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AF - 35877Village of Fridley, Minn. BUgI.DING PERMIT N° 212 Office off IN�PEG'�O� OF BiJILDINGS _. , ` a Owner Ca^`--�"L�KJ�C'..vAw`+� `'�"��t�''�J`,.�'1.,�..l�� Architect Fridley, Minn., � J , 19.�� Builder ��'�`�^^�i. LOCATION OF BUILDING No. /�v� Street �� Part of M Lot Block Addition or Sub-Division � '� ?� ' �b, � ..,�; ,'� DE�CRIFT�QIV OF B�TII.�DING � . _.., Uf �� Permit is hereby granted to � �"'Q "`�� -' `' `-�✓�'�X/�1 to `� �.��"��'�./��'� � �� . the building `�`` �-'`�"�`' -� '^" permit is granted �, described in the above statement. This upon the express condition that the � rson to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon aid buiiding, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and vnoving of buildinge within the city limits, and this perxnit may be revoked at any time upon violation of any of the proviaions of said ordinances. ` t� � � � � `�'" '�' �-�-" `�� Inspector of Buildings. AGR,EEIVIE,'VT APdD SWO1�,N STAZ'EMENT In consideration of the issue and delivery to .rne by the Ins�ector of Bttildings of P'ridley of the above permit, I hereb,y agree to do the pro;�o�� v��ork in �,ccorda.nce with the description above set forth and according to the provisions of the or^dinances of ]Frid�ey, and, l�eing first dul,y sworn, I hereby state and say that the facts stated by me and cor_ta,ined in the abeve permit are true as therein stated. . , > _�_.�"��r�'�r� � �' �.�"UC.1 _ Subscribed and sworn to before me at Fridley, day of `` ""r,,,,�: .D. 19`��. � Nlinnesota, this � �� - ` Z�l..'� — ' • Vallage o� Frac�leg�, 1rl.�nn. �iJILDING I'�R1dIIT �T�' 376 �flfa�� oi �N�P,�+�CTOp$ O�+' ��iJIL�9INGr� Oa;ner :,�C:�t�,i�'t� L�. �`��1•"•� � ��- a� ,1�,�'',;� Architect I'� id'e; �, Minn., •""�' Builder '�-�=1'<>; :�.. ' LOCA�T�Nd :Q�F BiJZLI�Il`�G ,� �d . !i , ! v �'C.i No. r4 b�G` Street � �..3� J��I �' � Part of Lot_ � ' t� . I!. ' �� Lot E?lock .r�.ddition or Sub-�ivision �ru��,1.��zv �r ��JTu?�TivG � .,, : _ .�• Frant Depth ��,r �s _ Height� Storin�_ � 1Vlanner of C�nst:uction �`'''s�''i% ��Q" O � 1' ' � �y' »� To be used as ``}`'<1:` �"'d. i' ;��6 'Y+<��'� To be completed� �- ��"�i Estimated Cost ��, r _+a"�Od {1„ � �i� �+l,. J / % � J .1r , , IT _ x r a � � - : . ,%��Ai ;'�s 4 /_;�t.±� 3CC�' <r:" ,c�' s v a�a%ri.R. � � � ., .,'"J. Permit is hereby granted to � V`��"��. GL e �� to :'` •�,`" •{ the building �'�'"� � descrihed in the above statement. This permit is granted upon the expre,ss conditian that the person to whom it is granted, and his agente, employees and workmen, in all the work done ia, around and upon said building, or ar.y p�..•� thereof, shall conform in all respects to the ordi- nar.ces of Fridley, rdinn., regarding the construction, altcr�tion, rnaintenance, repair and moving of buildings with:n the city limits, and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. •:r j�a�:�"1�`�.t,.5�iy�-� Inspector of Buildings. �G�ZE�NSEI�TT A1�TD S��VORN STATE2�ZENT In consideration of the issue and cielivery to xr�e �.�y t?�L Tn.~�ectc�r of T.3uiidin�s of Z+'ric�le�; of the a,bove permit, ? hereb,y agree to do the proro,ose�? �V:�r?� �?a. �Lc�.nrcl�,nce c�ith the descr.iption ai�ove set forth and according to the provisions oi �?�e or_�in�nce:� �f F'r.i.�ilev, and, Ue�n� first dul,y sworn, I hereb,y utate and say that the facts state� bay m�e a.r_c� containec� i.n th� aboVe p�r°rnit are true as therein stated. � ,; ��`'� t;, r,�'� �� —�:_s�_ �, �' i� Subscribed and sworn to before me at Fridley, �viinneso� a, tY�.is �'' � - day of �'��i!wFf _�4.D. 19``l ;� ��'e` +� ' .�. :: � �� .��,�,.� � • � � � � • • City of Fridley, Minn. BUILDING PERMIT N° .� �� _��' .. .. June 11, 1965 Date: _._.._..__..___._._________�._...._......___.._.__....._..�__.____ owner: Carl Haffer Bwlder �allace E Johnson _._..��.._.. Address 7.�.00 Able St._N. _E.� __..._...._...._.........._...---_-----.._ aaaress _.__-�---470� __ATine Mile Creek Pkwy LOCATION OF BUILDING 75� Able Street N. E. No. .----•-•-------...---•--.. Street .....----_-_••---._..._. _.._._...._.......-••_------_..._..__....._..... ----�-•�-�--•�--�-�--.. Part of Lot •-�------_......__.....--•--••-------�---- Lot _._._._---....__...._..._ Block ---_�__.._ Corner Lot ...___...__.._.___ Inside Lot Sewer Elevation ---•---•...._....---•-----------•---- To be Used as: 7j�pe of Constxuction Addition or Sub-Division _..._..._.._.._____. ..------ Setback ._--------.-••---.._.._._.--_-- Sideyard ............_..._.._ Foundation Elevation ._..._......._. DESCRIPTION OF BUILDING Fiont —______ Depth _.�_._ Height .._._ Front _---------.____ Depth -------_ Height ...._ ------- _.___.. Es� cost _._�3. � 000. o0 Storm damage repair Sq. E't. ._---.__.._ Cu. FL Sq. Ft. ---•--•------._ Ct�. F't To be Completed _..._..._.._..__.._ In conaideration 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 itt compliance with all provisions of ordinanoes of the city of FridleY• � ,,;� In caa�sideration of the payment of a fee o! �_��___....__.., permit is hereby granted to WallaCe E. �S2h11�4�_.__.._..._.�__.._ 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 lceation, construction, alteration, maintenance, repair and moving of buildings within the dty ]imits and this permit may be revoked at ar�v time upon violation of any of the provisions of said ordinanoea. Allen Jensen ._ � Buildins Inspector NOTICE: Yhb p�rmh dws nof eowr th� eonshuefioe, tnsf�llation for wieiny. Phnnbins. �u h�Nin�, s�wK er wabr. !� wr� to sN fll� BYIWIOO ID��CfO� f0� NPlHh pN1AI1! f0� NIM� NNllf. �--- •. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME C�X �,�/e��G� BUILDER �� s ADDRESS�'� o cs -,�`� d,i.r�. �l. �3 ADDRESS ��4'�..�_��'°.0 �'i�-��-�1� �1/ LOCATION OF BUILDING No. Street Part of Lot LOT BLOCK ADDITION OR SUBDYVISION Corner Lot Inside LOT Setback Side-�Yard SEWER ELEVATION FOUNDATIOR ELEVATION Applfcant attach to this form Two Certi£icates of Survey of Lot and proposed building location drawn on these Certificates. DES RIPTION OF B DING � u� �1 �+ �' �� -� f`� G�nG �j;, .�,lLz-�+ ��i'-yy1�6iL�� To be used '�s : f� Front �epth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cos�-� .�c%c, .'�� To be comp].eted 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 aIl the facts and representations stated in this application are true and correcC. �c� DATE �i�_,...� , �� SIGNATURE (Schedule of Fee Costs can be found on the Reverse de). i: 4 _ 1 + � � .. . . . � • . , � M HUILDING PERMIT FEE S(.HEDULE SECTION 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or strucCure, or for any addition to any existing build- ing or structure, or for any alterations or repairs to any existing buiiding or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein_ provided to-wit: 2.1. For any such permit for the erection of any fire ,proof building, other than a garage, warehouse, factory or grain elevator, or for the erection of any fire-proof addition, for similar occupancy, to any existing building, shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical Contents. 2.2. For any such permit for the erection of any fire-proof garage, Warehouse, factory or grain elevator, or for the erection of any fire-proof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non•fireproof building, other than a garage, warehouse, factoxy or grain elevator, or any non-fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. GAR�'GES 2.4. For any such permit for the erection.of any non-fireproaf garage, warehouse, facCory or grain elevator, or for the erection of any non-fireproof addition, far similar occupancy, to any existing building or for each such building or addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thexeof, in the cubical contents thereof with the minimum of $4.00. For the purpose of computing fees for building permita, the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to Che average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterationa to an existing structure, the fee ahall be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the coat of all proposed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. � . ♦ N • � .. .., �ity of Fridley �►PP�ication � Plu�q aed Gas Filii�q hn�it �, 5�,��`� �i Dept. of Bldq�. Phon• 3�0-3490 DESCRIPTION OF WORlC 7500 NE Able iiumbar, Kiad and Localioa oi Fixtursa �s�°° O I3�I� IS�I�I�i��IC�I�I�CIV�I��I<U'�IU�IUOI �I NIGSTENME� :: ■■■■��' ■■..■■' � ��i • ■��I ■��ai . . . PARTIAL RAT� SCHEDULE S�w�r � �� PLIIMSING FIXTURE RATES: NO. R1►TE TOTAL Number F`ixtures . . . . . . . . . . . . . . . . x $2.00 $ �ture Ftixture Opening . . . . . . . . . . . x �1.50 E—.-- New Fixture Old Opening . . . . . . . . . . . x 51.50 5--- Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 a �iifd��P�t'kr :Urep �o a'�OdrO�iP'1� . . . . �_ x 33.00 a 3.00 New Ground Run Old Bldg. . . . . . . . . x a3.25 $ Electric Wat�r H�at�r . . . . . . . . . . . . . . : i2.00 = GAS FITTING FEES: NO. RA?E TOTAL 1st3Fixtures •••.••••.•••••• • xs2.00 ; Additional PYxtures . . . . . . ..... . . . . . x = .7b ; Gae Range to 199,000 BTU ..... ...... x E5.00 t REPAIRS 8c ALTERATIONB—R�i�s to Cod� Description .........................................i TOTAI. P'EE : � ��. City of F�ridley: The undersigned hereby makes application [or a permit tor the arork herei specified, agreeing to do all work in strict accordance with the Cits Qrdinance and ruling of the Department of Buildings, and hereby declares that alt the tacl and representations stated in this application are true and correct Fridley, Minn May 10 1971 19_ Owner :^T. McEdwalin Kind of Building fr Used as res • To be completed about j'�aY 15 Estimated Cost, � 10.00 Old—New. Bui2ding Permit No. Permit No. �� Si ; -I ,-,�� • � . Business Phun . ROU�H r-�x�w l— 9 - 7/ "y'IT .'_�' sue�ecr PERM I . City of Fridley �,73� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T f ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. � � �y-------� r � � PROTECTIVE INSPECTION SEC. I � 1 �4 1 /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ""'�' `�� 612-560-3450 910-F15 9/1/76 � � JOB ADDRESS '7500 Able Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. % 3 Shaffer's SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE D. McElvain 7500 Able Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. �in City Storm Sash Company 2641 Louisiana Avenue S., Mpls. 55426 927-6534 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install aluminum trim 9 CHANGEOFUSEFROM TO STIPULATIONS TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Alum. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OF ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ]. STALLS GAFAGES 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 $l�SOO $.%S 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 PERFOFMANCE OF CONSTRUCTION. $9.00 PLAN CHECK FEE TOTAL FEE $9.75 SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT �Da.7Ei WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT _ < � n p �Q , ��t/w —_�'�/�— SiGNATURE OF OWNERIIF OWNER BUILDERI iDATE� BLDG iNSP �AT APPLICATIUN F=OR RtSIDE�7IRL ALTERATION, ADDITION, OR REPAI� 6UILDING PERMIT 0��1N�R' S NAME : ��y's'!'G�i �°b ILDrR : ADDP.ES S: % S 0 O� /J� .- ADDi�S S; NO • '7 � d� STR��T : LOT: � BLOCK: ' s/ S �G T'C„ .. c� /�/L �v1 i „��.�w�- olU . S J � ?�, 3 ADDITION: �� GORNER LOT: INSIllE LOT: SETBACK: SIDEYARD: Applicant attach to this form 'iiao Certificates of Su.rvey of Lot and proposed bui]_ding l.oca.tion drawn on these Certificates. DESCRIPTION OF BUILDING To 3�, t?sed As : L[.�Gi��..-c.� _,��J , Front : Squar.e I'eet: Front: Square Feet; Depth • Cubic Feet: Depth: _ Cuhic Feet: _ Height: Height: i Type of Construction: _ Estimated Cost: $ �,� 0�% To Be Comgleted: � Tt°�e undersigned hereby ma.kes applicatinn for a pei-mit for the taor?c herein speei.fied, agreeing t� uo all worlc in strict accordance �oith the City of Fxi_dley 0�-dinances and rulings of the Department of Eui7.ciings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE : --�` � _ SIGNATtJRE : � ' (SeP P,evexse Side For Additi�nal �nfoYmation..) �/S'v u X . /,�U u X �•��aou = _��o u� � . 7� �. 7� q.00 . F' � .�... _ �.� - BUILDING 1'I�)t�11'1' 1;J�E SCIJI�J)Ui..}; SEC'.I'ION ?_. 7.'he Insgector of Buildings shall, before a.ssuing pezmits for tl�e execti.on of any building or structure, o.r for �ny addition to any existing bui_lding or strt�.ctur.E., or for any alteration ox repairs to any existing buil_ding, or structure, upon application therefoxe, require th.e pa}�nlent by the app].icant for such pez;nit of fees to ti�e amount hexein below set forth and in the manner herein provided to-wit: HF:W (:.ODISTRUC�'ION: S.irzgl,P Farnily Homes and Garage�: $�.00/1000 cubic fe�t P;.�N CHLCK: 25 per_cent of building permit fee. ADD I T I ONAL I NFORTiA1' I ON �or th.e purpose of computing fees for building pez-mits, the cubical contents of any buil.ding or addition, is determiried by multi_plying the ground axea covered from a point six (6) inches ��elow the floor line of the basement ox the cellar to the avexage heights of the upper surface ox to the average* hei_ght of t�e rouf surface of the main gable of a pitched roof. For repairs or alterations to an existing stxucture, the �ee shall be at the rat� nf $3,00 ner each. fiv� hur.dred doll�rs i;$500.U(ij or tracti.on Lher•eol in the cost of all proposed �aork. In no case sl�all the fee chargc�d for any peaxnit as se� fori.h in Section 2. be less than S�.SO. VERIPIC�TION GF I'OUNDATION NOTL: Permits for eonstruc�ion will be issued a minimum of_ 24 haurs fr.om tl:ie time o{ appli.catiori, to a11ow for p�oper review oi the proposed structure and of the construction site. A Certified Survey oi the lot, showing the locaLion of the fouxidation, once it has been cons�xuci:ed, wil.l be required beiore pr.oceedinp �ait.h the framing. CERTIPICATE O1� GCCUPANCY ApPlication for a C�rtificate of Occ�ipancy shall be made ten (10) days prior to ihe use or occupancy of. any stru.cture L-or �a�iich a building permit has beeri issued; and said strucfiure shall not Le used or oc�upied until a Certifi.cate uf Occupancy lias been issued, . 0 c sue�ECT N . City of Fridley � 1631 9 AT THE TOP OF THE TWINS g U I L D i N G P E R M I T � r � � , � R . � ; y_______ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. �� 3 , A� /'��1 � CITY HAI.L FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPqOVED BV ` ��._J �•i �.J 612-571-3450 910-F15 8/3/81 / / JOB ADDRESS 7500 Able Street N.E. t IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. '] 3 Shaffer's Sllb. D1V. #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald Jelinek 7500 Able Street N.E. 786-8311 3 CONTRACTOF MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X X 8 DESCRIBE WORK Construct a 17' x 12' Deck and Convert Breezewa Into Livin Area 9 CHANGE OF USE FROM TO STIPULATIONS ��C,. � ��R �.��,��N�� WARI�I�i�G ��,t�t�� ,� P►�� S TEIEPNONE � EtECTRIC�fGAS Etc, �� e ��`�`�� REQUlRED BY s��'�,�, Q LAVy ��'� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PEFMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCZ FY'dICle 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 ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO 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 $2�300 $Z.IS DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGU�ATING CON- STRUCTION OR THE PERFORMANCE OF CONSTFUCTION. tiS3H. SO PLAN CHECKFEE TOTALFEE $ 8.13 47. 78 SiGN UREOFCONTRACT AOR U7 RiZEDn N7 IDATEI WHEN PROPERLY �ALIDATED THIS IS YOUR PERMIT -.� ' . � ` r � _ ../ v � F ' � � �' � = � hh .� 11 ��c�..� ,U� 1� SiGN TURE OF OWNER iiF OW R BUiLDER� �DA7Ei 1' B�.DG irv5p ��F E CITY OF FRIDLEY Effective Aug. 1, 1981 Af'PLICATIOFd FOR RESIDL"iVTIII� BU1LDIi1G PEf2irTTS (tde►•r, Al ter.�i:ions, Additions, or Repairs) Ot•! �dE R : � �� ,o �-- i� i'�. J � G. /�� F !�. ADDRESS : j S� � A� l_ f-� S�• /t.�f� �UILDER: I�,�r., �1 �L l�`k� l'�-- 11DDRCSS: /S4a A13�-� -�T� TEL �10: % �' � — �l � I i TEL (d0: % � � — � 3 // Cons�;ruction Location STRI�T NO : � .3 a � STREET: /� %j L � �1 ^ L07': � BLOQC: � ADDITION: ,jf��I / f- �_ �`L�S S[.�tJ !�/�� % Corner Lot: Inside Lot: Setback: Sideyards: Ap�licant attach to tliis form two Certificates af Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOid OF COh�STRUCTIOPd � ! ____l�� G� I'ront: /� Depth: ��' � Height: a Squane Feet_ �� Clibic Feet: �E/rio�+�f_ %31Q'E�ZE t.../Fi'� Front: a j � G 1 f/iN6 f�,F`£� Squar.e Fe�t: ��s�Oj�� 1�a.VU , � . ��7;� .. Type of Cor,struction : Zb Be Oor,�pleted: .,'� � i� % . / / � � i �P�= Gvbic I'eet: Proposed Drive�•�ay Width if New Opening Is Desired: Heiglit: Esiimai:ed Cost: $ � ? C�.%� , !? !� Alt. A Alt. B $ $ SE� Rc�VERSE SIDE OF SHEET 23ie undersigr.ed hereby ma};e� applicaticn for a permit fcr the �•:ork herein specified, agreeing to co .all work ir, strict accordance with the City of Pridley Ordiiiances a�id rulii�gs of tlte Department. of Buildings, and hereby declares that all tl�e i'acts and represen tatiens stated �i this application are true and correct. . 9 ,. ' � D.1T�: '� — j " � � SIGNI�TUF�.: Stipulations: ; , �,.; ? ��►�� . �� '�")C � � _ f r �- � r : ,.,� ,�f � � V� � � � BUILDI�G PERMIT FEE SCHEDULE The Inspector of buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any �xisting building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and i.n the manner herein provided to-wit: TOTAL VALIJ�ATION $1.00 to $500.00 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 and up FEES $10.00 Minimum Fee $15.00 plus surcharge $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000 $32.50 for the first $2,000 plus $6.00 for each additional $�,000 or fraction thereof, to and including $25,000 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000 $283. 00 for the first $50, 000 plus $3. 00 for each additional $1,000 or fraction thereof, to and including $100,000 $443.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof PLAN CHECK: 25 percent of building permit fee DRIVF:WAY DEPRESSION ESCROW: Concrete G1irb Streets Only Alternate "A": Removeal and replacement of curb and gutter only Driveway width plus 6 feet x$13.50 Alternate "B": Ranoval and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 f eet x$15. 75 VERIFICATION OF FOUNDATION Permits for constsuction will be issued a minimum of 24 hours fro�n the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with.the framing. �� J �- � �s s y S t� i— � r' � s -�9 --� N �_J � ; �� I f � ; . � T � I ' "��. z � ___I � � � W � <� �� . � L l•�S ,� � � � ;f . � � i�- - X ;� . ( A L'i !; .� , � '..� �./� . 1 (= .1 . � / ) .L �� 4 � , �-- '�� ;-i �1 •� �:� ;�, W t i �i `. �� ! :� 7C � ..� �''a -� � � �. � �.��._, ��. �� c� � -- — �. _ Q � v �9 � � f-i �i '� - .'� J � .` - +�- li1 �' ,, � - - I ._; � :: � � X �1 y � � -_ { . `� 1 ,� � �,. , v �J v � L1.. L�. 1 W �c� — c�"1 tl.�i c, L � �' � J }- u"� ri � � � � (Tl N� �L %# /Yo/Sl�'7/Q �'�►S S, � �.�.� �HS � �>��74' L �n7 = ��i �S� % �I� 34 ,� � �� , , ,�ii� ,, , i, � ;�� ,;- . _ . . . - - ��I;' .� ��gd ooSC b � c � � `� -�� jf9 �� i , i ; , �dM , ; ; ; j ; , �S�OH ----.______. _._. __ _ ._ __ �2Z I; , , ,, , - � Z � 321� � ��t�i�t 9 4�—� , L` 1 --.� �z ,�� 9 � I I �ii � i � CITY OF FRIDLEY INSPECTION DIV. f�� 6431 University Ave NE ', ;.�' � Fridley, MN 55432 '4 ' 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES � � �. i`� n,- �t �� APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR �r Sath Wash Drink. ' Floor Catcl� ', Auto. , et- Urinal Tub; j Shower Sink Tray �ouni......; Drain Basin' . Washer NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric � Water Heater — Gas** / Gas Range** Gas Dryer** Back Flow Preventer Required ()Yes () No Type _ 'S 7.00 :6 4,00 :S 5.00 $ 7.00 $ �.00 $ 7.00 :!� 7.00 g� o,00 s, �.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5°k of Value of Fixture or Appliance State Surcharge TOTAL FEE $ .50 JOB ADDRESS ��F1'�(C Effective On March 1, 1996 � r, 7 : . � ',, � Gas Misc. '' Water Heater Range Fixt. 'r < Gas Elec The undersigned hereby makes aK>plication 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 an correct. � 3r��.� , 1996 '�h1L I E Ownei ;'`>G�' ABLE FRIDLEY -. '— �-';;;. Buildir KENNETH STREET NORTHEAST �4' ��z � �3�/ � �S r i i � � Estimated Cost �° � r PERMIT NO. ��-��' ; PLUMBING COMPANY /��jZp��t �L,�(�,t,� �jl•�(� SIGNED BY TEL N0. C)�7'`fO.�.3 Approved By ��_ Rough—In Date Final Date MINIMUM FE�/FOR ANY PLUMBING/ $�� 5�' PLUS THE $.50 STATE SURCHARGE **COMBUS110N AIR SHALL BE PROVIDED PER UMC S�CTION 5o4(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. ��a�n"�� %� . 0 �7� SuB�ECT City of Fridley AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r � . � � � • COMMUNITY OEVEIOPMENT OIV. �V'�'�� r � � PqOTECTIVE INSPECTION SEC. � � � i---_��"' �'� CITY HAIL FRIOLE� 55132 NUMBER L 612-571-3450 9t0-F�5 JOB ADDRESS �500 Abl e Street NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDI710N DESCR. � 3 Shaffer's Sul 2 PROPERTY OWNER MAIL AODRESS Ken Omlie 3 CONTRACTOR MAIL ADDRESS Window-Lite 523 Central Ave. Osseo MN 5! � AiiCHITECT OR DESIGNEii MAtL ADDRESS 5 ENGINEER 6 USE OF BUILDING Residential 7 CLASS OF WORK MAIL AODRESS REv OATE 7/15/99 ZIP —%%%% ZIP 21P PAGE O� � � rFiM1T NO. 29880 ECEIPT NO. 4/�36 pAOvEO Br SEEATTACMED SHEE7 PMONE �-9361 PHONE LICENSE NO �nn�g�tiR PMONE UCENSENO PHONE LICENSE NO O NEW ❑ ADDITION �X ALTERATION � REPAIR O MOVE O REMOVE B DESCRIBE WORK Remodel bath; 1 window 9 CHANGE OF USE FROM STIPULATIONS TO See stipulations on plan Provide smoke detectors in all sleeping rooms and on all levels of the house SEPARATE PERMCI^g R�Q�� ' �ViR�i�G, HEATING, pLUMBING AND StGI`[�', . .. - - -- - SEPARATE PERMITS ARE REOUIRED FOF ELECTRICAL, PLUMBING, MEATING, VENTI�ATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL ANO VOIO IF WOfiK OR CONSTRUCTION ZpNING AUTHORI2ED IS NOT GOMMENCED WITHIN 60 DAVS. OR IF CONSTRUCTION OR WOAK IS SUSPENDED OR ABANDONEO FOF A PERIOD OP 120 DAVS AT ANV TIME AFTER WOfiK IS COMMENCED. NO DWLG. UNITS I HEREBV CERTIfV THAT I HAVE REAO AND EXAMINEO TMIS APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF �AWS yALUATION ANO OROINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED WITM WHETMER SPECIFIEO MEREIN OR NOT THE GRANTING OF A PERMIT $4618 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEI THE pEqM1T FEE PFOVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON- C STRUCTION OR THE PERfORMANCE Of CONST:iUCTION ��ZZ.Z:! PLAN CHECK FEE Li ce C S�GNATUQE O� CONCaA�TOQ OR vUTMOQ�ZEO eGENT ID�TE� � FN I S�GaatuAE O� OwtiEQ��F OwHEQBUi�OER� �OATE� 8� G�ti5� � I'ermit Inspection Cards Will Be Mailed To Hom��wner To �ast OCCUPANCVGROUP OCCUPANCV�OAD 5 SQ.FT STALIS CU FT ' PARKING GAfiAGES .�'p2, 31 SAC CHARGE Fir SC $4.62 TOT EE 3.18 _—NIS I$ V UR P��IT l/ �) r�c�t NEW � [ ] ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Effective 1 / 1 /99 � BUILDING PERMIT APPLICATION �� ConstructionAddress: `1'sQ [) Q b l e �� Y,�,� -�' Legal Description: � � Owner Name & Address: �� Dm ll � Tel. #%��rj- ��ol Contractor: � �� b,,,� .. � : .�p MN LICENSE #�� 00.�o?S� Address: �ca'�.3 ��r� J (� �j e d�S � �7 M� �� q Tel. # y�5-G?o?� 7 �— Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION 4�' IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: DECK AREA: OTHER: Length Length Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: Estimated Cost: $�� %� •� v I � �C/0``, (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� APPLICANT: Tel. #{ �� a�. % CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ � $ � $ % $ $ .�. 0 � $ $ $ $ $ ✓0��3 - Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.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 [ ] STIPULATIONS: �� J � / ' ! SUBJECT � City of Fridley 2 7 3 4 5 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T f 1 1 N�. � l � ` _�� COMMUNITY DEVELOPMENT DIV. 4 �� / r � v � PROTECTIVE INSPECTION SEC. r ` � � � � ' � �� CITY NALL FRIDLE� 55432 NUMBER NEV DATE PAGE OF APPROVEU BV �""'�'� ,'' 612-571-3450 910-F15 8/21/98 � � �os aooaESs 7500 Able Street NE t LEGAL LO7 NO. BLOCK TRACT OR ADDITION SEE ATTACMED DESCR. � 3 Shaf f er' s Sub .� 1 SHEET 2 PROPERTV OWNER MAIL ADDRESS 21P PHONE Kenneth Omlie - 3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO Seal Guard S stems In - 4 ARCHITECT OR DESIGNER MAIL ADDFESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PNONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WOFiK ❑ NEW � ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (17 Sq) Tear-off 9 CHANGE Of USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, FIEATING, VENTII.ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL ANO 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 OAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAFAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS Of LAWS yALUATION SURTAX AND Ofi01NANCES GOVERNING THIS TVPE OF WOFK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PEFMIT �1�F] ] 3�Y3�� . J1 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OF CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF A OTHEF STATE OR LOCA W REGULATING CON- STRUCTION OR T PERFORMANCE OF CON R�TION �FH. SO lY0 SC 1.�FZ j 7 �� PLAN CHECK FEE TAL FEE Llcens C 5 0 55.63 SIGNA uAEOF ON"RACTOROA DnGENi �On i HE PR V VA D THIS IS UR PERMIT % r S�GNATUAEOFOWNEAi�fOWNEABUI�DERi IDA1E1 B DG �NS� q�TE N�w , _ I 1 nllDN [ ] • AL`I'ER [ ] � ConstructionAddress: r Legal Description: Owner Name & Address:,� Contractor: Address: CITY OI+ FRIDLEY SINGLr FAMILY AND DUPLEXES R-1 AND R-2 I3UILDING PERIvIIT APPLICATION 0 �� =�- . i J � Cffective 1/1/97 �� 1 � ,�,�0 .�� Tel. !1 / �� -- � %��VIN LI � E # G�� S� _ . �'�� Tel. # 1� � ( Attach to this application, a Certifcate of Survey of the � lot, witli the proposed construction drawn on it to scale_ DESCRIPTION OF IMPROVEMENT LI�'�'G AREti: I.e►-►gih � ��idth Heign[ Sq. Ft. GARAGE AREA: Length . Width Height Sq. Ft. DECK AREA: Length Width Hgt/Grou Sq. Ft. OTHER: l' �� ' LO �-�(� �o � , Construction Type: � � Estimated Cost: $ / �� (Fee Schedule on Back) • Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ ; rM -7 f� DATE: APPLICANT: �Y / � _ � 'I'el. # � � / - �� / � CITY USE ONLY Permit Fee �/ c� ��$ . Fee Schedule Qn Reverse Side Fire Surcliarge ��`��2$ • .001 of Permit Valuation (1/lOth%) State Surcl:arg� �`�/ � (� $.�^v/$I,�i, Valuation � SAC Charge �$ �$950 per SAC Unit License Surcharg� $_ _•�.�.� $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 $ Agreenient Necessary [] Not Necessary [] � ��?TAI., s��l�c�l.n`!'IONS � \ \ � 1�� ,�j � � � / w , � RUlLUWG ['[:1LM["C l�EE SC[iLUt�t,!•: �l�l�e Chief I3uilding Official shall, beCore issuing pern�its for the erection of any building or structure, �r I��r any addition to any existing building or structure, or for any alteration or repair to any existing buildint or t s�ruccure, upon application theretore, require the payment by t��e applicant tc�r such pern�it of fees to the amount herein below set forth and in the manner herein provided to-wit: 'fOTAL VALUE $1 to $500 $�O1 to $2,000 ��,OU1 to $25,000 $25,001 to $50,000 $SO,OU1 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcl�arge) $21 for first $500 plus $2_75 for eacli additional $100 or fraction tliereof, to and including $2.000 $62.25 for first $2;000 plus $12.50 for each additional $1,000 or fraction thereof, to and including �2�,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $i0,000 $574.75 for first $50,000 plus $6.25 for each additionai $1,000 or fraction thereof, to and including $1U0,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, _ to and inctuding $500,000 $2887.�5 for the first.$500,000 plus $4:25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the fu-st $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROVV (Concmte Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Drive�vay width plus 6 feet times $13.�0. A(ternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VER[CICATION OF FOUl\TDATION I'cr►uits for construction will be issued a minimum of 24 hvurs from�the time of application to allow �or prorer rc�'ie�v of the proposed stiucture and of the construction site. ,-1 t�'c� tif icate c�i� Survcy c�f the lot, sha«�ing ti�e Ic�cation of thc foundalion nnce it has it h:lS I)C�fl C(lilSltUl'� _. � .i�i:i f��: rcyuirc<1 h�li�rc ��r��cccdin�� ilh tl�c (�r,iinin�,. ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 1631572-3604 FAX: (763) 571-1287 : 7500 ABLE ST NE : 113024110077 : SHAFFERS SUB NO 1 : LOT 7 BLOCK 3 : HEATING : RESIDENTIAL : ADDITION/ALTERATION PERMIT NO.: 2004-00681 ' � DATE ISSUED: OS/11/2004 . VALUATION : $ 11,320.00 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, ICP, 50,000 BTUS) AND AN AIR CONDITIONER # A/C LJNITS 1 # FURNACES # GAS DRYERS 0 # GAS RANGES APPLICANT HOME ENERGY CENTER 15200 25 AVE N #128 PLYMOUTH, MN 55447 (763)476-1990 OWNER OMLIE KENNETH R 7500 ABLE ST 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 wor� 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 constru ion or the performance of construction. AneiIicant ��' -._ � Date , Bldg Insp��'��--'---_ Date� ►�� '`� HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 54350 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1 0 0.00 35.00 0.00 0.00 25.00 0.50 60.50 �r m om �s M v � .-� w r v G*1' OF FRlDLEY BU4LDiNG INSPEC3lON 6431,Univarsity Ave NE �ridley, MN 55432 753-572 3604 FAX 763-5T1-1287 R�,TE SCNEDULE Res�dential Furnace Shell and Duct Work, Burner & also Replacement Fur►race Gas Piping (Ne+v Furnace, Fireptaoe, Insert) Gas Range � v`s' �" � Effective 4/1J2004 APPLICATEUN FOR POWER P�ANTS AND NFA`iING, C�DOLING� VENiif.}1ilON REFRIGERATION AND AIR CONDfTIONiNG SYSTEfvIS AND DEVICES lOBAODRESS �r'J�O P�j�C, �j}" � 7ot A�-- . owner K-PXlY1-P�'� '� 1v�XV �1�1. �i'Y�`1 � $35.�0 $ 3y °(� Buitding Used As .. $10.00 $ fSTIMATEO COST %l �ZU .�� PERMIT NO � ' � `( " � ' '-, _ . $10.d0 $ o Gas Dryer $10,00 � a _ z �Air Conditianing - All Sizes �25.00 w U �, All Ott�er Repairs or Alterati�ns (List on Back) wi°% of Value of Appliance or Work w Minlmum Fee $15.00 far Residential or 5�'0 oicoslaf W� lmpTOeement whichever iS greater � J x � Cornmerctal/IndvsVialllnsU"tutional u, 1.2556 af Ya3ue of Appliance or Work (List on 6acic) ° Minimum Fee $35.00 tor Commercia!/frtdustrial/Institutionaf � � State Swc�►arge � a � .� o m � TOTAL FEE n � r N REINSPECTION FEE $50.00/H�UR w�*A+r Conditioners can not be placecf in side yard without �vritten approval � from adjoining praperry owner -ca�py to City m N N FiLt OUT SACK SIDE FOR STACK VERiFiCAT10N ON REPLACEMENT FURiVACE i � DESCRiPTION OF FURNACE ASVD BURNER $ t► of t�eating Units 1 G�rcte One (Steam) (Hot Water) War Trade Name �� c'J � Size No. $ a5 � O� 8TU s� GJO CS� O HP EOR Fuel Totat �nect�d Load $ Bumer Trade Narne BTU iiP Size EDR �fhe undersi�ned hereby makes appiication for a permit For the vrork hereln specifie[� agreeing to do all work In strict accordance tvith the City Cvdes $ and rulings of the Building Division, and hereby deGares thal all the facts and representations stated In lhis application are true and correct. $_ . 5 6 $�b. 5D m � 0 .i � 0 0 ' N \ .�i � N O HEATING CO_ � ��x �_ �� Sign Tel # 1 b3 •47b � lqyo �EVt � �I�3� �lo � 11 `�3 �ate 4 -Z(� � 04 � � Rou -in D e Final Approved by gt► at Date ._ 05/11/2004 10:46 FAX 7634761143 HOME ENERGY CENTER APR-27-29C�4 10�30 FF�OM CITY OF FRIDLEY TO i�oos 4?61143 P.03/03 � FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, V'EN7 CONNECTOR AND GOMBUS710N AlR VERIFICA'T�oN When replac�rw an existins�iurr►ace, the undersigned hereby verifies that the venting has been examir�ed and is free from rust, deterioration, obstnactions, and is securely supported and firestopped where required, Yes No () The venting system is plastidPVC; and meets all cu►rent codes and manufacturer specifications incfuding sizing, length, number of elbows and terminatio�. Yes � No () The undersigned also verifles t�tat the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assiste�d and natural draft applianc.�es. The existinq co�n6ustion air is sized and installed to meet the cu��ent codes and manufacture�s specifications. When required to install a �ew cnmbustion air, it will �be s2ed and i�stalled to rneet the current oodes and manufacturer's specifications. When installinq a new ventinq s ste , the undersigned hereby verifies that it is a tisted assembly and meets the currerrt codes and manufactureNs s�ecifications. This does include NGA-GAMA Category I Central Fumace Venting Tab�es for fan assisted an�d natural draft appllances. Yes No ( ) Yes� No ( ) Yes No ( ) Ye� No � ) Is the common vent and vent con�ectors sized and installed correctly after an appliance has been removed fr+�m the common vent and vented separately as per current codes. Yes No () A,pAliance 7vl�e and SizelCommvn Vent and Vent Connector Informat7on AppGance �1 Type Cn� e BTU Input ,�5� � Fan Assisted or Nat �_ Applianc� �2 Type BTU Input Fan Assisted or Nat Appliance #3 Type B'fU Input Fan Assisted or Nat Total Appliance6 l Tdal Btu Input o00 Common Vent Type Vent Height Diameter inches Applianc� #1 Vent Connector Heig9�t ft Length ft Diameter in Type Apptiance #2 Vent Connector Heig[�t ��t Length ft Diameter in Type Apptiance #Ki Vent Connector Heigh�t ft Length ft Diameter in Type HEA7ING CO: Signed By: � �5 ��i�-� �8 S � �'D.� . , �r� ?''.�/�~ .. - - � � TOTAL P. ��3 Pro ect Summa Job: �� Date: Mar 15, 2004 Entire House By� Home Energy Center 15200 25th Avenue North, Plymouth, MN 55447 Phone: 763.476.1990 Fax: 763.476.1143 ' Y • # For: Omlie 7500 Able Avenue, Fridley, MN 55432 Phone: 763.785.9361 Notes: � : � � � - �� f; � � C1eSi n It'�f�ir�lla�itin Weather: Winter Design Conditions Outside db -22 °F Inside db 70 °F Design TD 92 °F Heating Summary Building heat loss 31034 Btuh Ventilation air 72 cfm Ventilation air loss 7069 Btuh Design heat Icad 38102 Btuh Infiltration Method Construction quality Fireplaces Minneapolis-St. Paul, MN, US Simplified Average 0 Heating Cooling Area (ft2) 960 960 Volume (ft3) 7680 7680 Air changes/hour 0.75 0.35 Equiv. AVF (cfm) 96 45 Heating Equipment Summary Make Trade Model Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 80 AFUE 0 Btuh 0 Btuh 0 'F 667 cfm 0.021 cfm/Btuh 0.00 in H20 Summer Design Conditions Outside db 91 °F Inside db 75 °F Design TD 16 °F Daily range M Relative humidity 50 % Moisture difference 30 gr/Ib Sensible Cooling Equipment Load Sizing Structure Ventilation Design temperature swing Use mfg. data Rate/swing multiplier Total sens. equip. load 12095 Btuh 1229 Btuh 3.0 °F n 0.96 12791 Btuh Latent Cooling Equipment Load Sizing Internal gains 1200 Btuh Ventilation 1421 Btuh Infiltration 884 Btuh Total latent equip. load 3505 Btuh Total equipment load 16296 Btuh Req. total capacity at 0.70 SHR 1.5 ton Cooling Equipment Summary Make Trade Cond Coil Efficiency Sensible cooling Latent cooling Totai cooling Actual air flow Air flow factor Static pressure Load sensible heat ratio 0 EER 0 Btuh 0 Btuh 0 Btuh 667 cfm 0.055 cfm/Btuh 0.00 in H20 79 % Printout certified by ACCA to meet all requirements of Manual J 8th Ed. ,t WI'19i1t50'FC Right-Suite Residential 5.9.11 RSR20001 2004-Apr-2010:43:10 AG�P. C:\DOCUments and Settings\J Scott Woolery\My Documents\WrightSoft�2004\aadefault.rrp Calc = MJS Page 1 ,�n '� '' ` �� , ��, E !, �; .,4 ; Short Form Entire House Home Energy Center Job: Date: Mar 15, 2004 gy: 15200 25th Avenue North, Plymouth, MN 55447 Phone: 763.476.1990 Fax: 763.476.1143 -"� �s � 0 i� t ` � ......�.�ia..�.r. .�� .,.ww � _ _ ... For: Omlie 7500 Able Avenue, Fridley, MN 55432 Phone: 763.785.9361 � �� ° • • • .�: � __�� Htg Clg Infiltration Outside db (°F) -22 91 Method Simplified Inside db (°F) 70 75 Construction quality Average Design TD (°F) 92 16 Fireplaces � Daily range - M Inside humidity (%) - 50 Moisture difference (gr/Ib) - 30 HEATING EQUIPMENT Make Trade Model Efficiency Heating input Neating out�ut Temperature rise Actual air flow Air flow factor Static pressure Space thermostat ROOM NAME Omlie Entire House Ventilation air Equip. @ 0.96 RSM Latent cooling TOTALS 80 AFUE 0 Btuh 0 8tuh 0 °F 667 cfm 0.021 cfm/Btuh 0.00 in H20 Area Htg load (ft2) (Btuh) 960 d 960 960 COOLING EQUIPMENT Make Trade Cond Coil Efficiency Sensible cooling Latent cooli��g Total cooling Actual air flow Air flow factor Static pressure Load sensible heat ratio 31034 31034 7069 38102 Clg load (Btuh) 12095 12095 1229 12791 3505 16296 0 EER 0 Btuh 0 Btuh 0 Btuh 667 cfm 0.055 cfm/Btuh 0.00 in H20 79 % Htg AVF Clg AVF (cfm) (cfm) 667 667 667 667 667 667 Printout certified by ACCA to meet all requirements of Manual J 8th Ed. ,�.., wrightsoft Right-Suite Residential 5.9.11 RSR20001 2004-Apr-2o 10:43:10 �� C:\Documents and SettingsW Scott Woolery\My Documents\WrightSoft�2004\aadefault.rrp Calc = MJ8 Page 1 05/11/2004 10:46 FAX 7634761143 HOME ENERGY CENTER C�001 I�OME ENERGY CENTER FACSIMILE TRANSMIT�Ai SHEET '�'a PROM: Da�re �'ensen L.isa yang COMPANY: DATE: Caty of Fzidley OS/ 11/2004 PA?C NLJNIDER; 1'01'AI, NO. OF PAGES INQ.UDING COVER: 763-571-1287 3 BHONE NUMBE1t SBNDGR'S REFEltFN�P. NCEN�EA 763-572-3604 �; YOUR REPERENCE NUN►�ER: P� ro�� ❑ CJIZGENT D FORREVIEW ❑ PLLASE COMMENT ❑ PLEASE REPLY ❑ PLPASE REGYCLE The back side of rhe permit has been done at 75Q0 .Able St If you have anyquestions, please call me at 763-476-1990. Thank y�u, Lisa Yang 15200 25�H AVE NORTH SUiT� 128 PLYMOUTH, MN 55447 � ��• HOUSE HEATING TEST RECORD OCCUPANT OWNER �OR� CITY �r� dl�� HEAT LOSS DATE HTG. INST. SOLD BY HOME ENERGY CENTER INSTALLED BY HOME ENERGY CENTER Electrical Work By HARRISON ELECTRIC Gas Line By TYPE OF HEAT GA FA X HW STEAM SPACE HTR. UNIT HTR. OTHER �� Model . Serial . INPUT V THERMOSTAT Heat PI g _ Valve Limit Limit Setting � � � Fan Setting Pilot Type Pilot Make Pilot Model Pilot Timing L.W. Cut Off Pressure � _ S Percent CO2 Input CFH � ercent 02_ Stack Temp. Percent CO . Form 235 C MAKE OF BURNER _ Model Max. BTU Rating _ MAKE OFFURNACE Model Vent Size KIND OF LINER SIZE NONE Draft Hood Regulator Filters Size Number Chimney Location Inside Outside Chimney Construction Smoke Bomb Wiring Draft Test Tag Door Pressure Lighting Inst. Date Tested Company Testing H ER Name of Tester ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763) 57Z-36U4 N'AX: : 7500 ABLE ST NE ' : 113024110077 : SHAFFERS SUB NO 1 : LOT 7 BLOCK 3 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION 571-122i7 PERMIT NO.: 2004-00777 DATE ISSUED: 05/25/2004 VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. REPLACE FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT HARRISON ELECTRIC INC 3440 KILMER LANE N PLYMOUTH, MN 55441- OWNER OMLIE KENNETH R 7500 ABLE ST NE FWDLEY, 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 worl� 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 ELEC PERMIT FEE - MIN (RESI) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 027559 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 20.00 0.50 20.50