PRE 2010 DOCS0
City of Fridley, Minn.
•
BUILDING PERMIT N® 383 6
Date: .. ......... ` ... ,........... .
...
Owner ....................................... Builder .:^ ..... ...................
Address...................................... Address .............................................
OCAT SOF BLj1LD[NG
No.®./ ... Street... ...... ......... /. /..�........ Part o t ......... .. .. .............. .
Lot ....10 ..... Block ..—.3 ............. Addition or Sub -Division .... ..........................
Corner Lot . x ........ Inside Lot ............ Setback Side .Z:O'..�. 7 ..............
DESCRIPTION OF BUILDING
To
.. ... Front a -Depth [ �. a Height : �t. Sq. Ft. .9.4. P Cu. Ft.
.................... Front ........ Depth ........ Height ........ Sq. Ft. .:...... Cu. Ft. ........
Type of Construction ................... Fit. Cost.. // rd0'26
..l� O • • ?!"� To be Completed
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.!. Y......., permit is hereby granted to ................:..
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
.... Building Inspector
INOTICE:
L This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
mater. Be sure to see the Building Inspector for separate permits for these Items
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder. `
_ r
Address _ Address S '%
LOCATION OF BUILDING
�a
No.," • Street Part of Lot
Lot Block - �� .Addition or Sub. Div. (:--:P
Corner Lot•— side Lot Set Back A--.
Applicant -attach to this form Certificate of Survey of Lot and proposed
building location.
DESCRIPTION OF BUILDING
To be used as
/ : Front Depth Height
Sq. Ft. �® Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction 2= a Estimated Cost
To be completed d)z rl
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.
Signature a�vDate �
(A Schedule of Fee Costs can be found on the Reverse Side)
Date: .....'moi ... .
City of Fridley, Minn.
BUILDING PERMIT
.s�:...... ...f. • .........
Owner .•
Address..........��..........................
N® 3918
Builder
Address................................. .........
,,��''
LOCATION OF BUILDING
No. ...L Street ...40e, ......... Part of Lot ............ ....... .....
Lot ....... Bo¢k ........ ....... Addition or Sub -Division ...
Corner Lot.... ` ..j.... Inside Lot ............ Setback ...` '... 0 Sideyard ./ 0 �&)...............
To Used
�`as
Type of Constructii
DESCRIPTION OF BUILDING
s
' 1 41'
Front . 34.7.."0 "Depth . �4 772 ,ght .. /j.:.!? Sq. Ft. ..Q Cu. Ft..
Front ....... Depth eight ........ Sq. FL ........ Cu. Ft. ........
......... e .. Eat. • . > 7 7jr.4"'Tb be Completed .................. .
In consideratio of the issuance to me of a permht to construct the: building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the of Fridley.
r
In considemtioof the payment of ;a fee of $... ...., permit is hereby granted to ...................
..... to construct the building or addition as described above. This permit is granted upon
the express con diti that the person to whom .it is granted and -his agents, employees and workmen, in all work
done in, around an 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 buildingss with-
in the city limitsnd this permit may be. revoked at any time upon violation of any of the provisions of .said
ordinances.
Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, pas heating,
sewer or water. Be sure to see the Building Inspector for. separate permits for these items.
Land Planniny cfa&r&&7t 370hfifj1ss1#iJtNf
Land SUIWY�7y M1nneq)w& 21,
Soils Tes tinq ENGINEERING, INC. mifl,7cvla
aw/ & mumaIrl I SlIhmi 11-60"
Eng neeriny Engineers Sur vectors
n
certificate of suzvey-:7, I.." �:'! L L I L
I
, ro V1
Li
Lj
hereby Cerfirpy fbd */-i sa h-ue and wrmcl representation 0,P,7 survey e#M bllndQr;eS If & OhOff ASCM&d Iffl7d, and
JklWit7fl V/ aw buildings , *revv, &,d at/ imble a7avachmeals , if mj, f vn or *7 mid /and. As surveyed by me this - *y
A.0 /9-"1.. SUB URBAN LENGINEERIN5, INC.
bn9ineers Fr Surveyors
A
SUBJECT.
P IT NO. -
City of Fridley
1388 \
AT THE TOP OF THE TWINS
PERMIT
rp
�
BUILDING
R
COMMUNITY DEVELOPMENT O
r � � PROTECTIVE INSPECTION SEC..
I}/(
�'--1 CITY HALL FRIDLEY 55432
It---- �'� ,`1
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
11/19/76
10B ADDRESS 6001 - 4th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRA CT OR ADDITION SEE ATTACHED
DESCR.
6
3
Bonny Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert D. Schmidt 6001 - 4th 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
l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 24' Detached garage
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surfaced driveway.
--IMPORTANT—
NOTIFY THE FRIDLEY
ENGR.
DIVISION REGARDING
CURB
'REMOVAL AND REPLACEMENT
AT DRIVEWAY OPENINGS,
SEPERATE PERMITS REQUIRED FOR WIRIAV-, Gr
HEATING, PLUMBING AND SIGN„ Before digong can local Wind
TELEPHONE - E«cra1C -US Etc
REQUIRED BY LA
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
'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
.
$426240
$2.13
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-
$23.04
NONE
STRUCTION OR THE PERFORMANCE OF NSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$25.17
SI A u EOFCONTR RO AUTHO IZEDAGENT IDATEI
HEN PRO ERLY VALIDAT D THIS IS YOUR PERMIT.
BLDG INSP DATE
SIG ATURE OF OWNER IIF OWNER RI IDATEI
CITY OF FRIDLEY
APPLICATION FOR. RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER'S NAME :2 V 1Cf� VYIIUVBU ILDER : 5 A �VL�
ADDRESS (Owl M L Sr Ni_ ADDRESS: 6A*A6
TEL. NO.:
NO:. 6920[_____ STREET:_4� 6i IVi
LOT: 6o BLOCK: � ADDITION: Q O AJA JC.
CORNER LOT: x INSIDE LOT: SETBACKi SIDEYARD:
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:
.6ara-Front:
Ili
Square Feet: 574 ub is Feet: ��lo
241
Depth: 24 'Height: It>r
Front: Depth:
Square Feet; Cubic Feet:
Height:
Type of Construction: Xfj Che_j-�r-cIYn4e_ Estimated Cost: $ 2000.00
6 T Be Completed: -5-1— %(A
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stxict 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:
(See Reverse Side For Additional Information.)
T r-DMIIWAT IM
V
I, Q&&49D C.� , owner of the property
located at 4o O // have no objection to the.
City allowing
the
construction of a_a
raj
a to be
located at 4op(
4+ - S -T- Ni—
without
the required
certificate of survey that the City ordinarily requires for all new
construction.
Address
Date
ov+ ems,/ (h.
fitness
7'-
SUBJECT
City of Fridley
q_=RTMPTWU._
20540
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
idC IIS•J• o
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
''' 612-571-3450
910415
8/28/90
JOB ADDRESS 6001 - 4th. Street N. E,
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
3
Bonney Addition SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Robert/Sandra Schmidt 6001 - 4th.Street N.E. 571-8198
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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 27`6" .x 12' Addition
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan,
SEPARATE PERMITS RE��1►P�� FOR
WIRING, WEA�`lNCI, I�t,UMSlNG AND SlON
S'
WARNING
_
Before. digging call far
On.ail net+ roofs or tear-offs and replacement roofs all utility.Wafians
State Code iquires that 2 layers of 15 lb, felt,454-4002
mopped together, be installed to a point 24 Inches Ray IRED BYLAW
from
up exterior wall line, or the use of other
approved underiayment membrane.
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
$16, 700
$8.35
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$180,00.
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
Fire SC 16.70
$205.05
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
ATU IF WIT 11OR.e&AUT ORIZED AGEMATEi
�a 2z—i�
-
BLDG INSP DATE
SIGNATURE OF OWNER OWd ER BUiLDE (DATE)
NEW [ ] Effective 8/16/90
ADM [ ] R-1 AND R-2
ALTER [ ] B AldingPermit Application`T
Construction Address: GOO l " S—C UJ e -L
Legal Description:
Owner Name & aadress�„'� � 0Y J �.V� cXA�G` � �C-� �C_l t�� • # � % �'' $ 19
V
Contractor: I- Q o eyc- r( 1I Tel. # to
Address:, (, Op l�-�'= S T �[Z-ia l�-� &,Lfj i..)
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF narmnam
Livnr. AREA: Length 97 (o Width _� Height Fid Sq. Ft. 3 3 C:>
MAMM AREA: Length Width Height Sq. Ft.
DEAR AREA: length Width Hgt/Ground Sq. Ft.
Corner Lot [ Inside int Side Yana Setbacks
ACA 9
Type of Construction: ADAA,.a;._ Estimated Cost: $
Apprcx. Cc¢pletion Date: AIDV l 199
d lit
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
DATE:- �3 —?,1 APPIZC . Tel.
CITY 0.4E ONLY
Permit Fee $ Q Fee Schedule on Reverse Side
Fire Surcharge $ ,.001 x Permit Valuation (1/10th �) l
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $600 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Marge $ Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS: l �, )0()
oocl
Coo
4th Street
NtiT r TO
1�
0
c®
L,�,u t �-s S`T t�1
�w s� •.Lei � u u�a d��i �,� �:ra,� �)
z,
�yI, J�
441,,5
Coo rbtN
Z * B
bezS-e- �
to F a o�
4�
6+��� dry
���-v�►��
e� �����;,,�
�D�r���
`f
V
o p
CITY OF FRIDLEY INSPECTION DIV.
Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
c�
�� j L] J► �-'
JOB ADDRESS
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work
Residential
Rate
TOTAL
herein specified agreeing to do all work in strict accordance with the
Furnace Shell and Duct Work, Burner -
T�C7
city codes and ruling of the Building Division, and hereby declares
Also Replacement Furnace
$ 20.00
that all the facts and representations stated in this application are
00
true and correct. � �� ,199
Gas Piping (Needed with new furnace)
$ 10.00
$10.
11b
OWNER
Gas Range
$ 10.00
$
n
RCS/dC) ee
BUILDING USED AS
Gas Dryer
$ 10.00
$
L*
17X f1,,2z1
ESTIMATED COST • PERMIT NO.
*Air Conditioning - All Sizes $ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $
Commercial/Industrial
1 % of Value of Appliance or Work $
State Surcharge $ .50_
TOTAL FEE $-A2. 540
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units 1— One (Steam) (Hot Water)Warm Air)
Trade Name Lamin® X Size No.
BTU HP EDR
Fuel N Total Connected Load
Burner Trade Name Size No.
BTU A HP EDR
HEATING
Signed
Approved By Rough -in Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
LI -2110
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
3. Has no foreign objects lodged within
4. Is securely supported
5. Meets all current Code requirements for
size and total BTU's connected
6. Has total heating BTU's of -7 0
All other BTU's r CJ 60
TOTAL BTU's CJ�J
Remarks
List Alterations Being Done:
Yes (YQ No ( )
Yes ('X-) No ( )
Yes C4 No ( )
Yes , (4 No ( )
HEATING COMPANY (C
Signed ByAhn/ JWPF
,
Date ��
SUBJECT
4rERMIT NO.
City of Fridley
26352
AT THE TOP OF THE TWINS
BUILDING
PERMIT
' ,
R
I t
` COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
r
'
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
it i %J
"" 612-571-3450
910415
6/25/98
JOB ADDRESS 6001 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6
3
Bonney Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bob Schmidt 6001 4 Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Advance Aluminum Supply Inc 7701 Main St NE, Fridley, MN 55432 571-3440 7983
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
8 DESCRIBE WORK
Soffit & Fascia - aluminum
9 CHANGE OF USE FROM TO
STIPULATIONS
Install soffit ventilation to meet 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
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
$1 500
$.75
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-
$48.50
Fire SC $1.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
/ f
2;�'/y5
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$55.75
$ Gg ATURE OF CONT ACTOR OR AUTHORIZED AGENT /// IDATEI
6
HEN P�RO�PERL Y�YATED THIS IS UR PERMIT
lfSfo
,SP
GATE
_I/!/J/
SIGNATURE OF OWNER IIF OWNER BUIL DERI IDATEI
G �1
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
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
Effective On January 1, 2001
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.
$ .50
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE Cj — 12 _ _VZ I
Rough -In Date
Final Date �� t
(P
S
JOB ADDRESS
•
'
OWNER Lrl
lYl I (�
Rate
TOTAL
BUILDING USED AS4=L
$ 30.00
$
ESTIMATED COST
PERMIT N0. / �
$ 10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00
$
No. of Heating Units
Circle One (Steam) (Hot Water) (Warm Air)
$ 10.00
$
Trade Name
Size No.
BTU
HP EDR
$ 25.00
$
Fuel
Total Connected Load
Burner Trade Name
Size No.
$
BTU
HP EDR
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.
$ .50
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE Cj — 12 _ _VZ I
Rough -In Date
Final Date �� t
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 plastictPVC 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 manufacturers 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 fr Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date
Uilf OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
March 7, 2003
Ms. Sandy Schmidt
60014 Street NE
Fridley, MN 55432
Re: Final Inspection at 60014 Street NE
Contractor: Maple Grove Heating & Air Conditioning
Dear Ms. Schmidt:
A mechanical permit was issued on September 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.
DJ/mh .