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SUBJECT City of Fridley o 18282 AT THE TOP OF THE TWINS BUILDING PERMIT i � r � COMMUNITY DEVELOPMENT DIV. ry PROTECTIVE INSPECTION SEC. 1 ` � ,,j CITY HALL FRIDLEY 55432 NUMBER REV. DATE OF APPROVED By L 612-571-3450 910-F15 11/7/85 7WAG / JOB ADDRESS 1421 - 66th Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 Creekridge SHEET 2 PROPERTY OWNER MAILADDRES$ ZIP PHONE John & Beth Slopper 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Brickner Builders Inc. 6199 Heather Place N.E., Fridley, MN 574-9871 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. SPA RA:FE 5 ENGINEER MAIL ADDRESS ITS' ZI �-�p 11� �1ON�®� LICENSE NO. I�lJ E �'®I�� HEATING, 8 USE OF BUILDING D SIGNS. Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE % 8 DESCRIBE WORK Construct a 37.661 x 28.331 Dwelling and a 22.66 x 40.33 Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. SEWER LOCATION: (Approx. 9.5' Deep in Street) 15' N. of M.H. (Inv. 884.21) WYE ELEV: 884.28 TOP OF FOOTING: 887.28 Minimum WATER LOCATION: In same trench and south.of sewer service. DRIVEWAY ESCROW-. Replace 24' and cut new 24' = 48' x $13.50 = $648.00 SAC credit from school razing. Paid Park Fee of $1,500.00 THE CITY OF FRIDLEY DOES GUARANTEE ,NOT THE 11 ACCURACY OF UTILITY LGCA-. IONS AND ELEVATIONS. Before digging Cell local U$IIItIES AND P RSONS USINIG THIS IN ORMATIONESHONLY ,TELEPHONE m ELECTRIC m GAS Etc. VERIFY OUL. IT ON THE SITE. REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 80 DAYS, OR IF CONSTRUCTION R-1 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 $112,600 $56.30 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE TO GIVE" HORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE OVISIONS F OTHER T EOR LOCAL LAW REGULATING CON- $465.50 Credit from School S UCTIO PERF O E 0CONSTRUCTION. PLAN CHECK FEE TOTALFEE . , �/ J $116.38 $638.18 + PF ATURE OF CONT ROR AUTHORIZEDAGENT IDATEI r WHEN PROP LY VALIDATED THIS IS YOUR PERMIT BLDG INSP E SIGNATUREOF OWNERIIF OWNER BUILDERi (DATEI J 1 NEW City of Fridley Effective 4/1/84 ADDN. [ ] I R-1 AND R-2 i ALTER. [ ] Building Permit Application Construction Address: 2--" ��— Legal Description: Gc�' Owner Name & Address: Contractor Address :'T 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 GARAGE AREA: Length Width DECK AREA: Length Width OTHER: Corner Lot [ ] Inside Lot [)1] Ft. Yd. Setback Type of Construction: Tel. # Tel. # j7y 9�'�% Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. J s, Side Yard Setback l/ , -6 Estimated Cost: $ jZ060 Approx. Completion Date: Z r r V� C'j re-, � i��'� p`�. Y V��2-Q Alt. A �✓ to Alt B Proposed Driveway Width If New Opening Is Desired: / $ ��J $ See Back Page for Explanation DATE: �1J APPLICANT: Tel. # CITY USE ONLY Permit Fee $ 444S• S0 Fee Schedule on Reverse Side Plan Check $ 116118 25% of Building Permit Fee del State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ 1 S0 0 Fee Determined by Engineering Sewer M4in Charge $ Q7 t.,ALy (6448• d 0 Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS:p;�� RONALD F. MEYER I-&,NSURPETOR LAND SURVCYINO SUBDIVISION D[110N T=XrmoNE 771.4586 085 Jassis s -r. ST. PAUL. MINN. 55101 } I hereby certify that this survey was prepared by me and that I am a duly Re istered Land Surveyor under the laws of the State of Minnesota. Reg. No. 9051 Date• nri 15 N digging call local ut""iie Cn PKONE -ELECTRIC -r- SQUIRED BY LA i , ti %HI — THE CITY OF FRIDLEY DOES NOT GUARANTEE THIS - LEVATIONS O Indicates iron port=ent placed Soalot 1" = 30' M ACCURACY OF UTILITY LOCIONS AND E ANIS DATA A SONSIS FOR USINGF©E RMATION PURPOSES ONLY, AND PER THIS INFORMATIONSHOULD VERIFY IT ON THE SITE. Lot 1. Blook 1. CRUXR.1?� Anoka County, Minnesota. 1 s a 95t pierTtil��r� D-7 i i EXTERIOR E*'V—vlO?E AVERAGE "U L'O.MPT.JM- TION ' • �' .., owNE� _ �•� _ SITE ADDRESS -��/ltil 'e. CONTRACTOR TE: //- Y— rc` PHONE -S-1 - 7/ • Determine working square footage of, each. 1. Total . exposed wall area . . . . Z 2 PO sq, ft. x _ 3 b 7, . 2.. Total roof/ceiling area . . . /0 sq. ft. x ' 0 s-*' _ �3 Total exposed wall area above floor - a. Total wall window area....* ....................... b. Tctal. door area ................................ c..Total sliding glass door area, ........ S3. 7-8' _ d. Total e. Total fireplace wall area ............ ........:... wall framing area (average 10%)........... / R'�• g f. Total net wall area above f loon ................. &71. g. Total rim joist•are............................ /� • Total exposed foundation area = 6 7 h.. Total foundation window area .................... i. Total net foundation area above grade........... Determine "U•" value of each wall segment. • b 3 9 flu It • er X C. X „Ute _ a� d X "v of _ f • 16 • 1 X flu 11 . D = (� f • 90 tl 11 9. I X U �2 3. ............ ...................Total = 3b•� If item #3 on previous page is the same as, or less than item #1,. you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area = �� j. Total skylight area ...... k. Total roof/ceiling framing area (average 10%) 1. Total net insulated roof/ceiling area ....... Determine "U" value for each roof/ceiling segment.' j• X „U so _ k: X IV p 1. X '"U"• •�.% = Z !j . 4 ...................... ......... ...Total = If total of #4 above is the same as, or less than ##2, you have met the intent of SBC 6006,(c) 1. Alternate Building Envelope Design To;utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than -the sum of items #1 and #2. 3: +4. _ 1. . 5 a, t I 9Y47 -- Ilax,013 I-lw VZ -1 ZZ, V 7 z:z OYJ7 Z, e2 ---------- yJAj 23- 10 I 9Y47 -- Ilax,013 ZZ, z:z I 9Y47 -- Ilax,013 SUBJECT PERMIT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT !572-306 RECEIPT NO. � ►v Mll ITV DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ; � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE of APPROVED BY 910 -FIS 110/22,98612-571-3450 10B ADDRESS 1421 66th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED OESCR. 1 1 1 1 Creekrid a SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John & Beth Gloppen 574-9517 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118 Snelling Ave S Xpls MN 55406721-6628 2179 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 JaK REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Roofing 32 S • Siding and fascia 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. 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 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 $13,016 $6.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $212.25 Fire SC $13.01 PLAN CHECK FEE TOTAL FEE tq-00 t9qA.76 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT iDATEj WHEN PROPERL ALIDAT D THIS IS YOUR PERMIT BLyfG iNSP DACE SIGNATURE OFOW NER sic OWNER BUILDER, IfOATEi tvyr�m CI'CY OF I�RIDLEY UiCCttve 1/ 1lJ4 ADDN AI�I'1sR SINGLI' FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Onstruction Address: la!_v-e. /rlC F�i���� -- -T-- -- Legal Description: ---_-_`_ _ — �,ssy3z Owner Name & Address: 1o�n �%3zf� �_� � /�l�l - 6 Ave, NE Tel. # Contractor: _'lP1�CL't-f Q i�/�Il_ —l— MN LICENSE lI^�2/ 71 Address: -3/4' S4 e ll h c xo-e .s 00/-S AV lq✓ Tel. # "< 5'i� I q �11 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Corner Lot I I Inside Lot [ I Ft. Yd Setback Side Yard Setbacks Sq. Ft. Sy. Ft.- Sq. t.Sq. Ft. t e ole Construction: SiQ;, 6: ��sc� , as h� .32,- os Estimated Cost: $ /3, ®l4O • roX. Completion Date: _ (Cost on Back) Driveway Curb Cut Width Needed: Ft. + G Ft = I.t x $ DATE: _ 6� o �� APPLICANT: Tel. // ?2-1 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge OTOTAL STIPULATIONS: CITY USE ONLY $� , �✓� Fee Schedule on Reverse Side $—_ .001. of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ /^ $800 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 I I Not Necessary I a3 (. CITY OF"FRIDLEY INSPECTION 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 FAX (763) 571-1287 RATE SCHEDULE DIViSION ek16 30 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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%n of Value of Appliance or Work Commercial/ Industrial 1.25% of Value of Appliance or Work Rate TOTAL $30.00 $Cm $ 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. $ .50 Effective January 1, 2003 JOB ADDRESS OWNER �bv- BUILDING USED ESTIMATED COST �%-Aerr- -c— 3goo, ®C-) PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units i Circle One (Steam) (Hot Wat (Warm Air Trade Name Carr;e r- Size No. 5,FmvPnr6 BTU '11E0 16 HP EDR Fuel , C 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 ar rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE e2F'O7 CeuterPoiut Energy Minnegasco HEATING C013562 Central Ave NE, Anoka, MN 55304 Signed -��eo, kS - �a�' .f# --763-J FAX # 763-757-6701 Approved By _1) � Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED -r ..�.�� �nnini�CTOR AND CD B IRTInKI AIR VERIFICATION nnMMnN Vr=N vc iY When ara inning an exi_eting f tranne, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes (x) No ( ) and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer Yes (X) No ( ) specifications including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and l Central manufacturer's Venting s for fan include AGA-GAMA Category Yes (x) No ( ) assisted and natural draft appliances. The0xiginn ''nniei`t'en air is sized and installed to meet the current codes Yes No ( ) and manufacturer's specifications. �) When required to :nst II ne�y cnmh���tinn air_ tt will be sized and installed Yes No( ) to most the current codes and manufacturer's specifications. VV hen Ing ftilang a now yAntinn s stun, 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 Yes f No( ) Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed as been removed from the commonvent and vented Yes after an appliance h Yes (x) No ( ) separately as per current codes. APPUMr., ' -q*7p- Ammon Vent and V _nt Conner or Information BTU Inputow Fan Assisted or Nat.��'� q +� Appliance #1 Type �"+ �K BTU Input Fan Assisted or Nat �! Appliance #2 Type BTU Input Fan Assisted or Nat _______ Appliance #3 Type Total Appliances Total Btu Inputof Common Vent Type Q /- Vent Height 1 f Diameter— inches Appliance #1 Vent Connector Height = Length _ Length ft Diameter ft Diameter _in Type in Type Appliance #2 Vent Connector Height Appliance #3 Vent Connector Height = = Length _ft Diameter _in Type HEATING CO: CenterPoint Energy Minxie$asee 13562 Central Ave NE, Anoka, MN 55304 Date Signed By: -�� �� Ah i{&7gfn. qw Enerff Minnega, ADDRESS f-" OCCUPANT 11 ® —! HEAT LOSS Yes DATE HTO. INST. SOLD BY_ CenterPoint Eng= Minnegasco Electrical Work By CONTROLS Heat Plug TYPE OF HEAT FA k-�— SPACE HTR. GAS DESIQN MAKE (- f-" Model 4 9s nj 11 ® —! Serial Percent CO NPUTQ,_f) 0,L) THERMOSTAT CONTROLS Heat Plug Value Limit Limit Setting fActo gy ny Fan Setting Pilot Type Pilot Make Pilot Model i Pilot Timing Pressure > Percent CO2 nput CFH Percent O2 Stack Temp. Percent CO HOUSE HEATING 'TEST RECORD fZIDLI'� APT. FLOOR CITY -M (�' OWNER <ZA INSTALLED BY CenterPoint Energy Minnegasco Gas Line By UNIT HTR. OTHER CONVERSION fl Vent Size KIND OF LINER NONE SIZE Draft Hood Regulator Filters Size lleyAS 4, 1 _ Number ! Chimney Location Inside Outside Chimney Construction M E; Wiring Test Tag Lighting Inst. Date Tested ` U Company Testing P' n r i negasco Name of Tester. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BF INSTAI I Fn ON FAr.N Ft OOP 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 neater -Electric Water Heater - Cas** NO. RATE .I— Gas Rauge"* _ Gas DDer** 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 TOTAL JOB e- 6�/ 6� �VL The undersigned hereby make; 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 Iluilding Division, and hereby declares that all the facts and representations stated in this application are true and correct. GLOPPEN, TOR 10 3l 1 1421 66TH AVENUE NORTHEAST 20 FRIDLEY, MN 55432 (763)574-9517 Owner _ Building Used As M6IN-7/i 6E Estimated CostPERMIT NO. PLUMBING COMPANYn.C� &uneaj4 C SIGNED BY " TEL N0. j,? SST ` O ,� Approved By, Rough -In Date Final Date $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20-00 $- PLUS THE $.SO STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. COMMON VENT INFO ON BACK SIDE ��Jffl� F 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 neater -Electric Water Heater - Cas** NO. RATE .I— Gas Rauge"* _ Gas DDer** 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 TOTAL JOB e- 6�/ 6� �VL The undersigned hereby make; 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 Iluilding Division, and hereby declares that all the facts and representations stated in this application are true and correct. GLOPPEN, TOR 10 3l 1 1421 66TH AVENUE NORTHEAST 20 FRIDLEY, MN 55432 (763)574-9517 Owner _ Building Used As M6IN-7/i 6E Estimated CostPERMIT NO. PLUMBING COMPANYn.C� &uneaj4 C SIGNED BY " TEL N0. j,? SST ` O ,� Approved By, Rough -In Date Final Date $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20-00 $- PLUS THE $.SO STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. 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 O 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, 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 venle6 separately as`;per current codes. Yes( ) No ( ) Appliance Type and Sipe/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 Diaiineter 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) .11 HEATING CO: Signed By: Date CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 PERMIT NO.: 2004-00157 DATE ISSUED: 02/05/2004 ADDRESS : 1421 66TH AVE NE PIN : 133024130058 LEGAL DESC : CREEKRIDGE LOT 1 BLOCK 1 PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE FURNACE (WARM AIR, CARRIER, 80,000 BTU) #FURNACES 1 APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- (763)757-6202 [911AWID1.7 GLOPPEN TOR J & BETH A 1421 66TH 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 wort 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 of any other state or local law regulating construction or the performance of construction. ��l1 a ?WC FURNACE SHELL/DUCT WORK 30.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 30.50 PAID WITH CHECK # 5313 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMIT NO.: 2004-00158 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 02/05/2004 571-36U4 YAX: (763) 571-1287 ADDRESS : 1421 66TH AVE NE PIN : 133024130058 LEGAL DESC : CREEKRIDGE : LOT 1 BLOCK 1 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. REPLACE FURNACE # INSPECTIONS APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- (763) 757-6202 OWNER GLOPPEN TOR J & BETH A 1421 66TH AVE NE FRIDLEY, MN 55432 1 STATE SURCHARGE, ELEC FLAT 0.50 ELEC PERMIT FEE - MIN (RESI) 20.00 TOTAL 20.50 PAID WITH CHECK # 5313 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 wort 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 of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date, SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. r-# 4qfl CITY OF FRIDLEY PERMIT NO.: 200400176 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 02/06/2004 572-3604 FAX: (763) 571-1287 ADDRESS : 1421 66TH AVE NE PIN : 133024130058 LEGAL DESC : CREEKRIDGE : LOT 1 BLOCK 1 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A INSTALL GAS WATER HEATER # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES # WATER TRMT APPLIANCES APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S NIINNEAPOLIS, MN 55408-2173 (612) 827-4033 GLOPPEN,TOR 1421 66TH AVE NE FRIDLEY, MN 55432 0 VALUE OF FIXTURE/APPLIANCE 0 0 # GAS WATER HEATERS 1 0 # GAS RANGES 0 0 ENTER VALUATION 400 0 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 wort 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 of any other state or local law regulating construction or the performance of construction. Annlica-1 /i Date Bldg Insp PLBG PERMIT MINIMUM FEE 20.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 27714 SEPARATE PERMITS ]REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.