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PRE 2010 DOCSFj SUBJECT PERMIT City of Fridley 12160 AT THE TOP OF THE TWINS BUILDING PERM I T i `L ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ��r 1 � NUMBER REV. DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 L'-'• ,'� 612-560-3450 910-F15 6/5/73 JOB ADDRESS 25 - 63rd Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 16 1 Fridley Park Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr. Lewis Doyle 25 - 63rd Way N.E. 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 IV NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' by 24' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. SEPERATE PERMITS HEATING, RE PLUMBING AND t°�IRINUI SIGN SIGNS.[ TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 576 5760 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 $2, 6O9 1.30 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTH TATE OR LOCAL LAW REGULATING CON- $11.00 STRUCTION R THEePE RMA C F ONSTRUCTION. PLAN CHECK FEE TOTALFEE $12.30 •- SIGNATURE OF CONTRACTOR ORAUTHO ED AGENT (DATE) WHEN PROPERL IDATED TJiIS IS YOUR PERMIT S. BLDG INSP f DATEF SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) Fj 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 812)571.3450 Nf� OBSTRUCTION: Lot Block Property Ow-er-.',ddress Z S 6,3 9- i', i �3 RECORD OF COM11I1,�ICAT NS : 2. CITY OF FRIDLEY INSPECTION DIV. 5431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON FACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. ® iQ ® New Fixtures �Y�I� 4. ® .si '•fig W�ii[i� Beer Dispenser $ 5.00 ®•Q — r �® and ref and correct. Catch Basin $ 7.00 DOYLE, LEWIS Rain Water Leader $ 7.00 25 63RD WAY NORTHEAST 2001 Sump/Receiving Tank $ 7.00 FRIDLEY, MN 55432 (763)571-3280 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 'i Water Heater - Gas** _ $10.00 Building Used As `e6 w4y1Y cz Gas Range** Gas Dryer** $10.00 $10.00 00 f� Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 (� PLUMBING COMPANY Q�}-1 / Z,(1/✓j� C-6 Reinspection Fee $47.00/Hr SIGNED BY TEL N0. Zr a ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance a Approved By Rough -In Date Final Date PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 5})VC Ots 6WO e— New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the-13.uilding Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and ref and correct. Catch Basin $ 7.00 DOYLE, LEWIS Rain Water Leader $ 7.00 25 63RD WAY NORTHEAST 2001 Sump/Receiving Tank $ 7.00 FRIDLEY, MN 55432 (763)571-3280 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 'i Water Heater - Gas** _ $10.00 Building Used As `e6 w4y1Y cz Gas Range** Gas Dryer** $10.00 $10.00 00 f� Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 (� PLUMBING COMPANY Q�}-1 / Z,(1/✓j� C-6 Reinspection Fee $47.00/Hr SIGNED BY TEL N0. Zr a ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance a Approved By Rough -In Date Final Date State Surcharge TOTAL FEE 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 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 Installina 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 (.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 :