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PRE 2010 DOCSn U • J''174 7 City of Fridley, - Mnm N° 8626 BUILDING PERMIT Date: December 9, 1965 Owner: ]Kpnneth Sohnson Builder _truce iphgson Construction Address __ 5980 - 7th Street N.E. Address 12841 Taylor Street N.E. LOCATION OF BUILDING No. 5980 Street 7th Street X.E. Part of Lot Lot __ Block Addition or Sub -Division Corner Lot _X Inside Lot — Setback of house. Sideyard 20' Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 20 Depth Z6 Height 8 Sq. Ft. 520 Cu, Ft. 4,160 Remodel Att. Gar Front 12_ Depth 22 Height _. $ Sq. Ft. 26� _ Cu. Ft. 2,112 Type of Construction FKAM Est. Cost 2,500.00 _ To be Completed P arch 1, 1966 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 coo with ail provisions of otrlinancos of the city of Fridley. AA 101 In consideration of the payment of a fee of It 1.Q.09 , permit is hereby granted to Rruce JpbnsAm C ons t ruc t i on to construct the building or addition as described above. This permit is granted upon the condition that the person to whom it is granterd onound and upon sad building, oany pari therZYTWnnnnesg local;l camstruot[on, altermaintenance, repair and movin8 of buildiaas city tspermit maybe revokedat anyancos. NOTICE ills psmnh don not cover the conmucdon, WmWen hr wkh o, phmbino, oa h*m&& sso r or water. Be sun to ao the Bulidina bupalor for alarato pormtM for Una Domt. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING Street Part of Lot ..LOT -------.,W=k_ADDITION OR Corner Lot 4, Inside LOT -SEWER EL l� FOUNDATION ELEVATrOh 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: I Front D Depth,96 Heights__ Sq. Cu. Ft. %/ 0 Front Depth Height C Sq. Ft._ Cu. Ft. Q Type of Construction ham, a Estimated Cost 91 001, 0 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. (Schedule of Fee Costs can be found on the Reverse Side). 0 If . V .. . " 9U041C•T City, ®f Fridley Permit No. At• THE TOP OP THE TWIN$ f PLUM-ING PERMIT APPLICATION r tw------- COMMVNITY DEVELOPMENT DIV. 'a e I i PROTECTIVR VI9ftCTIDN KK �---` CITY WALL FIUD4EY 00492 �•..�,�.� .� 013-800-3"0 NiAl0Q1! Nov. DATE PAGE OF 8A T"ROVIED ®Y Job Address - 0 2 15 73 1 1 800 ner,I_ 14 Address Pone d'. Plumbing Contractor Address Phone Kind of Building Use Comp etion Date lEstimatedCost t Plumbing Fixture Rates: N0, RATE TOTAL W — i --- Number Fixtures_ x $2.00 $ V,,od j Future Fixtures x.$1.50 Svc New Fixture -Old Open. x $1.50 O ',ddYl I I Catch Basin x $3.25 Qvfl I I Water Heater -99,000 BTU x $3.00 ! I Ground Run Old Bldg. x $3.25 6ea,I •MNlval d ! I Elec. Water Heater x $2.00 sNISYS � HolY7i � I I I W Gas Fitting Fees: !O O ENIv"a I •Qp 1st 3 Fixtures x $2.00 itWsaaMUNs b '0 i�� o Additional Fixtures x $ .75 tl uNnodl a'O NNlaa it i Gas Range -199,000 BTU x $5.O0 a U� iQ _ 1: NSYMI I ` I Repairs &- Alterations ISee ' x S""'SI I I I Description: Code I - vv c3 .NISYY l `II (( i l l l I State Surcharge .50 l I I TOTAL FEE $ '7 5-0 N1va I I ! I SwNun !The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work olaeo,� in strict accordance with the City Ordinances and ruling 1171YM �I I I I of the Department of Buildings, and hereby declare that d all'the f c s and repres9ptations stated in this t. applicaio are trud Anj,'aorrect. 'gt /�Z/17 1 46 -S gna re ate s , A t MINNEGASCO 53-84-5-915.51 City of Fridley Appll= Slza fW Mmlbbq and Gm vS g Po m?? Dept. of Bldgs. Phone SM -3450 DESCRIPTION OF WORK •5980 N. E. 7th, Street Number, Kind and Location of Fixtures Lon $ G I; rn S i� 12 I N WATER MTA. GAS ELEC. _ Base. Tn t 1 Dry r 1st 2nd 3rd 4th -Future Connection Openings + New Fixture, Old Openings Connected with sower C] Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................. x $2.00 $ Future Fixture Opening ........... x $1.50 $ _. New Fixture Old Opening .....:.... . x $1.50 Catch Basin .................... x $3.25 $ Water Heater :Up to 99,000 BTU) .... x $3.00 $ New Ground Run Old Bldg. ...... x $3.25 $ Electric Water Heater........... 2 $2.00 $ 3AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $2.00 $ Additional Fixtures ................. x $ .75 $ Gas Range to 199.000 BTU .............. x $5.00 $ City of Fridley: The .undersigned hereby makes application for a permit for the stork 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 fact and representations stated in this application are true and correct Fridley, Wnn 9-3-74 19— owner Kenneth R. Johnson - Kind of Building Frame Used as Res. To be completed about 9-10-74 Estimated Cost, $ 10.00 Old—rAMMuilding Permit No.04 P it �GNdi�aiLi Signed By (/ MINNEGASCO Business Phune No ROUGH REPAIRS & ALTERATIONS—Roger to Code .50 State Surcharge Description .... T . t 11 Dryer .................. 5.00 TOTAL FEE I♦ - SD Class KAP' aurchargo .50¢ SUBJECT PE NO. City of Fridley 15576 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T R EIPT NO. I ; L'______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 9 9 17fdA r PROTECTIVE -­11, CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j, J\ 612-571-3450 910-F15 11/28/79 JOB ADDRESS 5980 - 7th Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ] 5 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ken Johnson 5980 - 7th Street N.E. 571-1164 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 X X B DESCRIBE WORK Construct a 12' x 10' Addition and add Free-standing fireplace 7-8,m Co —/Y)OA a —/>PS 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REOapt?EU F HEATING, PLUMBING OR .�NI�?l�, AMD SI(� DARNING Before digging call local utilities TELEPHONE o ELECTRIC - GAS Etc. RIEUERE By LAW 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN BO 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 $3,000 $1.50 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. $18.00 PLAN CHECK FEE TOTALFEE $24.00 SIGH T E OF CON i RACTO HOR�ZEDVG'T ATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT 'OWN ` Zl IF OWNER BUILD (DATE) BLDG INSP DATE CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) 0WNER: law ADDRESS:' TEL NO: L,��j Z/ � BUILDER: . e ADDRESS: TEL NO: Construction Location STBBNT NO: STREET: Q� LOT: BLOCK: �� ADDITION: Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION it j?`CF; C"�►n�f'ront� Depth: Height: Square. Feet: Cubic Feet: Front: Depth: /t� Height: Square - Feet: ov Cubic Feet: Estimated Cost: $ Type of Construction: To Be Oampleted: 7 0-n T 1 1 °% `/ '3®G a. Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET The undersigned hereby makes application for a permit for the work herein specified, agrucing 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: Stipulations: 1,00 0 a i1 t P t r, X x q J"� i ao QA IAN o law ;. i 7 kill k 6 �s i e -�T e��.re-.✓-+.er...•�..ru>.. ..-�.--`--.���v s �-.:..-r.�_,.'++.�-». rr�e...�.�,.'^_..�.M.•r�-!+i•-..wi�wc+rrr.�w' f� wAMp+suor _ • O 4 r yam.' SUBJECT P City of Fridley AC 404 AT THE TOP OF THE TWINS BUILDING PERMIT _ CEIPT � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �6 S�3 4 1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---- •� 612-571-3450 910-F15 5/1/86 JOB ADDRESS 5980 - 7th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 5 Bonny SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Lloyd's Hoene Improvement Inc. 1012 - 4231 Avenue N.E. 788-5602 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 Install soffit & Facia 9 CHANGEOFUSEFROM TO STIPULATIONS 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 1 1 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 AWORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,100 $.55 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- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $19.00 LAN CHECKFEE TOTALFEE S� $19.55 SIGNATURE OF CONTRACTOR OR AUTHORIZED AG T (DATE) WHEN PROPEPCY VALIDATED THIS IS YOUR PERMIT BLDG INSP 6ATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] J R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: z,— � d O — -7 " " -,14 j1`-' Legal Description: % -71� Tel. # S 71 / /(4,r Name & A ress : /rD" Cl Contractor: ��-�� �4[-U-rry �c-r� Tel. Address: M Q 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: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ Approx. Completion Date: �- 3_7 Proposed Driveway Width If New Opening Is Desired: Alt. A Alt B See Back. Page for Explanation DATE: APPLICANT: Tel. # U Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $•50/$1,000 Valuation $475 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] -RESIDENTIAL CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE ` RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer $ 20.00 $Gly $ 10.00 $ $ 10.00 $ $ 10.00 $ • Air Conditioning (all sizes) $ 10.00 $ All Others/Repairs and Alterations 18 of Value of Appliance or Work $ COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. -3' _ / Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission frac adjoining neighbor. $ $ .50 $ Job Address �ff R� 7 Zf— ZI AAS Department of Buildings,, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. 19 -27 - OWNER KIND OF BUILDING dp USED AS TO BE COMPLETED ABOUT ESTIMATED COST 3 OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity .1 Sq. Ft. EDR BTU % HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company ��'✓ Signed By Tel. No. Fill out back side for stack verification on replacement furnaces CHIM14EY 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 connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date SUBJECT P City of Fridley2 6 7 6 5 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIP COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . I NUMBER REV DATE PAGE OF APPROVED BY l w "'1,'� CITY HALL FRIDLEY 55432 .-_• L J` 612-571-3450 910-FlS 7/22/98 JOB ADDRESS 5980 7th St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 5 1 Bonn Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barbara Johnson574-1939 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Four Seasons Roo i 7930 University Ave NE Fridley 795-9410 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20138780 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE, OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION NI REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof (20 S Tear -off 8 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF. WORK OR CONSTRUCTION ZONING SQ. 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 $1668 .83 DOES NOT PRESU TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF OTHER OCAL LAW REGUL TING ON- STRUCTIO OR PERFO NCE F NSTRUCTION. $54.00 ire SC $1.66 PLAN CHECK FEE TOTAL FEE L 47 ®I +� License SC $5.00 61.49 SIG ATURE OF CONTRACTOR OR AUT RIZED AGENT IDAT I WHEN PROPERLY LIRA ED THIS IS YOUR PERMIT 9 INSP IDATE r _ SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY.OF FRIDLEY ALTER [ ] SINGLE FAMILY -AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 59 S4� W E' - Legal Legal Description: q Owner Name & Address: �,g-�e �a.2.�l (� n s crr� TeL Contractor: .oa / Se�So h s �o o�� v►a �Re�►v�c, L L�' . MN LICENSE # �l �� %�� Address:. ` lg 3 a U r% v V_Q,r's 4--w Aa� N �. �r d fie. �� Tel. # °�g.S d? (116 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF UdPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ;Q p m 19\/ ._ cf- 'Q6 Sq Q-� 5A t r -w Le 5 Construction Type \te (. 6WIgccc ' Estimated Cost: $ /(a �00 (Fee Schedule, on Back) . Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ r/� DATE:. � APPLICANT:ZL Q Tel. # CITY USE ONLY Permit Fee $ U ® Fee Schedule on Reverse Side Fire Surcharge $ w .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1',000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S-.00 $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 [ J Not Necessary [ J TOTAL $ �q STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. A In Effective On January 1, 1998 6431 University Ave NE �J Fridley, MN 55432 APPLICATION FOR PLtlMBING AND GAS FITTING PERMIT 572-3-604 rStories _ E ,,sement Floor 1 Floor 2 - Floor 3 C Floor 4 PLUMBING FIXT'.J;! -- , New F-MWrr-s Old Oper - ,i Beer Dur= -s - Blow Off Basin Catch Basin zir. Water Leader Sump/Receiving `a- Water Treating Ap- Water Heater Water:'.,, -.T - Gas P'. Gas E3ac k I;r,,. _ MARK NUMBER OF FIXTURES TO 8E INST _ ACH FLOOR Water Bath I E Wash 1 Drink i Floor Cat( --]Auto. Auto. Gas Gas -- Closet Urinal Tub Shower ; Sink Tray Fount Drain Bas+r cher Appl. Ran t I ' Misc. Water Heater Frit. Gas � Elec �ff9,T-0 % C111 S7- /ld f 9/'c, 8 —J ei A/Af.eX% N I RE, 5 4-6 /iv, 7�1 CITY OF FRIDLEY INSPECTION DIV. ` �> �%� Effective On August 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Y9 W �% . N6 - Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill_ Back) Gas Piping ,(Needed with new furnace) Gas Range Gas Dryer *Air All Sizes All Others[Regairs,:& Alterations (LIST ON BACK) I% of Value of.Appliance or Work Commercial/industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ $10.00 $ yn;n.26<<' $10.00 $10.00 $ $ 25.00 $ State Surcharge TOTAL FEE $.60 gS..50 MINIMUM FEE FOR' ANY HEATING/COOLINGNENTILATION 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. 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. 9-5-97 ,1995 OWNER 5ohnson, Barbar& BUILDING USED AS ESTIMATED COST 3 SCS , v© PERMIT NO. 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 iV INV4LUASCO HEATING COMPANY ATTN: JUDI - 321-5282 MRS., MN 55440-1165 Signed By Tel No. 4: )/z' Approved By Rough—In Date Final Date FILL OUT BACK SIDE FOSTACK VERIFICATION ON REPLACEMENT FURI 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 ( ) I Has no foreign objects lodged within Yes () No (). 4. Is securely supported Yes () No ( ) 5. Meets all 6iffent 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: ARN: P.O. BOX 1165 MPLS., MN 554441105