PRE 2010 DOCS'd _'41s:014
CITY OF FRIDLEY INSPECTION DIV,
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR POWER PLANTS AND HEATING, COOL;NG, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace $ 20.00
Gas Piping (Needed with new furnace) $10,00 $
Gas Range $ 10,00 $
Gas Dryer $ 10.00 $
*Air Conditioning — All Sizes $10,00 $ , ®c�
All Others/Repairs.& Alterations (LIST ON BACK)
w 1% of Value of Appliance or Work $
Commercial/Industrial
1% of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE I ":� "6Z)
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-Mthout
written permission from adjoining property owner.
Effective On January 1, 1993
JOB ADDRESS ,fJJJ
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.
—tai ,1993
BUILDING USED AS_�
ESTIMATED COST __ PERMIT NO. /C�'
No, of Heating Units / Circle One (Steam) (Hot Water) (arm Air ,
Trade Names, _ Size No.
BTU_. HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
SEDIC
HEATING COMPANY HEATING & AIR CONDITIONING CO.
MINNEAPOLIS, MN 55420.2853
Signed B j Tel No, sa2.anpp
Approved By Rough—In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FUPNACE
lie A6 CHIMNEY AND STACK VMUFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes No ( )
Z. Is free from rust or deterioration Yes ( ) Nof
3. Has no foreign objects lodged within Yes ( ) No X
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 iTrU 4 s of (� _
All other BTU's
TOTAL BTU's �ZOCoo
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By HEATING & AIR CONDITIONING CO.
89 10 WENTWORTI 1 AVE. 96
Date
MINNEAPOLIS, MN 55420.2853
R81 •anpp
a
SUBJECT
City of Fridley
26588
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
� `
RECEIPT NO.
______ COMMUNITY DEVELOPMENT DIV.
~ PROTECTIVE INSPECTION SEC.
- 0//�
L7/`
r i
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-Ft 5
7-13-98
JOB ADDRESS 5323 6TH ST NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
19, S1/2
0 16
Hamilton's Addn. to
Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Terrance P. Lewis 5323 6th St NE
574-2463
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 O ADDITION O ALTERATION
REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Tear-off (12 Sq) RAM111 Reroof House
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with 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
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
$1,000
$.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 LO AL LAW REGULATING CON-
$34.75
Fire SC $1.00
STRUCT ON R THE PERFORMANCE OF
418TRUCTION.
( k rm ��— -
PLAN CHECK FEE
/
TOTA EE $36.25
-
SIGNATURE OF CONTRACTOR OA AUTHORIZED AGENT IDATEI
N P OPE Y ALIDAT IS IS�YOUR
/PERMIT
BLDG NSP C lvrJATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ]
ADDN [ l
ALTER [ ]
ConstructionAddress:
CITY, OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
3� 3 67* 5 -7- Nit,
Effective 1/1/98
Legal Description:
Owner Name & Address: 7r?7 Tel. #
Contractor: 5;9 fm E MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. #
--) 7 4/ & z/Z 3
DESCRIPTION OF 1WROVEMENT
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: L9 -Tq Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: I — APPLICANT: ��'� Tel. #
CITY USE ONLY
Permit Fee $ ,,5 Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ �b $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ $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 $•
STIPULATIONS: