Loading...
PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: .. ..•... .......................... Owner....................................... Address ...................................... No 3443 Builder (!d!... ....... ...t...... . ri Address ......................................... LOC#TION OF BUILDING No. . .!. Street .... .�.�.... .. Part of Lot ............ .. .. .. ... Lot .. / ..... Block ...... 0 ........ Addition or Sub -Division .. ...... ... ..... .. . Corner Lot .. ......... Inside Lot ............ Setback �. ®.. Sideyard .. a:..� ................ DESCRIPTION OF BUILDING To be 'Used as: Q , // p /� ,, ..... Front . 7'. 0. ®Depth 9 0< — ® Height J (' . � Sq. Ft. W /. X� Cu. Ft. °:.0 ��� -7 � �-- 0 @ay Front lam.. � :. � Depth R 0 :. "Height %Q� ® Sq. Ft. 1�.. Cu. Ft. 7 . Type of Construction ..... list Cost ..................... To be Completed ................... a r% 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 $.�.l. ., permit is hereby granted to ....... ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done In, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �j� .... ..'.?':'/....... Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate rpermits for these Item& ' OUSTS SVC AV P"WD; Too "IT via, o, A D t*, 4', 'OIAII'.��11"z __2 T& m Zia gi­ log AIR - 405 hit AW SO L 41 so -In lop old TWO NSA, ARK Asia" V VT� low W. its lot City of Fridley, Minn. N° 8 210 BUILDING PERMIT Date: July 4s 1965 Owner: ARCKE AUSS Builder ANDREW GAWER CONTRACTORS Address 501 — 63rd A'IE. N.E. Address 2407 Washington St. N.E. Fridley$ Minnesota Fridley., Minnesota LOCATION OF BUILDING No. 501 Street 63rd AVENUE N.E. Part of Lot Lot 10 _ Block 3 Addition or Sub -Division —Christie Corner Lot Inside Lot Setback _ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost $16000-00 To be Completed • REPAIRS DUE TO STORM DAMAGE 11 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 fo and in coin fiance ail provisions of ordinances the city of Fridley. _ �� In consideration of the payment of a fee of $ 10000 , permit is hereby granted to ARCS AUSS 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, Minnesotalocation, construction, alteration, maintenance, repair and moving of buildg ins rdinanceswithin city limits a� permit may be revoked at any time upon violation of any of the provisions of said ALLEN G. JENSEN Building Inspector NOTICE: Sic pamk don not cower t6 construclioe, lestagetioe for wbh* phnobing, gas hedIM saww or water. Be are to no die Wding lespoder fw aparafo poreft for those hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, M114NESOTA OWNER'S NAME BUILDER ADDRESS LOCATION OF BUILDING NO. STREET PART OF LOT LOT _,/ _DLOCR ADDITION OR SUBDIVISION 14 CORNER LOT�4 INSIDE LOT SETBACK SIDE -YARD_ SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; Type of Construction To be completed DESCRIPTION OF BUILDING Front Depth Height. Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft.'' Cu. Ft. Estimated Cost f a G 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). SUBJECT P?T1 City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT r8203 REC COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 i �� " �•� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY .---� L 612-571-3450 910-F15 9/11/85 108 ADDRESS 501 - 63rd Avenue N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 3 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ruth. Huss RM 501 - 63rd Avenue N.E. 571-2068 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Lloyd's Home Improvement 1012 - 4211 Avenue N.E. 788-5602 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof Dwelling. 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be X$ 2nd layer but not 3rd. Install ridged galvanized valley, 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 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 $1,400 $.70 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 ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $23.50 AN CHECK FEE TOTAL FEE $24.20 SIGNATURE OF CONTRACTOR OFAUTHORIZED T (DATE) � U - 'WHEN PROPERLYrftIDATED THIS IS YOUR P RM IT "='=:BT...G IS SAT ll &' SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: �4 �— �3 Legal Description: - Owner Name a contractor: ss : _.Qdz/1K, 0/ e:a: ;7e Tel. # s Z. , 1. ?J' • Tel. # a a Address: Z -a 7- �z a e 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: $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ / ® P/ Alt. A Alt B $ $ See Back Page for Explanation DATE:.J'-('� // APPLICANT: Tel. #�_ STIPULATIONS: CITY USE ONLY Permit Fee $ ••Z Fee Schedule on Reverse Side Plan Check $ 25$ of Building Permit Fee State Surcharge $ �% C� $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: SUBJECT . P of Fridley 30453 0City AT THE TOP OF THE TWINS B U I L D I N G P E R M I T i L AEeftPrW_0_- COMMUNITY DEVELOPMENT DIV. v __���_ PROTECTIVE INSPECTION SEC. ��� 1 1 ; � NUMBER 11EV DATE PAGE OF APPROVED BY 55 CITY HALL FRIOLEV132 �.__.11: '•� 612-571-3450 910-F15 10 /29/99 JOB ADDRESS 501 63rd Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 3 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ruth Huss 571-2068 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Eagleview Const. Inc. 2937 174th Ln NW Andover 55304 753-5469 20067043 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION iU REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 24 SO Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the 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 SQ. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 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 $2098 $1.05 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- $83.25 Fire$2.10 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION AC PLAN CHECK FEE License $5.00 E TO;;�/.4 $ 0 AfGNATUWE OFCONTRACTOR ORAUTHORIZED AGENT IDATEI N P OP LIDAT HIS IIs YOUR F O S-GNATURE OF OWNERIIF OWNER BUILDER, IDATE, BLDA INSF' qAt NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ,\ Construction Address: '50/ Legal Description: Owner Name & Address: utSS Tel. #�/—®� d' Contractor. �� �6 N' _ MN LICENSE #6 70 `f Address: q 3 q Ltie Vy Tel. # 75--3 SYS 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: Construction Type: � yp /.l�c�v+;/�, ,e rCeiv�.I� � o G�Estimated Cost: $ �Y �, ,� (�9� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ ME DATE: J O 2 APPLICANT: '� Tel. # Permit Fee $ c�3- �f Fire Surcharge $ / b State Surcharge $ /. OS - jSAC SAC Charge $ License Surcharge $ . Q 0 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 $1050 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 [ ] J SUB.IEct PER O. City of Fridley 32139 AT THE TOP OF THE TWINS P, BUILDING PERMIT Ir RECEIPT NO. COMMUNITY DEVELOPMENT DIV. SEC. �s��o�® PROTECTIVE INSPECTION ICITY HALL FRIDLEY 55432 NUMBERpEV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 9/6/01 JOB ADDRESS 501 63 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 3 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mary Huss 501 63 Avenue NE 763-571-2068 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Pella Windows & Doors 15300 25 Ave N STE 4100, Plymouth, MN 55447 763-745-1400 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20165884 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Replace 15 windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Permit Inspection Cards Will Be Bailed TO Homeowner To Post SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING. TYPE 00 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 ABANOONEO 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 $11,590 $5.80 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 $209.25 Fire SC $11.59 PLAN CHECK FEE TOTAL FEE License $5.00 $231.64 SIGNATURE OF CON"RACTOR OR AUTHORIZED AGENT IOATEI WH PROPERLY VALIDATED THIS IS YOUR PERMIT c?— S-GNATURE OF OWNEROF OWNER SUILDERI IDATEI INSP - rjATt J NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAldnLY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: co3i`� i,W . �• 4t - Legal Legal Description: Owner Name & Address:'Tel. # ' ��" • ao(Gg Contractor:, PELLA WINDOWS & DOORS MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: Construction Type: 15300 -25TH AVE. N. STE. #100 PLYMOUTH, MN 55447 763-745-1400 LICENSE #20165884 Survey. Of the �_..Aonitto scale. DESC UY-RDN OF IMP -ROVE . Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. D- -&- - Ie- t t — - - .-I I' . Tel. # Driveway Curb Cut Width Needed: A t r`u Estimated Cost: . $ 111,h ) R. + 6 Ft = Ft x $ 1W DATE: ON- o APPLICANT: Tel. # '159-3 -W q Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge, CITY USE ONLY $ a 6 ! Fee Schedule on Reverse Side $ • S .001 of Permit Valuation (1/10th%) $ �jr. $.50/$1,000 Valuation $ $1050 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 [ ] TOTAL $ a J 1 L04 11�,T STIPULATIONS: CITY OF FRIDLEY PERMIT NO.: 200402122 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/18/2004 ` (763) 572-3604 FAX: (763) 571-1287 M� ADDRESS : 50163 AVE NE (; 0'1 V PIN : 143024420038 LEGAL DESC : CHRISTIE ADDITION LOT 10 BLOCK 3 PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM NOTE: AIR CONDITIONERS COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. ADJOINING PROPERTY OWNER. # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES 0 # GAS WATER HEATERS I # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 300 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 0.00 0.00 NORBLOM PLUMBING CO GAS RANGE FEE 0.00 2905 GARFIELD AVE S 0.00 MINNEAPOLIS, MN 55408-2173 GAS DRYER FEE (612) 827-4033 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 WATER HEATER - GAS TOTAL 35.00 35.50 OWNER HUSS RUTH ANNE PAID WITH CHECK # 29428 501 63RD AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions 9f any other state or local law regulating cbnstruction or the p orman a of construction. Applicant Date Bldg Insp—�e? Dat SEPARATE PERMITS REOUTAD FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MAKrc NUMM:K OF FIXTURES TO BE INSTALLED ON EACH FLOOR $10.00 Beer Dispenser $10.00 $10.00 Wash:F Tray Drain �::::::: Auto. -`"� ��• Washer .:�... �:::::;: Gas�.= Range t Heater StonesUrinalShower � Gas Elec Basement ment Water Heater -Electric $35.00 Water Heater - Gas*" �_ $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Floor 1 I I Floor2 Flour 3 Floor 00 4 PLUMBING FIXTURE RATES: NO. RATE- TOTAL JOB ADDRESS 6rAn6&& • &S oW NjnI- New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas*" �_ $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes ( ) No Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance 35. M State Surcharge $ - tZ TOTAL FEE $ -3ESb 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 OWNER HUSS, MARY 501 63RD AVENUE NORTHEAST FRIDLEY, MN 55432 (763)571-2068 BUILDING USED AS k&,51 J e "C -z ESTIMATED COST q6 LI oo PERMIT NO. PLUMBING COMPANY NO O r U O W� 29 20±y NJ SIGNED BY TEL NO. I nn 12) 927-clo.33 Approved By. AQ Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS S15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. 4 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITa COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 existina 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., --ft 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( ) Apollance 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 : 4 Li ulluiii , lig U 11-J.0111k7 renmt No.;©(a --61 l G _3 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: �t '�' do 761-S01-4977 FAX DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR TT ATTT Tt7 !�\S /1►TTT / TENANT ADDRESSk_ 4r 3V A"e CITY / o STATL�tl�fj PHONE: CONTRACTOR NAME: y� f206 6 lam'/ N SUBMIT A COPY OF AND CERTIFICATE OFADDRESS: ,6 = CITY" STATIC ZIP INSURANCE PHONE-�e� /'® d - 73 " FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES DTV AIUrTT TVDF n AT)T1MnW n (.AR AGFNT-WT) n wTNTX1wC y ..... 1Ly ❑ DECK• IDING® ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING TIRQrVTAR 11117! AFTAT(: TY\NF- SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING p ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES?— ❑ HOUSE & GARAGE I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans wMinnWC i FnPrw ralr•nlatinnQ OR FOR NEW OPENINGS -DESCRIBE SIZE OF y MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) Permit Fee Plan Review Fire Surcharge Surcharge Ll vt' su J SAC Charge Curb Cut Escrow Erosion Control Park Fee Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $5.00 $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering to: Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in at ordance with the approved plan in the case of a},1W Work which requires review and approval of pl._� � , d SIGNATURE OF APPLICANT _ F�, � PRINT NAME ��-> r - DATE APPROVAL INSPECTOR SIGNA O� L PLEASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING. ELECTRICAL AND MECHANICAL WORK