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0 -W City of Fridley, Minn. 11 BUILDING PER Wr N® 3626 Date: .,(.. . .. ........ � ...!�........... Owner ....................................... Builder<ZZ?f................ e Address ....................................... Address ............................................. LOCATION OF BUILDING No... /..�,. Street ........��.i�!�.... Part of Lo ... . ...... ............ ...... Lot Block .... %........... Addition or Sub -Division .. . .. . .. .. .. .. . Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING To Used I c ry f/ ... Front: Depth r? t: O .� Height I*V. ! �. Sq. Ft. ? 1 t? . Cu. Ft. e........ ....741*&r*J nt ........ Depth ........ Height ........ Sq. Ft. .......o t. ' CFt. .... of Construction ........ Mit. Cost. /�.roi . To be Completed G:,.................... In consideration of the issuance to me of a permit to construct the buil ng desribed above, I agree to do the proposed work In accordance with the description above set forth in compliance with all provisions of ordinances of the city of Fridley. ,, �. �.. ° ..�.. In consideration of the payment of a fee of $./rn— , 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. ... A ........ 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 permits for these Items. City of Fridley, Minn. BUILDING PERMIT Date: Owner: 61r' t Builder Address Address N° 4827 LOCATION O BUILDING Street Part of Lot ........... .._.._. _.... .......... ........ __...._ Lot ....._........ Block ...............''F................. _........ Addition or Sub -Divi on ....._..... _-•------_....__.-----_._..--_---- y Corner Lot .................................... Inside Lot ..... _............. .................. aetback A .... Sideyard .......................................... Sewer Elevation --- _......._...._.._:.._...._._.._........... ..... ..................................... Fpfniiation Elevation _..._-------...__-. _. _. _------ DESCRIPTION _. DESCRIPTION OF BUILDING o.Used _.. _..fir -• �.------- Front �'...__ Depth #�.-.. Height �..,�" .:....._.. Sq. Ft. 4Y-4 ---4 Cu. Ft..- -•--•--.�.r. _....-....::.. ....... ..........................DepthEst. Cost...... Height .......:..........._.. Sq. Ft. ..................... Cu. Ft. ......... ............... OtJ- Type of Construction .---.. �.... ._.. e .............:-.. To be Completed ..-__...._..... -----..---- G��T1®� PRIZE V101-A�. ERMIT p�� p VENAI�TS A�10 ION OF PAN( R GT DIES. gU1LpING 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 city of Fridley. ,_ In consideration of the payment of a fee of $. _____..., permit is hereby granted to. ... _.... ..................... _. to constructthe 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 within the city limits and this permit may be revoked at any time upon violation .o any of the provisions of said ordinances. . - _ Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, Bas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. - 10 OM04 0 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name G Ca �J Builder t� +�+ ��►[��� �� . Address `/ — _3 A&E /'Y.� Address ,,lqli:� jj LOCATION OF No. �'/ Street 7, C /� j$4rt of Lot Lot Block . Addition or Sub.Div. �_,,, Corner Lot_.Inside Lot Set Back _ % �—� Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. ESCRIPTION OF BUILDING To be used as: %qax� Front 126 Depth ? height�.,. Sq. Ft. 4.16 Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft, Type of Construction®_ Estimated Cost 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 Ordinances -and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. DATE J - i� ® SIGNATURE (A Schedule of Fee costs can be found o A I b" 15; 4�,p - 4 - 2. -%-o S= Zo x BLOCK ADDRNISS VALUATICK ADD. TYPE ...... ..... . ...... ....... .... ...... .. .... ........ .......... ............ ........ .... . ................. . ................ . .. ... .................................... ............................................................. '0 N. 0 -j E e ---t r -I c, A ................................. , . e -0--i . , . r . ....... .. 11 ........... ... .. .... . PF 9 for Pewer Plants and Hea ft Cooling, Vessalion. Reif "raftn and Air Conditioning S"eeis and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: ]RATE TOTAL Furnace Shell & Duct Work ... .... I . ..... .. $10.00 $ Replacement of Furnace ..... . 6.00 Repairs & Alterations—up to $500.00 600 Repairs & Alterations each add. $500.00 3.00 MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ...... . $10.00 $._ each add. 60,000 BTU .................... 3.00 i Replacement of Furnace . .. ... 6.00 $ Repairs & Alterations -up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 &00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft, EDR Steam $10.00 $. _ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam vm Each add. 320 sq. ft. EDR Hot Water 3,00 $— OIL BURNER—to 3 gal. per hour 6.00 $ — over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 199.000 BTU) I ...... 5.00 ; area 199,000 BTU See Fee Schedule GAS FITTING FEF.B: NO RATE TOTAL 1st 3 Fixtures x$ 2.00 $ Additional Fixtures a .75 $ Gas Range to 199,000 x$ 500 ; Dept. of Bldgs. Phone MO -M 7&c/—G.3eL-e City of Fridley: The undersigned hereby makes application for a permit for the work herein 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 facts and representations stated in this application are true and correct. Owner Kind of To be completed about __._ _ t Z d Estimated Cost, $_--___..7 Oew. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER P1.ANTS--Steam, Hot Water, Warm Air—No Trade Name Size Ne. Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No AIR CONDITIONING �d� Capacity Sq. Ft. E.D.R BTU IMP. FAN HEATING SYSTEM T86"aFee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ; S ROUGH (SURCHARGE _.50) By Business Phme N � ' 5�r (REMARKS -OVER) �� ze 5��� SUBJECT City of Fridley WPEMI 14656 AT THE TOP OF THE TWINS BUILDING PERMIT r i � ECEIPT NO. `� ----__ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. t CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 812-580-3450 910-F15 14/27/78 JOB ADDRESS 764 - 63rd Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert W. Cuddih 764 - 63rd Avenue N.E. 571-2216 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 121 x 101 Deck 9 CHANGE OF USE FROM TO STIPULATIONS Call for footing inspection before pouring concrete. SEPERATE PERMITS REQUIRED FOR IWIRINa WARNING HEATING,'PLUMBING AND SIGNS. Before digging call local utilities TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Redwood 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 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. $3255 $.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 LOCAL LAW REGULATING CON- $7.550 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $8.00 SIGNATURE OF CONTRACTOR OR AUTHORIZE AGENT (DATE) ! WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT V- �t1, 7o Z / 7 BLDG 11 PATE SIGNATURE OF OWNER (I OWNER BUILDER) IDATEI •' CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEIMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER:rl �e v W C BUILDER: SL✓' Address: /V c Address: _e;a -e_ Tel. No.: No. Street:&3v-l.- �v-E- E LOT: BLOCK: ADDITION: 4r-,Lj k- 1.5 1, e-_ CORNER LOT: INSIDE LOT: t--' SETBACK: SIDEYARDS: Applicant attach -to this form ZNoo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: e -_ Front: / ` Depth: /� / Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: I 00 Type of Construction: e- cJ Estimated Cost: $ 32-1 To Be Completed: �„/ y' I1 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, 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. See reverse side for additional information. DATE: /Z17S SIGNATURE: Stipulations: P TV 13 suedEcr PER City of Fridley • 146'78 AT THE TOP OF THE TWINS PERMIT i BUILDING EIPT ` r ; Tr ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 812-560-3450 910-F15 5/5/78 JOB ADDRESS 764 - 63rd Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Cuddihy 764 - 63rd Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Custom Pools Inc. 701 Excelsior Avenue 933-2255 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 ElADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a L8' x 36' Swiming Pool 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on letter dated May 5, 1978 by Environmental Officer. 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 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, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,500 $4.25 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY THER STATE OR LOCAL LAW REGULATING CON- STRU ON ORT E P FORM�F CONSTRUCTION. 51.00 PLAN CHECK FEE TOTAL FEE (�L $55.25 S NATUREO CONTRA TOR ORAUTHORIZE DAGENT (DATE) WHEN PRO ERLY VALIDATED THIS IS YOUR PERMIT DATE GNATURE OF OWNER IIF OWNER BUILDE (DATE) t 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 1978 Custom Pools Inc. 701 Excelsior Avenue Hopkins, AST 55343 Swimming Pool Construction at 764 - 63rd Avenue N.E. Dear Sirs: This letter is to make clear this departments requirements for the swimming poolconstruction at the above address. I. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, two (2) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6-8 hours. S. A deck of at least three (3) feet wide, measured from the pool water's edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. The diving area will be acceptable provided there is no overhead obstruction. 7. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: (a) The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. (b) The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. (c) Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. 8. An automatic chlorinator should be provided with a suitable test kit. 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. Custom Pools May 5, 1978 Page 2 10. All electrical lines must be 10-20 feet or more away from the pool* surface - 11. The pool fill spout must be air gapped or protected by a vacuum breaker. 12. .:Suitable safety equipment to include but not limited to a ring buoy and rope that is lh times the pool diameter and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is.approved contingent on final inspections and approval by the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450, ext. 170. Sincerely, S JO/mh CC: Mr. Robert Cuddi.hy. 4 CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEIZ14ITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) BUILDER: �- £ ®:�.5 Address: �� Z Address: :Z0 f Tel. No.: 2 3 7� — No.: Street: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: Appl.icart attach to this form T.-io Certificates of Survey of Lot and proposed • building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: j k Q Front:_ Depth: j Height: j Square Feet: Cubic Feet: 'Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ f5co To Be Completed: ' 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, 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. See reverse side for additional information. DATE: / 7 _ SIGNATURE -:7,i _ _- Stipulati i <� IL J' 00 6�, ops , ' p,4 B �G �"V%� �.� .fir, .f��•S d'�/ �� PA 24" CLEARANCE r OVE FILT0 'A' FILTER --,-- DIAMETER 27" t:.Xa t���JTH CIIALATROL VALVE - .. To v1BSTE AIR RELIEF AND PRESSURE GAL'S e s rti: r u 014"" { 1 1/2" POOL F.ETV-P.N f l PUMP SUCTION I STRUCTURAL FOAM SKIS) • N1ITIT J.B SELECTION DART CAT�LCGI,ODEL WUdNU".ICER FILTER AREA (dfl. FT.) FUMP Il.P.�6J ! PATr 0. FT. i TUrN®VER 1; —(1 C:APACIT4-5 +8 Rs. - 24735-216 ;IRSD-16 1.4 •1/2 21 I 1260 7,51-0 10,001 12,603 1611 33 ' 20 16--0 10,090 13,440 1G,CZO 2040- 24741-224 HRSD-24 �)2 3.1 3/4 1 33 1980 11,800 15,840 19,800 201 24n 37" 41" 47 A4 2340 2023 15, 16,920 22 6"400 28,200 2 741 m9 4 1 1 62 3720 22, 0 27,760 3;,203 GMERAL NOTES: 1. Flow rates shown are .rased on 15 and 10 G.P.M. per sq. ft. of filter area. However, rates may vary from 10 to 20 G.P.M. per sq. ft. as desired. Tlq ons tics Tqt ea, orasa"a AMAW Ta w 4T 1= vUrAm lUae WATUM6 e o air TPPrB. ra+ erg, amo. en rsar.:a. saw. 3,x33 vsa unwu No Lo.,, csrm esi. eserm4 r"er ri.iwJ 39141'.WN COLVA M. Mo. The filter tanks and DUMP L unitrol valve as.: appro.-ed by the 4ational Sanitation Foundation. These filters are covered 6y the follm+ing patents: Australia Pat. No. 275,346; Canada Pat. ho. 722.''19; Great Britain P;.t. No. 034,797; Aexieo Pat. 11). 79.x77; South Africa Pat. I;o. 1100/G5. VERTICAL HI -RATE (SKI® UNIT) HRSU SERIES W/®IALATR®L VALVE - � JUP1rIi,'773�s�- CITY OF FRIDLEY 1 0 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND each add. AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE Furnace 7.00 ` � ' "- � GRAVITY WAIM AIR: RATE TOTAL Job Address ���� Furnace' Shell & Duct Work $12.00 $ up to 100,000 BTU Replace ent of Furnace 7.00 7.00 $ $ Department of Buildings Repairs & Alterations -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 6.00 OIL BURNER- to 3 Tel. #571-3450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTL' $12.00 each add. 50,300 BTU 4.00 Replacement of Furnace 7.00 Repairs & A1LerdtY6ns-up to $500.00 7.00 .'e airs & Alterations each add. $500.00 4.00 STEAM OR HOT {ti aTiR SYSTLM : Boiler &Lines up to 100,000 BTU $12.00 each addn. 50,000 BTU 4.00 Boiler only up to 100,000 BTU 7.00 each addn. 50,000 BTL` 6.00 OIL BURNER- to 3 gal. per hour $10.00 each add. 3 gal. per hour 10.00 GAS BURNER- frog 100,000 BTU to 199,999 BTU $10.00 (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures _L x $ 3.00 Additional Fixtures x $ 1.00 Gas Range to 199,000 BTU x $10.00 :IR CONDITIONING FAN HEATING SYSTEMS See Fee Schedule VENTILATING SYSTEMS - ALTERATIONS $ REPAIRS State Surcharge TOTAL FEE ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. Date APPROVAL FOR PEFU%SIT MINIMUM FEE FOR ANY HEATING PER:4IT IS $7.50 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 and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. OWNER KIND OF USED AS Fridley, Minn. 17-5 192-0 TO BE COMPLETED ABOUT -- ESTIMATED COST / V© OLD )NEW BUILDING PERMIT NO. PERMIT NO. $ �,�� DESCRIPTION OF FURNACE/BURNER $ HEATING or POWER PLANTS, Steam, Hot Water, arm Air- No. $ Trade Name 42,0 [%�' 7 Size No.('7 $ Capacity A Ft. EDR BTU , HP $ ,6 $ .50 Total Connected Load e5 7i S;? / Kind of Fuel ���� Size No. c� BURNER - Trade Name - Capacity Sq. Ft. EDR BTU_ HP Company Signed By 7F:44 Tel. No. A, kw°i,lj', V, A 51, 1 MMANT 5!! 'Won I tut,Wan Rw 7-77 Rom. Leaptflit F.L land ARBA .;Wl WS aid DOORS CRAC tgad; AAlit►' o NO. ofo15131% 1 11 bhp =I 63 V,grOX cosif. Btu. Coat WWOM I'M ' Wall NO Wal} W. wen co"Ing or "Cor -ratal, aw D. L -Or sqlljiw W. A."itallf ordlikIt"vired !9. ft. L D. L or sq, tus. W.A. LaoOipr area em to Width "a Room Leeglh Wah Hight RNWOWS, ii*d 0001tv A— 4L4jl*Af*'.jW AR WINDOWS and DOORS cmuc eVoiWARFA Ax" No, eitb ata v , -j' Btu. Ifu. wF"3;Q *70 JLT—pq, wan Wwa 7 — -5 111-7 lo. wail —f 060M Flow "o Coln g or Floor Tow Btu. eq. ft. L D. L or sq* Ins. W.A. Loader area R"Utrad eq. ft. ED L or sq Ins. W.A. Leader area t Rom I Length Width Height FL Room Length Width Height "d DOORS cc AREA is!� WINDOWS and DOORS CRACKAGE and AREA No. No- a, Area of p.. ll9hh uneal ft. of I so. N. ,"of Height No. of of of pulb Robb "54:114, S4 I I- I Rd Coof. Btu. Ce. f. io4iiibmi wm Infiltration 5"—, Won Net Sip, Wall Int. Wan Jw. Apoffal, or Floor Total, $ft. a% AfL L D. R. or ig.. In. W. A. Leader area virad ft. L Q. R. or sq. Ins. W.A. Leader area eow - I - Ion GRAND TOTAL_ SUBJECT PERMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. INSPECTION /y r PROTECTIVE SEC. 1 ` CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/18/87 JOB ADDRESS 764 - 63rd Avenue N. E. 1 LEGAL LOT NO. BLOCK ACT OR ADDITION TRChristie SEE ATTACHED DESCR. 5 9 Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Cuddihy 764 , 63rd Avenue N.E. 571-2316 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Fred Cool Construction 3929 Dakota Avenue, St Louis Park 929-5265 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 Enclose rear stoop 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan Before dig-gUlg 11i 40 calf lQCa! TEREPHONE. ujllifies SEI�gRAT PERMITS RE FOR EtE . REQUIRED �''E �:� �r �u�� A Y CA AND SIGNS. 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX GOVERNINGAND ORDINANCES THIS TYPE $4,500 $2.25 WITH WHETHER SPECIFIED HEREINOR NOT. THE GRANTING OF AO PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE ORLeOL LAW REGULATING CON- $50.50 TRUCTION. ZRZ7;�77 PLAN CHECK FEE TOTALFEE $12.63 $65.38 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY V IDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI LDG INSPSATE NEW [ ] ADDN. ALTER./k[ ] Construction Address: Legal Description: /,� Owner Name & Address: l " Contractor: �F Address: �/il�/ ©A City of Fridley �R-1 AND R-2 Building Permit Application Effective 4/1/86 Tel. #',S -2L -,23Z4 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. X20 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: /f?� ?&,P-�/t%L'�©� C-0 Corner Lot [ ] Inside Lot PQ Ft. Yd. Setback Side Yard Setback � 64evei2em£ Cost: $ Type of Construction: leg, Estimated Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: Aj $ $ See Back Page for Explanation DATE: �� �_ APPLICANT:���©©G ( iSd9S Tel.�/��/'�Z�e (� CITY USE ONLY Permit Fee $ �,�GV Fee Schedule on Reverse Side Plan Check $ )ti.. Cal 25% of Building Permit Fee State Surcharge $ $•50/$1,000 Valuation SAC Charge $ _ $ 525 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS. v ��o a V r------- N ------ I- -- - - . ka cn yt) r------- N ------ I- -- - - . cn x C) ke; CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 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) 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 August 1, 1995 JOB ADDRESS r7& q 63 1() /gVtfl tLL A) - JE The undersigned hereby makes application for a permit for the work herein Rate TOTAL specfied 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 $ 30.00 $ representations stated in this application are true and correct. ,1995 $ 10.00 $ OWNER Q $ 10.00 $ BUILDING USED AS $ 10.00 $ ESTIMATED COST 1100, PERMIT NO.�� $ 25.00 DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load State Surcharge TOTAL FEE .50 MINIMUM FEE FOR ANY HEATING/COOLIBVGIVENTI_LATION REFRIGERATION/AIR CONDITIONING _PERMIT IS_ 25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Burner Trade Name BTU HP Size No. EDR BLAINE MT(L A►C & ELECT. INC. HEATING COM ANY UM CENTfkAL AVL N.E. 552164 Signed. By I No. q 5 �—U eJOD Approved Rough—In Date Final Date L *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE 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: CHIMNEY AND STACK VERIFICATION The undersigned heroy`verifies that the existing chimney or stack: d ':: ynl9&.4 1. Has been ca�g441,}+ examined Yes ( ) No ( ) 2. .per Is free from ,or deterioration Yes ( ) No ( ) 3. Has no forei =4�%ects lodged within Yes O No .( ) 4. 4 Is securely suited Yes () No ( ) 5. Meets a current 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: sue�Ecr P NO. City of Fridley 2 714 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. ` COMMUNITY DEVELOPMENT DIV. ______ tr r PROTECTIVE INSPECTION SEC. ����® NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/12/98 JOB ADDRESS 764 63 Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Cuddih 571-2316 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Remodelers 99014 794-26461748 CustomMWAWMXR Tne 474 Apollo Dr TAno Lakps 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 1X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 23 S Tear -off; reside house (5 Sq) 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. Call for building wrap inspection before covering. 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 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 ISTALLS 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 18 $2.96 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PR ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- S RUCT ON OR THE P FO ANCE OF CONSTRUCTION. $112.25 Fire SC $5.92 -a PLAN CHECK FEE TOTA , EE n ` . 6 13 SIGNA F ACTOR OR AUTHORIZED AGENT IDATEI N POP A IDA HIS IS IR PER IT SIGNATURE OF OWNER OF OWNER BUILDERI (DATE) BLDG INSP DATE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: ' Contractor.4�.s Address: Tel. # MN LICENSE # 7 S0 /�/— Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Alou_ 23 l Construction Type: Estimated Cost: $ & (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. #�� CITY USE ONLY Permit Fee $ l - U —Fee Schedule on Reverse Side Fire Surcharge $ 9,2 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ UO $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: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432, 6 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2000 PLUMBING FIXWAE RATES: NO. RATE New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas" 0 $10.00 Gas Range" $10.00 Gas Dryer"` $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge -7 3 "-'o TOTAL JOB ADDRESS TOTAL FEE $ ZC .50 The undersigned heresy makes application for a permit for the work herein specified agreeing to do all work in stria 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. 20-00 Owner ROLX-� LLd=d.1 Building Used As Estimated Cost 5(00 .OU PERMIT NO. )-3c)67 LEE STULL PLUMBING PLUMBING COMPANY 905 -SI -1 t4 c =4 -'N RhVft ANOKA. MN SWIM SIGNED BY _h _. 411-8158 TEL N0. Approved By Rough -In Date Final Date /d -dd -0 / COMBUSTION AIR -SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE �C G7YOE FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 October 17, 2001 Mr. Robert Cuddihy 764 63 Avenue NE Fridley, MN 55432 Re: Final Inspection at 764 63 Avenue NE Contractor: Lee Stull Plumbing Dear Mr. Cuddihy: A plumbing permit was issued on November 20, 2000 to install a water heater at your address. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Plumbing Code. 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 expire the permit and no further action will be taken. To set up the inspection, or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DAVE Building DJ/mh v SuB.,Ett MIT City of Fridley 32692 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. ' 1I V ------ COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. "I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 6/13/02 JOB ADDRESS 764 63rd Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 9 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert & Marilyn Cuddihy, 764 63rd Ave, Fridley, MN 55432 763-571-2316 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Patio Enclosures, Inc., 2123 Old Hwy 8 NW, New Brighton, MN 55112 BC -1676 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP 763 PHONE -2316 LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK OX NEW O ADDITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct sunroom. 9 CHANGE OF USE FROM TO STIPULATIONS See notations on building plans. WARIVING Before digging Call for all Utility location SEPARATE PERMIT S 454.0002 REQUIRED FOR: "IFOUARIFID CAW WIRING "EARNS, LUMB1196 AND SS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING. TYPE OFCONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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 @ $3,914.40 $1.96 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- $97.25 Fire SC $3.91 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION oo PLAN CHECK FEE TOTAL FEE ,. 0 �,1 ) (v � �_ License .00 $108/2 1- SIGNATURE OF CON'RACTOR OR AUTHOR1AGENT IQXTE. N OPERLY VA ATED TH IS YOUR PERMIT _ I BL NSP qAt S-GNATURE OF OWNEROF OWNER BWLDERI .DATE, NOV-04-1999 11:05 FROM CITY OF FRIDLEY TO 6516312521 P.01i02 NEW ( ] Effective 5/10/99 ADDN CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Z& Y lo; ,& Ate • � E. i`r dJ-e L, , JJAl 55 V 3 Legal Description: Owner Name & Address: Aero' * 14a (, u n Curj Lbq Tel. # 7& 3 - 571 -A'?) (99 Contractor: Tal /70, �/� C�d (2rPs , �O- MN LICENSE #OC " 16 7 Address:_/Q3 ®b 9 /101a , Ne,j Ali Ch&a . 41 k S_'s/i'-�L Tel. #7� -:571 - 0,3)b Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EVIPROVEMENT LIVING AREA: Length / C r Width /,;z Height Sq. Ft. 42 0 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width I%/Ground Sq. Ft. OTHER: c h4�� /�� �O > 7 �� Construction Type: S u n roe Estimated Cost: $ as -1 1 L), yd Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Jt.;2 0 ;?- APPLICANT: Tel. # -� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control 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 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ICA % d 0. 1A STIPULATIONS: 0 05 4 q htiecLivu January I, 1003 CITY OF FRIDLEY INSPECTION DIVISION ��� TM /� 6431 University Ave NE V -�''1 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, - (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287V/ JOB AP4 I �0, ;� 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 OWNER C_Q 1 GL V_1 Rate TOTAL V-71LX5,0? 6 � BUILDING USED AS ESTIMATED COST X0-00 PERMIT NO. $ 10.00 i *Air Conditioning -'All Sizes $ 25.00 6 All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work 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. R DESCRIPTION OF FURNACE AND OR BURNER No. of Heatin Units i Circle One (Steam) (Hot Water) Warm $ Trade M e� VAC Size No.BTUEDR $ Fuel Total Connected Loyd $ $ .50 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 rulings of the Building Division, and hereby declares.that all the facts and representations stated in this application are true hd correct. n DATE H EATI Signe) FAX # Approved By Rough -In Date Final Date f FILL OUT BACK SIDE FOR STACK VERIF CAT ON ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILLBE RETURNED rnmMnN VENT LENT rnK1NFGTnR ANn MUIRI ISTIQN AIR VFRIFICATInN When mnla _ina an existrnn fiwanep, th4*undersigned hereby verifies that the venting has-been examined and is free #rom:rust, deterioration, obstructions, and is:securely supported and firestopped where required. ' Yesi N ( ) The venting system is plastic tPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes o ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does indude AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) The aYr-hnffn0 rnmh mffnn sir is sized and installed to meet the current codes and manufacturer's spedfications. Yes (,j)No ( ) (11./When required to i c+ail a n _w _nmb ms+inn airs it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ((�No ( ) When in-atallinn a naw vary6nn qVztem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. "Yes fo 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. Yes6�4o ( ) Appliance #1 Type�'(A1L� BTU Input Appliance #2 Type BTU Input Appliance #3 Type BTU Input Total. Appliances Total Btu Input Fan Assisted or Natal-�:�)k L_ Fan Assisted or Nat Fan Assisted or Nat 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 Al TFRATInNS- (nAneA al HEATING CO: - 1 x. ----- _ FEB.23.2006 8:53AM SELA ROOFING SALES NO.860•.r••.xoP.2/4 NEW [ ] Cl rY OF FRIDLEY ADQN [ ] 6431 University Ave NE, Fridley, MN 55432 763 Effective 1/1/2004 ad ALTER [ I SINGLE FAMILY AND pUPt,EXES R.1 AND R-2 - '763) 5 1-i4 7 Paxg Insp BUILDING PERMIT APPLICATION Construction Address: % Ir y d31- A Legal Description: Owner Name & Address: __tJ14-A Contractor: -- ! d d y Tel. ;?S:9- S7—. y/ MN LICENSE i Address: SWA WQFW & Tel. t 4100 EXCELSIOR BLVD- SELA ROOFING & REMbDELIFI� Qf MMK a Certificate of Survey of the 4100 EXCELSIQE aLVV'• v VtWjV sed construction drawn on it to scale. $T LOUIS PARK, MN ,SSI Ijr. ID #W01050 DESCRIPTION OF IMPROVEMENT d12- - XZ -1 Zo LIVING AREA: Length Width , Height_ Sq. Ft. . GARAGE AREA: Length - Width Height `� Sq. DECK AREA: Length Width HgtJGro4hd � Sq,,: t OTHER: Construction Type: v fZ �% dse Estimated Cost: s_____ Driveway Curb Cut Width Needed: _Ft. + 6 Ft = Ft x $ DATE: Z PPLICANT:,,-�� :2s -777J ' Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 it rising edit card n7w d will call you for card number, . Permit Fee Fire Surcharge State Surcharge SAC Charge license Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ TOTAL $ e 1 CITY USE ONLY - --�— Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50!$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Cor I Rctors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ) Not Neces; , ry [ ] STIPULATIONS: