AF - 43292��" s(�("// �/II jI 6e�S Nighwoy Wo.65 N. E
,. , , �� � • • ( Mi�neapol�s,
� tfiw9 \' ,� ��,����t�,��� ��j��• Mi�e SS13]
,�"�9 �� � Teleplwne 16�-606e
� ���ineer �n�
.enlcipal Enginee� �
Et�Kineers & Stirvevc�rs A•en coa� ei�
' � - ; ; � I (.1:. � ��UM l.-5
tificate of Survey for �tC.�-iA�.�.� L �__ _____
Cer .
I 55.00
o a
— — — — — — — — — — — — — — — — i �1
�� / /� 7 % I
,,a
C� � .a C i� / / 1 /
� ,�a
�4
�g
�? iv wE
1
` I �
� �
�
�
�
a�
�
--- .
p = �l7 °A8'4g" , .
.�
�., S'-
� ✓�.,° _
o.
I `
LIryG
, � ,}
/36 6' `\
dA, . '�J INARNI G
��ViQ Befnre digging cail local utilities
�D� TELEPHONE - ELECTRIC - GAS Etc.
�T REC�UIRED BY �AW
-
�
�
L _.
Scaic.� 1�=�'iL.�
�IMPORT�RiT—
NOTIFY THE FRIDLEY ENGR.
DIVISION REGF�RDING CURB
REMOVAL AND REPLACEMENT
AT DRIVEWAY OPENII�GS.
I�OT 7� 0 C K�
H �s Ta-r� �
a.,oka �a��!y
I herebr cerl�fy /ha► r{��+ �� o hua ond co�rrc� •rp�etr���o��0� o/ u+u►vey of the bou�dor�ef of /hf obove
d��cr�bed lond, ond ol /he locar�on o{ all bu�ldmq �hr.eon� ond ull �,sible encroathn+sn�ti, ii o�r, /rom w or+
_�
soid land. As turveyed by me th�s__ doy o� ! .s_ . 4 �'o �
o pEN07ES ►RON ►uWNUNIENT
----- DENDZES ��NP%E � VT►� i 1 E�SE�EN7
SUSURBAN ENGINEERING, INC.
E ny�nee.c Su. veyo. •
bti�-----i�___ _L
0
a
�� r� �
5 STu�@F�60 l� Td
(�D � �20� ��P ,13d st
7� T-/� SOz.0 7�i
3
%68
�
67a
P
87� �g
���z
� 8� ��L
.��o� ry �.��� �- � ` �1..E. o-�' ���J�/o �.�J
7� Tr-�FE ,� t 5 7°;' 5�5� � r-,e u� srv/� ,c�d x
5����
.� o c,�- T� � iv ' c��s i d� 2J�4T��2. , 4� y� � v c. �q- T� � �J
/ 6� �� �e4s � c� � �1A-� /�k� �� — 4� Y� c ti.E d.4-T7 Q��'8 d, 3�
i'17�a� �rn u r� �80. 35'
� O o �- � a �--, .v � -� �
8�g3.3S
�
�
THE Cf� pp FRIDLTM OCA.flONS AN�A E�IF�A �h''
ACCURACY OF U71LI
TNIS DATA IS PQR IN�O�T10� PUr�OSES ONLY ANJ
PERSONS USING IT SHOULD VERiFY THE INFORN►ATION
ON THE S17E.
0
SUBJECT
City of Fridley � 1339� �
AT THE TOP OF THE TVdINS g U I L D 1 N G P E R M I T •
r
� � RECEIPT NO
COMMUNITY DEVELOPMENT DIV. l/ Q
f � L � PROTECTIVE INSPECTION SEC. � 7 "7�/ ��
1 = �
�` �"�i � CITY HALL FRIDLE� 55432 NUMBEfi fiEV. DATE PAGE OF APPROVED BV
"•�«� � ,•� 612-560-3450
910-F15 3/3/76 � �
JOB ADDHESS 1581 Dana Court N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. % 2 Harris Lake Estates SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Richard Miller Homes 1600 Ri.ce Creek Road N.E.
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Same
4 ARCHITECT OR DESI(iNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADORESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
%
8 DESCRIBE WORK �� "��� '��
` 'f -•�iiC3s`c��f:r
Construct a 37' x 26' Dwelling and a 24' x 22' Gara e
TELE "��,; c�A� .;,�;,.�� tf;;:�t:F�s
F'HG��ar - Et� ��; �-,ii, � �f: �.
9 CHAN�EQFUSEFROM TO �����i W����� �� �� �
�L.fi
STIPULATIONS • -- .....:.x,a _._ .. ,_�-,:�.�:� � r.- � e
_ -- �
,
Provide a hard surface driveway. Provide a verifying survey before capping.
Provide sod in the fr6nt and side gards. City may require soil tests after
inspection.
SEWER AND WATER LOCATIONS WILL BE KNOfn11�T WHEN 5URVEY WITH HOUSE LOCATION ON IT IS
RECEIVED
SEWER LOCATION: Located 10' W. of Water. Wye Location 168' E. o'�� ����-_
wye Elev���R�T��FP����4�����.�t�� ' �`I��i��4�s NoroFy r� �EY ENGr,
WATER LO r ty � 50' N.E. of
���4��-� � � ��� ���or�� �
stop box , �the south. REM01/AL ,qND ��`��IV�-= C'uPiG
AT p �rE�L�C�:,;:�r���� r
R�VC�{f,qY UPtIVrfV��e
TYPE OF CONST. OCGUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCZ . FrdIIl@
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 R 1 32, 028
ANY TIME AFTER WORK �S 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 COMPUED. 51�316 $25.66
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $59. ZS $350.00
STRUCTION TH PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
� $434.91
� � TRAC70AORAU7MORiZE�AGEN7 IDATE� WHEN PROPERLY VALIDATED THIS IS YOUF PERMIT
� � i ��Q i1� �.� �� � -.� - ��, _
,
5 E WNERIIF BUILDERI ID EI BLDG INSP �ATE `
' � � � •Ri'd�Lj(./�l lU1V 1'UiC I�:i:J11J1::V i d/�L.� l�La a.i�r�� av+�' .
� , . �R lllllllTION. 13UILUItiG P�RI�iIT _ �
, s� CITY OF FRIDLEY, 1�ITNNESOTA • � ;
. , . , , , .. . .• . . . .
OWN�R
� S NAt•I� : i . r o/r �]IUILD�R : � �`lL � `�sh e� � .
• . . ' ADDIt�S S : % Ov ��{ �
ADD1tESS . .
. . . . .
1Z0 : . � .�� � STIt��T : ,��✓i v � � ' � d
, �,
I.OT s, 13LOCK• Z � � ADDITTOn : soro S ��P_ � s�z�5 :.
�
�
. COItI�'ER LOT : INS IDE LOT :_�______SETfiACK : � 5 _ � SIDL'YAT.D : � �= !� f . � ;
. �.
. . .
. • • � ' � -' m
. Applicant attacr. �o this f_arm Ztao CertificaCes. �f Surve .of Lnt and.pxoposed .
buildir.g ?ocaCion di•.t�•�n on these Cextificates. . . . . �
� � . . . • � 2I
.
. . . . , _��
, • . . . � . . . . 9
. � � �•, • . . �,
. . ' . a
, � •DESCRIPTION�OF BUILDING . � ' ' °
0
• • ' � - - �
. • • . • • a
� To Be Used As : . . . . . •
. ¢� � Tront : � ,� % Depth •�� H�eight • � � . • .
� �
, . . . . Squaxe Feet • 9� � ' Cubic . Feet : � , � � � . .
' � � • . Height : / �
�zr<� � � Front : � �Deptli � .
�. . , � � � Sguare Feet; ,,S°�'�2 � Cubi,c Feet ; �� �'C� : ' _
. � ljtpe o� �Construction: . r�.� �� Estima.ted �ost: $ G/S a�U .
To� Be Completed: >'�z,��,���,�.r.�._ • ' . . .. . .
. . . . , •. .
� The undersigned hereby malces applicativn• for a permit for the tv�rk herein � �
speca.iied, a;reein� to do all woxlc in strict accordance with thc Cit}• of -
� Fxidlcy OrdS,nances and rulinr�s o:C the Dcpartment of Tuildings, and her�by
dcclares t}iat all tlie f�cts and representaCions statccl i.n �lais agplicatioz -
t�rc txue� ancl correct. � . � � • .
� �/ °/�, f� � SIGNATIJIt� : • .
• L1ATE: �
.
(See l�everse Sidc For Additional Inforn�ation.)' - . �.��,���%%� •
. ,
. . � ' �s 25 . �� '. � _ . • ,• . �
� • � �,� � � � �"'y� � ' . . , ` .
, 1 , • • , M
� j� � � r � • • . . • • ' • i • ` r ` .
• �4 / ✓ I � I � � • ' , • � • • ' ' • .
♦
' • f . . . - � ' . . . - ., -.,."°�'�-p�'�.
• • l3U1Lll1N� L��:ltral t rLL �u,�L�,u�.� ---�-.�
� '• � • . � .
. ' . , , ' . •
. . . , • , . .
, � � � • ' .
� S�CTI02J 2. Tt�c InspecCor oi Buildin�s shall, Uctore issuin� permits for the
GxecCi.on ot any Uuilding or s�ructure, ox fox �ny lddition L-o any exisCin� , ;
buildin� or sCruc�uxc, or tor any al�cration ox rep�irs Co any cxisting ;
building or strucCurc, upon application tl�cretore, rcquirc the �aymenC. by the � ;
appl icanC iox sucli pennit of fecs to tllc anount }icrein bclow seC tort-li and in
, the manner licrcin provided to-wit: . ., • �
. . �
. UPiZTOI'Si BUILDIt�G COD�: Type 1, 2& 4-$2.15 tox each one thousand cubic ,
ieet, or traction L-hereof, in sucli cubical �ontents. �pe 3& 5-$1.85 for '' ' �
' eacli one° thousand cubic feet. � • •� i
� • � ADDITION/�L INFORI�IATION •� �
� .Tor i:he purpose �f .:omputing fees fox buildins ^ermits, the cubical contents �•
of any building or addition, is detexmined by multiplying�the gxound area
� • c�vered from a point si:c (6) inches below the floor line of the basement •
.� ox the cell.ar ta the avera�e heights �f the upper surface or Co the avexages ,
height of the•roof surface �f the main gable of a pitched roof. � '
' .. . . �
• Fox repairs.or alterations to�an eaisting structure, the fee sha11 be a� the
• rate of $3.00 per each five hundred�dollaxs ($500.00) or fraction thereof in .
the cost of all �roposed work. ' . . • �
�� � 7ai no case shall the fee charged for any permit as set forth i.n Sect� on 2 be •
� less than $5.00. •. • � . ' ��
� VERIFICATION OF�FOUNDATION � • �
� ' . . � � • � , � .
]�OT�: Pexmits tor construction will be issued.a minimum of 24 hours fxora th.e
tiane of application, to allo�a for pr�pex xevie�a of the pxoposed structurc and, �
� oi thc con�stxuction site. . . • , � .. .
A Cextified Survcy of the lot, showin� the locaL-iori of the ioundation, once it �
has been construcCed, will be requixed before proceedi��r� with the framing. I
. . I
. , � C�RTIrICATE OF�OC�UPANCY ' .
ApplicaCion for a Certificate of Occupancy shall be made ten (10) days prior
� to Ll�e use or occupancj► of zny structure for wl�ic}i a building Fermi� I��s been
� issued; and s.1id sCructure shall noC be used or occupied until a Gert-i�icate
� • ' of Occupancy h.zs becn issuccl. , . , ' ' ' '
. . , , �
. � . ,• _ ' . �
• ' • ' � • . � �
' . , • . ' . ' . �
. � •
� ' . � . • � �
. . . . .� .
. , , . _
, , , , ..
� uBU���►N
�l� ��t����ee��
1 NC.
� Civil, Municipol & Environ�rcent¢l Engineering
❑ Land Surveying • Land Planning � Soil Testing
� � � � � ��
�� �
�• . '
�
�V Mr. Dave Harris
6279 University Avenue Ne
Fridley, Minnesota 55432
Dear Dave:
Main Office 571•6066
6875 Highway No. 65 N. E.
Minneapolis, Minnesota 55432
South Office 890-6510
1101 Cliff Road
Burnsville, Minnesota 55337
March 15, 1976
Re: Lot 7 Block 2
Harris Lake Estates
At your request we inspected the foundation soils for the
Richard Miller home on the above lot. Four hand auger holes
made after the basement excavation for the full rambler house
indicated that a one (1) foot layer of black organic topsoil
lay at approximately 2 1/2-3 1/2 feet below the surficial loose
black sand. (Previously excavated pond material.)
lfohrr� .l�inrle�, /reg. F,n�.
Wm. h'. Jenxen. !{eg. F.ng.
We recommended removal of the organic material in the
footing areas and backfill with either black sand or mineral
borrow soil compacted to 90�' of modified Proctor density. The
removal was to be wide enough to allow the base of the backfill
to lie within a 1:1 slope down from each side of the footing.
Subsequent inspection by ourselves indicate that the
Contractor, Jerry Belair, did remove the orangic soils to
native sand and backfilled the excavation with granular bo.rrow.
On March 11 we took two densities to check compaction of
the fill which indicated 83% and 88%. Subsequent compaction
effort took place under our direction.
Based on the foregoing it is our opinion that
been adequately excavated and backfilled and that
settlement should take place.
W�/JP
cc: City of Fridley - Darrel Clark
E. A. ltathbun, Reg. Suru.
Wm. K. tlleyer, Reg. Ertg.
0
Sincerely,
the lot has
no substantial
SUBURBAN ENGINEERING, INC.
�'(/��G�� - �`�
�4 �
William K. Meyer, P.E.
Wm. E. Price, Reg. Eng. Cary (t. Harris. Reg. Swo.
H. WiUiam Rogera, Reg. Swu.
�
EY.TEP.IOR �N'�IELOP� AVERAGE °U" �.UMPUTIITION
% '
� J ' I,�; %' e' rl/� ''%` • ,
� � j %�/ % - ... �: i � ;�
� � gI4/'�°�� �.�' s'��/.-l/ ' — .!1/aiDr.� - �
Page 1 of 4
DATE o��� ��� �
PHON�: .���° A���
Determine working square foatage of each
1. Total exposed wall area...... �,5��'0 �� sq. ft. x .17 `_ ���,� ��
2. Toal roof/ceiling area ...... ��„�a �� sq. ft. x .05 = ,� ���'
Total exposed wall area above floor =�,�� �,, ��
a: Total wall win�ow area . . .. . . . . . ... . . . . . . .. . . . . . .. .. .... �,'.�6,, ��
b. Total docr area ....................................... �s�,v� �
c. Total slidin� gl� :s door as:ea ......................... ��, ��,
d. Total fireplace wall area ............................. �
e. Total wall frasaing area (average 10%) .................. �
f. Total rim jois•� area .................................. .����
g. � wall area a2mve floor .......................... � f� c��
_�_�
h. wall area above floor .......................... �
i. wall area above floor .......................... �—
j. _ wall axea above floor .......................... �
T�t�l exposed foundation area = �,/ � a��
k. R'otal four_dation window area ........................... '��, �j�
l. Tota� net foundation area above grade ................. ,/�� ,�_QS
0
Dstermine "U" value of each wall segment
(e.g. window, door, each separate walZ section)
a. ��'� �� x ��U�� o �� _
b. .��a �� X "TJ"� �/o� �� _ � �"°�e � �
i� �� .
C • �� A � � �( ItUq `_= Q J � " �_5�.�
CZ � X nUo � _
. �
e. ��� X ��Un � �� _
f . �n� �4.� `� X „Uu � �
A
Q• ,�N.la��A a�� X �evn e�� -
�
�� .,,
r E> : � l
� I _1..
! ' _
h. "`� X °t�° �� _ ��
i. g ����� � _. �'
�. X �.��� � _
k � ���. X :,U�i B� _
i . ��� �� a „U„ _...�.___ _
3 . ................ ........... Total =
�s��� �.
y°�������5
��� ����
��� ���P
�ie���t ✓�e ���
I
� u ; o
F
� If item u3 is thc same as, �
-- or less`than item #1, you
�� have met the intenC of �
SBC 6006 (c) 2.� ��� ��
L���� � � '� o
�� � x /�� 1���� • �-�-�����
r�
;Er.terior Envelope Average "U" Camputat3.on Page 2 of 4
�
,� Total exposed roof/ceiling area = ���, ��
y
e
m. Total skylight area ............................ ---�
n. Total roof/ceiling framing area (average 10�)... /� �,, ��
o. Total net insulated roof/ceiling a�ea........... �� �,��
Determine "U" value for each roof/ceiling segment
1Q. iC °ZJ° °'°� _
A. �� �n o(�� }� nV�� n 6� � -
O. �A �'p � � X °U° � �,� _
�
4 ........................... Tota].
�
�
"�, ,
��:i
r= r • :
:fi`,��
�� � l����� ���✓/� ✓ �
If tota.l of #4 is the same as, or less than #2, you have met the intent of
SBC 6006 (c) l. �
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.
L
l. �� ���,_t� + 2. �s �� � � e�
3. �n `�� + 4. ,���o �� � 3��� � e ��O vIJ�L/ /�%/eA/etld�
0
` 9,'
- �. �
�� ,��.
,
; -
3
♦
6 WALL SECTIONS Page 3 of 4
: Use 10� of opaque wall area for
t fxame construction
Construction R-Value
., 1 � _
� 1. Interior air film 0.68
� � � -� �e°d 2 • �3 ���� s� �e� B �
, 3 �1°ust/sl� 3. � � `� �s�� �3��,� ,�
o ��
�4 � 4. ���� � �� �
�—
EASIC �l . �� 5• �OA,c�,�iz9���l���' �.��
WALL :�` 6, Exter ior a ir f ilm 0.17
�� • Total
. • ���'�
FIG. �l TOPVIEIv' 0�' � o � � �
- FR7�lE li1►LL '
• Y � 1. Interior air film 0.68
, , � � ' • ��P� 2 . _ ��3_ �d c����d,,,�, n '�%�
- " .�;� ,��d����� 3. � � �� �ia�.e���� ��i �,,���i�,�i /�. ��
i
• �� � . � ��- � � 4 . '�� '� .�'�'� � �G,�e�rA�'.�,,�l�d�_ f � � �
TIG. �`2 �� �_�,�, -_..�.:� 5• �/���Ar,� ,�� r�s.¢l ��_ o � ,�
--_--
.� w^�� �• 6. Exterior air film 0.17
• �e� �ee� s �� ���e �,�m �i � � TOtal / y� � �
�•�----� • •
� � .---•--� • � • .���� a��" �/�A ���• � � �° a � �
• . r"
.�.c.+. --r.r. ' ' ' • � .
�M�r+r" .
:� , w����' ''--�°-�----�°--�/ '.��� l. Interior air film 0.68
���
��l'L �S��L�-a( ;_ � 3 oss� 2. � �e � 1
��137Ci a.l I-'f f � � . ,-+—� � � O ,I��PG��� ���SY�� �/a � �
Y• •?a 1 ���`w:,�,. � �: � 3. l� ��. ��� 1�� ��� e� � a�
.�� r..\j�. � j • . r .
. �! �� �i��•:�.'t"i"'-'%' o« • �� 4. �� �
:.,..,..4 � •� ,� - . .
a �� • � ' � . a ' ' � 5. ����eee�ean � �,�oa� a ��
I• Y�i ' � � µ � ' . • ' . , 6. Exterior air film� 0.17
. .
� i a � �� ,� • � • Total � � �.��
;Lital�e�`iIC�� ° � - ' � , 3 .
A�'C.Ie I i :�,• _.�� � 4��:.._ -` �,
�� ' �l. , •�: -� — �^'�..� _ •
�oe
. u ..�„ ���� � \.;..-.
. �j�-� . • ;,� `— � .J �,,���l�. Interior air film 0.68
� t_?r `r . ..
. . e. fi . :r �' .. � . • 2
� ....�t . ' - - • • ' ��
� ;... t . • 3. �� �
.�
4. �
� +� 5 . _ �€� �� ��c� ,�dad � � � e � �
�� ' 6. Exterior air film 0.17
. . Total �a /�
. —' \ � . �
` • • a • • ' Q • ' , �— • • � 4
• � �. ,
�` �� ; y �. r��� .. %1�,T���l� � ,� • � . .
./ • • . .' � . ��i � — Yr /�� ��� ,' , . --
`� • �f- , I' l �- :_ • /� _ I �(�� A � � � �6 � •
' 4 � i^ `�� --- ��l � � ` V • � • � ' � • ./
� •` ` �(� • ` � I i f -
� ' � • • ^__ • � - • `
.'' � ([� .. ' . ' ' • ,� ` �� �
�— ' ' /(! � .
�SG. #3 ' ` FIG: �9 /!( � �t�' _ .` � � J r. /�/
.v . �' . . r. • � t // ( �
.
__ ' . • . o � ' jl( ' X ` X ,: f!�
• ' o - . ` � � ' • /l ( � 1 f ( _. 1/< <
. . , ; ` =
r�,: : -! . �_ NOTr': Indicat� tyoe, °�° v�luc, d�pt}i and
� � placeMent of in_�u�ation.
�'
�'
ti:
�
Yr.2tT
.!� .
t�ente�i
ROOF/CEILING
��.-�' r � �--
�.-..�r � f' �
,'� � �
� ,ti� .
j�l� ;.� ���i��i�irl�jljjT
%�� jC�li�►_. �l ` .
�f�� .�=�rr�lltl,l��lll,�
� .. -+_...�..._.�
: :� � �;_.
��� t �
•%� --Q �
� , �teat flow
1 up '
1�IG. �S �
. '
Page 4 of 4
Construction R-Value
%��v �P���Interior air film 0.61
2. � ������ ' ��
� 3 • �°�� � ,�.�i s��11�?r�,/�'. .r,��a S131� ------�-� o �
� 4. Exterior air film.(still) 0.61
, Total ��e c6�
.. . � � e � �
y
. '
.'c�l.�'�' 1. Interior air f ilm 0. 61
�' �������� 2. _ ��� �,���� a.�
3 . !� �� .e��� /� �� ���� ��d� �� A a� �
� 4. Exterior air film (still) 0.61
Totdl � ��e � �
0
. `� `� � � � '
�.
}:eat floc�� up . � � ; •venCed
. .FIr,. �6' . ... . � � � ` , : .
3 1�r . � � .
� • li
. �,_S„�,�r �,�
,' � ,tt��i,� �,�oS:. :. .
' - •- :_t.;c�rpy .i.r `, '��'.-�-►- �s
'�'`"i- " / J %1�, -�i �77"i
6
� . `-� . �///
• _ hTo�r-vr.��n ' :
...�� •� �..
. � Hent �
, .' • ElOW u� _ ' .
� _ �� � ..
r.r.r, a�7 . . .
� � o �3
1. Inside air film 0.61
2.
4.
5. Outside air film 0.17
• Total
Note: Use additional sheets if more space is
needed for details and calculations
0
�
�
1
\
f
/
0
�
,
�/Ie•qY i.�i �(�v��7�/0 �1 s
DATE ��1��_ SUBJECT �S�] I%ar� z G�avi7�
r
a'/'i �%� �J � .� � .
.�1�, n yo y/ G . -
pp,e�,�:� Y3x.�.�
.
,
���f- _ 4�¢ yr G , �.
�s�t'': 1��1a�- ,��:/�;
,
/a , . . . . , . - :� �---�.---�--
= �a.$�59��� �� �s�.ng
. � . . ���� y �x � i
. � . . a,z�.x�
_ . a s� �.� :
: _ ,� •. 7z.. -
, ; � �
ya
. . � . _. �._ � _ . : _ ; . . : . , . . �,2�, . ; _ _
,
; i ; ; ; :
,. , :. _ _.l .. . �. _.. � .. i._. ..r . , _. __ _ . . ;.. . : , . _ _ _ . __ . _ _ _ _ ,
;
, ; , .
��'P� � ;.�+��. � ��. � � , , . _ _ . , . _ _ , _. . . :_
—�-----.__ _ _ ..___ . .
i '� : �
_ �'���'%"___� __ �_.s���6 .� _< __. ; .3�' � :_ b. , __. _ . __ . - - -- _ : __ _
� � � , ,
; -, � �y �
_ %Y
; G�� �, � _}.. _,�_.� _� - � . _ _�__ + _� _ __ _
C�. % .. ._ _ . . . � „ i�iwja . + 4 � F
; ; , , � � � : . . .
f , � � _-t ' i
, ' ,
_ , , . --_ __. _ � � _�_ �_ _ _. : 5.�� 3,' `� + , __�- - --
, , �
I � � � F � i ! � - � :
__. r .___..�._ .____ .� ...__-!- . - .-.— � . .. 1. _..__._ ; �. ; . � .. � _. _ _.-_ t— .' ___..
: r +
�� � p/ i !
� � i i ?
t .(M�.�'/✓ _ {��--�+G_t}, ._ ��?��.Cr._��Q�O! ;._ , . ; ! +. . ; ,. . . .. , , _ _ _.. ., _. . --
�
;. �
;_�"�p�7`- __t_ _`�?� ;3� _; _ : . . ; .�:o�;j3� -- -
, j�
, ; ,
_ ` �� : _.... .._i ._ __' ..__�II .91_ _. t1.� 1 _ *� ___ .+ . i _.. . ;_. ... . *_ J . _�I'c/71 P�. • v ��1 ; � Q_�2-;-! L-� - �- „ — -
,
� __ _; _'i � __ _ � _
, �
� !
, !� 5�-�-� -
i % �l i �
_ _ }_. . . i.. .... _.... i...
� ' :
�s }�
!
__ , _. _
` _�'I _ �
� __
T- f
I
If "% i'
i
1_
i �
i �
� �:�
! ��
+ �/ �
; �
, /b ;
� i-
i i � /
� I / i�
e�
. r ? _ �
.�y � . L'_' "
-- � -+- -
t ?
` ; ;
�--w ;
��' '
��
r ,.
,, ;
r' a �
� ; ,
�
i
�
-f t
i • " _ �"
. i
�
.._ ..
�
4-
� �
���._.� �__ }_..._ .__;..,.';__1�L��.��s _�1_��a��__ - -
; , ; ; ; ; � '
, :
'
�� __._t__, - -- . _ , ._ �► � : _ _+ _ �3 r 3 � + - —
;
7 �.. ._. + . .; _ � . _ � . _. . � _. ��'�_� �Q�!�J:-; --- � i 0 _ _±
�- � ' � �
r : ;
� � � .�.j y�
, , y_ / /LV
� ..t. _ r.___.; _. ..+.._... . . .. ,_.. .. ..�._ . �!�!� , •-__ j-'�"����i�"'� �� ._ ..- -
i ��
,
� ; . � :
-- - ._ _ � . _ , , , � t _ r ,—_.
; i
i
1 � ; ��s�, � : � � � � ; � �
_+_ . _ � .__ t _ �. +- ---_ �--- � �_-
; �
: ; ;
, � '
� :�_Ob'9►� ' ' _� _ fi .- - � _
__ _ _� . _ . - -
� ' � - - - . � � .
i
�
� � � ' : . i : � i � i
. ..4. .. f _._ • � : i i �.. '� . . : ... ._ 1 }. _. _ .. i. .. .. }_.. � .
�
i j . _ ,. ' ... � i
1 . r i } , , . } � i f ' �
� '
i �� , ; i ;
, �
, ..
�._ t t_ ; ; , ; . , ,_ : � _. '_ �
; , � , ' j � i ; ,
. � . . . . , , ;_ _� __ r , ,
( � a�i.� .. ' ' l� x: /,�'�� �+ !� '� �� Il-�� - -
; .��-+ . /?� . . ' . . : : t
t .t�� ; , ,..�!�:X,/��� ; ��- 1 � .
; �
; /� � � ' � . ' ' '
; v, . , . . . i i , 7 �,1 } � . . . ,
_ � � ' ; . : ' � �� " .
_. � .� ; ...� � ! � +� � t , i � 4 . . < -Y
I � I '
I
� .
t 1. . � ♦ ♦ . . � . t }. .... .� l .._ . .i'"'
� . , ' ' :' I � '
,
, . :
- - 1-- -+. .... i a � .—.:- ._.�. - . -. ' - •_ .--• - • _�-.-
r . .. — � -t ---t —}-- j � S
� � � ;
i , � . i � t �
,
.^
i
�
�.,
0
�
DATE 3�I SI7(. SUBJECT I S�'8'/ �a•� a��,,�� �
V�� �C1C�•„(�C �kt �r a� .111�b��s �!G /"��00.-. . .
� `�
— � ,,,,,'�n
.�
� ,� �
��t:��
'' /� �'v = /$O . . . . : .
�oQ . , �� . . , ;
r.. � ; �. . . : . ; ` : , . . ; . , - -
� � zir `� _ :?6�w. .�1��► . � : : _ : , . _ _
� y!� _�
, �� Y'�_ �'�
,
��{ ;
:-- �Da�
, f ?, . . - }� . , �_
_� ,
_.. � ...f ....... ......._.i.
�
;
_ _ ; �c�s�
i
. .. _ r f• "��'�'t�'_
- -1-- �--��
_ _� _ �. _ s�
�
;,
_ _....__ . _.�G �F_ �/_" _.1
t . . �_ �
i �
� _ �..
���� �
� � �.
�� �
I
. I
i
� i
I
_{
I
F
, 4
,
,
t_ .. �._ _ :._
r_. �
x � _?� _
;:
,,. � i
_ .....1 .1__
1
� !
�_ ... .i y ..
i �
r.� � Y� ; ..a
�
;
._ _.._ �. _ _�.. .
- --� �� -�-
:."�_ r�_.
t-- -�- - -
_ _ _ t. . _..! '_.' _ �.
f
� !
� � i
i �
i �- i
' ! i
! i i
i. . ..t -�-�t
. t i ...__ {
� �I
1 t i +-- :
�
I j I I
F � � '"'_h t
I j
i �_
t i
i
�__ _ __ : �_ ; .
r- __ _. . _ _ . . .
T
3�n ' : ` --- ---
; ,
_ . : _ _ : _ : . ._ : .� . __ _ _ , ,
�_ ;--
`1 , -- - ' ' _
, _ ; ; , ,
, . �� � _ �_ . --�-- ---�-
. . . .. .� � - - -
�C� -� ��o �'a = `t �9' _ � _ _ - - -
}.
i
{
� i
- .�..' .-'_ .. t.. .- � . .., .�... . . ,._ _. ..r. � , ,
� '
�
; : ; ! ; �. , i .
a
. . � . ; . � ..j � ' . . � ., . -..--
... _�._. . . ._................. . . . . _. ,. ... 1 .. ,. .. .. . �.._._ T . . ...._ ... .... .. _� ... .,._. ._ ' . .I ¢
, ,
,
� ���.� . * ;_:_.
. . . .T .,...._ . . .. _,.. . �
, ; �
��._ _. �. .. . , __ __ _ _ _ �.___ �__ + � �_- . ,--- —
� ' ; ,
�__ � _ � . �: __ _ : _ . _ : _ _ -}--_ -�--� -- j �
�,,. � ,� ; �
�X_, ��_.� x-- . . _; __� l �, 6 9 �__� �_t _--�-- _ + _
� : ..
,� : � ; � , ;
,
__`�" __ -i,__. . �.. ._ ....... .__ ..}. _ .. . . !....._. _ . . _"_..Y. . }—._. .��_— —_ —1-.._ F
i �
-L
I � , ' � � � :
; F � �
-?-__ y _ i. . . . s , ::.._..._ ,_�_._ �_ { _ _. .�- —�, - — —
�
1 � ...
� i I i
;
; : ;,
{+_ 7 � . :_ . � ; _ _ _� '�_ -�_ _, r
1 I � i f 1 � � I � � + �_ _ _
� : _ ..:... . i--. _ ' ' � ' ' .�- � - - -'- - — —
I �
___}_ F._ ; . ._1 t....__t- +-_ —{ _ ��_. _-}.- -+— : i-
`. . . , . i ,i ,
. ; ! ; � `
: , � !
� , 1
r
f. �.._ .. � � .; . .. . i _. . . ...-`. . _t_.. � �_.�.�_ .t .. �. : . . _ _ _-� .. . i----_"---
__ '
�� � , , �
, � �
i i
� i
} . i . , . , r . : : � _ _ f }._ _ a. _(_ ._ f_ _ . .t _-
_+ _� - r- :
i � i , ; ,
; �� ; ; ; �
i . , '
' ' � i � . { � . T : s _. � __.;.. » _ . . i . ._ . ---
- _ .. ' ' � : . . . . , .
._ � / / � . . . � � . .. � --. . . _ .. . . _ ._ . ..
i ' � � i : � � � � j
_ { i - . , � o � � , i ,
..� I � I ! { � i � � .
� . .� . , . � . . . , i . � i � + - - � --
� .,�. .. . t• • 1 T . . _� . t - ... � ._ _ . • . "
. i . - . I � . ' - ,
� � �
i ' �
� ; . . � i y . { i . F i
i � � ,
� i
. � � � - �. . : �_ , , . . : �
� , � : ��. . : � � �.
;
' � i � � , .. � . •- t— , � - {. -Y � -� - --' -- ! --
{ .__. i _. ,. ; � , . -�
; , ;
� ; : i � " :. : .
;
; � _, _.. . } y . . a , - � - 1 �- - -�. .� .'i _ _t. ..
1 i
`.._. 1 . . .. , ' • I :
�, r 1 � . � j T t : i
i
4 { . � 1 . _ i t � } � . . ' _1" .. _._'t.. .
} - ; i - . .- _ � . . . . . } r . � : ..-- -
1 '� • , i " '. � . : i
� i � , � �. � i i ; I i � : I C �,
� �
_-__.i.._—_ {.—'- i--. —i.. _i _ _. f .� .. . i ..___y._ l... .+. _ �. .._ _�___ +..__ �— . .L _.- �-� � _.. . �__ . _ �. ..., _. , _.__
i , � �
i i
I � ' ! i . , , ' i
__���
0
�
�
�
G�
��.�
�
�
�
e�'�
4� @�
�a
�';� �y
��
� �
��
� �
� A
�
�;� �
f; f�"8
m: .<
� ��a
�:� c:'9
�� f'
��
��:k.
�.� �g
��
� �
� `�°
�
�
�
�
�
�
�
�
�
�
�
�
�
0
�
�
.�
�
�
�
�
e8�
�
�
i'�'
<
�
W
z
�
U
t0
�
�
o�
N
�
��� 1
� e �
��
���
�~p
�u��
��ffi�
���
3 v�'�
�
���y �O
�
L' PW y � �
ML'� 'r �
��b� �
�,��Q � u�
v���a �
G�y�u p �
a '�:7 � ►�
�v°"a
�"�.�. m N
�'s°o« '—' r-�I
v �
'E�`'� '�" $"
eo �
� o � �i
to�y �
� mQ � .4
m � 't�, � _�-VI
� G�oa a
� = °m i
�'�'C Z
0
����
� �
U �' � �
�
�
N
� � � 8 �
�O t0 �C /9
f�9
8
� a
� 9
w �
�
����
� �
p G
� � b e �
O��
���Qa
�v� �
Y: �
� �
� � a �
�
s � '---'��i
. ... ... .. y
J
N
U
�
�
b
-rl
�I,
m �I
e ,
b
�
W �
�g � �
O aC �
�
�
�
0
M
I
et'
N a� N N
8 � � � �
O ^� 1O fD M
�
� g
� �pQ �
N • « �
s � s �°
� � �
����
�����
����sE
�, «aa
� � � �
� C' M 1�
� � � �
�
�
a
E
�
h
�
g
U
�
E
w
�
oa
a
0�
z
�
�
h W M N
� � � 8
O O R. �7
V) ~
�\
�,
,.
.
:i
d
� �
� O
V� .,.
a a
A w
M �
�
� � � �
..
� � � x
�, s o a a
� ! � W �
3,��z
� � � � �i
�_ o
����M
� tn v, '7 �
M � � �
0
�����
�
0
�
�
,
M
a
z �
I �
� �
� �
�
�
�
�
�k
�
� �
C'.
�
� a
a d
E
� z
� �
v
�
�
�
�
�i
�
�
a
o "
� �
��
� �'
�, �
��
�
pc
a
�
a
v
1�i
O
��
�I
�
�
a
ro
u
a�
b
� �
� '�
�
✓
0
'�
N
b
d' �M fd
� N
�
�
� �
�
� (
u
� �
H �
£
�
�
�
�
�
N
O
�
M
�
�
�.
i
rn
N
x
x
O
A
�
a
a � �
� o� .
�� .�
M �pa�
� � �� � � � ��
� I�l M /4 y.�j �
� � � �
i U
I � �
� � H�i
� �
�
cn .e.....
�
� �
�� ��
��.. � �
Q�; � � �
������
����$ �
�q � �. c7
� �
�v
:
�* �:
}x Y'
• ;� w
� �: �
.� .
� a
�
� �
�,
�?�
�
0
oa
�
x
h
�
0
�
�r
�
�
�
�
�
l
O
�A
�
����i
i.
s� .
DEPARTMENT OF INSPECTIONS - 220 GRAIN EXCF'�ANGE
/�p��j ��s�� `��� ���E'�' MINNEAPOLIS, MINNESOTA 55415
6.�a��6. '�8
--�-- -_ -- -- __- - -- - - __ - ---- -- - -- -- --- - _�. ---. '-- �
._.- _ --- - _ _ _--- - ---_..- _ - - - _ `' -- - - --- --- - , �...
JOh N9MC � '
��� �1�'-1r�..�� -�--- Address l S � � �� °�l - � C.-.�:. • .
Raom: Width ZS ; 7:ength � 7 ; Height ��, 1�me: __ A. M. 3:� P. M.
------- - -
Design Conditions: Outside: T�ry Bulb ; Wet I3ulb Inside: i�ry Bulb ; Wet_Bulh _
11Va11 Color: Da •k ❑; Li�ht ❑; Medium ❑. __ _ Roof _Dark ❑; Light Cl;_ Medium p.
Windows: Shades ❑; Awnin�s ❑; Bare p.
- --- -
- -- - - -- - -- -
-_ _ =. _ -_-- - --= _- -- - - - --r--- -- -- - - -- -T - --- --
- - -- -
WO. - -_- _ - -- ESEfd1 ----
CO�lDUCT40� ��A� taAlbd$
1. F.Yteri�r v. all, ��nss
2. F.xtcri�r gluss __
3 � F.xterior w.�ll, net _
9. Pr�rti4irms, net
3. I�']oor
6. Ceiling nr rrlof
��i��53 SOdAR GA6fd5
114fA�L5 (diarse4uon 4�+e�ed)
7. 5 . GcJ ; '
�. � . /^
3.
10. R�f __
C°,LA55 (dires4aon faeed)
1�. s.�,
��. �
AREA
DIMEW410N5 � SQ FT. K
SEMSIBLE LATENT
D F4EAY FdEAY
� ✓ � �o •s ws _ .e.. ---
---���'=' -- - '-5�- _-�- � - --f 1-�-�--
% �'�' ti� _ _ . ? 7 � / - -l' 5���-
_ _ _... _ _. --- _ _ _--- -_ .
-�"'i5¢ � -UG �� L� � �,
_... /Dyj � I �S �o in I . li
4-�rr� -- v
/ _s �g cr-v
% �` -----
,�� I 3 � I � ��
/SsI�-� I��G��
_ r��•
-- .... ---
--- ....----
P��O
oo••
- •Mf•
0t04
•«.o
tR�•
....
�...
....
`,' 1a. - ...e
k- -- ---- --- -- - ---- ---
f,`- 14. Skylit,hts e•••
._
�, ___. _ __ _ ___ ._ ._.._. -----. - --- - - -- _...
----------------_ _ _- - -- --- -- --
� 60�Y H�A�T fsABBd4
.
]5. rrn;iV�l� ��" No. nf pmnPl� x 225 ��Ct-t,) •��•
1. V .__... . . __. _ " 1"_.""_._...-__,
FI '_ _
�]6. I.ttt�nt fruiet) N��. r�f j�tK�pl� x 17� ooea ----- �`�i!_L�.' -•--
t-- - � --- -- -- _... - - �_ _
`* 17. Latent �active) No. of �ple x 450 0400
�EAI�iPM�9�Y P��Ai CsAIRlS
:' 18. E1CC4ric lic,hts "- " _ ' ? %
, -�%�_L^__�_Watts x 3.4- - ------ ---- - - �?-f -- o��•
i' 19. EIcctric Tnotors f total H.P.) x 2545 s Power Factor ____ ___'_ ���__
f-- --- - - - - - -- _
{ 2Q. Other eler_trical equipment ���- _ o� .� � V-'t�_ ---
r-- -- - - -- - - .
, 21. Gas bnrn;ng equipment C. F. H x]000 ____
� - --- -- -- �
22. Miscellaneous heat gains /�.r_.-� ,L 7-�2 � --r�;Z� ¢ � v -_ � .a U
�� �
�: _� _ - --__ _
4' 23. Miscellaneous heat gains __-
�l 24. TOTAL HEAT GAIN fSENSIL�LE) �_��_� �� "��
�` 25. TOTAL HEAT GAIN- �LATENT) - -- oosa -- --- � q' G�
` ---- -- --
�' ---- -- --------- -
� 26. Sensible heat ra4io=- Item 24 x 100 = _______ X_1� = r�„
it�m 24 + Item 25
� 27. Temp�rature of air supply Dry bu]b, «'et bulb _____ __ ____
-- - -- - - ----
28. T�tal �ir su 1- Item 24 -_ _._ - C.F.M.
� PP Y --
.--- _
].1 [raim d.b. Item 27 d.b.]
--- - -- - --- ---- -- � - - - -- '-
f H��� LOAD OI� �/�6dTldA�IIdG a4�� _ _ -
�.
., 29. No. �,f rmo�le x ` - C.F'.M. per �rson ----1 `"? - -- -- ----- - --_--- C.F.AT. (lutside Air.
-- - -------�-----�----_ - ---- ---
30. Item 29 �'/�' x--�`=-B_T.U__per CF.M.----�J__-----_ __-----.--I"'C�_-_ Ft.T.iT. Trer hour�
+, - - --
---
� 31. Total cc�ling lnad - Item �4 + Item 25 + Item 30 = �/� 1.� �_ �•T.iT. prr hour
; .... --
_ _ _ _ _ _ --- - - -- - --- ---- ---- --
� 32. Tonna�e equivalenY •of cooling load=-I12�01 - -� 120005� �� � Tons
: --- - ---- --
�; ----- - - - ... --- ---�_•_- _-°- ,_
__ , �/ q... ,�,
a.-� � �'i+ e � � af ���"x e �b _�� , , � ^�.' _�"
P� �,� �! .. .._�.�_�..� ..__ ` � `
�
.... '� �� (. � . 4+A.�
� F F � . - . , � . . .. .
''' HEAT LOSS CALCULAi10NS . � .
�l�atherstripa A' ' ' Conotruction fVo. Inaulaeion
G�,ode
Windov+s Doo�a R¢feeense Out. !$�all Int. �lsll �'eilinB Roo¢ Floor Kind Hoev Applied
1'es—Ido I Xes—Ido 19_
� '� El.� �,?,? >: „��:' :;� aom Len�th , l8�idth �',., e$eighc - -' . , � Fl.� " ,-�?! � `�' Roam L.eneth , °'�,? .__ l�/idth ." Heighe �;' `=�
V/sndow� and Doors—Crac�age and Area Windows and Doora—Crackage and Area
\v�dth Helght No. ot Llnenl tt. Are• �� Wldth He18nt No. ot Llneel [t. Area
No. ot pune o! Dd�e IIQAte o! crack ea. tt. �� No. o[ Dane ot Dane Ilghtu ot crech ep. [t.
�.-, f,�°" �?, .�' C, �F �j 1;� ' �,: f� �l ;, �9:
� �, � t� a��
— e "
Coef. Btu Coef. Btu
Infiltraiion :% f";a ¢' "° 'A �' �'`� 1n61tration � a ', �'`
'' � �°' t- ,��a � �" �°�
Glase ; °• s. Glass
f.Ap. wall ,: �' ' '� :r° Esp. wall ., „ . mR ; �
(det eap. Wall `, • d� �` )�° N.� P4fl WAII � ' �''' �,�c� �°
Int. wall •
Ceiling ..a . ` �, �,� s:�
Fl�or ' -
�'otal �tu. I � `` e
Requir�d sq. ft. E.D.R. or aq. ine. 1'�I.A. Leader area
FI.� �; " �' . I�oom � L�n�th Width I-�eight `�° "::�`
l6/indows and Door�-�rackage and Area
Width HalgAt No. oL Llneal ft. Are�
No. o[ pane o( ocno IIQ�t• o! crack sa. tt.
.E^e"'� . . _ .,�'�'' � ° �__ °�+ ,*4
Cot{.
In6ltretion 1 ,� j
Glaai T � %.�,
�tp. wall � ' �` ,;' a�.
Rlet exp. wall , ' .� CPi�,
Int. wall
Cei�ing , ;�, �
Floor - "
7'otal Btu.
Required sq. Ft. E.D.R. or aq. ena. 1�I.A. S.eader area
°� G'1. ,� �' .! �''�?:� ��om Len�th _ Width
Windows and D00%�aaeEsag� and Area
Wldth HaIQOt No. ot Llnonl ¢t. wrea
No. of D�no ot Dn�e 116Pte oP craeh ep. !t.
� _ . � � � _ . � �-.a
Int. •rall
Ce��ing ,
Flaor
Total Btu.
��
�,�
Required sq. ft. E.D.R. or sq. ina. W.A. Leader area
� FI.I a�.-'�>,, ,, :�- Room � Lengch r.p W° idth ;�
� Windows and Doors--Craclsa�e �nd Area
a'idth Hetght No. ot Llneal [e. Aree
No. o[ D`�e o[ Dane 116hts ot crack sp tt.
.. �m r_.0 . sv' e.-� 4' �.T'� A� A:a
Btu -- � �
� �' �, Infiltration
'" '" Glass
,�
Eup. wall ' "
'� Net exp. wall
Int. wall
� � M c� Ce�Iing •
�,
Floor
P-i 'Y�' .� Total Btu.
Coef. Btu
In6ltration ,f° �� r�' �
Csleo� �°�` "' .
� _a
�acp. wall �° �', " �� > �
I�let e:p. evell f° ;� '�°� � �
Int. wall �
�..a
Ceiling � �' ,^ ' r-�.
Floor �-°`
7'otal Btu. �-d �' •= ��
Rrquieed aq. ft. E.D.R. or eq. ina. W.A. �ader aeea
m' E'I. .� ,, , � � 1 Room � Len�t6 , ,� _ _ Width / ! I-Ieight '�`� �?�--
a��
a Windows-and I�a�TS—Css�ltage and /�rea-
Wldt� H�16At No. of Llneal tt. Arr�
No. o! Dsne o( Dens 11[hts o[ crack �a. ft.
� � . ' 6 'F,�'� r�,. d _� �-8 � �w
Coef
In6ltration I � � 6' .`�'
Glaas �° �
E.�cp. wall ^ < 6 .
t�et eap. wall f', '
Int. wall
Ceiline . s` �; °" [�
$� loor
7'otal 0tu.
Reauir�d ma. f¢. E.D.R. or eq. ina. QI.A. S�ader ares
Btu
�--
�
a..
�1�`",r�L�
�—
��
�—
��
�,, � ,
��
��
-�
��
Required sq. ft. E.D.R. oe sq. ins. !�l.A. Leader eeea
n F7.��� � Room I L.Qn�th �`� _�lideh ,'
L.
�lindowa and Dooea—Craclsa�e and Area
�
.�"
�
Wldth Hel�ht No. ot Lineal @t. Aron �
No. ot pane ot Dsne IlQhta ot crnck ep. tt. '"�
. . , , -� � . � ��` �
� �� 1 ��
� � �`�� I
co�f. �cu
lnfiltration �I ; • , �' "
Glas� �� ;�; r j,
Exp. wall ' �+ ° � ': '
Net exp. wall r"�,�t P;� �'�
lnt. wall
CeiGng _
Floor
T�otal Btu.
Required sq. ft. E.D.i3. or �q. ins. �A. Lea�ee aeea _
' Fl.� ,,� "t% ° Rosm I Len�eh �" Wideh ,'�? Heigf
Wiadows and �,00rs-•-Crackaga acu� ;�eea _ _ - _
t
Wldt� Helgh[ No. oi Llneal [t. Aree
No. o} pane o[ Dane Ilshts o[ crack �a. 4t.
� ,-��-
_ % d� �
1
e
r
Coef. Btu
In6lttation ` ' ''':�'� °,
Glass �� � �� , � ° �`
Exp. wall ,r^: .
Net exp. wall
Int. wall
Ceiling �`�"" �
Floor �
Total Btu.
Reauired sa. ft. E.Q.R. or sa. ins. WA. l.ea�r arca
, I �
�
� ,
�
� �
L ' + w
` �� E�if�►T LOSS CALClJLA7'IOtdS ' .
�leathersteips A' ' ' Coaatruc¢son Alo. Inaulation
Guadx
Windows I Door� �ef�e¢nse Out.1�a11 Int. l�lall �",eiline Roof F•loor {Cind Hoa� Applied
Yes—No Xes-1l�o 99_ �
fr"!.� ;% e�aJ [3aam Length � _ Widch /� H�i�ht � �'— ,;�- Fl.�;"-r.�:_,;`r- Room Len�th =' � �/idth F _. Hei�ht " �
Windows and Doors—Crac�age and Area Windows and Dooea--Crackage and Area
tvidth HcIBAt No. ot Llncal !t. Are• Wldth HelBht No. ot Llneal 4t. Area
No. ot pune of Da�e I�Qhte ot crack ea. tt. No. ot pane ot Dano IlShto ot creck •a. [t.
..� .' � � � i'' < <� �� ��: ,'� `%` % �P �a
Coef.l Btu
9nhltration �'
Glass � �
F.�tp. wal) �,� ^ ;: ,,
[det ezp. a�all , c�'
Int. wall •
Ceiling
Fl�or ' _
7'otal Btu.
Rcquired sq. ft. E.I3.R. or eq. ins. W.A. l.zader area
' f•1.�;;� �. ,^ , �,, Rcom � Lensth � Width �
Windows ana Dooro—�eackaBe and Arra
Wldth MolBht Mo. ot Llneal tt. Ares
No. of pane o[ ppno IlQhts ot crack p. [t.
' �'' �� �* �l
° � f"-. (, ,_; 1/'I As � �.
. � _ - !' _ ( _� i.�' , � , � f 9
CO�{.
dn6ltration ; ;^ °� --,
,
(alasa - - �;��,,
Esp. wall -A ? � A � �,
Net eap. wall `�"�- ��
flnt. wall
Ceiling "
Floor ,. ._�' �
T'otal Btu.
6Required sq. €t. E.D.R. or aq. ins. W.�►, l.eader area
6 G7. �°° -± ',�r � fc3aam �..ength �', Width .�/a
� e
1T/indowrs and [�ooro—�eachage and Arra
Wldth Ha1QAt No. ot Ltno�l tt. Area
No. ot pono ot Dano IlaOtn oP craeh e0. !t.
� � � e 1 �_ , (° ,�,; . , << . ^
COtf
� �.
� ..� � �
�
Height `P'� ,
BtU
.� � c
i�]l�1
Hnfileration � t ; �- �->
A
Glaoa ,�� . s�
��. �ass fa � ,� ;�,;,;
�Ci lA�. lYfl�� i?r �� ,' �'
� /;,� ,va, +<;
Bnt. oaall .
�eiGng .
�loor �
'd'otal Btu. � � �
RQquirQd aq. ft. E.1).R. ,ar aq. ina. �I.A. �.xader avea �
(� FI. .� , . � ,' �?. R�am � L�r,Br@, -' W;dth .:' ;� d-deight �`.,� �
Windows and Do�ra—Crachage and Area
Wldth Ha16At No. ot Llneal !t. Are4
No. ot pane ot pnne I1Qhta ot crack ep. tt. g�
�%'� „� �/s F��. A s^4 <n � p � b��
� 4� "�AA �� ` I�l
/
� ;` k1�L
�'f.
, t
Coef. Bcu
infiltrateon � ,�.A a�r �, ,
(alaea � �7i�
�cp. wall � �.a � ;1,,�
1Vet eap. wall ,,±, P� �
Int. eyall f�!,;� F., �
Ceiling
Q' I00� ` ' „ F ° ' ° � 'j
�'otal �tu.
E�@f�U1P2d 5Q. �e. �.D.R. or nq. ina. W.A. Q.eader aree
� �
���
Coef.� �tu
In6ltration ` � e
Glass �s !�?��
E:xp. wall • n,°' ° 1
Net eap. waU _ �� � i I
1nt. •vall � ��`� �
Ce�ung
Floor %' � • �
.�
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI.I Roam I Length �lidth -
Windows and Doors—Cracka�e and Acca
No. ot Da e ot Dana 1N16�to o't crack r Qr tt.
In6ltration
Glase
Exp. wall
Net eap. wall
Int. wall
Cei�ing
Floor
7'otal Btu.
Requited sq. ft. E.D.E�. or sq, iris. �/.A. l.eedee meea
1F1.� Room I Length Width
Windows and Doora—Cracka�e end APea
Wldth He1QAt No. oP Llnanl !t, � Area
No. ot v«�e ot Dnne IlHhta ot eeaek eQ. ft.
Fiei�6t
Coef.� Beu
In6ltration
Glass
Exp. wall
Net eap. wall
Int. well
�ei�ing
Floor
Total Btu.
Required sq. fe. E.D.R. or sq. ins. W.A. Ixa�r nrea
�1•� Roam I C.ength Wideh
Windows and Door�-�rarkage and Area
Wldth Helsht No. of Lln¢al [t. Ares
No. ot pane ot Dane tl6hta _ oL ernck _ aa. tt. _
In6ltration
Glaas .
Exp. wall
Net exp. waU
Int. wall
Ceiling
Floor
Total Btu.
Required aq. ft. E.D.R. o� aq. ins. QYA. L.eader ar�a
Height
e
Btu
��
�� •
. � ,
. �
,
. � � A � `
� � u ~ ^ •�
�
b�� ^ �
�u5 .� v �
���� � � �
� °���
� M v E � z.
�3�� • � `
�
� � � v � 0. �
t0 4 � �
��x� � z
.
� " '�° � � � i
�
�x�� ��� �
A H a �
� �3 a � � �
Q '" a q a
z� 00 `� s9 �� l' � '� � a
X� .n � � _a u �
�t
.� ' '
� � • ' .
. • ' �
�
m
g o �
'� M � 3 ++ •�1 ,�' � • � � 'Z tn ' • • .
. �, V u � � � Oi ` � �. • . .
p p � .^v \1
ak G�
6+� � � ro Q y. � � � r � a � � .
� � � � � oq �a �� � y' � ' '
� C4 `
^' A �� e, � � � !� a v .; �
. •,•\ �
µ+ . ,� d a v �, �C � m p - � ' � \ .
\ 6'a � � � �oMy '� � C% .a 1
S.J p � . .
O � -�i u � � L . O t0 u . 'p Z , '� N� �
U� F; R � � �'C! 'O C � � o E _ O � (0
4adt '�q
� � � C� N N N � .tiC ►�i E+ W ' . , . a � ' . �
� � • _ ' . VI . .
d � . • ' . ' � ,
� -r "• rT � j � � e1 , .. N t� .
. �. r� ai ..1 :, I J ►.1 .! O
(� � i - I � s •Hs :,, 1 J � "J in �
` a � i • O :�
� � < � �� t»,'� I I 'T H �j , ��'1
� J
' � o a W v► r► w W Y► w�y so� v► v • vp•
O " Y � � wC C7 tt7 � CV S N �� U � Cl • i�4
•
� d> N en. d� �i S vi �' M W � �'S
�� S�N�N�dO �
�', w 3! x X X X X M YC I� at . � s
�.. �' tf � � � z •
�'a � ' iONra ' 1 •
� � SY9 � � � •
Y �] •
o O r 1dJV � ,,. \ . . : � . .
L�J
q �i. •
OlflY A � • • • � • • • • i !
� G SMISW (� �i • • / • � • • • •
� " • • • • • •� . . • • •
(� �' M7lY) � • • • • • • • • • • 0 •
� � SNIWO .. p..., • • 1 • '� • • • • � •:
�,,, • • • ' � � • (�
� YOOl1 '� • • • • �M • • • t • « •
N T% w/ • • • • W • • • • •
F.. c �� . . . . • • . . . .
a � -stiw.s . . . . Qj� eo . o .
~ � • • .� V �% • N •
R: '� �.u.no, ' � ; . � ; � .
� BO G •
� � '1NID0 � . • � � a
�� • • • • •
f�i • � d. • �7 � • � •
W S+�w � .yc,� ri' . a"_ W C . O •
A ~ IKY M [7 �� � F" . ` � • O � • 6%i � �R
� __ .� • •
'� '� � ; C z • a � � `� S� O •
� s �.H,� b � . � a x . � ... .
� '- m o . oc ,e � •
� y+
� x i�dli�n � {ti ti � �( M 4. � « Ti • pr� � Mj � ��y7 •
i S� �7 O i.�.. '�'� .GKi ►M�t '� d a� W � m d N O
NlH f1 �. :`e ►q�s i'� � V i � �V �j � ►� {� •
� �fQl �y �` .O ►�.. `" j! w '[, i: «'1 �
� TNMIYA (J i/ C� � � 6� r7 � 6i � � +' 'O t! � � '
, s►xvr� e C'v x:4 Gy r U �'!. j„j Hr: � C� V1
re�v,w ` � p � W ►�
I I a » � �G L
6J�.1o1$� a 'h v � � � � � � ..7 �
� ` � 1 tQ I� H I v, I ea 1• er { M. , �h 0.
�-�� . , ' • ��' 1
�� 7,-' :�� ..
�� -- w
X y u ^
; � i� Y J
o „� .
• : d � ;� .
�' •-� w .
M�5 �
` � � C
• u �cS
��"E
, . `� i: ..••i
' � V
3 v �
• � r.�u �� .
u
� t0 � �
' , a, �� �' •~+
. . ���„ o JC � 1
.
C u �tt p
. o r.
� � `0 $ �_�
. „
' ' ;� ��
' A �� ,�� �
� � Q� a p
!j X �`Lr p o� d
U � ° 0 :� '�
� • � •� i
. = A. e7 • � � � � {: a�i
.� ^'l1`) �j 4 � a,: '� ,d
Y N b Q t� � �•�
� e � � '[7 a ti • L4
� �S� o � ��� N
�G q
� C. �e � er o
r /� . y ���
' � '� l7 �s �"� �
� b � b � p L .
, �.� � � u
t� � ' � � Q M :
t� ° e' �° .'" a
i � �''
4
� � o.�� x
`\� � �� u ya�
. '4� � . : � _ -
ll..
� � .
-�-� �� �T I
• �.. � ►�- r I
. �e/ �� ,
Co .
�ti.- �
< i
ti 9 3 �
' c. � _
� � o.
E� '
i�:
U s�+n+�.�o
.^
r�
t3.. � �
• �� N 7�r� '
. � � svo
>
� .i
. . O .
t.n
�
rn
rn
, �
a
1
�,
. ,�
—
�
� . .
l •
Y• .
. �
0. ,
O
x
y
O �
•o '
ti o �
� �
t
N ° �
� � '� � w
a
� . � �
� � O
02 4�-I � iG fA ' •
�r F-I , .�
0 �
�
7 Q�
�, � �o �
`° .�► � .
ta t� �
� .
� N
� � Q ��
0. V �
Q: p � � .
�.. o � u .n
� .� .
4 . v �o � � .
O jC � b°. w o .
u u
N A
's
R �
�� �
�
�
�► �
L' �•• r,o ..
N
� Q i��iY+► � .
� � o�� �
�' 4
�y �� Sw�SW
(� �' N�LY�
►� � SN�WO .
r
r0p11
" c
a� 'S1ruK
�
t►. � •yu+o�
� �.'. '�rtliJ p
� f�
Dl swvr• �; �•
Q "q �,. d '�
11 • ,j `
� r...�s ,, v 1J
� a
%4 �.ns�r. :, O
�0�+ ;i e
N\r �' M
..�
�,r,�.� t`� �
— e �v
s � rwr� � �
r���.r �� •
._� � � x
�
` "�r°� g= ;; I t: �� t'. !i .
� Q,� .. .v 1 r� v� 1• 1r
. � , . • •
. '
• � •
. �
� \ � � Li7
� r��
�
, ] � . � �,�
L�. t r � V�
• ' v�1 ..
. • • • • � . � . �.
. . . . � y .
�
I N
.� �
d � �
O � � .! H' 1
1
N .
W !7 H N N N �► M! _� M• N �l ' �• t
:� ' �
. 4 a � � � � N 3�c 3 ��� , :
..: q r+ ci (f, N N u� •' r�
� d) N h. N V� YI Y! h �
x x x �e x x M K x x. •' r-�.
J O � ' ' � E+
� x x . =
Q i .
u� :
. _ .• .
.
� .:..... ..: .
�, ......... . .. :
. • • . • • • . • • •
� • • • 4 •
� • • • • • • • �p .�
� • • i • '� . • . . b
• • • • � • • • • • V •
'� � • • • • • • • j i •
� . M O •
• • • • W • • • • � N
. . .• . •• . . . •
r �
• J . . . . � ei . . . � o
. . ne . v . . . .. .
. �
� : �, � � � ay . • . . �y a �
� • • •
N • r' �. • '�'7 • � • 3 - • .
• � 6'1 : •� J� ' r � � � O `� �
F- � '" •
.
�• � .a c �l • ` 3; O �
� � a C � . � 7 ` • � ..
0. W M;; � •� a x » yx. o �':
' Pti K ' C� � v 'O r �Il v W �' Oi
� '(� x w � ; '-�+ � W « � i� � o
�" � {y p � �� 1„� 7f p �. � 1•
� � w
u �" a -'
` ~ �{
� �
r. � M ` -.
t7 � .3, � �+ � Y ; „ � � � �
�:c � � u �� iJ i- ... � o �
`° � �
• �
1 ` . . � �. . °
� HOUSE H E, TING TEST RECORD �° �� ��,
�'°� � '`'� � � �
� � ���,� �' � �� � � y �� " ; ,� ,���
ADDRESS - �- �' �:, r� ��' '' APT. FLOOR CITY SUBURB r''k
� � �� =�
OCCU PANT z'�� " � ° `��" � � - ��,
� �, d *��:'•� � ��, OWNER
HEAT LOSS D�TE,HTG }NSTK
SOLD BY �� � � ,. � � � ,� b _ �4:
� " " , ' INSTALLED BY �--
Eleetrical Work By Gas Line By - _ --
TYPE OF HEAT GA FA � HW STEAM SPACE HTR. UNIT HTR. � OTHER
GAS DESIGN CONVERSION
MAKE '_ �-rt�- '` F`� � MAKE OF BURNER
Model '' � � ° � " t� �� - Model
q ,,�. ;� �r ,a� � � ��: �':�' .;�
Serial � -� Max. BTU Rating
INPUT "A A�-_°" ' MAKE OF FURNACE
THERMOSTA
VOIVO r
Limit '
Limit Sefting
Fan Setting _
Pilot Type _
Pilot Make
Model
� `� � CONTROLS , ,
�Heat Plug Vent Size "�y`'
�`�'����� KIND OF LINER -�a="'� °� �^f� SIZE �`' NONE
�.- 'H c � Drah Hood ��°_ `�'F°�-` r �- �_ � Regularor
. ! �� *i�7 ?�=�J
� Fi Iters Size Number
,
�` � ,+�'��''' Chimney Loeation Inside- #" Outsida
_ � 4�, � , , � �, , ,.
. , -< �'"'.`�,'"��`'�'. C}�imney Construdion � ? s'' sx-
Pilot Model 3` Smoke Bomb Wiring � �
Pilot Timing ��` � �� i.�° Draft �-" �=�� Test Tag
L.W. Cut Off ,-- Door Pressure Lighting Inst. �' �`'
ti �a � �� p— �w�'' +% r _
�° �9
Prossuro ,_ � Percent CO2 F � Date Tested �;� � � � �
Input CFH ��,� �� Percent 0 Company Tast�ng y j 4 �
a � � " {.�- �`y pt '�
2
i ��
� !�
Staek Temp. �- `� �� Percent CO ���' Name of Tester s" -
Form 235
f-
�
W
d
t7
z
H
t-
w "'
J tn
A 4
.--. U�
U_ A
Z
Q
L.L
O C7
Z
� �
U �
�
�
O
�
z
0
1--
a
U •
J
d
a
Q
r"I
�
O
r-1
O�
C'
I
�
1
��
lS�
u
�b��
.�c ci m ro I
u �+' m ro �
� u � a,
y m m %
� � � v
H .0 .-� %+
p i� U N
� 3 b �
�O
�� U A y I
s�cvm
p, 'ro v ..Vi r�
w rc .a =R
'�OUroa �
H u r� ro
o ro
c u ui ."'c
.,°� �H � " �
V � r�i � �
0
U ' j .,�� �� � .�
ax 0°" �
� N 3 � � �
���°
y
� m a�°o m�
o+ a, w a
'—� r� � ,°� a w
� v �� v
w���°n a'►°1+oro
m °� ra, lNi m m m
N 1� H I a) b+ y
'U � W t�rl � � r�-I U
� �o� ���,w
h AUH E a�+�
t`��
��
0
c�
c�
o �
z � �
� �: Z
s
W '�S
a, �
� �
n �i
� N O �
� D. o
�+ � O � o w °J z .
r-t
� �"� � U iiil E
n 4..i
� � N W
s�, o °'
�a z
� HW N �
i-i �] U Pq
� W 3W
k� u1 U H Z�
�° `� w � �
o a� � � c� o
� v
d � �
3 x ro
3aq�0 � �
�
S +�
m ro
abu� se� N �
�Xt3 •osrW
. �
• jddtt se� �
3
.zaqsaM •6D ,�y
�t�en�oany C �
a�
SUTSY$ V
�
u��p� �
U
F�zQ ��i3
S20MOL;S
sute�uno3 b'
butxutxQ � ,[
StIE3y I{SP�y O a
� o
SSN�S o v
N O
sutseg �
w
S4nL u�eH u �
sTeu��n N 3
� d
s�asoT� �
� r, U p
u v v� a �
. eat.zo�s � nCi rNi <r
0
�
�
N
N
H
H
� a
r� H
� �
� a
d �
� � � �
a o
a w(�
N Ua�yI LO�'.�] w
H i-1 �
� z a �
a w °� �
d
O
E-�
v� vf vr v� v� v� vr vr vr
� � �
u�1 Q
�
� � � �n
W o 0 0 0 0 0 0 0 0 0 0 0 0 0
F+ o 0 0 0 0 0 0 0 0 0 0 0 0 0
. � rvl N N tf1 ifl O h N �I) M r-1 O tf1 N
th 4f N 4J N r-1 (? VT V} f? f? i-i tR t?
N f?
x x x x x k x �a x x k x �
A z ( I I I I I I I I I I � w
(
�'-� �n w
_
U �
N �
� H
w t�il H
� � W O
J
"-' !n � � � rt
F--- W � o° .� � tn u
� E-� rn•a o o: •.� w z w
¢� •.�i a�i o� �-01i ro� a�i o � H
� a�i o p1 o v ro d°o E-� °
� �' ro a�+ " o x c�i� � o� � o°
X � N O 1�� a�i � a�i w ,U •a �p F" o 0
►-1 1� N N 4' Ol O N id C7 � � 1� Q � N
u' � � a m ro o° w'd 3 i �+ .-i o
� � W k � �C o N o�.�i E'' w o F � u�i �
•�.'• �� w u v� a�i � u w "' .�i � H u�i .a
� t +y' 3 � a� a� @. Cl ay�� �cl N�y ,� N o
a �(+� d � 3 3 Z W � .-1 � C7 � I�v m
w c�
�
O ,.,
� o
0
a °
N v
2
HW
[G
� � �-',G,
5 ,�
, ,.
,� � �.a,
;,� „�-
-.. ;: �-
����
-+ � -*=�
� P
Y
A �"y���i.� .i>_
�' �,.t'�'�*�.
s 3'�``
� �h�
,„ry�A-y�i �::t'; y..�
��� ,
,��� ,
�;';�,�
;t':
__�
��
,/�'`?°�!� �� � `''° ��P.��
CITY OF FF�IDLEY
8431 UNIVERSITY AVENUE N.E.. FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571-3460
June 1, 1982
Mr. Dale V. Hadtrath
Transcontinental Brokers, Inc.
534 Plymouth Building
12 South Sixth Street
Minneapolis, Minnesota 55402
Re: Welch V. Brickner Builders and
Johnson V. Harris
Dear Mr. Hadtrath:
The City received today, a notice from the John E. Daubney
Law Office that two lawsuits have been commenced in the
City of Fridley regarding walkway easements owned by the
City. Please see attached letter for details.
Would you please take whatever action is necessary to
protect the City.
' Very truly yours,
oL�� �
Sidney C. Inman
Director of Central Services
SCI:sh
Enclosure
cc: Mr. Nasim M. Qureshi, City P1anager
Mr. Virgil C. Herrick, City Attorney
P1r. Cari Newquist, Prosecuting Attorney
Mr. Charles Boudreau, Park and Recreation ir.
Mr. John Flora, Director of Public 4Jorks �
0
. •
�
JOMN E. DAUBNEY
JANET C. FESLER
LAW OFFICES
JOHN E. DAUBNEY
ATTORNEY6 AND COUNSELORS AT LAW
304 DEGREE OF HONOR BUILDING
FOURTM AND CEDAR STREET3
ST. PAUL, MN 56101
May 26, 1982 '
Mr. Nasim Qureshi
City Manager, City of Fridley
6431 University Ave. N. E.
Fridley, Minnesota 55432
Re: We1ch V. Brickner Builders and
Johnson V. Harris
Dear Mr. Qureshi:
- _ /
,'
�/�c�� ` �
(6121224-4348
, This letter serves to give notice that two lawsuits have been commenced �
in the City of Fridley regarding walkway easements owned by the City. The
two plaintiffs (home buyers and adjacent land owners) have sued their
respective home sellers for the devaluation of their property as a result of
the existence of said walkway easement. '
The parties request that the City of Fridley give them notice of any
hearings or meetings regarding any physical improvement of said easement.
Below are the parties' addresses and property description.
Robert G. and Marlis A. Johnson
1581 Dana Court, Fridley, Minnesota
Legal: Lot 7, Block 2, Harris Lake Estates
Anoka County, Minnesota
• Michael J, and Carol L. Welch
1591 Dana Court, Fridley, Minnesota
Legal: Lot 8, Block 2, Harris Lake Estates
Anoka County, Minnesota
Thank you for your assistance.
JCF:mdm
cc: Mike Welch
Bob Johnson
Yours very truly,
THE JOHN E. DAUBNEY LAW OFFICE
Attorney for the Plaintiffs
�.
Ja t C. Fesler
0
�
��
� �.
�
T
era
�
�
�
c
O
>
�
w
Z
J
•� .
��
�
� �
Z w
U
O�
U aZ
t'3 Q
L �'
W �'N'
_ }
D �
Q Z
� Z
Z O
�o
d Z
W U
OQ
ao
O a
� Z
�• O
- O Q
� �
U �
J �
Q LC
�
�
Z
0
i--
U
a
� W
Z Z
�„ > N
�� � �
�� � �
���z
�� � � �
�O��ch
�����
\ U tL u�
tA
�
LU
�
�
�
Q
m
O
�
rn
rn
v •-
c �
t � �
�
�U+�
� U m
.� m � �
� � � �
•� � ,,, a
= � o
t
Q! U � C
� � � �
m
` a m .'�.
'� U �
O at � �a
� . G
r ` � O
Q. y � �
Q = � U
� Y � Q"
Y � � �
� 3 o v_,
C y +�+
� �
� � � �
�
� �
m
z o � �
�-- -r —
-a=��, .
mm
rn m m o
� � � �
7 � aI �
N
d
� � C Q
F- H � i
�
F-
�
F-
� � �
il
�
\
�,
O�
Z
H
�
2
w
a
\
.`
�
Q �
�-- 0
� U
� p
C'3 �
Z
� �
H
m W
ts� cfl
m
� o � o o°_
� o � o 0 0
N 'r +- r
- i�i �F � �}
1
m`
�
7
m
i
� �
r �
� �i
� �
�
� U
� � �
m � OC
0
��a
m
U
�
�
m
C
�
'a
'�O
Z
�
c
a
a
�
�
m
�
�
�
�
c�
i
� �
�
�
� � .
= o p
Z W
� N J �
o��
�
W
i
�
�
C�
�
�
as
�
c
�
co cn � � � �
� � � V ��
C �
� _ ♦�n p � � l�
� � � �
U� V � v3 =
U � WO •
Q t
U � ►�- _ � o u�ai rn
= o� z �
I �y oo a o
� J � Q
�
� . � a, Z �
� - _ Z- � -- ,�: ��
� � � � d ��
m
U �
m `� �= � m m
� d m H d �
� � Cl � � Q = d
� �
Z N m ti 00 [0 = tn Q
�
0
0
0
�
--� -- -- -
�
v
��
m
.�
N
Q
!
�
�
O
m �
� U
�, �
� a
���
Q
m
Z
O
� Y
`: 9
�
c
O �
� �
a�
��
� �
mm
7
•a.� j
t •-
� �
�
aT
�i,
�
�
Y
�
O
m
��
7 4
�o
�
� �
� �
E�
0
E �
o�
U �
m
�
�
L
i
�
�
�
�
W
W
�
�
O
�
�1�'
�
C
/
O
�
W
Z
�
1�--
U
w
a
�
z
W
oC
Z
0
Z
O
Q
�
�
Y
Q
H
�
� �
U
O Z
W �
0
� �
��
m �
� �O
J a
� �
� i
t� m
a
,a O
� r
� m
c o
� Q
t6 C
Q- C
� O
�r �
O �
c
� �
� O
� �
O
O �
c
� �
��
sue�ecr PER
c;ty of Fridley � � � :�5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � REC
� ; L �__�� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC, ��` �
� � �
' � /'��1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED 8�
�""� � �'' 612-571-3450 910-F15 6/2/95 / /
J08 ADDRESS 1581 Dana Court NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ] 2 Harris Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Clayton/Linda Riihiluoma 1581 Dana Court NE 574-2471
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Twintown Exteriors 9301 Bryant Ave S, Bloomin ton MN 55420 881-3949 5724
a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO '
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reroof house & garage (25 Sq) Tear-off; Replace basement window
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code. Bedroom
windows being replaced must meet the State Egress Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE fiEOUIRED FOR ELECTRtCAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOO OF 120 DAYS AT
ANV TIME AFTEfi WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE FiEAD AND EXAMINEO THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WOFiK WILL 8E COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1 S7S .9�F
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW fiEGULATING CON-
STqUCTI N OR T E PERFORMANCE OF CONSTRUCTION. �F3.00 Fire SC 1. HS
PLAN CHECK FEE TOTAI FEE
License SC 0 Q.82
S�GNATUREOFCON'RACTOAOAAUTHOAIZEDAGENT IOATEi WHEN PqOPERL ALIDATED THIS IS YOUR PERMIT
� . ^
� �
i
S�GNATUREOFOWNEA�iFOWNERBUILDERi IDATEI B6-0 �NSP paTE
NEW
ADDN
ALTER
[l
[l
Il
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: �.�
� � �-, ���
Effeetive 1 / 1 /95
��-�rl
Legal Description:
Owner Name & Address: ��� � GriL� � r�l��Y /t / i� t 1�.�`—�i/�c�— Tel. #._5 ��¢ Z�{ 7%
Contra.ctor: %ii� �z�1� �x�/��s MN LICENSE # � �Z�
Address: % �C� / %�`�'r�����Js� �c�� Tel. # �d �' ( —=j -�'j �f 9
LIVING AREA:
GARAGE AREA:
DECK AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction dra.wn on it to scale.
Length
Length
Length
� �
DESCRIPTION OF IMPROVEMENT
O R: � � �
�e�; �� �
Co er Lot [] Inside Lot [] Ft. Yd Setbac
Type of Construction:
Approx. Comple6on Date:
Width Height
Width Height
Width Hgt/Grouad
s
Sq. Ft. _
Sq. Ft.
Sq. Ft.
AS e�/��t 7'� `lji//Y�lG�O-�tJ `
k Side Yard Setbacks
Estimated Cost: $ %4 �1 �
��
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + t— t x$ _$
DATE: �' Z�� S APPLICANT: ..4'� Tel. #� 7' il 2 5`' ?/
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
�wer Main Charge
■ l�/_ Li��
$ � /2 0�
—�_
$ �- ��4
$ � ���
$
$ � ����
$
$
$
$
$ �v � �'�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuatioa (1/lOth%)
$.so�$1,� valuation
$850 per SAC Unit
$5.00 (State Licensed Residentiat Contractors)
Alt. "A" ar Alt. "B" Above
$450.00 Conservation P1an Review
Fee Determi.ned by Engineering
Agreement Nec�ssary [ ] Not Necessary [ ]
STIPULATIONS: , _ a
13UILDING PERM["f FEIi SCHED(ILE
'i'hc (;lii;:t� 13uilding UCticial shall, tx;foce issuing permits for the ercction of any building or structure,
c�r- ti�r any a�iciition to any existing building or structure, or for any alteration or repair to any existin�;
(>uiliiing <�r st�-ucture, u�n a�plication the�efore, require tfie payment by die applicant for such �ermit
��t� tceti tc� thc; amount hercin t�clbw set fi��ih and in thc �iu�nncn c�rein provi�lcxi to-wi(_
"I'O"1'nL vALtll:
� 1 to $500
$SOi to $Z,000
$Z,001 to $25,000
$25;001 to $50,OOU �
$50,001 to a100,000
$100,001 to �SOO,IX}0
$500,001 to 51,000,000- .
$1,000,001 and up
rr_cs
$IS (Minimum Fce is $15 plus surcharge)
$15 for fust $500 pius $l for each additional $100 or
fracaion thereof, to and including $2,000 -
$45 for first $2,OQ0 plus $9 for each additional $1;000
or fraceion theroof, to and includiag �25,000 '
$252 �for first $25,000 pt�s $6_50 for each additional $1;000
or fraction th�eof, to. and inclading $50,000
$41450 for first $50,000 plus $4S0 for each additional
$1,000 or fractiou thereof, to and including $lIX},000
$63950 for €irst -$100,OOQ plus- $3_SO for each additional•
$1,000 or fradion tf�reo� to and including •$SOO,U00
$2039.50 for the 5rst $�O,U00 pins S3 for each additional
$i,000 or fraction thereof, to and including $1,000,000
$3539_50 for the fYrst $1,OU0,000 plus $2 for each additional
$1,000 or fraction d�eof -
DRIVEWAY DEPRESSIOM ESCROW
(Concrete Gu-b Streets Only)
Alternate "A": Removal and rep(acement of c�rb and gut�r only - Driveway widifi plus 6 feet times
S13_SO_
Alternate ° t3": Removal and replacement of curb and gutier and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15_75.
VCRIFICA"CION OF FOUNDAT[OIVr
Permits for constiuction witl be issued a minimum of 24 hours from the time of a�plication to allow
for proper review of the pro�seci stnicture and of the constniction site_
A Certific;:�te of Survcy of t2ie lot, showing the locatio� of die foundation once it ha.e it has t�ccn
constructe�i wiii be rc;yuirexl (�efore proceeding with the �raming_
' -� � �� Su9�ECT
City of Fridley
AT TME TOP OF TME TW�NS B � I L D I N G P E R M i T
r
� .
� �
� ; v _�___ COMMUNI7Y OEVELOPMENT DIV.
r � � PROTEGTIVE INSPECTION SEC.
i � �
� _ �""1 � CITY HAII FRIDLE� tjS' 132 NUMBEh
�'""'� � �'' 612-571-34b0 s�aF�S
JOB ADDRESS
1581 Dana Court NE
t LEGAL �OT NO. 9LOCK TfiACT OR AODITION
DESCR. � 2 Harris Lake Estates
2 PROPERTY OWNER MAIL ADpR�S$
Clayton Riihiluoma � 158.1 Dana Court NE
3 CONTRACTOR MAIL AODRESS
Columbus Exteriors Inc 2131 111 Lane NW, Coon
a ARCNITECT OR OESIGNER MAIL AODRESS
5 ENGINEER MAII ApOFiESS
8 USE OF BUILDING
Residential
OATB PAGE OR
3/29/99 / /
ZIP
29105
RECEIPT NO.
/5 7�
►nvqOVED Br
SEE ATTACMED
SNEET
PMONE
574-2471
PNONE LICENSE NO
33 701-9569
PMONE LICENSE NO.
3509
PNONE IICENSE NO
7 CLASS OF WORK
O NEW ❑ ADOITION O ALTERATIQN ❑ REPAIR O MOVE O REMOVE
x
8 DESCRIBE WOHK
Reside House & Gara�e �
9 CHANOE OF USE FROM
STIPULATIONS
TO
Call for building wrap inspection before covering.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
TYPH OF CONST
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING
TNIS PEFMIT BECOMES NULI ANO VOIO IF WORK OR CONSTRUCTION ZONING
AUTHOR12E0 IS NOT COMMENCED V�1ITMIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIQO OF 120 DAYS A7 '
ANV TIME AF7ER WORK IS COMMENCED. NO DWLG. UN
I MEREBY CEFiTIFV THAT I HAVE READ ANO E%AM�NEO TMIS APPLICATION 1
AND KNOW TME SAME TO BE TAUE ANO CORREC7. ALL PROVISIONS OF LAWS yp�UATION
AND OR�INANCES GOVEfiNING THIS TVPE Of WORK WILL QE GOMPLIEO @
WITH WMETHEfi SPECIfIED MEREIN OR NOT. TME GRANTING OF A PEFiM1T y�8 f 6OO
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CAMCEI THE pEFiMtT FEE
PROVISIONS OF ANY OTHER 57ATE OR LOCAI LAW REGULA7ING CON-
TqUCTlO THE PERFORMANCE OF CONSTRUC710N $149. 7S
PLAN CMECK fE
,��'� Licens�
SiGH�UpE O� CON7RACTOA ON AUTMOA�ZED OGENT IOATEi
C�
S�GNniUFE 0� OWaEA�i� OWNEA BW�DEA� iO�TEi
SO.
STA�LS
$5.
ROUP OCCUPANCV�OAD
CU fT
OFFSTpEET PARKING
IGaRAGES
SURTAX
$4.30
SAC CHARGE
Fire C $8.60
TOTAL EE
167.65
MIS 1�Y OI� PEFlMIT/�,
/ • ! l � / �i
/ �
q�tt
NEw
ADDN
ALTER
I]
[l
[l
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: � � C� � ��� � � �
Effective 1/1/99
h
�\� /��
� �V )
Legal Description:
Owner Name & ddress: �� � �- �� � �� � � � � b � � Tel. # � � 2 - � � �`- � �' �/
ntra t • �� ! �r �� cr � � � i � � � � MN LICENSE # .� S� `�
C• c �r. � s� �c r .S , � �.
Address: �/�% /// �`' �� l� � � 0--�1 .���.�d�� � N S� � 3.� Tel. # G �� - l o% �g 6�r
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:
OT'HER:
Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
W'd Hgt/Ground Sq. Ft.
�� � / _
�
Construction Type: Estimated Cost: $ �', ��
� ��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � �� � APPLICANT:��'� Tel. # �i z � �' � - y`�� �
Permit Fee
Fire Surcharge
�— State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ �- ,�.i Fee Schedule on Reverse Side
$ �- (D O .OU1 of Permit Valuation (1/lOth%)
$ - �D $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ �. C1 \I� $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ J Not Necessary []
� /� . �s�
BUII.DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon appl'ication 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�
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
Alternate "A°:
Alternate "B":
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $SUO plus $2.75 for each additional $100 or
fraction thereof, 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 $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $SO,OQO plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for ea.ch additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof -
_ . � `�
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only) `�
� � ���'
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times �
Removal and replacement of curb and gutter and install a 3�oot wide
approach with 6 inch depth - Driveway width plus 6 feet times $�35. ��� ��
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Cert�cate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required bef.ore proceeding with the f�aming.
_
C� � I �F
FRIDLE.Y
FRIDLEY Mi7NICIPAL CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
June 1, 1999
Ciayton Riihiluoma
1581 Dana Court NE
Fridley, MN 55432
Re: Final inspection at 1581 Dana Court NE
Contractor: Sedgwick Heating & AC Co.
Dear Mr. Riihiluoma:
��
� /� C
I
�
�
A mechanical permit was issued on June 24, 1998 for the property located at 1581
Dana Court NE for a new fumace. According to Section 305(a) of the 1991 Uniform
Mechanical Code a final inspection shall be performed on the mechanical permit. As of
this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, we will expire the permit and any inspections on this installation will
require a new permit.
Any questions can be addressed to myself at (612) 572-3603.
Sincerely,
Barry Riesch
Building Inspector
�
�
r�
� �
�
c
�
c
m
�
W
�
\ �
��
�
0
Z
F
�
F
>
� w
Z U
O �
8p
Z �
W �
_�
-Q �
�d�
�z
0
�o
z
��tJ U
�a
0
�
�
O F
Q w
= C'3
a�
� � �
�
0
Z
O
U
a
� w
Z Z
� N
�a�
� � � �
� �����
O = m
� �vc�
�•. �.i � LL �
� �.
c � �
•� � C T
� � �
�o (j w
� �
3 r- �
� � �
� w - �
• � � � o
€ 3 w
°d.� � �
� U � 2
m
o c�a � a
w m c
� •c m �
� t �
c�_ � U
� Q-
� o c �
3 o v,
�-'u�s
.r
.o°o�
�
.� � � s
�'a
� c � �'n
� rn � m o
w
oC �L R .'�.. :_.
¢ � a o cS
C � y
m m � c �
° ��2�'
7
�
�
w
2
U
�.
�
a �
o �H
� �
� 8 S
¢ � o
� �,
�
C C
m �
Y '�
.� � 3
� m � c
� E O �
> > _ 3
0 t�, j„L '6
� c � �
�
c
m m
� � � m �
C V Na� �Q.
� � � v a,
��a c�
Q
�
�
�
C7
Z
9
m
�� �
�� i
�
�
O
Z
�
�
W
a
.�
�
U
�
�
�
w
� � �
8 $ $
O O N
� �s �
rn
�
�
�
c�
z
�
�
�
m
¢
I
�
a
U
Q
�
\
€�
�
�
°�
� o � w
Z W a
� N J Z
� � � N
� .. in
m �
c �
O �
m
� �
U a t°- _
2
� �
= Z
c a�
_� F=
Z ,,,,
o��� ��
Z�m� mm
� �
� � .
�
Q
m
Z
�
�
v O
C �
�
�, o
� �
d. �u
o� �.
� Q
�� o
a�i m
a�i �
� �
a�
t„ :_.
�
O
U
� Q�qqq,,,
7 O
� m
��
e�
.� o
m o
E �
E�. N
v �
U
�
U W
� �
� �
� O
� .�
�
m
c
�
�
O
�°"
S
�
W
LWL
Z
O
U
a
�
Z
�
Z
O
Z
O
Q
U
�
a�
Y
Q
�
O U
��
�
��
Y H
��
j U
og
�a
��
�
3
$ �,:
l� �
A
� O
�N �
l� �
C p
N �
� C
Q c
� O
.. �
� o
� C
0
c �
o €
�
Ci �
a 3
_ :a�EQ
:�Cg pau�is
�O� JI�tIZd'3H
s
� � :auoQ utag Sl�IOI.L�'2I�.L'Id isi-y
: sxieivag
() oK () sa� ia��aq ia�Enn io3 paptno.�d uaaq n� uoi�snquio� s�g ' g
() ou () sa� . ia��aq ia��nn io3 papino.�d uaaq iautl ��H ' L
S�I1.Lg 'IN.LOZ
S�llsg ia�o iid
3o S�ILLS �uTl�aq i�o� s�g � 9
() orI i) SaA pa��auuo� s�f1ZS I�o� puE
azis io3 s�uauia.nnbai apo� 1�a.un� II� ��L1i ' S
( ) oH ( ) sa� pauoddns �ia.�n�as sI •�
m
() oN () sa� uicpinn pa�poi s��afqo u�taio� ou sEH '£
() oN () sa� uot��oualap l0 1sn1 uioi� aa� sI 'Z
() ol�i () Sa1� pautu�xa �Clin3a.ie� uaaq s�g ' I
:X��s io �Cauunq� �uilsixa a� �� sa�uan �qaiau pau�ts�apun aqZ
I�tOIZ��I3I��A �I��.LS Ql�i�' 1��1�1IIH�
a �
�
a
r
♦ �
��� ��1�OTE: 4�1 throu h#8 re uired w
g Q hen using a side vent furnace.
� �c � h , ��� F,q i � L �-- Y
��
� ���'� � CHIMNFY �ND STACK VERIFICATION
The undersigned hereby veaifies that the �xxisting chimney or stack:
1. Has been c�refully eaamined Yes �. No ()
2.
3.
4.
5.
Is free from rust or dete�ioration
Has no foreign objects lodg� wit�in
Is se�urely supported
A�i� all ct�t ��e �ir�i�� f� �
and total BTU's conne�ed
6 Has tatal heating BTU's of j(�0� t`�0 �
All other BTU's � C��(��%C�
TOTAL BTU's � �V f (�O(�
Yes (� No ( )
Yes�No()
Yes �- e) No ( )
Yes � No ( }
7. Has a liner been provid� for water heater /� ��� Yes () No ()
_�.- � c�mbmrtian �fiae�n pravic%d for waRer fi�ter ��--i�o f�-
Remarks: �'�'i� �`� ��- � �f � l � S S � .J�' 6 � �
„ •
. J _! _ ..f_ t� � , � � � � , �1
.. . , ... � . _ _ ., . -.�,�_ s �... . - . �. .. ' . . .
�fy�F�4�kA/�'Q. f7�11Atl�1 � 9"90� i�A�9Ad61 6R���6fi9�1 aJ�J�a
�� � �8C9$�f$�1 � '�SUi`�
. � °'" i �, MR(� �.�?l� .
, ,��5� �,
�'I'�iC.+�-O: � � _ _ _ - .
Sig�d; By:
17ate:
��:r a
�
��
�
�
Building PLUN.�ING Permit No.: � y
Inspections �i r,Jj�]E�OjTTAT,� ApPL][CA�'IO1oT Received By:
763-572-3604 CITY OF FRIDLE�I Date Rec'ct:
763-502-4977 FAX EFFECTIVE i-]-08
DATE _�i� ^ l — O� YOUR E-MAIL ADDRESS /' ci � C�Olih
srrE a.nDxESS I.5'SI I_ia�r �GC�'z°� �tf,� �4',!�l.,�'�! m�l/ ��3 Z
THIS APPLICANT IS: �OWNER OCONTRACTOR �
PROPERTY Np,ME: ` e(� tyi��
OWNER/ ADDRESS: �S� '� /i� CiTY �Oi°%���STATE�ZIP .7�-s ��
TENANT PHONE: �%� �l -- s � �- �� �i
CONTRACTOR Nq�:
SUBMIT A COPY OF STATE LICENSE � EXP DATE
YOUR STATE
LICENSE, BOND AND S7'ATE BOND # EXP DATE
CERTIFICATE OF qDD�g: CITY STATE ZIP
INSURANCE . PHONE FAX
PERMIT TYPE �SMGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE
TYPE OF WORK: � �W ��p�CEMENT
DETAILED DESCRIPTION OF WORK � Gf ` E PG`��� � � ��
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, insta.11ation or replacement of a residential fixture, excluding the fi�ctures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge
OR
FOR PROJECTS WI-�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.Q0 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDiCATE TOTAL
NiJMBER OF EACH BELOV�. MINiMUM FE� $15.50.
BATH SINK/LAV _FLOOR DRAINS SHOWER _ WATER PIPiNG
BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($IS)
DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) �OR IRRIGATION
— WATER METER _ OTHER
L � �< G`F �' '"4 ... ^�*.,a � � ^ �,r �i;
ga _ � £ i �` �.�a, � ;k _ �s`'� -��_..r�:.,Ta:�. �'�i.' '( _ .�d+.
Permit Fee $ .� � Number of fixtures @ $10.00 � x $10.00 = $
Surchat e .50 Number of fixtures @$15.00 x$15.00 =$
TOTAL DUE $��� OR Number of fixtures @$35.00 x$35.OQ =$
State Suz�charge = $ .50
(MINIMLJM $I5.50 S� MINIMUM $I5.50) Total = $
THIS IS AN APPLICA'CION FOR A PERMIT-NOT VAL1D UIJ7'IL PROCESSED
I hereby apply for a plumbi�g 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 on site; that the work will be in accordance
with the approved plan in the al or � h requires review and approval of plans.
SIGNATURE OF APPLICANT �� � PRINT NAME� �D/! /LirlilOht�ATE C�v —%Z — U' �
APPROVED BY DATE
;�. � s �. �� � � � �� � � � p � ���$�;`;;
City of Fridley
�uilding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977