 Fax 852.6861 117 Ce�1ot00 7000 Oy TAeo i01et. i weradlawsta 6uaMs>ts. 7.t -Proms sRd Tl S�yAO"' se UsdoMM�! O�ThN .tela . Mtps40+4tts t+adsns><ll dTeus J01R . t3'tEN4�tt1617JnG12p0 tsitsWt ttM6.�s 6128% 1117 PAGE. 04 >rotc TOTAL PAGE . 05 > I r � P ROJ EC_T_INRORMATI ON Stock Banding Supply Gateway East Town ttgmes Unlversity Ave. & 57th 5t. N. E Fridley. MN M -01 -IMS t 4"d�a�ai+trl,oi� , L I 3pcs.4 1;4'x 16"M!crollun LYL INFOR Trus J019t Eric RoloN 4530 Wa6t 77th street, suits 2D0, Edina, MN 55435 1-800-43&1427 Fax 852.6861 117 Ce�1ot00 7000 Oy TAeo i01et. i weradlawsta 6uaMs>ts. 7.t -Proms sRd Tl S�yAO"' se UsdoMM�! O�ThN .tela . Mtps40+4tts t+adsns><ll dTeus J01R . t3'tEN4�tt1617JnG12p0 tsitsWt ttM6.�s 6128% 1117 PAGE. 04 >rotc TOTAL PAGE . 05 > DEC 21 2001 09"-45 FR STOCK LLIMBER—EAGAN 651 454 1511 TO 7635712992 P.04i05 12/21/01 FRI gf:YT YAA use 000 aJ.ir &^W4 3 Pts of 1.75" x W 1.9E MicrollamiII&I LVL 7J.SI "- %8.66 times Number 408MIN MMT&[zN Gt111 121 "01 4:54:14PM Paps t of = Qww COet:148 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LI STED 14'• Product Diagram Is COneopb+al, LO- AD&: CONTROL CONTROL 7611 Analyais for Beam Member SuppOrUn9 FLOOR - RES. AppllCaWR- Tributary Load Width: 1' LoadSWf : 40 Live at 10095 Wall= 12 Dead; 0 Partition; Arid: 46671 TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Unlform(of) Floor(1.00) 640 480 0 to 14' Replaces Flow Load POinNib$.) Flo341.00) 10255 8825 l' 6' Adds to SUP -RTS' INPUT BEARING REACTIONSMS-) WIDTH LENGTH LIVEMBADMOT. PLY DEI TM DETAIL OTHER 1 2x4 Plate 3.SW 10A a 13735 / 9662 123416 1 1S.& Oher. 2 2x4 Plate 3.50' 4.333' 548014189! 9689 1 16.0' Oder: - Bearng lengin requirement exceeds input 3t SUOPOrt(s)1, 2• Suppomiantol hardware is required to S&0* besring re0 m ilts- L Tt0 R S: USER LOCATION "x;• (HOFU7—) DIMENSION COMMENT 1 9' 4- diameter hole 2 11' r diameter hole _DESIGN CONTROLS: MAXIMUM Shear(lb) 23228 Moment(ft-lb) 38292 Live Dd.(In) , Total Detl.(in) DESIGN CONTROL CONTROL 7611 ISM Paesed(40%) 39282 46671 Passed(06%) M260 0.456 Passed(Lt531) 0.453 0.063 Paesed(U362) LOCATION Fit. end Span 1 Under Floor wading MID Span 1 under Floor ba&4 MID Span 1 under Floor loading MID Span 1 under Floor loading - Defl jon Criteria: STANDARD(LL' L/3W, TL -U240). - Bracing(Lux All compreallon edge$ (top end battem) must be braced at 7' 10- ore untess detailed otheiw[SO. Proper attachment and positioning of lateral bracing is required to achieve member SUW14. ADpMQNAL NOTE E: -1MPORTANTI The analysis presented is 01410tdfrW 69fNvare doped by Trus Joist (TJ). Allowable product vailm shown are in accordance vwth cwenrTJ materials and t design values. T jErigirmring has verrtied tte analysis. Tne input loads and dimensbris have been provided by others and muni be verilirod and Approved for the specific application by the design profesMonal for th prgeCt - THtS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY[ PRODUCT SUBSTITUTION MDS THIS ANALYSIS. - Mlowable Stress Design methcidOlogy w*$ used for Code NER aMlyZDV the TJ Residential prudud listed above. - Now: See TJ SPECIFIER'S / BUILDER'S GUIDES for multiple ply connection. PROJECT INFORMATION Stock Build" Supply Gateway East Town Nomas University Ave. 6 S71h St. N.E Fridley, MN WO1-10255 -O-PERATQR IP Trus Joist Eric PWW 4530 Wast 77th Street. Suite 200, Edina. MN 95435 1-i 0.4311-1427 Fax 952.8961117 CevyapM !01000 � Tna Jour. a v4ayaerawsor BurarWs• TJ.vap'� and TJ$Ia:rtp"' aK uadaMrrs orTryo lolct . vowme is a ragkearaa vaninerk of Tru J9te1, G7Ero01a@ER1$t7JN ►t'1Z001ava1a1 ion 0a DEC 21 2801.08:23 612 896 1117 PpaE.W JAN -02-2002 15:23 FROM:HKS ASSOCIATES INC 6516590891 TO:763 571 1287 P.001/002 ' 4 CM1. FVGINF.F. U G 3 LUNDSCAPE ARCfl7TECTU" V E.NMONNIENMAI. URVICESdo URI AX PTAND"NG It FAX TRA N SAUTTA L Re; HKS Project Number: 1�1 Number of Pages Including This Cover Letter: _ 1000 Purpose: Remarks: Copy to; As You Requested ;or Your lnforrhation Please Review and Return Please Reply to Sender $21 Raymond A venue - Srrire 100 - Sr..Paul, Minnesota 5511.1 Tel: 651-•659--9:?2 - Fax: 651--659-0891 JAN -02-2002 15:23 FROM:HKS ASSOCIATES INC 6516590891 TO:763 571 1287 P.002/002 0 Partitions P~05W6 0"M dM Dwserlpdm 6 tM ne 4rc D Iter a tori ren nlete,rce Non -Combustible Wall Systems — Cement Board (continued) Steel Stud Partitions (Load -Bearing) — 2 -Hour Rating ,,,^ry c: rrrtuoaerend�nemlmxf-b�rmya5�e-90ETAoaersna WA SaD1i 67 ,I ' ' { iadaetodwne � yaa ae �I�oc.�ha�awwu 5/.•. 1 1 : : hata"MIR•fam 1.518•S14t1110ta &andGINA pwft FPS. F � Gwc, Mw 1100.- an 04 Chase Walls —1 -Hour Rating T Ihtlatpngt Ws0--12"W�p�Brapolemp11Fa11B�ana1,4-Cd9�niC G, EaSeGon3'SAf9331P'stu0�- Sw aa ab -I Ir 26 0awd 41um.16'we is I"m%.wM twit ma<7;9�1.1lr M-40 4 5160 SaFs->baro ea wo 1 •t/A' DLND6G mai jouns 60 MUM un 2'M. Ran amp-, A.9e061s Gyomum tenets w-a1an F U"d IT7 .................. ............ —r I .............. .. ........... •...............•.....I....... ................................................ 1'hmm6lDalasewatt-I?Dullpat8,aeeG�xlupandaresba-t W8'2s� s7 SMBB r sko 16' u C 111 two mv� w>nl nett Drat¢®- l• I12' Tk�uaF p SR-0ROS08 d'/s■ SAFE in b* 0A cauirms•--entad 60 *AM 1.114' kftCtt BMW ariews-pieta l�t ■11 W S'fl7Rpxa lumen I.ypalrm Pmets, Mee C C4Qe. GM W& -- UL Des Us59 wt7 Chase Wall — 2 -Hour Rating -r PWn njCtm was -112' COU&M woo" %wu$ and 114' a mm a 0- 65 SA -M112 Sgg3� BQ D889 tavet 112-',adFlroa &and Go= ft". Pam C Corr C2 BB9e0 on elf des pfHSA•R61102 fir/i■ 1.518' 2"i Da 6DB912ArOs 10' aC. in M9 rawG whn Irorlt bmtea-1.112' r,aRuu�•p SaFe--oemenr oanet an►aln 1 •sro- t1ProCK ¢rand saes {olntateeea--aU.de7pn247yms1/2i 947:71oocmandGypcum Panms fptL11pE C Care, onK s'yfe- -I{l Oa Uw wi. tb Shaft Wall — 2 -Hour Rating T- , h 9mn Ngll CKrdil PAetdr4ypy101 mye2b-1/1' aptl 8rana WA SAM at 3b CementParret-5iR s1s71nfrx Stand Gvanlm Parents, Fo of SAM ' ' Cae-1• $dOt &8110 CyDman 11ttrDanela xt 17pW I$G-feel -L--"-'�'—�' 20 p8. mill C•II �uas 24' o.e-1.112' nn9pml�ASafD--pennant Daatd Sttaw an 1P4n I•Sw DA019 motel=MerB & tandn w tD 0,MA "A wit8 r atnp MV* me tl=M aP0W vAM 114• np1C11ad ft" M&Wb'sws—idnzQis--11LDes W15Ude w000 rramea wan systems — Gypsum Drywall or Veneer Plaster Wood Stud Partition (Loa&Bearing) — 45 -Minute Rating T Wd $W-112, Sr4e "%stand Gypsum P. 1,k FMAM C Cele- NIA MA 92 � 2x116• ox.-yrdk� nv'IyL 1' o.c -t •St8' sem cM n>ds-pmt: ran - Oe UL ods 0917 1K G Wood Stud Partitions (Load -Bearing) —1 -Hour Rating T wood SM --SM metro vMyl-WO GYP= PXWS, FAsam Cure- SM 23 4'/.• 2e41G' ae-p8nB18 maoened r aG with 1.1/0• Ivagtets-.01, pea Ug05 ............................ )4p............ . r' ,�� . 94 -----rr- - - '+� �•►�' MMM 8rsndGtaalap am. ram cmc sit dnoW s WA mw moo* Mw Mymun -m IC ac -case rwso rax. e t n*- CO. 1n r, yawcr ftftV iib taped -G Of C 10.27.64 wa t ........... -'- W65[ud-SA' 9sEw+a(x Brynd G Panels• Flnamfs Can• or 3 t Ip�ad on t 8' mus apxln0 WatreM SMELT!ta0c FPanO GyP8W11 Patel; watm �J,-Wr1t F41CcvW 6- ax.--USG•00-F r-G&H 4%i- Core -4111G' a t4' o.a -Wft MM r as-1.?W c m Go naAa 7T BavoO on 24 spW 10- -io1M1b e10 of ren -ileum ki*1-UL 09611905 end UL pee I1314- USG -86060 (amen 4n -AL - - -- - !!7_ ...................... .. . 5• wt s T w1. � 14 ........................... • wd 6laa-112' 9+mndUr WanO GyPeum tenets ram«ltir G Coo1- 2x4 I6-aa-219ye1-ttme byes 11d• 51rI1;fROG+c6tand evpmrm Farads applt�OttWlln 10 Cri M1etlB•-1/2-p:ntd lacr, (aye SQIp IarNn Aloe ed nai�c d• ac rn Wil S Dpapm dams -lents sem R r.o-�mr coua�oa--ca-wa��41 54024 95 • � u j&Qt .................:.-.. 45 nah•9 54024 96 53 ¢Seed en S/8- Imtda 1="& & I. O SAM- usr aM 9.0•11 ........... ............................... .. ...................... ...... WaGtw-.adp m-,-wSetaoacmaw r*%,Nmr kvs. dt OMonRC 1 drolla¢pubmteeekardV- M* 97 FenliAtE Cap -2[418' ar. -RG t m epuN mgtl one 81da4 spices USC -880602 IOU 24• ac --mm an wmi 1- roe s lmm-* tluu ren•-penmeta C 011-4.136.0SU ti CITY' OF FRIDLEY INSPLL; i 1UN DIV. 6431 University Ave NE Fridley, MN 55432 763-572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2001 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 15Mrk 04 '-1- !�a CIO_Z� Q E , New Fixtures G $ 7.00 W, aThe undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 2Ce) Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner V\ Water Heater -Electric $ 7.00 -T-OL-0 r Water Heater - Gas`" $10.00 �(ZQQ Building Used As 1 OL -0 Vl,VL[rl W, -Q:5, Gas Range`* $10.00 -M ,�•� Gas Dryer" $10.00 Estimated Cost �C�J� PERMIT NO. 3,39 Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY P I l Reinspection Fee $47.00/Hr SIGNED TEL N� _ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance L-7 Approved By Rough -In Date Final Date8 l State Surcharge $ .50 QR ANY PLUMBING/GAS PERMIT IS $20.00 MINIMUM FEE TOTAL FEE $ c�3%, S�PLUS THE $,56 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 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 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( )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 : CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2002 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 JOB ADDRESS ��0� Q RATE SCHEDULE OWNER ` 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 Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 TOTAL BUILDING USED AS nn l $�� ESTIMATED COST �� `LD c �D PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Co i U n Size No. BTU HP EDR $afi, (aD Fuel ' c r 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 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. $ 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 A— I 6t HEATING CO A' 1 SigC Al 04n FAX tt 7 Approved By Date Final Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED .COMMON VFNT. VFNT CONN CTOR AND COMBUSTION AIR V RIFT ATION When replacing an existing f ,ran . _, 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The exkfina rnmht,stinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new _nmb ,coon airy it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When ins ailing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers 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 #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 HEATING CO: Signed By: Date :