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City of Fridley, Minn.. BUILDING PERMIT x?(! 6675 - -5 Date: Owner: it id d! !1 Builder V Address ddress LOCATION 0 BUILDING Part nf Tn+ 111W die Lot _ Block IF Addition or Sub -Division Corner Lot _ K... Tot 4wmMe Setback Q Si yard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Used T U:2 AA Front Depth Height ACAO Sq. n Cu. Ft Fro Depth P Height Sq. Ft. Type of Construction I _Est, C9P- /;j;jWA—;ro be Completed -W- WV� F 441W Cu. Ft. Xn consideration of the Issuance to me of a permit to construct the building described above, I agree to do ,the in accordance with the description above set forth. and In, compliance, with all provisions of the City of Fridley. A In consideration of fhepayment of a fee of $ god �, 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 don in 7 Y� Minnesota regarding location, construction, alteration, _maintenance, repair and moving of buildings di within NOTICE: Thb perm* don not cover the condrudion, haftwon for WMW* Phunbing, 9" boding, "Wer or Water. Be "n to M the sulming Inspeftr for soparde Pornaft for the" Nene. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA 04NE- R'S NAME teP & 77 BUILDER �J�c� 6/ �� %�i /�' �s �C�EP_C ADDRESS :7 ADDRESS /.2 00 C/ / %A G' �i74)RA C -A LOCATION OF BUILDING No. 7 Street �"J` /J/P art of Lot X Lot "T Block Addition or Subdivision 'VLJ6 r 11�w/'p e Corner Lot Inside Lot -Y Setback ,3S '- Side -Yard /0 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: 5� V 15 '4S Front Depth Height �� Sq. Ft. /[.s Cu. Ft. Z2 �� 6 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed 0;;, - The ;;,-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. DATE_ SIGNATURE ` (Schedule of Fee Costs can be found on the Reverse Side). ity of Fridley Application for Plumbing and G= Fitting Permit \\ ` Dept. of Bldgs. Phone SII 4-74� 7 DESCRIPTION OF WORK ps;� `/2X� 41, Number, Kind and Location of Fixtures Location pp I N x 3.25 $ _ '12 sY.' Y zrz New Ground Run Old Bldg. ............ .t Z �7z °C 5O ,� W 0 a z NO. RATE TOTAL WATER HTR. GAS ELEC. Base Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd 4th • Future Coanect€on Openings e New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOT,, --AL Number Fixtures ......................� x $1.50 $S®®O* 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 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ �✓ '�® Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description..............................................$ � 1 .. TOTAL FEE P 41-6 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 facl and representations stated in this application are true and correct. Fridley, Minn- Owner Kind of Building Used as ZZ) 4) ' To be completed about —Zef Estimated Cost, $ /e-'LZ�e �7 - Old ew uilding Permit No, 6 G ozz-- Permit No. a Signe By Business Phone ROUGH FINAL 42 MA Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ 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 ............ 8.00 $ each add. 80,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR 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 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ 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 $ ROUGH FINAL Dept. of Bldgs. Phone SU 4-7747; 47 Lnentinn/• , 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, Minn ®/ 9 Owner �Z A,* C - Kind of Building �C-fe ar Used as )?4z To be completed about Estimated Cost, Old Building Permit No. Permit No. 17? DESCRIPTION OF WORIC HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No ® A'e Trade Name C- Size No- V J) /v to o /,—VVI' Capacity. Sq. Ft. E.D.R BTU H.P. Total Connected Load 3 � � Q 9 Kind of rue, -v% & 4 - BURNER — Trade Nam Size No ate► LAI t& Capacity Sq. Ft. E.D.R BTU — H.P. (REMARKS—OVER) Signed2V-4o 4# YA By 42 2M Business Phone No- 1J�J Windows and Dooril--Crackage and Ana IZ,MMA Btu Infiltration Glass Exp. wall Q Net exp. wall Int. W&JI r Ceiling ^ Floor Z-� COLI G�J��1' AAM Ml A rzicAran �i- wri Windows and Dooril--Crackage and Ana Width Height No. of Lineal ft. Area No. of p of pq2e lights of cr ek ep. tt, Btu Infiltration Glass Exp. wall Q Net exp. wall Int. W&JI Ceiling ^ Floor Z-� winaowa ana N I.t th No. of Daae � 5 or A-& 0 Date: Sept. 29, 1967 • 0 City of Fridley, Minn. N° 9474 BUILDING PERMIT owner: - Bruce B. Brazil Builder Same Address 5978 4th St. N. E. Address Same LOCATION OF BUILDING No. _ 5938 street 4th St. N. E. Part of Lot Lot 3 N.�, of_4B1ock 13 Addition or Sub -Division .._..__.jjyde Park Addn. Corner Lot — Inside Lot Setback ____ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 26. Depth 2016" Height 10' Sq. Fit, 533 Cu, Ft, 5330 Type of Construction Front Depth Height Sq. Ft. Cu. Ft. Frame Est. Cost _$1500. 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 with 21 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to Bruce B. Brazil 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 anypart 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. CLAUNCE BELISLE Building Inspector NOTICE: This permit don not cover the construction, lm taWllea ler wiring, plumbing, gas Haft, sower or water. Be son to as the Building ingm for for soparab permit for these lino. Yq FOR -% T ':M! + I APS x���C3'! �.fi� }s�_t :3?JIi.D...�iG :r'.:_.,._I.T Cbz: of NINNESOTA OWLER'S NA21F��2 �J� BT1,.'�-DER ADDRESS 7-2 % 9 - y ADDRESS LOCATION OF BUILDIA.iG STREET FART OF LOT � LOT 4 BLOCK / ADDITI.ON OR SUBDIVISION CORNER LOT INSIDE LOT SET -BACK SIDE -YARD SE4TER ELEVATION FOUNDATa.01d ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drax-m on these Certificates. DESCRIPTION OF BUILDING - To Be Used Ad: A � Front � � ® " Depth c� L �6 Height Sq. Ft. ')33 Cu. Ft. "5'5� 3 C� Front Depth Height Sq. Ft. Cu. Ft` Type of Construction �/zec Estimated Cost O �� To Be Completed 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. DATE led/ ` SIGNATURE 1191 1W-- (Schedul of Fee Costs can be found on the Reverse Side). PERMIT for Power Rants and Heatlng. Cool o - A_ -&r' ing, ventilation. Refrigeration and Air Feet N° 4375 Conditioning Systems and Devices �� DESCRIPTION OF WORK No. of__ Heating Plants to be installed—altered—repaired Make , Size r245 - Oil fired ; Coal firppee�d ; Gas fired ; Gas Authorization No. Remarks B'a'o Approved Final Inspection Date , 19_ Inspector Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. - , 19_2 Owner v Location 6-92f J J' Kind of Buildi - How OccupA-a&,Aen, al Work to be Commenced a ,19 6B To be Completed Estimated Cost, $V�®• awl Old -New, Building Permit Permission is hereby granted to 2L44e� - D to install—erect—use the material and devices described in the above statement. This permit is granted upon t1fe express condition that the person to whom 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 mentioned 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 speciftlayons set forth in the approved application for this permit on file in the office of the Inspector of Buildings. p �, Inspector of Buildings .QW42 2M11 -UV V. Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices J� PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 560-3450 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 $ MECH. WARM AIR 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 Dv GAS BURNER (up to 199,000 BTU) ................ 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures _l x$ 200 $ QP Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH 01 FINAL— 4 See Fee Schedule TOTAL FEE $—�— City of Fridley: The undersigned hereby makes application for a permit for the work hereit 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, Owner Kind of Building Used as To be completed about,r�/e��,�,/ Estimated Cost, $ f �D Old—New. Building Permit No. Permit No._ 113 2.67 DESCRIPTION OF WORK • HEATING or PO R PT.AN Steam, Hot Water, Warm Air—Nom- ,�y7 Trade Nam Size No �J , O '9 Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load /V Kind of Fue BURNER —Trade Name Size No Capacity. Sq. Ft. E.D.R BTU H.P. Si Z I gn a$ Business Phone (REMARKS—OVER) CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 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 $ 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 $ Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge TOTAL FEE $ .50 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS �?-L"j 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. 1997 OWNER_ _ �� � /�v� SG--� BUILDING USED ASZ" ESTIMATED COST/42©x' PERMITNO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) Trade Name ize No. BTUs' "ate HP EDR Fuel_ Total Connected Load Burner Trade Name BTU HEATING COMPANY--' Signed Size No. HP EDR Tel No. (Warm Air) Approved By d `— Rough—In Date Final Date 3-C " 4,D FILL OUT BACK SIDE F6k STACK VERIFICATION ON 15'a REPLACEMENT FURNACE 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: N 33 SUBJECT P IT City of Fridley 26377 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r I v PROTECTIVE INSPECTION SEC. NUMBER REVDATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910 -FIS 6 29/98 JOB ADDRESS 5978 4thStrejet NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 N2 4 13 lHvde Park Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS R9==%79MQ 59:76 4t4 NE ZIP PHONE 574-9-IOA 3 CONTRACTOR A ZIP PHONE LICENSE NO. Johnny on the Spot 4208 Brunswick Ave N Cr - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICEN 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House - 15 sq. tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING MOT. 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 $1,251.00 $.63 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• $43.00 Fire SC $1.25 STRUCTIO O HEP ORMA CE OF CONSTRUCTION. r PLAN CHECK FEE TOTAL FEE —��—� License SC5.00 $49. SIGNATURE OF CO TRACTOR OR AUTHORIZED AGENT IDATEI 1250PERL V DATED THHIS YOUR PERMIT BL NSP 2 742. GATE _ SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI N 33 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY /1 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ✓� BUILDING PERMIT APPLICATION ConstructionAddress: zl -4�A 7:rr, Legal Description: 9-g- r lre- Owner Name & Address: t) l ,' k4- Tel. # �5-7q - / Contractor:a ®.� '�'I�ri_ ��-���-�-� MN SE #_ f� 13 3 Address: 4/� 0 S' � .s"a � � Z/� Tel. # a'3� � �� �(tS 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: Wi th Hgt/Ground Sq. Ft. OTHER: o `' Construction Type: )Zry Estimated Cost: $ JvZ.T-/ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ ��r,�-1-.�� Tel. # 53-3-35-4o DATE: 6 �.3—`�,� APPLICANT: ZjA(11,'R11P1 9�-�Jdl 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 [ ] 00 Permit Fee $ Fire Surcharge $ -� State Surcharge $ , SAC Charge $ License Surcharge $ .5 --Te) 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 [ ] CITY OF FRIDLEY INSPECTION DIViSION �p� Effective On January 1, 2001 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 y� JOB ADDRESS �� YO 5t N� RATE SCHEDULE - 6- L-66- OWNER Residential Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $ p (Side Vent - Fill Out Back) ESTIMATED COST d�C3 ,0'> PERMIT NO. / 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) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. * r Con itioning -All es $ 25.00 $2-5,00 BTU HP EDR Fuel Total Connected Load hers/Repairs & terations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial balk 7--Oe?-y ��� �' Z f,,-'6 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 $ ZS � 5� DATE `/ /6 P MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO /� % Ar)® eW- �.•`�u-i�,wwr,► REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE 7�� ��3� ��� $.50 STATE SURCHARGE Signed? TEL # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough-In Date Final Date written permission from adjoining property owner. BACK SIDE MUST E FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTIO 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 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 manufacturers 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 : CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 7, 2003 a Ms. Lee ro 4 U ��� 5978 4 Xet NE Fri , 55432 Final Inspection at 5978 4 Street NE Contractor: Marsh Heating & Air Conditioning Dear Ms. Brown: A mechanical permit was issued on June 6, 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. DJ/mh G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 21, 2003 Mr. Mathew Nordin 5978 4 Street NE Fridley, MN 55432 Re: Final Inspection at 5978 4 Street NE Contractor: Marsh Heating & Air Conditioning Dear Mr. Nordin: A mechanical permit was issued on June 6, 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.