AF - 43745��� : �.�. ,�--Q�..,.�.�.,..�..-.-�.,�,.�.� s.�..�..-�..�.,.�.—..�.._....,.,,,,.._ . _
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r_=- __:_ �.:;�c�,��.aT�o��s HEATIiVG� AIR CG1�lDITIONING CO. �'�"h�HPv�'` :`'ti�;.
� �`_ -= = .;s .:.S.N.'J.E. �o-�.��.• _ .. ��s�,at�o�
� Gu�de - ___ _ __ _.
� ����c��r.�_ ��oors 0:.2. W� ^2. YJall I �G _ Roof �� *,.�.� k,,� How tic„ 'ed
Reference
� Vc�-'�_ es-tic �q
' / Fi y% _-r;:..,�.. � � R��Om i �2'?g2h / (f ��, _.- � � !-�Pi� . %���, r•�� c'E ' �i�i�?t �� LP-� - �,(� Y1'�di~,s�' yeip...
� — -� � ---�--1�- --
�� �__� _=nd Doors-Crackage ar,d A�e� l'r'incie�,� an,1 Doc�rs- Crac+.�,: and Area
I�,F �-• � ti . � E:<. - i i, � _,t j ti -- �;
s " - o( c:inF � I,ghts j t ra�t : 'vo. _,n - - - =-t ' sa.e`t
E =� .>� � � ! 1 i .� s =Y ��� ; -�� : �� �= � .� � = i � � i y,
; � , 4' ;.Y' � �3 cr ' f �l � � _� ``f i
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I ,/ � ��3 (� ; j � � I �,
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i�=� ._. _- � � I y �' litfi!tr3;��-
;' ,;� ;�- /.� � � y"� � 7-� s�
G!=s; � � ulass
� � �+ i i ; �� � �/ ; �� �''� Sl C•S� � C
Ex�. wa' .� �/ �'� � Exp. �tiai! f �l`f! '' �S ��%�; !
NP� fY:. .3�! / ��, �: ry I ( / �� '/
k het ex�. ti•.a �//'2,�' �C !�� 3 T`
i^t. w=, I Int. �aai� � I i
.
Ce._ �^ � i�:� ���-� Ceiline� � �
F�•��_- � i � Floor � L`�r2� -� ;_�.� 7�
To:=_ �;:. Total 3?u.
ne�_ -ec _,. �t. E.C.R. or sq. ins. W.A. Leade� area I Requ:reC sq.'t. E.D.R, or sq. ��s. N.A. Leader area ����
�
F. Room Length 1'�,cft^ He�g'�t FI. Room ! Le�ct� Width Height
itm�cr�s and Doors-Crackage and Area j �;!indews and Doors-Crackage and Area
�y_ d� r He�qht No. of L�neai ft. � �--a i �,;.,h Ha�qht Nc. c` ! u^.ea! ft. Area
- � _3ne of pane lights of crack • sc.c� No. � cf�ca�e � of pane I� �� ! f
6 5� e erack sq. ft,
I i �
i i � 1
� � � � I � � i
� �
, Coef� Btu I Coef! Btu
I^`+ t'at,D' I ' Infiltra!io^ !
i
Glass , Glass
Ex,: . wa � ! �
Exp. wall
Ne: ex�. sn�:! � Net exp. walf
InL ,n,•all ' Int. wal�
Cei'i-�G 1 � Ceilir,g
F'� , � F loor
To:= 3t,:. Total Btu.
r;ec_-�� 5= `t. E.C.R, or sq. ins. �U.A. Leace- area Requ�red sa. `!. E.D.R. or sq. �^s. ti"�.=:. Leader area {
r, Room ! Lenath 1', � He ,�- FI. Room , Le-c*.� Width Heigh;
�'; -�~.:,��= and Doors-Crackage and Ar"=
��� - i �. , � _ -
, . --- o'cc:�^.e I ^I�g�ts c'^r :.K
I -
'� _ _�
G!as_
Et.. r'
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Ce �-
F I;�•
4'�incc:�:s and Doors-Crackece and Area
tic. �. - . �.� .. ti. .,. _� a,. Ar?a
' ' - ~ C..nc. ;..Eh.c ' `•3�t j SQ. ft
I �
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1
:
sue�ecr PER1v11T NO.
City of Fridley ° 13584
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� � RECEIPT 17Q:
� i y_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �, �, 4!�
1 �
`__-_ �,�/"�1,,� CITY HALL FRIDLE� SS43Z NUMBER REV. DATE PAGE OF APPROVED BV
� � � 612-560-3450
910-F15 6/11/76 � �
JOB ADDRESS 1551 Camelot Lane N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 12 4 Harris Lake Estates SHEET
2 PROPERTY OWNER MAII ADDRESS ZIP PHONE
The Rpttlund Company, Inc. P.O. Box 32082, Fridley
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
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 ❑ ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
X
8 DESCRIBE WORK
Construct a 26' x 42' Dwellin and a 28' x 24' Gara e `�MPORTANT-�
:�c�ERATE PERMI TS RE�jU1kED fOR �II{R1P�G NO iS ON REGARDING cuRa
," MBiNG AND SK��IS, TO REMOVAL AND REPI.ACEMENi
A OPENINGS.
STIPU�ATIONS provide a truss design. Provide a hard surface driveway. Provide sod
in the front and side yards. Provide a verifying suzvey before capping. Set house
back 36' to compensate for cantelever on front. Soil tests and/or borings may be
required.
SEWER LOCATION (Approx. 13' Deep) 45' East of Manhole (Inv. 876.43)
WYE ELEV: 876.61
TOP OF FOOTING: 879.61 Minimum �������
WATER LOCATION: 10' East of sewer service.
T' i:' C►tY p"r F<IDI�Y DO�S Npt GUARANTE :'r�{� sefae di�ging calf toGal utitities
� C�::U :ACY OF UTILITY LO�ATIONS At�D EtEVATIC. ,, TEtEPHONE - ELECTRIC - GAS EtC.
�i •:�.i DATA IS FOR INFORMATION PU�POSES OhIY AN� R F Q U I R E D BY LA W
PERSONS USINCa R SHOULD VERlf7 THE iNFORMATION
ON THE SITE
TVPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCl FYdIIlE
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 R 1 1164 i' 6OO 22,496 'F Fj�OO
ANY TIME AFTER WORK �S 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 TFUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OFDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $35,540 517•77
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRU TION OR THE PER ORMA CE OF CONSTRUCTION. $�j2. %2 $350. OO
��� `f�{ �b /.f � �°!� a—j/A P�AN CHECK FEE TOTAL FEE
• �' . - ,,.,. 6 -- 7-�' 7 � $420. 49
SIGNA�UREOF N�RnC7 ORAUTHOR12EDAGENT iDnrE� � WHEN PROPERLY VALIDATED THIS IS YpUR PERMIT
`,�.?J1 G..'Y�%. C� � ?� ��' (C�-���E;'
SiGNA7UREOFOWNERiIFOWNERBUILDERi IDATEI BLDG iNSP DATE
�
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OPilt�� C(3. r,';'��� °�.;� �
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Windov��<_ �oors G,:�Ce r;; �.,--- � Wali �� -- -k.,c,f - c,... n v ' Hcr. ���.,ec
Peference _ _�_ � � � ' *'�
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i
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1; _-, _ a^d �oers-Crackage and A�--� N - — � � �-- ^.,- ,� � �
c m,.ou. :��.: .:� r s- �,,, r,..,.� and Area
---r- --- — --
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Exp. wz °" ` v { i c- rS � , l' t
� 'L .^ O �_� � E �c p w3 I I � �/� � ; ���
Net exr. ,.- � �,� het exp. ��a': ��
In;. w•a� I I ,
� I Int. wa!I j
Cei ;n- r
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'� �^��•� i.�J� :,� � Ce;i��g /� %� / !r / f i.
Floo+ i i ; Floor I i
T°ta' �''�. Total 3tu. ��i� � I'
Re�,;:-e� =c. �t. E.C.n, or sG. irs. NJ.A. LeaCer area n^eqwred sq. �t. E.D.R, or sc. ,rs. W.A. Leader area I��
�
F'.�r' , C�F�y'� Room � Length 1'r dt� / Hei9�.t / FI.���T� Room Le^gth / Width � Height
t'�inc_�,�,� and Doors-Crackage and Arez j VJinde�,�s and Doors-Crackage and Area j
�'C�.---.� I ne�gr.t i No. cf Lineal `; ., :.•e= I
Ne. � _-_ ���ne • ,�o. ' V,�c•� �a�g^.t � �'�. �` L�neal ft. Area I
, o. i I�ghts of crack �� sc � of p3^,� � of eanv i i,6n•s � of crack s4. ft. �
� /tc � ,�l� ! / :� �� ; !� � ..� ; ��, �� ! ,/ .� �' /
! i � � � I i I I !
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I ' Coef Btu
Infil,ra�:_� � C j �S! u C. Infiitraiio� �� f/�� 4
IGtass
� Exp. wa! i �
Ne; ex�. v��'!
I Int. waii
Ceiiinc
Floor
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i f� / I - I G.� ..,
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' Rec:;,re� _.`L E.D.R. or sq. ins. VV.A. Leader are2
i --
1 FI.�; � �,���r Room Lenath �/ 1`;:d*.h,
< t
t';i�cc;,_ =^c Doors-Crackage and Area
N, . _ �z - �,:��;� < < � �< -
q I �
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— t.
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I
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Glass ��
Exp. wall , O
Net exp. �val I
int. wall
Ceiling /
Floor
To:al Btu.
ReGuired sq. �t. E.�.P, or sq. irs. W.A, Leader area
/ FI�/ J?5� d�� Foom Le�c*.h �. Width
ti'�indc.;� anc Doors-Crackage and Area
��; ^ _ ", �. N. , ��nea� ft. Area
.�. ' cf p - C�nF � c` crack sQ. ft.
_' �.� ' ' � � � � � �.� -�
I �
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Exp. wa! i , �` ;
i
.e! exp. v,a !
I ,. v.all
— =z' , , �; �X / .�
F.c :r
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�y
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Btu
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u
��'1'LICnTION 1�OIt Rl:SI1)!�N'fI/1L, AI,T)�It/1TION,
OR /1ll1)I"TION 13UI1,llING I'1:IZI�IIT
CITY Or FRIDLLY, b1INNL'•SO'I'A
OWNEIt' S NAP1� :-il Y i��� r r/ h:� c� �,� F BuzLVr� : f�Y �'o rT /��k �� r-�- .��,., r,_
�nnrs:ss : ADDR�SS :,1�• �•� i,,- X :3 � o �� 2__
uo : �. � : ��- � s ��x : � � ,a ��,-, r � r- �,� � � ,� ' ,=
LOT : / �' �LOCK : / AADITION : f�,e i� r� .t 1i9,(/-�� _f- S y'�a7'� �
COI:NJ�I: LOT; INSIDI. TOT:_� SETBACK: .5.� SIDEYIIP.D:/� �%
Appli.cant attach to this forni �ao CerL-ificatc:s of Surv� of T ot and proposed
building locarion dra���n on these Cext-iiicnL-es.
. �--.
TiL-'SCRIPTION OP 13UILllING
To }3e Used As :`�'r �%%�E- f,�9 �� r i�'
, . , -
- � r. � r Fxoi.t : � � pepth : y Z Height : "�; j' —
�� � y �,
• Sc�uare Feet : ,��.�-.� `. Cubic �eet : ,.�Z�
,
� � f, i� f � Fxont : �' � �DeptJi o � y � Height : ��
�C �
Square 1'ecY.;,�-� Cubic Feet: _ ��� U
7�pe of Construct=on: = i,� �,..,, .� L'sLimated CosL: $..;��•-f+ d�—��•�----
�
To �ie Compl.eted: �- 5 �"' -- �'�� - — � `�1 .� 4�G7. d v
1'he c�nc?ersi�necl hereby malce � aPplieati�n fox a pexmit- fox t:lic c•�orlc lierein
speci_tied, a�;ree.-�ng to do all woxk in st'rict accoxdnnce �aith Clie City of
Fzidley O�d�nanec�s and rulin�;s of the Department oj 13uilciings, and her.eby
declares that �11 the f�cts and representations stated in this appli.cation
ure txue ancl corxect. �
. ,, /
� .- �, =� <<r � -
, � +' j?c. 7Y- (i-' Br •
. .
'� • — —
• �x . �� � -;? ?�,- s�cr�AZVr.�:__�� �,�``� ,�,�-�S .
(See Revezse Side I'or Addi.tional Infoi-�nation.)
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5431 U;JIVE�tSiTY AVENUt N.E., FAIDLEY, MINNESO'iA 55432
ROTTLUND COMPANY, INC.
P. 0. Box 32082.
Fridley, r.'IN 55432
Dear Sir:
August 2nd, 1976
TELEPHONE ( 612)571-3450
During routine inspections throughout the city, by city forces during
the past few weeks, it has been noticed that the existing curb and
gutter in front of j.551 Camelot Lane has been
removed to facilitate the construction of a future concrete driveway
depression. i'dhile the removal portion of this work has been satis- �
factorily completed, the replacement with the new Gonstruction has
not followed in a timely manner. i'lithout prompt replacement of the
removed gutter section, severe damage can occur to the existing road
base and adjacent curbing foundation during everx rainfall.
Therefore, it is mandatory that your proposed drivetivay entrance de-
pression be constructed as soon as possible. A xeinspection will be
made seven (7) days after receipt of this letter and if it is found
to be in its present unc�mpleted condition, the city will contract
out the work and bi11 you directly for the costs incurred to completie
the work. �
Your anticipated cooperation will be appreciated. ::�ould you have
any questions or concerns regarding this notice, please contact our
Engineering Division at 571-34500
TAC/grs
�,
Sincerely,
CITY OF FRIDLEY
J I��C� \���_� �,� . `,.lT� �`..�.� •\ _�, � � J��
�
Thomas A. Colbert, P.E.
Assistant Czty Engireer
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sue�ecr PERM
City of Fridley
, , �_TH�T�P�QFTHETWINS gUILDING PERMIT 28582
, � �7z �
� • COMMUNITY OEVELOPMENT DIV. � � / �
� LV������
r � � PROTECTIVE INSPECTION SEC.
i �
i_-_-�,��"'1,'� CITV HA�� FRIDLE� SS�J2 NUMBEA REV O�TE P�GE oc ♦anROVED Br
Z 612-571-3450 9�0-F�5 11/16/98 � �
J08 ADDFESS 1551 Camelot Lane NE
t LEGAL �OT N0. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. 12 4 Harris Lake Estates SNEET
2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE
James Pa ne 571-1445
3 CONTqACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Midwest Sidin & Roofin -
� ARCHITECT OR DESIGNER MAtL AODRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO
6 USE OF BUILDING ,
Residential
7 CIASS OF WORK
O NEW O ADDITION ❑ ALTERATION � REPAIR p MOVE O REMOVE
6 DESCRIBE WORK
Reroof house and ara e 25 S tear-off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVPEOFCONST OCCUPANCYGROUP OCCUPANCVLOAp
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, P�UMBING. NEATING,
VENTILATING OR AIR CONDITIONING
TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONS7RUCTION 20NING SQ. FT CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTqUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOFi A PERIOD Of 120 OAVS A7 �
ANY TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OfFSTREET PARKING
I HEREBY CEfiTIFV THAT I HAVE fiEAD AND EXAMINED TMIS APPLICATION STALLS GARAGE$
AND KNOW TME SAME TO BE TRUE AND CORAECT. ALL PROVISIONS Of LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPLIED
WITH WMETHER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE
PFOVISIONS OF ANY OTHER STATE OR LOCAL lAW REGULATING CON-
ST TION OA TNE PERFOiiMANCE OF CONSTAUCTION 1
� PLAN CHECKfEE TOTA� E
�_ ,�� !/ l b �
S�GtiatuQEOFCON'Qa�ipaOQ�uT�OQi2ED�GENt i��rE� HE PROP L VALIOATED T IS IS �OUQ PEQMIT
i /
S�GNY7UQE O� OWNEp��f OWNEpBU�LDEAi �D�TEi B G�NS� f�pf(
.
Page
r FXTEFIOR Et1VELOPE AVE127�GF "U" COMPUTIITION � o � S c o7G x N a� _�3G �
' ------ ( o w � r a �e x S/ / _ ! 3 �/ �
�'p ,6 �� O 7 J /�cY�,- / 2'
O��INER : _ _ � DAZ'E �- / I ' % �
SITE ADDRL,SS: ISSI CAM��o�' �AA�� PHONE: ��i� ' aO�O
CONTRACTOR:. %ij�_(�o j-rL v�t d �. X N`�_
Determine ti�orking square footage of each
1. Toi:al �posed wall area...... �Q ,� sq. ft. x
2. Toal roof/ceiling area . . . . . . / / ��__ sq. ft. x
.17 = 3 `i �• �
. 05 = s7. 6
To�a.l exposed wall area above floor =
a. Total wall winuow area. . VP�°'�Y. :�: .S!��. .��9�TS. , . . . , , . , $��%, / y
b. Z'o�al door. ar�a ...................................... �p a0
c. Total s].�_ding glass door area ........................ _�'jl•9�_
d. Total �.=irep1_ace ti�all area .......................... ___�t�1¢—_
e. Toi�al wall framing area (average 1G%) ... .... ....... . /�a, 3Ff
f. Total rim joist area ................................�,,/ �Oa. O�
�J•SnlSulc e wall. ar�a above floor........ ............... y�a9
h. ,. .�_ wall area above �loor.�N$ulo��d1 . , , , , , , , , , , , /` �, �
a_. $r j�k wall area abo�,�e floor �N�f1(A7.e a • . . . . . . . . . . . . .di: I 30. O v
7 • ��—_ �� area above fioor =NSy�At{d. . . . . � , . . . . . . . . . _ a� •.._��1_
Totai exp�sed foundation area =
�OWeY IP�� ` 4 � 9 •�2
k. Tc�tal f��� F�i�?�� ai-ea ............................
1. Total net foun�:ation a ea above grzde ................. _�,�
�
Det�z�min� "U" value of each �:�all scgmc:..s:
(�.q. window, door, each arate wal' scction)
�
�.. gy, � x „U,� , � _ ��� g o
,'
b. �Q. DO X��U�� -� : SS = I I• o d
C. '1 �. 9y X��t,�� . s8' =
a. _ ��� _ _ X „U�, , �a y .� °
„ „ �i
� . �I_��. �._._ x u _ ' 3 _ _ _ �
�. loa�oo X "U�� ,os� _
`�!_? �
i S, � 9 .
� � 3y__
�.or
g . �. �9 � ,<<,,, . 0 6s = -��� —
n. _ �. 6_ x ,�U„ ,a`z = 19•�
i. _1 6. oo __ x ��U�� ,�"D� =_
� • -- �-�---- X �, �,,, , o b��J =
�.• _._ �q_92_..__ ,�U„ � S� -- -
$. 9�
i, i 2
__ No� � g_
� . 7( , 3 �---- X „U„ , � g _ - ._�S%��
3 . ................... ........ ToLal = ✓✓��_3 �.
If itcin #3 is the sarle as,
or less than item ikl, ��ou
have mc�t ttie i11t-.ent of
s�c �oo� (c> 2.. _
,,,�„�,:.� •.; �
.,
� I:xterior Fnveloi�e Average "U" Computation
,
Total exposed roof/ceiling area = /%S 2
m. Tota1 skylight area ............................
17. Total roof/ceiling framing area (average 10°�) ... 1 �S , 2_
o. Tota� net insulated roof/ceiling area........... ��j 3 6.�i
m.
Determine "U" value for each roof/ceiling segment
X "U"
�
Page 2 of 4
n. I I S• 2, x��U�� . � 3� - y• �,�'
L
�. la3G. g X„U„ .a31 =, 3a- _� �_ ti�
4 ........................... Total �.= 3�. � � ,
�
If total. of n4 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 syst�n method, the values establi.sheci by the sum of
items ;�3 and #4 shall not be greater than the sum oL items #1 and #2.
�. 3y� i� + 2. s�Z� _ �oS. �9
3. 3 33.33 + 4. 3�• �_ = 3�9 6/
j,d r A f� w �A l C.
Z�Nrt v� o r � I r F� � nti • 9'7
/�- � S % �r7'ra r . �/ 5
���� �N v �,a Tio.+i I J o O
a.�
�a b�it �'- - r; T�. o? a L
�� Fl v-� w�A l( Si
�xttr�or A�� �i�,,,c ,9�
TorAl � S• 9a i2
,a� z v
C,� N T �4 r e A�
��' .Z<�vT�rrior Ai�- �i�An . /, Q'
��/
Z'��5 v le r��o.�, 11. a D
i�� ,�,-r r- Y, r-� �. o r�
� P�Y�vo e � . 5 7
�X 7�*° r� Or �d I Y F� �MC ./�i
i�, y��
.o�y U
. 1= l Ye p%,o� �
�/�l %fY/O Y� A I Y' �l �/d` e��
�OMMON �r�e,� t,��
�' 6/ �,� 1 / J
. �4 ► � ��o,��e q g
s'�' �lo�k l lI
� �X %rio r ,d ►Y F� /nn � 1'�
y. y s �
-��4 U
� WALL SEC�l'IONS
NOTi;: use 10� of: o�>aque wall area for
� frame construction
.' 1
_ i' ;
,; � �_�
.� �
�
.I.� 3
� '�'r
PT.S?C } l
WALL I�—� , 1.�----_ —�v�
FIG. �rl
FRI�P4� 1tALL
�
Construction
Page 3 of 4
R-Value
l. Interior air film 0.68
a. ' �' sh��r,-a�i� , �
3. Fr.4rnia9 !i• 3J
a� •
4. � ��lT - r�r4 � , D�
5. �i �NSU�iTs, S�diN9 � . � `�
6. Exteri�r air film 0.17
Total S� 8'S
.113 V
�, ` 1. Interior air film 0.68
• 2 . � ���"�P �k - �.�
� . � �r-,-�; , � � 3 / „ .
,l� � . �-. ° :-�.. �,�.. 3�__���su�Ar,o�� r1 00
� l�,,�-�-�� ��it ��. �• a�a b��r - r�r� �-�
rzc. �!2 i _.N � � '
�--.-� _! � � . /.2 ' S'M v�i _r� � � �i �r9 i _ y_
��� �� 6. Exterior air film 0.17
�� . Total /,5. so %Z
� �.--J � _ .�.,-,�._._.� � . - o d s U
i ;• � �, �.- � - --� .
r... ;4,:.'�,=" - -�i �`�'� ` ��� 1 0. 68
. , -;�.���! � R� ' . Iritei-io� air film �
�j� L �`��;r (.��( � �R -�i i (�_._.._.���....� �,,� _
� ��-"� : i i `{� ? 3 ��� ZN,�rJI,G T/o.c� � I � � 4�_
'�;�� �� � � ��..1. ,, . : �,� _ �`,'`�,,J _
��'_'_�_`.+_5, ,�. _�r�'�� I`�..�,; �-i_'- i`) %" 3 . --- �nn _ So i sT______ 1 � �
�' ;; t,:��; ��. .� �� �° �-J �. _.--�!l'' a� .
�,, � �:��.��. ; ,\`�r ��.� ' • �,� 4• �a �.��cT -v �T� _____ �. O �
�. ._....I I_r ` ������ �'__.:.� �_. .a,v..__..��_...,...�� - 5 . �?--.�N�e�r��_�e� � � � �
x % ��✓ _�_
:r-� . .
� j 3;�� �'''. �� El • �. � 6. Exte.rior. air f ilm 0.17
j� �%; �"�' ���`�"� ' ----�---.0 ---- — Tota� � � . � 9 �
>,-, ,°' �-'•� , '` ='-�--_. ,____.-� {.�``' •o sg v
r.i.•:J�.�,�:C: :•�:.'-�-',�- __. -�-�-�,_ ;;,�.
'i � ��, � t � �'� ' .- ------------��
_'��'��' i f �i,��i � �i- .-:,;� i : _-----_ \.' � - cva�c u,l �Y,��,�
_ Ii •� , ►� . �_r'''��� . �
� 1 Inter�or air film 0.68
I �< �� ���-•_`� S�
''�r� � f� � !` p �, �"'"
,_._._1'4, ��._...r �. . � _� !�"" ' ���._ Z �s vL,e r�o�v l 1• o 0
t ._
j •`•.� 3,�a ,� T- Y I 7"c. o? 0
4.�q � �- � i l nn ,/ 7
��`c , 5. 3 .. �DM1�neN �vL� ��
i� 6. E�;terior air :Eilm 0.17
`_�� � ^�` Tota1 � p 69 U
►�>�_ , � . . - -- -
� --- ��, .
� � • � ti ' • r • ' � ` '„
— �-- -- • r^ � � �
��_ �_r f�C",?1==--- -�� t�
.:, :-, �' . , : rr� �``„��: ..��r_,,,, - i�i,� - ,, , � ._ , . - , ,
� � . f. . , �>� ,;.� __ � ��i�---_ i<<.~ _ . . . �ti .
,-
-- ;-; = >� , �rt
�� i�. f _ �� � ��
' �� �' . • �'
FS G . #f 3. _.yY�,
� � /' • . ` tr ._._
�_ .,�._ �
< <` .
. ` U � „ �
. . � . l
�•� � • - , -1 � • �t .
/(( >' " t � ' 6 • � . ' f 1 � ._-s
( c ( �' . , . . � � ��/(/. � �� �.
FIG. ��� ' ° /' .-= J�(
�. / < ( ti ' • . c? �, "" `
' � ( � _ u— X � � � ���(r .
� ll ( ..: Il f _. (/l ._
NOT�;: TI�1c�1C�it-�� tync�, "r:" v�i:l.uc, deptli and
}?]_ace���ar�t oL i�i�,tilaticaii. •
.
.�
.
�t .
/
----�% �i
��i-
:1-�'' /
. ��"%I : i
`�C11l:Gti
ROOF/CEIL,71'1G
, ..•
� —� �
�'"T' .='•� � � (t
,,- ,
� ,
��i?=Y' � � r--
�
"%�;� ";,��!!ii ;�r��'�.. ��.�,
%%i �i� �� 1�y��.��-`�1i�..�� � � ��
,�, �.,�,,I„�I ��i �
� ��� ;; �____�---� .�.f,�...___.--t_
'%%� �.�j ) •-
. � � . . .
� ����r slpW
�'
f.��_ uP
IIG. „5
-rr�,_r�._._�,-,•_-,.��_.r,• ``�•_ _-�,°�-�`-°=��<c�_'" _`Jt-� r,`�!
----------�_�.�_�� ___ .-. ;�---------,,.
� � � `i'%
�,
1 �'
;I i�
; �
. ����-! �?' �r �
0
C
---}--------.�. . ,
��---�'� � � l �-- �° -
� � � �
??e�t: f1o�1 v}., , , ;�ven�ed
. ,F1�;. iiC� . . .. .
. ___�� _. . 4��� : � 1;
� S
' ! �. S -, t` r-,.^�-1
1 C.il.t'-F-f�-.ij� I _ - 1 '�
• ' ��I:.�.+.;�::l� .. •, • ;:�
Y y 4 . `� ;;i _�, . _� � : ''� ._^.-.--��� -' j•'. ` j ":--- ✓'y1�.a
1:,:••:,:.,,..�,�:.;.�---�' ,-- /f-��� �` _�...—T�%
:'� j r i .,/ /�°� �'.---`�- . � i /�//�
�=- r �...�-- . .
, y,
1;..-- - �:-� % `�-V. q f
` .!i �� � . , y /
��' ��
�, � i l�'�
, �� . . .,� .
:�.....�. . .
� t;a��-�� ��:� � .
. .. . . � .
. �,
- . Hen� �
, . Zluw u� . • '
7'):�. �47 . •
,
Construction
Page 4 of 4
R-Value
1: Interior air fi_lm 0.61
2. ��5� ee7` Noe� -�
3. lQ „ SNSv�ATiO �� 30 . DQ
4. Exter.ior air film (still) 0.61
Total 3l • ?9 �
,031 U
1. Intcrior air film 0.61
� 2 • =NSU�AY'�oM � �� 0��� �o�sr 1 �• 00
'�'oiST CFrAM�Ny i� ���
3. S�.Fi� P rrr p ek � 57 �
4. �xterior air film (sti_11) 0.61
Total �7• S7 R
•03� V
1. .T.nside air fi]_m
3.
4.
5. Outside air film
Total
0.�1
0.17
Note: Use addi.tional shee.ts if more space is
needeci for details and calculations
;.�-:n��-,.
. � �
• • ,o .
• ' V ? � �� �i'y :""e . G i �' i f ' • ' - �/y
y .o ° ..+.. �`O.af`�..._, U�� rn�'� y V
' r1 `e-���S',T�::i��:: y4:: ��s':.,�:t�::.�'� G:.:r�l ��..:;� li Sio;;�� ,. t��:'.:,: .
. r--�• i _
. • _��^. ,._.._._...-- 3�0�:. cf �Id�. ihor.a S-"^,.•3"' ... -
r a. PTIO:i G:•" �:lC1�:: ,4: '%� _S � � � t .�
) _ S C _ 1 y�„=-. --
tiL-�.S:-. ::i=..'' e.^.� L^c-!�c� c� r���_�es . .
— � � � I, ' i I �-� City o! ^:c'cy:
� �� wxTfQ
� � 7 I, � iu - � � �' I u � - � � ; :.akes s^ �c�a:ion .cr a pe.^^it .'cr .`:e Qc:� he_
r � � � .+ � i ( � % I � ? I � � � � < � i � � i < � � 7 � I i "" 0 N � r,�S [�[C. i`hC L'n�C'S.o cd hercby . y�- .. �_ ^
_, 1< � i � N �; .� v I ,�, �_ c � i < 3 �u �'V j:, �J I !� eCl�:^d, � �c:^^ .o �D �,1 \'.'C,-T: ..� ...^C: 's::C. .....'Z �:'::�1 :~2 C:ti C:y::.�..
� � L i � �1 S � - j� - , i -,_ ! I � �� - � ..;, ✓'�+u` ^+ F � C:at ii'��e f:
--v�_ i =--*— ' / , ,:; ;,; r ,,, � a.. e:e.,; eec:a:es
II+�j� I � a^d :-�Ii�g ot �he �}, r.:c o
-�r f; 1 I �� 1� I i �/ � �. I � • ar.d r::;,:e�t:.tatio.^.s ,. :cti '_n �.�...�. Gry���.r�..�. sm t:�•� :..�,c co::cz.
�� ��l �� I. � � I I I � �� %� :�_
� f � 1 � � � � I � — � 1__�_-��`_`�' i ~`- =a:� � � � .
� � ---
�: � l I I 1 I � I -
_. � � i i-I I
; � - ` ' c�: _.�_.�.,� rz�
• F�.�a �.c:.:......... Cr� =°". `_,";.Ncz 1�
c }{.c .....�:�a. O:d G�s=.r.vs Ccr;?w: �
��P,i'lAt. R�T� S�H�DUL�
O�xr.cr '
iiind o2 B::i,r..^� �� �+ � ,��G �`� /�� -
L;sed �s
To t�e corr:ple:ed a :out
Es:ir: atsd Cos:, S
� � ::Ca. _ `a:ai! ti0. �0 �
:d—t�;ev�. F3u �r.� ?e--ni! \�. �
..�.-,.:- :i�. RAT� 707nL � - jl,
r,•��V�t,iG :�:i. V. .. P.1li'ES: cr.,;;Cd /! "%r �
• � � , .
�� ��. S ���,oc� .,.,
:�`...:.�:r F�xtu:�s . . . . ...... .... . . x �- � •--
� x S'.�0 S ".?.f ' �y. �,�'� � , <
Fl::�.:ce c^:x'.c:e C:;,er.i^g ........... . —,--
� Bu�;r,� Y.^�ne tic %� �—�l�'�
x S1.5J �_ " -
;:ew F;x:_:e 0;:; O�jening.......... . .-_.
. f� �^ �
Calch Bas:a . . . . . . . . . . . . . . . . . . � . x .,.,...., �
� x� 3 ir? 5 3`'' �: . '• ,
11'.!e: }?eoter `l;? ;o �3.OG� °Tli�•••• • RCUDii
tie a G: c•�:,3 _°.ua Ol� B:dg. . . . . . . . . .. :1.25 �
i .'.ct::c Y,'.:,: Y..s:.ar . . . . . . . . . . . . . . s � �.C�; � pIN:� � � r 3 � % (o � .
:�'' _rQ, ?ZO. ::: � TCTr:L
:s�S F: � ; .. : .. .
�_ x 5''. G� ,+, ,� c c-' �� .
. I:. 3 F:x'.:res . .. . . . .. .... . . .. . . .
�►,��!L'�nal F:xt::ses .. .. . ..... . . ... _----- x .°. .75 5 .
Gu P.�^je to 1G3.� a;J .......... , x S5.G� � �� � .
. ��� ���
. -i
. . :�`�J S�<:.�� S1:�C�''__'.^ J` • .
v�c--��.�g bc �:.:E.'O�T:vY.S--:'.o:er :o Cc�'s
e ,
. r,c�:: f•.:on . . . . . . . . . . . . ... . . . , . . . . . .... . ... . .� .
� ..... . . � , . ,
i�Jit!. F�. S '% �, f'v
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N
CITY OF FRIDLEY
� � �% 1./ � .,� J
��F'PLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING $YSTEMS AND DEVICES
PAf�T1�L FJ�IE SCHEDULL
l�lt.\1 I I'1" k:\I:�t iU R:
i��u�lit�;u St�i�l.l. � f��,�,.t:. Wux'k
kuE�lac�>tu�,nt. ��f' i'itrr,.i�:�•
krn��.�lt'x F. �l l:�•r��t.Jr,n:-iiE, Lo $`-�OU.UO
Fmk�airw G Alr_er..�t.i�.r,t: ��.xc:n ecld. S5()O.Ut)
)liit:t{.1,'iIC,11, t5;�ti.^4 �\ I R:
F`�rnace :i%:ell & Luct Wu!S; to 1U0,000 BTU
each add. 5Ci,0UU DTU
Raplacement of Furnace
kop�:iiru & Alt.��zat.i.ons-i�E, t.o 5500.00
N�t{�air.� h J1.lt.�:�Ynl..iotia c�r�c;h �icid. $500.00
.ti'llli'�1 [ilt li�a'l' W�1'l 111 :.1r�t't �1;
i3�ilet' G I.inc:s� u�� co li)�i,iiU:1 BTU
eu�:h a�'l�;n. tiU,O��:�l) Fi`PlJ
liolle[ c:nly u� W tOU, 00J b`I'U
uac:h �lddii. SU, U00 Li'lU
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AUPJtUVAL F'pR rL•'FtMIT �f�.�
__`
lt1•;7:J3Pl:C'PIU:J 1�'Eli
($10.00)
MINI:�UM F�E FOR ANY HEATING PERMIT IS $%.50
r
Jot, Acldr. t;air, l � ,� � �Gr � � f' �/; � `- �� . �- ".__
Uupartment of Buildings
City of Fridley
Tel. t�571-3450
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 pf the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. � �/ f . 19 � �
OWNF;fi ....,�..�..,_ �� , ��� . �/ lG - �r! .._�._.__._._........_Y..,.�,._..,..�...-
KIND OF HUII,DING �' �'� =-'� -
USED 1L; ✓ �•.• Y' / /% ''^ j
TO BE COMPLETED ABOUT ¢��/ }� � % ��
SSTIMATED COST ��� - �' "
OLU -� IIUZLDING YERMIT NO. _ YEF2b:IT NO. /IS
DESCRIPTION OF FUkI4ACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. �
Trade Name i�i^^ �.-` �- Size No. �" !�%d u.S J i'= -�
Capacity Sq. Ft. EDR �G-�` BTU HP
Total Connected Load $ L`� �% Kind of Fuel C� ✓
BURNER - Trade Name
Capacity
Size No.
Sq. Ft. EDR _�_ BTU iiP
Company
,��GEO. SEDGYt'iCK HEATING & alp CGhi?�'.Ti;'P;:�:; G�`s�gnea ay ___ ��--
1�01 XENIA A��t. SO�_!Ti-� � �' J�
MINNEAPOL!S, MN. 5E;,.:.:. Te1. xo.
545•16T 1
NEW r [ ]
ADDN [ ]
CITY OF FRIDLEY
Effective 1/1/98
ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ��
�� l�
ConstructionAddress: l55 / �"«� �/�, f 1-,v-
� ��
Legal Description:
Owner Name & Address: ; J �f,� � s �� �;c%' Tel. �/ :� ��- � ���
Contractor: y l� �� i �lc�, c s�-- S, ��, i, �, � �c�;�� �; �i G- MN LICENSE #}vo/o� ��
Address:lk���7� l�la���S�Z�rf /sl����� ����,�� ���.T Tel. # �/� - /�v�/
�
Attach to this application, a Certificate of Survey of the
, lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
� S ss �`<<t y � �
Construction Type: lzu%-c� ,�; � ` �n�-�� Estimated Cost: $ 3 , � � >> ��� o�� �%a
—�-
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: I � �/�O - � � APPLICANT: �c � Tel. � �//� ' /�J ��
,
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ ,` S Fee Schedule on Reverse Side
$ �. / y .001 of Permit Valuation (1/lOth%)
$ /, D % $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ � • UD $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 [ ]
$ ��. ��
s�e�ec* P
City of Fridley 312 0
AT TME TOP OF TME TWINS g � i L D I N G P E R M I T
� ` RECEIPT NO.
� • COMMUNITY DEVEIOPMENT DIV. J� � -
� ; V'�'��� ,
r � � PROTECTIVE INSPECTION SEC. 1f �
i �
� � r"'1 � CITV HALI FRIOLE� SSIJ2 NUMBER pEV O�TE VAGE OF •CVAOVED 9�
�'""�'� �'� 612-571-3450 910-F15 7/17/00 � �
JOB ADDRESS 1551 Camelot Lane
t LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACMED
DESCR. 12 4 Harris Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIp PMONE
John H. Payne 1551 Camelot Lane, Fridley, bqV 55432 763-571-1445
3 CONTRACTOR MAIL ADORESS 21P PHONE LICENSE NO
Owner
� AfiCHITECT Ofi DESiGNER MAIL ADOf;ESS ZIP PHONE UCENSE NO
5 ENGINEER MAII ADDRESS 21P PHONE LICENSE NO
6 USE Of BUILOING
Residential
7 CLASS OF WORK
p NEW O ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reside House and Garage
9 CNANGEOFUSEFROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building code, requires that a weather resistive
barrier be placed over exterior sheathing to protect the interior wall covering.
Exceptions for this provision would be if sheathing is an approved weatherproof
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
TYPEOFCONST OCCUPANCVGROUP OCCUPANCvLOAD
SEPARATE PERMITS ARE REOUIRED FOF ELECTRICAL, PLUMBING. MEATING,
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NUII ANO VOIO IF WORK OR CONSTRUCTION ZpNING SO. fT CU fT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED Oq ABANDONEO fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCEO NO DWLG. UNITS OffSTREET PARKING
I MEREBY CERTIFV THAT I MAVE READ AN� EXAMINED TMIS APPLICATION 1 $TA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND COiiRECT ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�� BE COMPLIEO �4. ,�S
WITH WHETMER SPECIFIEO HEREIN Oii NOT THE GRANTING Of A PERMIT �9�SOO.00
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEqMIT FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL lAW REGUTATING CON-
STRUCTiON OR TME .PERFORMANCE OF CONSTRUCTION � I81 . ZS F� SC �9. SO
PI.AN CHECK FEE TOT L FEE
$195.50
�GN4fUAEO� N'AA TpaOr+• iHpaizED�GENt �O�rE� EN ROP VALIO TE THIS I�,OUR PEQMIT ��1/�
� r%5 �V
7 —%?—Ga � � ci
S Na7U E O� OwHEQ �� WNEQ i�OEQ� iDATE� B� �ti5� ��<<E
NEW [ ] Effective 1/1/2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER �(] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ,�O `\C�
�
'�r��` ;�
Construction Address: !� S% �°AlylE��"l � �n/F .
Legal Description: �a;T !� f�co��c 5� �i9/'�i.S L�l�E E.�ivfTE'S
Owner Name & Address: VAmrS l�. f�YNE /S�/ �sfiriri,_cca-r ��1 Tel. #��3 S�/ -/5�5�s
Contractor: QrNN.�2 MN LICENSE #
Address: Tel. #
LIVING AREA:
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 Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA:
•�:[��
Length Wdth Hgt/Ground Sq. Ft.
/z�' � S��r �v vs� � G,�2,��-
Construction Type:��''-�; •�� � �( 2�!'1 � Estimated Cost: $ ��po� o0
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: %�/7 -GU APPLICANT: G f- ' Tel. # 7� 3�7� -iS�S�-�
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ l�l °2-� I Fee Schedule on Reverse Side
$ ,S� .001 of Permit Valuation (1/10th%)
$ �/, %S" $.50/$1,000 Valuation
$ $1100 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$
$
$
$ d
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
s�e�ec* PER
City of Fridley 3131
AT THE TOP OF TME TWINS g� i L D I N G P E R M I T
r
� � " RECEIPT NO.
� �
� COMMUNirv OEVE�OPMENT DiV.
� ; �-------. 5a�
r � � PqOTECTIVE INSPECTtON SEC
1 �
1 �
� ����� � CITY MALL FRIDIE� SS��I NUMBEA REV OATE PAGE Of ACPNOVEO BY
�.---�•� �'� 612-571-3450 9t0-F15 8/15/00 / /
JOB ADDRESS 1551 CAMELOT LN NE
1 LEGA� �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. 12 4 Harris Lake Estates SHEET
2 PFOPERTY OWNER MAII AODFiES$ ZIP PMONE
James H. Payne 1551 Camelot LN NE
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Owner
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUI�OING
Residential
7 CIASS OF WOFK
O NEW ❑ ADDITION dt ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
B DESCFIBE WORK
Construct 12' x 26' treated cedar deck
9 CHANGEOFUSEFROM TO
STIPULATIONS
For stipulations, see attached plans.
'�aRHe
1VG
$efore d�89ing �all for
SEPARATE PERMITS a�� ����tY locations
REQUIRED FOR: 454-0002
PLUMB NGG� AND�S G REQ��RED gY �
IG�IS A�/
TYPEOFCONST OCCUPANCVGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE AE�UIRED fOR ELECTRICAL. PLUMBING, HEATING.
VENTILATING OR AIF CONDITIONING
TNIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO fT CU FT
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PER100 OF 120 DAVS AT
ANV TIME AFTER WORK IS COMMENCED NO DW�G. UNITS OFFSTREET PARKING
I HEREBV CERTIfV THAT I HAVE REAO AND EXAMINED THIS APPLICATION 1 STALIS GAFAGES
AND KNOW THE SAME TO BE TRUE AND COF±RECT. ALL PROVISIONS Of LAWS VALUATION SURTAx
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILI BE COMPLIED
WITH WHETHEfi SPECIFIEO HEREIN OF NOT TME GRANTING OF A PERMIT �2s932.O0 ��..4%
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMITFEE SACCHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- �83.25 F1T SC �L.93
STRUCTION OR THE PERfORMANCE Of CONSTRUCTION
PLAN CHECK F ?OT L FEE
87.65
�Gti TuAEO CONTQ CTOpOROUTNOAi2EDAGENT iD�7Ei E P O R VA�I T TNIS IS R PER IT
; �'- iS-O L ����
S�GNA UAEO�OWNEQ�� wtiEpBU�tDER� iDATE� B G�hS� � �iLif
N EW [ ] Effective 1 /1 /2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Construction Address: �.S�S/ C�lt�1E�o ?r GA�/�
Legal Description: �-oT �� 8�o�x �{ fiA�/�iS 1�9�F�.��S
Owner Name & Address: c�fl�rEs �/• f�Y�� Tel. #
Contractor: D'�%���'2 MN UCENSE #
Address: Tel. #
LIVING AREA
GARAGE AREA
DECK AREA:
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 Sq. Ft.
Length Width
Length �� � Width �?G� �
Height Sq. Ft.
Hgt/Ground � '_ Sq. Ft. =���
OTHER:
L�
Construction Type: IZ����% ����'�' Estimated Cost: $ ��3�
Driveway Curb Cut Width Needed: Ft _+ 6 Ft = Ft x$ _$,
DATE: � C( UU APPLICANT: � -V�-
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ ��..�5 Fee Schedule on Reverse Side
Fire Surcharge $ �?. 9.� .001 of Permit Valuation (1/10th%)
State Surcharge $ /- ��1 $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Tel.# 76�-59/- /S�SlS
$ $1100 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 [ ]
� ��. �s
�
08/10/2000 28:34 6126332528 DAVE GAPIN�CI PAGE 02
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0875 M�yl+way No.6S N.E.
Minnsapells,
Minn SS432
Tel�phone 7t1-600A
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Engineers dc Surveyors '•° °
Loan Survey for R �T.T_L� N��O.
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lo�or�on of oll buJd�oqa� �f any� �hereon, and oll viaibl• •��•ooc6msnl�, �l w�y, frs� o. on fo�d bn� Th�s w.�ey i�
mude �only �o cennec��en w��h o TorrOaOr leo� n�w b�mq placed on �br pr�ptrey ond no lioril��y �s a+tu�ned
e■«pt ►e �I+e hold�r of ►u�h ..�or�qaqe o. uny ofhe. �n/er�s� ncquv�d by �tie v�ason of ��th mo.lgog� If is
w+denrood ond oqrt�d no moovme�N I�ov• b��n plo��d for the purposv e� •s�obhshlog Is� ���e� o♦ boundarr
co.nc.t Darod �1ri� doy o� A D 19_
SU�URdAN iNGINEERING, INC. C��: �"�40'.
r / Eny�n�yy S
— - - o�►�fes d►�.� E uf�l,{y ��,►x��s . �y�--C -- -�Z� �� �-�'I . ;
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE�
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMTT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 7-I-2010
YOUR E-MAIL ADDRESS
❑ OWNER ❑CONTRACTOR
NAME:�
ADDRESS:� S
PHONE:
COMPANY NAME:_
CONTACTPERSON
i��`�ti � i
� � ��- U ITY "� ✓' � C
� �j ,�- (
�� �v r��2
. `
• � �� ��
� - - , : �t:a
•
� . -�v,,.:: .• �
STATE�i��/ZIP g ���
STATE LICENSE # ' EXP DATE
ADDRESS: I/ 3-3 l G�� L-�C ���CITY� �1 G/J,�(' STATE ZIP
PHONE FAX
SINGLE FAMILY ❑ TWO FAMILY
NEW � REPLACEMENT
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK LL _��+"! e I`- ���
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH SELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
�A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILER $35.00 �FURNACE $35.00 GAS LJNIT HTR $]0.00
CHIMNEY LINER $] 0.00 GAS DRYER $10.00 POOL HEATER $35.00
P;U°`i` `>>J�RY� �1f}.00 GAS PiPING $1Q00 VENTII.ATOR $15.00
�, s�s; �� � c�: ���.�:7� � !�x,- � 10.�{� x � 1 U.4{} - �,
Number �f fixti�res �$1 �.{�0 _ x� I 5.0{i -$
x $25.t30 �= � - -��
��Numba�c����tur�s @,$25.00��� � �
� , � ���, __�- -_�
, t,_ _
�� Nu�be�r Of fixtures t�r �3�,00 __ � �35.04 ° � -- � ��- � �
St�te Surc�Yar�e = � 5.00
, ' � ���,
��r?���:���.�t ���� �ao.oa� �o�a� = ��� � �� ��, �-- � � �
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID CTNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of work which review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME '� C--r ��' DATE C�' �I �
APPROVAL INSPECTORS SIGNA
DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977