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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. N° 2222 Date!.�..................... ....... • Owner ....".�, + Builder ... ......................... Address ItYpt* -Address .......................................... LOCATION OF BUILDING No. . Street ...................... Part of Lot ....................... Lot ........... Block . �� ........... Addition or Sub -Division Corner Lot ...... .. Inside Lot ............ Setback .,•; Sideyard ............. DESCRIPTION, OF BUILDING. To be Used as: Front Depth +'"" Height ' " • • • : • ....� �`� ... + th ...: `lie ht .................. Front ........ Depth ........ Height ......... Type of Constructioni6!`ldb .. Est. Cost...'� ....""""`..... . Sq. Ft......... . Cu. Ft. ........ Sq. Ft......... Cu. Ft......... 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 all provisions of ordinances of the village of Fridley. j. ........... consideration of the payment of a fee of $.*...,'permit is $ereby granted to ..)YA:ZA- e ........ • �. v ............. to construct the building br 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 village limits and this permit maybe revoked at any time upon violation- of any of the provisions of said ordinances. ... ,.. ..... Building Inspector NOTICE: This permit does not cover the construcflbrl, ins#allatlon or alteration for wiring, plumbing, gas heating, sewer or water. 86 sure to see the Building _Inspector for separate permits for these items. SUBJECT PER City of Fridley 16 4 3 7 AT THE TOP OF THE TWINS BUILDING P E R M I T _ r RECEIPT NO. it rrV ______ COMMUNITY DEVELOPMENT DIV. �r 707 9 r PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY "'j 612-571-3450 910-F15 10/23/81 JOB ADDRESS 6736 - 7th Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 5 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Jim Hagen 6736 - 7th Street N.E. 574-9026 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Home Place Builder's Inc. 11312 Fairfield Road, Mtka. 55356 544-8141 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 Majestic Free-standing Fireplace 9 CHANGE OF USE FROM 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 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 PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $17.50 STRUCTION iE PERFOF OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE f `P-r $18.00 SIGNATURE OF CONTRACTOR ORA RIZED AGENT (DATEI PROPERLY VALIDATED THIS IS YOUR ��PERMIT lla-i ®V m BLDG INSP GATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) v O11it1ER: s M .� �g P1. BUILDER: &110elf5 �Cr ADDRESS: �o 73 6 �2ff �f tiP� ADDRESS: �,¢,1� TEL NO: S_ -7V - &:2-k TEL NO: Construction Location Location STREET NO: 617,3 (o STREET: L 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 Yrront: Square. Feet: Depth: Height: Cubic Feet: Front: Depth: H eight: Square -Feet: Cubic Feet: 1.14J e Type of Construction: -ClfOlcPh ee- / s(aP /4 ee, Estimated Cost: $ To Be 0:)mpleted: 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 t.,ork' 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_re true and correct. DATE: ' ��SIGNATUM: � Stipulations: . . R J 01 SUBJECT PE City of Fridley 21845 AT THE TOP OF THE TWINS BUILDING PERMIT r ` EC COMMUNITY DEVELOPMENT DIV. i rr _��.__ S�3 r F PROTECTIVE INSPECTION SEC. F NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/12/93 JOB ADDRESS 6736 7th Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 5 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Aaron Milton 6736 7th Street -NE 574-2284 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Avenue NE, Fridley 55432 784-7543 4840 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 Reroof rear porch (5 Squares) 9 CHANGEOFUSEFROM TO STIPULATIONS 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 1 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 $270 $.50 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 PROVISI S F ANY OTHER STATE OR LOCAL LAW REGULATING CON- $l5' 00 $a r,0 Y STRUC ONO THE PERF ANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00: $21.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N PR PE� V LID HIS IS YOUR PERMIT +1 B G SP , ��- DA S,GNATURE OF OWNER 0F OWNER BUILDERI IDATEI J 01 MW [ ] Effective 1,/2/91 ADM [ ] I-1 AND 1-2 AMR [ ] ®® Building Permit Application Cmwtruction Address: legal - arlption: Owner Name i Address: � �y Tel. Contractor: D & D Home Improvement. Inc. Tel. $ 784-7543 Address: 7401 Central Avenue N A'.. Fridley, MN 55432 State Li c. # 4840 Attach to this application, a Certificate of Survey of the lot, with the proposed drawn on it to scale. �RIPI'ICDT or IMPUNEMM LIVIM AMM: Iength Width Height Sq. Ft. GREM AM: Length Width Height Sq. Ft. ME= AMM: Length Width Hgt/Grcund Sq. Ft. O7MM: Corner Lot [ ] Inside Iat [ J Ft. Yd Setback Side Yard Setbacks Zy►pe of Construction: Aw,� adz �F, stimated Cost: $ o� % C Approx. Cmpletion Date: wdep 45;-/M14 Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DP,TE:� APPLIC ANr: Teel. # 784-7543 Permit Fee $ 0" Flee Schedule on Reverse Side Fire Surcharge $ 77, .001 x Permit Valuation (1/10th $) State Surcharge S 5-0 $.50/$1,000 Valuation SAC Charge $ $650 per SAC Unit Driveway Escrow $ -5-.00 Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Sewer Mair, Ouuge IS Agnaaoen1 Naoessa y [ ] Not Necessary [ ] SUBJECT City of Fridley 267 7`- AT THE TOP OF THE TWINS BUILDING PERMIT NO. Ir ' ' � • COMMUNITY DEVELOPMENT DIV. ______ ' rr PROTECTIVE INSPECTION SEC r J �� CITY HALL FRIDLEY 55432 ,.J NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/4/95 JOB ADDRESS 6736 7 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 5 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jean Milton 6737 7 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sampson Lindgren Inc 2228 East 35 St M ls. MN 55407 721-5546 3129 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 O ALTERATION ❑ REPAIR R ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Repair damaged sheetrock (water damage) 9 CHANGE OF USE FROM 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 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME T BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GO RNING THIS TYPE OF WORK WILL BE COMPLIED $2,500 $1.25 WITH WHETHER SPE IED H €IN OR NOT. THE GRANTING OF A PERMIT DOES NOT P UM TO EIAUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS A Y O ER STATE OR LOCAL LAW REGULATING CON - Fire Fire SC $2.50 TRUCTIO T E;PF'ORMANCE OF CONSTRUCTIONPLAN CHECK FEE TOTALFEE License SC $5.00 $62.75 TOR OR AUTHORIZED AGENT MATEi WHEN PROPERLX VALIDATED THIS IS YOUR PERMIT ax 04 p u ,P DAT _ SIGNATURE OF pryNER iiF OWNER BUILDERi IDATEi -17 NEW CITY OF FRIDLEY ADDN ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: )", Tel. # MN LICENSE # 000.331,2 Tel. # �7,2J-61-V( Contractor: Address: 2-2 2 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: wn Effective 1/ 1/95 Z - Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot [ Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ �. Sc�o- Approx. Completion Date: 63 c) -S (Cost on Back) Driveway Curb Cut Width Needed: Ft. Ft = Ft x = $ DATE: APPLICANT: Tel. #—%4i/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge 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 $850 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 [ ] SUBJECT IT NO. City of Fridley 27738 AT THE TOP OF THE TWINS BUILDING PERMIT RE EIPT NO. � �46 ___ COMMUNITY DEVELOPMENT DIV. V �� PROTECTIVE INSPECTION SEC. �W 1 � I NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/14/98 JOB ADDRESS 6736 7th St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 5 1 Rice Creek Terrace, Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michell Wong Same 572-9151 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Trevor Foss Roofing Inc 5260 Lake Sarah Hts Dr Loretto 991-8619 20064313 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIF55357 PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (29SQ) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 $2,485.00 $1.24 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- W STRUCTION OR THE PERFORMANCE OF CONSTRUCTION, PLAN CHECK FEET AL FEE Lic SC .00 $83.47 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT MATE) HE ALI A D THIS IS UR P 1 B G INSP MPY V�l ATE 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 APPLICATIONS ConstructionAddress: �7 73 <p — � l/�l �iL,'Qt�� Legal Description: Owner Name & Address: Tel. # S ')Z Contractor:I, MN LICENSE # ��51� Address: 5z(w Tel. # tDr 1 A= to tAs 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: Construction Type: -e Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: CIll APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 9 ,'75-_ Fee Schedule on Reverse Side $ 2. YJ .001 of Permit Valuation (1/10th%) $ jjY $.50/$1,000 Valuation $ $1000 per SAC Unit $ 0 $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 [ ] $ f z ted&* Vin-enf" /'6 US7 CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES �� 3 C2 RATE SCHEDULE JOB ADDRESSOWNER ! ° I Il kdk WCL41 Q 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 Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 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. TOTAL ,,pp ` 11ro� BUILDING USED AS c� � .�llrtca $ 2/ ESTIMATED COST CNO PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units— Circle One (Steam) (Hot Water) arm ) $ Trade Namer'UQ Size No. 3�3 BTU i9Xn HP EDR $ Fuel N(-- Total Connected Load Burner Trade Name Size No. $ BTU HP EDR $ 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 "-On 13562 CENTRAL HEATING CO t ,r Signed m #�3 e 757 -C --xCa Approved By Rough -in Date Final Date g�Z c'cl COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the BTU Input Fan Assisted or Nat venting has been examined and is free from rust, deterioration, obstructions, BTU Input Fan Assisted or Nat and is securely supported and firestopped where required. Yes No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer Total Btu Input 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 ro ( ) 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) 13662 CE? RAL'' HEATING CO: ;o ,kV 49 r :' Signed By:�� r ti Date–�—®� :,ITY OF FRIDLEY INSPECTION DIV. 5431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK N11MRFR ()F FIXTI IRFS TO RF INCTAI I Fn nM r-er`u P7 nnQ Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** NO. RATE TOTAL Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS fA40fC it', duet✓ e - 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 Puilding Division, and hereby declares that all the facts .and representations stated in this application arg4.rue and correct. YOUNGREN, RONNIE 6736 7TH STREET NORTHEAST / 9'102, FRIDL.EY, MN 55432 - ' 20 (763) 502-0337 Owner Building Used Aso SSi Com, Estimated Cost PERMIT NO. 1 3S4 PLUMBING COMPANY j&/6I &:PIAS SIGNED BY TEL N0. Z-8Z7'4Op�3 T Approved By Rough -In Date Final Date3 / _ 0 oZ $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 $20-550 PLUS THE S.50 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 6pecifications.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 CV- (10 05 -00go — v CITY 0 DLEY BUILDING INSPECTION Effective 4/1/2004 9 3431 University Ave NE 9=ridley, MN 65432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION L 763-5723604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 9 b JOB ADDRESS U 2 3 Cc, S n RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) D Gas Range Gas Dryer Fee. Tota $35.00 $ $10.00 $ $10.00 $ *Air Conditioning -All Sizes $25.00 All Other Repairs or Alterations (List on Back) r 1% of Value of Appliance or Work $ A Minimum Fee $15.00 for Residential or 5% of cast of Y Improvement whichever is greater on work less than $300.00 i � Commercialfindustriat/Institutional r 1.25% of Value of Appliance or Work (List on Back) $ i Minimum Fee $35.00 for Commercialjindustriai/institutional Y State Surcharge .50 TOTAL FEE $'PS, Sid v REINSPECTION FEE $50.00/HOUR m*Air Conditioners can not be placed in side yard without written approval 1 + from adjoining property owner - copy to City FILL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Building Used As ESTIMATED COSTI 00 PERMIT Iso DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle One (Stearn) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No. EDR 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. CENTERPOINT ENERGY HEATING CO 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed Tel #763-757-6202 FAX # 763-757-6701 Date Approved by Rough -in Date Final Date Z0, d 77101 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verges that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (ID No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ()6 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 (�l No The existing combustion air is sized and installed to meet the current codes and manufacturers specifications. Yes (io 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 manufacturers specifications. This does include AGA -LAMA 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) CENTERPOINT ENERGY HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed By: ®A _Date ?.OI/pA' A TPVAJAL Ol A310I NA AO Al 1 O WON -1 CF: T t 0002-LZ-Nd8