AF - 42093sue�ecr P E
City of Fridley -- . 14202
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T�
r
� i. ECEIPT NO.
�i L_____. COMMUNITY DEVELOPMENT DIV. ^`��,^�-
' ; PROTECTIVE INSPECTION SEC. �j( �J
� (J
�.-_- A; ���;,, CITY HALL FRIDLE`/ SS432 NUMBER REV. DATE PAGE OF APPROVED BY
J � si 2-5so-saso 910-F15 � � / �
7�7�77
JOB ADDRESS
360 El Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCF. 6 1 Rottlund Oaks SHEET
2 PROPERTYOWNER MAILADORESS ZIP PHONE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
The Rottlund Co., Inc. P.O. Box 32082 561-4340
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO.
6 USE OF BUILDING
Sin le Famil Dwellin
7 CLASS OF WORK
� NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
House and Gara e
9 CHANGE QF USE FROM TO
STIPULATIONS
1. Provide copy of truss design.
2. Provide hard surfaced drivewa.y.
3. Provide verifying survey before capping.
4. Provide sod in�,,� front and side yards.
5. Provide loi'v�red door to utility area..
6. Provide standrail on garage stairs.
SEWER LOCATION
5' to 10' of water service
Expose sewer service to determine top of footing
Wye elevation not noted on as-builts.
WATER LOCATION
44.8' SW of M.H.
17.9' S of hydrant D/W depression $ N/A
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. Fi8.ID2
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 PERI00 OF 120 DAYS AT 1 696 27 966
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE fiEAD AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 3�} LF9O.00 �.%.LS
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE � SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
ST�RU�C�T% ON OR THE PERFOR�°` NCE�Q F CONSTRUCTION. ].11. %�} �D 375.00
�,j�/�+� ��� (� q �`-e• �'k � PLAN CHECK FEE 1 TOTAL FEE
V
.-�'vy L�-�-. 7'_ "% 27. .93
SIGNATUREO�NiRACTO OFAUTHORI2EDAGENT IDATEI W EN P PERLY VALIDATED THIS IS YOU PERMIT
* �. % 7
SiGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG. �NSP DATE
CITY OF FRIDLEY
APPLICATION FpR RESIDENTIAL BUILDING PERMITS
�NcW, �LTERATIONS, ADDITIONS, OR REPAIRS)
OWf7ER:� �7`l�'/!/•ci � U°j . .�I�/P. BUILQER: �� /f4i"�`��+t K -�°O . �•fir.
Address : Address : �• p ,[30X � Z- D g'Z
Tel . No . : ��"� / — y� _5%d
No.: s�Q� Street: ��� CT �✓. �
e
LOT: _ � BLOCK: �_ ADDITION: �7'y'�,v� /��,L/S
CORNER LOT: INSIDE IAT: ^� SLTBACK: SIJEYARDS:
Applicant attach to this form �uo Certificates of Survev of Lot and proposed
building location drawn on these Certificates.
a
DESCRIPTION OF BUILDING
To Be used As: S'j�l�.� �� /�nt l X
�o ,
}fav 5�G Front: y2 ' Depth: 2�o Height: _�_�___
�l t o �y�"
Square Feet: Cubic Feet: 02��� �/V
« •
J
, /�
�.DY.�7� Front: o?y Depth: L y� Height:
Square Feet: ,,�'% Cubic Feet: ,� 7(t d
Type af Construction: �r'�4 M�2.. Estimated Cost: DO. e e
- �3t/ yyo =
Zb Be Completed: S.�,o r. 3 0�/ q 7� %
/Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired � $ $
� t I Dv-oy� L°�c,y �j (SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances ar.d rulir.gs of the Department of Buildings, and hereby
dec:lares that all tne facts and representations stated in this application
�� are true and carrect. See reverse side for additional information.
.
E ��,��� DATE:�j — .�O -- '�'� SIGNATURE: r-.�
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ACCt�R.4CY QF UTi�111f �QCATIQNS AND � ELEVAjIpNS.
TNlS DATA IS FpR INFORMATIOIJ PURPOSES ONLY ANA
PERSONS USING R SHOULQ V�Rj�! j�€ �Npp��N
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____ _ __
/��'rl:i�TUFt ENVELOPE AVE;RAGE "U" COtr1YUTATION
, `
� �� OWNFIR � �? .=o �� L i / � /� � r� . .�in/ r' ,DATE — — �
SITE ADDF2ESS: /Q ��`�_/� � ��Tr Iv.Y �' �,.a,E'S PIIONE: _ S6�" y3 5�U
CONTR7ICTOR:' �,v %� y /ti,�i t/ /`�r•� .7'ti �
Determine working square footage of each
Z. Tata1 exposed wall area. ..... �/ 3 f, f�, / sq. ft, x .17 =_ 3� ,2 , 3 7
2. Toal roof/ceiling area ..... o _/ j a a sq. ft, x , 05 = �(� ,/ Q
Total exposed wall area above floor =
a. Total wall window area......e
b. Total door area ..e.,,.,......•�...�...... ......�....
c. Total sliding glass door area .o.oe..o.o„ ��..........•
d. Toi.:al fireplace wall area ....e...,e •�" "'••�.�.
e. Total� wall framing area (average 1Qo)......,,...,',••..
f. �'otai rim joist area �.�i�(S s�����e�.�,. � � � � �
g •.�n; �,r1�r. e wal,l area above . . � . . . . . . . � • . . . � . . . . . .
, floor....e,o.e.. a
h• j,9ya�-e. wall, area above floor.��!S�1[Ar� d , _ . � � � ' ' ' ' � . � .
i. �ei� wall area above floor. �r�S a/,fir��1 . . . . . . . .. . � . . .
�• wall area above flooreo.e,�..o�o...Oei.......e.
�� . 4 0
-- % �: �f�
-/a�,iz
/93,/,�
_/�/ Q
—�� �• �� ?
7?�, a��,
-a���.00
3�l ��
Toi:al exposed foundation area = �
/Ars., r►r f.• v r f
k. Total fe�rtcia�raIr window area. e S-�. ��
1. Total net €��-�,� area above.gradeee.e...a...,..,.e. 6�
Determine "U" value o�'each wall segment
(eege window, door� each separate wall section)
a . �6 , v x „U,� , � g � _ �, g �
b. � ��, `�% X ��Uo, ''-' _
-- ��.7 %D.l�
C. _ � � -7. � a x „U„ , Sg - 7 �- � �
a. _ ��3, ��a x ,�U., �aa - �3.3�
e. _ 1 ( �� � 70 x ��U�� ,1/3 = ��j'. �
f. _10 � f o 3 X ��U�� . n,� 9 =
7• _ /JQ.D J }{ ��U�� �0„r __
h. _ 07 `� , O b X ��U�� � 0�o Z —
�. _ 3a�. �9 X ,.U„ o� _
,
J•
X "U" _.
� , 3,5
�l � 9 7
/S 3/
a�. �o
k. �� G� X ��U�� �.5� _ ��� y�
1. _ l I� 3>� X ��U�� •?� _ Jr'`�, 0
.
3 . ............................. Tota1 _ ,s,� 7'7• 3 �
�1
0
Tf item #3 is the satne as,
or less than itera #1, you
have met the intent of
SBC 6006 (c) 2.
v� �-
Exterior Envelope Average "U° Camputation
� . Page 2 of 4
� Total ex�osed roof/ceiling a�ea =- ll� �`
m.. Total sky�ight area ...,,.,,
n. Total roof/ceiling framing area•(average'10�)...
o. Total net insuia"ted roof/ceiling area.......... 11 �� �
. • _l o a �. �- o
Determ.zne "U" va2ue tor each roof/ceiling segment
� m. � X ��u�� _
n. �)a, � g ��U„ .1�.�� _ _ �/,o`�
0o C�9• £�D g�,U�� , d 3/ _
��� 3 �
4••.....<.e...e ............. Zbtal = ������--
If total of ##4 is the;same as, or less than #2, you have met the intent of
SBC 6006 .(c) 1.
Alternate Buildin 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.
�o _ ��a. � �
3 e :� 7 y. 3�
+ z- _ �6.�0 = y�_��
� + 4. ,�� L � Q �, .� �
�� YePI,� P �
.�l`.�/T-�rior A�i- F'i/�n , /�
(-.'L� n �t 1 Vi � �C r ��i �.� ,�/ Z�
�. %�� /� � �
�
� i r Sx�,��-.e , 9 �
�' ,� /d �.� 1 / l
�i� T-r r/O r � 1 Y �I /An. , / �
y. � s /�
,ZZyv
0
�
0
WALL SECTIONS
NO�'ia: Use lO e o£ opaque wall area for
frame construction
.IG. #3
��� �~. `�
o � .
. ' o � � t.� �`
. . _ ` �• �
� � ': . ��' . � ` � .
0
Page 3 of 4
Construction R-Value
I 1. Interior air film 0.6£i
� 2��„ �-�;✓.r�',.��;1_ -
i �i �
' 3. �rqn���iq y 3 S
/ ,
4 ' �. a /�' / �'-- ` �. ` � .,, Z D (a
s . % " �. ����. , / � y
,
6. Fxter:ior air film 0.17
To tal �, ;r SS !�,
�/!3 ✓
1. interior air film 0.68
2.�7—� � Y' r7'-t�.� r� ,� y; ---
3 . � '�, ��,s �� /,� � �•�, r �l � �
4. `
�% � % i ! ?� - j-i � ,c '�
' cr' • G ,
5 . ��. � S� .,�. � I • /y
6. Eacterior. air film 0.17
Total /S S"� /�
•�aS!/
1, Interior air film a.6$
2 e 3/2 ZivSv/A �`i�r_P // o/�
3- i J./� Td /.S 7- /, r'': �
4.����
�`�� 1��1r- r�*< < af
5 . �7 , , _ c ,�,l,,�, � 1 1 �
6. Exterior air f ilm 0.17
Total l� . -� � �
�,�1 Y' � �� (�t/ � l ( � o � 9 (>
1. Interior air f ilm 0.68
2.�� ,.
a S� r7Ya r',�'_ . y�
3. 3%�' .�^ ��'c• //.! 7`i oir %% D D
4.��� .C� / i;'- - y r�7 �e- 2 r l
5 . '� �� T' Y .L t,� ,n / l ____ �-'� 7
6. Exterior air film 0.17
' Total /.� `�; . `'
• � - � ��', � i/
. a . r . .
� C��..���`-�1=- f%( � � . " a . ��`� G �
._.---- _� � r r : - .,
�- • , . -
Il(`� ` �' ; - • , =
...-- �b' '
/r� >� � . • . '
. � � 6 . ', � � 11! �
((1 : . . . . . i .__.- � � t
.--. , . � /(/ '
FIG. �r4 `- � ' � � /�(
• / i ( � li ' • . (� ..�"--
� ' , (C! � � k —: x � � // �(
' �� � � « .— / i � � ..�. �
NOT'r : Indicate tyn�, ��n��� �Vc11L:C� CiCDtil dt'1C�
��.iICCP.IF`]lt O� lnsul�ti�,.,
M'
• Yi.I�i'�
��enCed
F.00F/ �E I LI NG
� ;+'- -''�
>''.--` � �'
.
/�. _:✓
;�I' !r�,��l,►����'�;
���1� �'��t�crl11���
_ �. - �—U � �
flea t f lour
up . . . :
Fxc� �s� '
' � i
, �.ra.-�r',,. e ca- •; ti��_T1 _=` ^
� . � �� �� �'$� � -
Heat floc�r up . ••venCed
.•
. ,Fyro �k6 .. .. . : .. ..
� 3 � � � 5
. � ..
�; �•�t,fa.3�•S "' ''�
. n1 0.5:,..^: -•, .
• r „fG��`�� •�L'��: . �,�.. • .: :� ...
�..0 l 4=1j.(�1} :•:� .'� � •' •,••'•••� / � � • /
�� �.�._�,;���:.s�.i. � /• �'.//...--- 1' %��1
�.., � _,_,�,...�_.
� . . . ' �/�F��
� . � . . �! =�
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,.
• h��u�p�,,.� ' ."
� ' . Hent � ' ,
, ' • �I.QW ��} . . . .
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r.r,c;. ��7 . . .
Page 4 of 4
Constr.uction R-Value
l. Interior air film 0.61
2 . %,_._._,�, `�''7'rar k. . c-`? ,
3. L� " 2"�t ; u�,� �-r �;a e � O O
4. Exterior air film (still) 0.61
Total 3 /. 7� � /�'
.03� U
1. Interior air film 0.61
2. �Il1.s c1f.0�-«v! �� �� n v�r �0 /57'� I S� G d
3.`S`O /S i� F t' A-` F-r%.7 � �, 7 f%
°�./i f ii -i J-Y Y 4�° i_' � S' -7
4. Fxterior air film (still) 0.61
Total a � � � �
.a3(, v
],. Inside air fiZm 0.61
� 2.
t+ 3.
� 4.
, 5. Outside air film 0.17
• Total
Note: Use additional sheets if more space is
needed for details and calculations
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CITY OF FRIDLEY
� - z Y � dJ�
�PPLICATION FOR POWER PL.ANTS AND HEATING, COOLIN6, VENTILATION, REFRIGERATION AND
.AIR CONDITIONING SYSTEMS AND DEVICES
PARTII�L FATE SCHEDULE :' 3� Q �, �y ��
Job Address
GRAVITY V�ARM AIR: RATE TOTAI.
ftirnace Shell & Duct Work $12.00 $
Replacement of FUrnace 7.00 $
Repairs & Alterations-up to $500.00 7.00 $
Repairs & Alterations each add. $500.00 4.00 $
MECHANICAL WARM AIR:
FUrnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations-up to $500.00
Repairs & Alterations each add. $500.00
S'TFAM OR HOT WATER SYSTEM:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 F3TU
Boiler only up to 100,000 BTU
each addn. 50,000 PTU
OIL BURNER- to 3 gal� per hour
each add. 3 gal. ger hour
GAS BURNER- f.rom 100,000 BTU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
GAS FITTING FEES:
lst 3 Fixtures L^
Additional Fixtures
Gas Range to 199,000 BTU
AIR CONDITIONING �
FAN HEATING SYSTEb9S See Fee Schedule
VENTILATING SYSTEMS
ALTERATIONS $ REPAIRS
ROUGH INSP.
Date
FINAL INSP. L/ -II - %�
Date
APPROVAL FOR PERMIT !W�
Slz. OO S/ L. �✓
4. 00 $ y. u u
7. 00 $
7.00 $
4.00 $
$12.00 $
4.00 $�
7. 0� $
6.00 $
$10.00 $
10.00 $
$10.00 $ l �• � J_
S
x $ 3.00 S �• "."
X $ 1.00 $
x $10.00 � $
State Surcharge
TOTAL FEE
REINSPECTION FEE
($10.00)
S
S
S
S
$ .50
$'L9.�-v
MINIMUM FEE FOR ANY HEATING P$RMIT IS $7.50 PLUS $.50 STATE SURCHARGE
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the wark herein
specified agreeing to do all work in strict accordance with the Ci.ty Cbdes �-
and rulings of the Department of Huildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. � ' y _. 19 ? �
OWNER � b �( "'t � �° �+ ✓ !�
KIND OF BUILDING ��' R +'�- -
USED AS �w�`(_a
TO BE COMPLETED ABOUT � / ' � !
ESTIMATED COST � � L �' v `�
/'7/�,_ �/
OLD -�BUILDING PERMIT NO. PERMIT NO. / L,! ��
, DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm AiY- No. �
Trade Name Lr� ^° J� Size t�w. �'/ L�2 .? -// �
Capacity Sq. Ft. EDR�O O G �' B� �
Total Connected I,oad (O`i 3! �'"� Kind of Fuel `�-i
BURNER - Trade Name� Size No. �
Capacity Sq. Ft. EDR BTU HP
CoIDl3any
�, ��:� :�, , . ' . . ' „'�J�-
" , ` ` Siqned By .
I� , - � � �
►Yl' ' Tel. No.
!
. . � ` � ''i�� .
HEAT IOSS CALCULATIONS ���'T���� �'� ����'T�C��IING CO. MINNEAPOLIS, MINN.
�Neatherstrips A.S.H.V.E. Construction No. Insulation t
Windows Doors Guide p� yyall Int. Wall 9 �
Reference Ceilin Roof Floor Kind How Applied
Yes—No Yes—No � 9
�•� ���� Room Length � Width Height FI. � � Room Length � Width/� Height
V'Jindows and Doors-Crackage and Area Windows and Doors-Crackage and Area
No. Widrh Height No. of Lineal ft. Area yy,d�h ye,qht No, of Lineal f�, Area
., of pa e of pa lights of crack sq, ft. No. � of pane I of pane lights oi crack sq. ft,
s � �' 3 � �! c�
�2 � S� 4� �' 1 � � � / � � � � � 7 �
Infiltration
Glass
Exp. wa I I d,
Nst exp. wail
Int. wali
Ceiiing
Floor ,''
Total Btu
�
�
Btu
�� � �
Required sq. ft. E.D.R. or sq. ins. W.A. Lead area
� FI ��'�LC Room Length Width j? Height
VJindows and Doors-Crackage and Area
No, Witlih Height No. of Lineal ft. Area
of pane of pane lights of crac sq. ft.
� ,� --- .�'.�
B tu
Infiitration
Glass
Exp. wall �
Net exp. wall
Int. wall
Ceiling
Flo-- or �--
Tota I Btu
Required sq. ft. E.D,R. or sq. ins. W.A. Leader area f_�}�
FI. Room I Leng*.h Width Height
VVindows and Doors-Crackage and Area
ry�_ Wicirh Height No. of L�neal ft. Area
of pane of pane tights_�. of crack sq. tt.
�
Infiltration
Giass �
Exp. wall
Net exp, wail
int. wail
Ceiling
Fioor
Total Bfu.
Required sq. ft. E.D.R. or s�. ins, i1�'.A. ! eade� area
Btu
Coef B tu
Infiltration !� �
Glass O
Exp. wall � 7 ��
Net exp, wall � �p �
Int. wall
Ceiling , ,'•'�;
Floor` -,�G� �//V%/��% _ '� l/� � �
Total Bt�.�:� a��� -r
Requi4edisy.`f4`. E.O.R. or sq. ins. W.A. Leader area
,�F��{L!,(��.;}��l���o�n � Len th � Width / J Height .
�—
� Wintic�s��'and Door Cs acl��g�._and Area
N�,�1s W�dth Heigh'�i No. of Lineal ft. AreB
o£ �'a, ot pa 7ights ��ot crack sq. ft.
�'' - � / /
I
� Coef B 2u
Infiltration �7I����
Glass / I O �
!
Exp. wall � �X�°
N°t exp. wall ------ -- fS��"�
-- ----- � rz�
I nt, wa! I _�_ I
� _i`
Ceiling
r�oo� � ���c�— ��z � c
Total Btu.
F�equired sq. ft. F.D.R. or sq. irs. 'vU.A. Leader area
F�• Room Lenyth bVidth Height
VJindows and Doors-Crackage and Area
N�� 'J��atr, H�:�qht No. of i Lineal ft. 4iea
! of pa�ey�ne:� li�hts ��f crack �q. ft,
Infiltratipn i �
Glass
— — ' --�—
— -- ---�
Exp, w�ii i
— —+---
Net exp. wall �
int. wall ' �
-- � i
Ceilirg 1
____ __------
F!oor
Totat Btu.
Requ�red sa, fL E.v.R. or sq. �ns. V:_A. 1 eade� area
Coef� Btu
r � "E.s-�� c= �a =``" , !�% ..���r
� '-� � .� ^ � . �, � � "L�..--
� � � . .�-�- G �'� �
HEAT LOSS CALCULATlONS ��� ����� �'� �����-r'oIV'RIC7 vo� MINNEAPOLIS, MINN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Windows Doors Guide Out. Watl Int. Wali ,
Reference Ceiling Roof Floor Kind HowApplied
Yes-No Yes-No 19
F�• � o✓ 1,,. Room Length � Width� Height FI �T� ��—�ioom Length "Width � Heighi
V'Jindows and Doors—Crackage and Area Windows and Doors—Crackage and Area
Np, W�drh Heipht No. of Lineal fL Area
, of pdne Of pene liph[5 Of CreCk 5 fL Np, Widih He�qht No. of L�neal ft. Ar@B
Q' of pane of pane lights of crack sq. ft.
.� a � i .� � �" J � �,
/ � ,�, c,ct .�'�
0 '0 4� �d �
Coef B tu Coef B tu
Infiitration � �7
s�` <a 7� � � Infiltration ���C�
G lass
-- ,�,.� ,jL�' �'j Glass � ,�.�
Exp. wa ( i ` ` Gj �
Exp. wali � Q
Net exp. wail � Net exp. wall �
Int. wall �C/f'� �J� [� � � Int. wall
Ceiling `i � j Ceiling �� �, ,�' "6 � "�
•o
Floor
Floor�.`��. � . , ,
Total 6tu. � Total BYir:;� .z - �
Required sq. ft. E.D.R, or sq. ins. W.A, Leader area <� Requif"� sq.�F#:-E.O.R, or sq. ins. N�:A, Leader area %
: , --� ., - , —.. . e.
FI, Cy � Room Length Width Height FI. {� ` Room � Length Width, Height
V'Jindows and Daors—Crackage and Area ; VJind��u;s,�nd Doots-Crackage and Area
No. W��'th Height No. of Lineai ft, Area '� H,���rh He�
of pane of pa lights ot crack sq. ft. � N 9h4�a No. of Lmeai ft. Area
� � �:.` c�f pane of pane�` , lights '��of crack sq. ft.
ry` � . � . .. :!�?, �J ,.: ". .
� � v� � J LY � � G.�-- I
Coef B tu
Infiltration � l � � � � � 5/ � � � L,
Glass � � � � �,
Exp. wal I �� `�� . �
Net exp, walf
Int, wall
_Ceiling� � Y �
4
Floor
Tota I Btu
� �� �
����,�
Required sq. fL E.D.R, or sq. ins. W.A. Leader area----_��r��
�FI�1� �y'��'��Room � Length Width �� Height
VJindows and Doors—Crackag� Area
N� WidTh Height No. of Lineal ft. Area
of pane of pan lights of crack sq. ft.
� '�`{�-_- S _� v''
�— c±eri - ac�
Infiltration � � � � �J � ��
Ci I �355
Exp. wal I 3� �/�
Net exp. wail
I nt. wa I I ��,E"`!'
Ceiting f ��//�
Floor
Total Btu.
��
�_ �
Requrred sq. f;. c.p,R, or Sq, ins. Ni.A, LPader area
a
Btu
�_ Infiltrdtion - j
Q Glass �
--
Exp, wall
-- --- �y
� Net exp. wall�_- L� �--- --- --- '� �% �. �)
Int. wal l — - A
O C e i I i n 9---�-�-�=---- ---- _ �� ..� :rt �
Floor
Total Btu. � �
Required sq. ft. E.D.R, or sq. ins. W.A. Leader area
_ FI �(,(:i,�-(�(�3��om � Length Width � Height
VJindows and Doors-Crackage and Area
N��. �lNir�th� N�igrrt No. ofT L�neal fi. Are�
__ i of pane � of pane � iights I of r_rack sq. ft.
Ir,fi ItratiOr? �
CiI�SS
Exp. wall
Net exp. wall�jX� � ` �
Int. wall
Ceiling �_ Y_ � � � �' �
14_
FiOOr
Tota; Btu.
Rnquired sq. `t. E.D.�. or sq. ins. th'.A. Leader area
B tu
i, �
J �
CITY OF FRIDLEY
APPLI�E7:ON FOR PLUMBIN� AND GAS FI�TING PERMIT
N � N � u • X w Water
�� � r+ � N F•c •� N a u a w cN Heater
•.i S� J ry C N .> ll N id .0 ^ E N /„ � P4 1J
1+ J•^ c � �-+ .c c c 3 O u•.�+ O� u al
O ' O •� +� .1 � �� �� � O 0 �U N 1� N N N Ul .0
y � f-+ w n � •.+ ��+ o.q .-i ro rs � ro ro � � o'as lec
cn u :� m v7 3 n R. tn t+. U tzl RC 3 C7
/ /. / � �
.st / j /
:;:::i
� 3r3
�f :.'1
�(R) = Ft:t�re Connection Opening Coiinected with Sewer
(*) _ .:•=.� Fixture, Old Opening Water
PARTIAL RJ�TE SCNEDULE
PLU`•;3I':G FIXTUEtG }L�1TIiS: N0. RATE
h"1.:._,er Fix:ures / x 53.�0
F1*_��:Yt. F1:ctULO Ooening ? x 52.00
Ne•a Fixture, Old Opening x $2.00 �
Cr�t.h B3sin x $5.00
hat,=r Fie.;ter -?.0 99,000 BTU �� x $5.00
li-J, 000 IIT:; to 199, 000 HTU � x $10. 00
Water SoFte::er x $7.00
New Gr�ur.d �:,an Ci3 Buil3inq x $5.00
Elactric Water f?eater x $5.00
G�S i:T"lI`U FEES:
I lst 3 :ixtures �_ x $3,00
r,3ditior.al Fixtures x $1.60
:.as i:.a::3e to 199, 000 BTU x Sj.0.00
REc AI itS y ALTER.�ITIONS
Pir� = S:,^,0, OJ $5.00
each a:i.3. $100. CJ or fzaction $2.00
State Surcharge
TOTA:, FEE
R.°•INSPi:::TZON f'EE
($1C.OU)
TOTAL
$ ,a� �v
$ ��' �
$
S
$ �'�,u
$
S
$
$
s �:�u •
$
$
S
S�
$ .50
S
-�.��
Job Address 7 � � � / L ���
Department of Buildings
City of Fridley
Tel. #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 Coces
and rulings of the Department of Suildings, and hereby declares t�:at a12
the facts and representations stated in this applicat on are true and correct
' \ ridley, Mn. � S , 19 �Z �
ow�R —4" ��I � I 1, 7--
KIND OF BUILDING
USED AS
TO BE COMPLETED ASOUT
ESTIMATED COST
OLD /NEWJBUILDING PERMIT NO.
��
Compan
Signed
Tel. N
ROUGH INSP.
Date
FINAL INSP. % ` �- � � 7 �
' Ddte
APPROVAL FOR PERMIT �L�1��
MINIMUM FEE FOR ANY PLUMBING PERMZT IS $7,50 pLUS $.50 STATE SURCHARGE
.--F �
GEU. SEDGWICK HTG. & AIR COND. CO. ���D ,.;�,!
HOUSE HEATING TEST RECORD }j �S
ADDRESS � CITY `
dCCUPAMT OWNER
HEAT LOSS DATE HTG. INST.
SOiD BY INSTALLED BY
Electrical iNork By Gas Line By i� C( �Z
TYPE OF HEAT GA_ FA W_ S7EAM SPACE HTR. UNIfi H7R. 07HER
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER
Model a Model
Serial � -� Max, BTU Rating
INPUT �� � D�� MAKE OF FURNACE
` Model
`7�� ,� CONTROLS _,,� ��
THERMOSTAT� Heat Piug Vent Size -- �� —' �
Valve �X� l� �� KIND OF LINER ,l�2.,�_____ SiZE `� NONE�
Limit � �1�� .L�'4' Draft Hood Regulator �
Limit Setting � d��- Filters Size Number
Fan Setting g'g�3� Chimney Location Inside /-�'''; Outside
Pilot Type ��— Chimney Construction
Pilot Make
Pilot Model Smqke Bomb Wiring �
Pilot Timinq --- - - -���,�'' Draft �,'1 �� Test Tag �-f
L.W: Cut Off Door Pressure Lighting Inst. �-'" -
Pressure ���' Percent COZ � Z- 7 �� Z Date Tested �
tnput CFH /1 � PerceM 02 ��� � Company Testing
Stack Temp..i''�'� Percent CO a�v a�� d•D Name of Tester
Form 235
�
��
February 28, 1978
C�Ti( OF FRIC�L.EV
6431 UNIVERSITY AVENUE N.E.� Fii1DLEY, MlNNESOTA db432
TELEPMONE ( 612)57t-34S0
� Mr. Roy Lund
Rottlund Can�pany
P.O. Box 32082
Fridley, Mn. 55432
Re: Fi.nal finspections at 341, 350, and 360 Ely Street N.E.
Dear Mr. Lund:
Final inspections were made on Febzuary 27, 1978 of the above addresses
and the following items were noted which.must be completed before the
structures can be f ina].ed out;
341 Ely Street N.E.
1. Provide anchar bolts in garage by March 10, 1978.
2. Provide sod in the front and side yards by June 15, 1978.
35Q Ely Street N.E.
Provide sod in the front and side yards by June 15, 1978.
360 Ely S treet N.E.
1. Install make-up air to furnace area by March 10, 197$.
2. Provide sod in the front and side yards by June 15, 1978.
We will expect the ahove items to be comp].e�ed by the scheduled dates
when reinspections will be made to detezmine compliance. I£ you have
any questions an these items, please contact me at 571-3450.
Si rely,
DARREL G. CLARK
Community Development Adm.
DGC/mh
m
_
_
C[TYOF
FR(DLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
January 31, 1989
Mr. aryd MrS. Riaker
360 Ely Street
Fridley, NIl�T 55432
Dear' Mr'. & Mrs. Ri.CJcer:
PW89-16
I have contacf:ed you within the past twn weeks r�gazdityg the City's d�e.sire ta
loop the dead erid watermain on Ely Street. I irydicated ta you what the tw�
options are and I am naw enclosing a map illustrating aligrmients of these
options. �
As you can see, Option A(red) i.nvolved the shortest run and affec.-ts thQ fe�est
n�m�ber of trees. This aption wov.ld i.nvolve obtaining a utility eas�m�nt frcen
360 aricl 361 Ely Street. Optiari B(blue) will r�t irivolve any ac�ditional
e,aseme�nts but potentially cauld adve,rsely affect a Y►�uch greatex rnanbex of trees.
Also, Option B would approx�mateJ.y double the watermain length and restoration
work. Obviausly, Option A is by far the most attractive o�tian to the City.
Belaa, please itx3icate yo�ur preferenc.e of the options and su�anit your response
in the self-addressed postage-paid envelope no later than Febn�ary 10, 1989.
�
�
Carrunexits :
I agree with Option A and agree to grant a utility
e.ase�xit of seven feet.
I prefer Option B even tho�uqh it appeaYS that many
more trees cou].d be adversely affectsd.
Sincerely/ ��
(_����
Clyc�e V. Moravetz
F�gineexing Ac'�ministxation
��
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� `, 'o. �H
- .i . :�.�...,�, v ir.� � ����` '• � .
t� l ' t . :t� � l�"iG.�y p4s. tt �� : —'-` r�.�
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T'�;'.a� �� �� t
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.;.. -t� � � �'' . . �;, f`�' ti , •_ r .'° '*� . ' �" ,.�
��+ ' ,:�� � � l �' ..�'�: � � ;r!�� . , .�:� ��-'� f,
�
�------ - .
LIBERTY ST
�
�
d �
�,
Y*
"Y�.r r: �
,.,
TO:
FROM:
DATE : ,
SUBJECTt
E�,<����o���„y
Scwcr
Water
PttrkS
Sirecis
Maintenance
MEMORANDUM
Jo� . Flora, Public Works Director PW89-46
Cly V. Moravetz, Engineering Administration
March 10, 1989
Watermain Loop at East River Road and Ely Street
/� ��
�3�a �/y
As you know, I have corresponded with affected area residents in
the above area verbally and on paper during the past couple of
months. You also know that I presented the City�s desire to loop
the Ely Street and East River Road watermains to ensure quality and
continuous service.
The property owners do not desire a looped system at this time.
They indicated that there has never been any water problems caused
by deadend waterlines in this area. The property owners at 360 and
361 Ely Street consequently were opposed to granting the Ci he
necessary easements to accommodate the loop.
I suggest the Council be informed of this situation and that the
City does not pursue any further this looping of the water system.
I have provided relating memos and correspondences to the Ely
Street file. If we receive any water quality complaints in the
future, we will have supportive material on why the loo� wasn't
completed.
CVM/ts
,' �
�
•, �
� r
_
_
�i ■ l V i _
FRIDLE,Y
CIV1C CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHON� (612) 571-3450
Jarivary 31, 1989
Mr. ar�d Nirs. Doa�wati Wrti.s
361 Ely Str�t
FYidley, NIl�i 55432
Dear Mr. & Mrs. C�.irtis:
PW89-16
I have ornztac.�ted yau within the past two weeks regardir�g the City's desire to
loo� the dead eryd waternnain cn Ely Street. I indi.cated to you what the tw�
aptions are arid I am naw enclosityg a map illustrating aligrmients of the,se
options. '
As you can see, Option A(red) ixivolved the shortest run ar�d affects the fewest
number of trees. �+; � aption wnuld irivolve abtaining a utility eas�nt frce�►
360 arid 361 Ely Street. Optio� B(blue) will not irYVOlve any additional
ease�nents but potentially oould advezsely affect a 7rnuch gr�ater rnm�bes of tr�ees.
Also, Option B wauld app,-�;,,+�tely dcxable the watermain length ar�d restoration
work. Obviausly, Optiari A is by far the most attractive aption to the City.
Helaw, please ir�dicate your prefererice of the aptions ar�d suianit yair �o�.se
in the self-addre.ssed postaqe-paid e.nve],c�e no later than February 10, 1989.
a I agt�ee with Option A and agree to grarit a utility ,
e,asesnerit of s�ven feet.
a I prefer Option B even thcx� it appears that mzny
nr�re trees coul.d be adversely affect-�ed.
C�unents:
�� Y, ��► �
� �
a �. ���
��� ���
��
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v
_
_
� Vi
FRtDLEY
CIVIC CENT'ER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 '
Jarn�ary 31, 1989
Mr. and Mrs. Ric;Jter
360 Ely Street
�'idley, NIl�T 55432
Dear Mr. & Mrs. Ric'.Jz,er':
PW89-16
I have c�ontact�ed yau within the past tw� w�eeks regarding the City's desire to
loap the dead end watermain oai Ely Street. I i�d.icated to ya�t �at the two
aptions are arid I am nvw enclosiryg a map illu.stratir�g aligrm�ts of ti�e�e
aptions. �
As you can see, Option A(red) irtvolve�d the short�est run ard affects the fe�aest
rnmiber of trees. 'I3zis aption wvuld involve abtainim a utility easement froan
360 and 361 Ely Street. Optian B(blue) will nat involve any additiaria].
easements but potentially cauld adversely affect a�ch greater rnm�b�x of tr�es.
Also, Option B wauld approxim-�te1y dauble the watermain ler�gtii ar�d restoration
w�ork. Obviausly, Option A is by far the m�ost attractive optiari to the City.
Belaa, please iridicate yaur prefererx�e of the options and sulanit your response
in the self-addressed postage-paid errvelape no later th�n Febn�v.y 10, 1989.
� I agree with Option A ar�d agree to grant a utility
eas�t of seven feet.
� I prefer Opti� B even th� it appeats that n�any
m�re trees owld be adver�.,el.y affec�ted.
Goatunents:
Sincerely,
�������
�� �. ��
�gi�aexing A�ini.stmti�
C'VN�/ts
F.hclosures
0
sua�ecr P�AMIL
c�ty of Fridley �� �� t� 4-
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � R
� � COMMUNITY DEVELOPMENT OW �
r �~ � PROTECTIVE INSPECTION SEC. a��
� �
� � -
� � /'��1 � CITY HALL FRIDI.E� 55432 NUMBER REV DATE PAGE OF FPPROVEO B�
�'""'��� ,�� 612-571-3450 910-F15 6/13/97 / /
JOB ADDRESS 360 Ely Street NE
1 LEGAL LOT NO. BLOCK TqACT OR ADDITtON SEE ATTACMEO
DESCR. O 1 Rottlund Oaks SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PHONE
Cliff Oberg 360 Ely Street NE 780-3286
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
Panelcraft 3118 Snelling Ave S, Mpls, MN 55406 721-6628 2179
4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAtL ADDRESS Z�P PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
CI NEW ❑ ADDITION ❑ ALTERATION � REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Replacement windows
9 CHANGEOFUSEFROM TO
STIPULATIONS
Replacement sleeping room windows must meet the State Building Code.
Provide smoke detectors to meet the State Building Code.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE iiE0U1RED FOR ELECTRICAL, PIUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 50. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Ofi ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE ANO COFRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED
W�TH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2�708 �1.35
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ��[� . JS Fire SC �2. %1
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION
PLAN CHECK FEE TOTAL FEE
License SC $5.00 $83.81
S�GNATURE OF CONTRACTOP70A AUTMOR�ZED AGENT IOATEI WHEN PiiOPE VAL ATED THIS IS YpyR PERMIT
, G� 3
SiGNATUFiEOFOWNEPi1FOWNEABU�LDERi IDATEi .8 �� �NSP �1FTE
i�LW I I
/1UDN � ( CI"I'Y Or �IZiDL�Y
nL'['I�R ( � SINGI.r rAM1LY ANll llUPI_CXl'sS R-1 AND R-2
Builclinb Perinit AP�lication
Cc��islructiun Acl�ress: ��Q ,(��C� �i��'��T ��
L��a( Descri�tic�n: ----.—
Owner Name & Aciclre�s: _ �
cunlr�ictur: �G�/�Z.°�C'r 2�
A�lclresti: �%�� CJ/7 t°��.
LIVING ARC/i:
GARAGr ARCA:
DCCK ARrA_
OTI-IrR:
.`.,� �
L't1eCUVC 1/ I/J4
�a��s
� T�t. ii ��D-32�� —
MN LICLNSC If o2/ %9
Tel. 1l �%i �D� ��
Attach to this a�plication, a Certificate <�f Survey of the
lot, with the Prc>rc�sect eons�-uction drawn on it to seale.
Len�;th
Length
Lengdi
DCSCRIPTION Or IMPROVCM�NT
W idtli
w�au�
W idtli
Height
I-ieibht
HbUGrouncl
Sy. �t.
Sy. rt:
Sy. rt.
Corner Lot ( � InsiJe Lot ( � Pt. Yd Setback Side Yard Setbacks _
"1'y�e of' Cc�nslruclion: `'��i�Q���zo�7� GU�,S�: �stimated Cost: $ �o1 �Q ; DD
�l��rox. Com�lecion Dale:
( cos t on .B�ck )
llriv��vay Curb C«l Wicith I�Iccciccl; Pl. -t� G l�t = lit x$ __$ ___ ____
llA`f�: �o /� � �PPLICANT: � ���,�]�� ��i���S,.J Tel. // ���_��2�
Pcrinil �ce
Pire Surchar�;e
�i�i(e Surchar�;e
SnC: C:i�ar};�
Lice��se Surchart'e
Dr�v�way rs�row
F_rosion Cc>ntrol
r�����: r��
Scwcr Main Cl�ar�;c.
�roTn��
0
STIPULATIONS:
�—��
$— ei�—�—
�_�-��
� ----- —
$ _� �
.�p_ �
� —
'�------�- --
�
$__����
CITY CJSI: (?NLY '
�ee Scl�edule on Reverse Sicic � ����
� ��' � �-
.001 ot� Permil Valuation (1/101h l ) ��y�jk,G ��
$.50/$1,(?0� Valuation (� � ✓���r'�
(?0
$80Q per SAC Unii ��� �
G�� ��
$5.00 (State Liccnsecl Resieiential Contractors) �
/11t. "A° or All. "I3" Abovc �t�L �>���
$450.(}0 Conservation Plan Revie�v � ��`��,, ��
I;ee DetermineJ hy �nbineering ��,
/1�;rceinenl Necess�u'Y I I Ne�t NeccslarY I I
�j',�
�/�
� . • �'�%3 '�% %
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
Residential
APPLICATION FOR POWER PLANTS AND HFJ�TING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Furnace Shel! and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Afterations (LIST ON BACI�
1% of Value of Appliance or Work
Commerciai/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00 $
$ 10.00 $
$ 10,00 $
$ 10.00 $
$ 25.00 $
State Surcharge
TOTALFEE
Effective On January 1, 1997
JOBADDF�ESS�� O ��/� �L y
The undersigned liereby rnakes application for a permit forthe work herein
TOTAL specified agreeing to do all work in. strict accordance with the Ciry Codes and
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
� � — � ' ,1997
OWNER_ l.. L/ 0� `� l d.r�/ir f4' �j �/Z�
BUILDING USED AS
ESTIMATED COST _ � PERMIT N0._1�� ��
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of Heating Units / Circle One (Steam} (Hot Water) (Warm Air)
Trade Name %G. ��-, �,�-v/L Size No. �-��^aP.L' f
BTUs�=S�-Q�j HP EDR
$ Fuei Total Connected Load .
$ .50
Z� S` 50
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 S�A7E SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Canditioners can not be placed in a side yard without
written permission from adjoining property o�Nner.
8urner Trade Name Size No.
BTU HP EDR
�� Q;�'�Pc�� ����� o� - �, �� ���1
HEATING COMPANY �'2 �z. S j O�t- C-v2�,/�_� �C �- �e �-�
� ��l13-�f%
Signed B Tel No. ��g — 3 3c�c�
� �
Approved By Rough-In Date Final Date ���'%
FILL OUT BACK SIDE F R S7ACK VERIFICATION ON ��
AEPLACEMENT FUR CE
CHIlVIl�IEY AND STACK VERiFICATION
The undersigned hereby verifies that the existing chimmey or stack:
1. Has been carefully examined � Yes O No O
2. Is free from nist or deterioration Yes () No ()
3. Has no foreign objects lodged within
4. Is securely supported
5. Ivieets all current Code requirements for size
and total BTU's connected
6
7
:
Has total heating BTU's of
All other BTU's
TOTAL BTU's
Has a liner been provided for water heater
Has combustion air been provided for water heater
!: -�i!�
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000 ,
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572•3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS_ .3lod �� y ..5�; /�211�! 7�'0 �3•�'So
RATE SCHEDULE
OWNER ��/�� 'f' Ly�lliv ��
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Sack)
/ Gas Piping (Needed with new furnace,
�,Q�� �ut no re�la_ ce�nent}
Gas-Ra�ige "�
Gas Dryer
*Air Conditioning • All Sizes
A!! Others/Repairs & Alterations (l.IST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25yo of Value of Appliance or Work
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT �S $25 00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION F�E $47.00/Hr
BUILDING USED AS �GU��G��G-
$
ESTIMATED COST
$
PERMIT N0. � "-� �
DESCRIPTI�N OF FURNACE AND OR BURNER
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name Size No.
BTU HP EDR
$ Fuel Total Connected Load
$
$ ,��D
$ .50
g�S:.�'o
Burner Trade Name Size No.
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE ��— 11—Do
HEATING CO �j//.G/L G7U i�2�`�L L��%jO�DS
Signed ��� ��J�
TEL # s� %S�" / %�
*Air Conditioners can not be placed in a side yard without Approved By� Rough-In Date Final Date �� �`�z��
written permission from adjoining property owner.
r
� ' � SUBJECT . .. � � " ... . .
c;ty of Fridley 32693
AT THE TOP OF TNE TWINS g u I L D I N G P E R M I T
r
� � TN
� ' COMMUNITY DEVEIOP�ENT OIV.
r � � � PROTECTIVE INSPECTION SEC. i L
� � , "I
� � �"'1 � CITY HAIL fRIOIE� 55�32 NUMBEP aEV D�TE PAGE O� �vvnOvED Br
�'""'�"� �'' 612-571-3450 910-F15 6/13/02 � /
�oe nooRess 360 Ely St NE
1 LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ( 1 Rottlund Oaks SHEET
2 PHOPERTY OWNER MAIL ADOiiES$ 21P PMONE
Clifford Oberg, 360 Ely St NE, Fridley, MN 55432 763-780-3286
3 CONTiiACTOR MAIL ADDRESS ZIP PHONE IICENSE NO
Pella Windows & Doors, 15300 25th Ave N, ��100, Plymouth, MN 55447 763-745-1400
a ARCHITECT OR DESIGNER MAII ADORESS ZIP PHONE LICENSE NO.
20165884
5 ENGINEER MAIL ADORESS ZIP PMONE UCENSE NO
6 USE OF BUIIDING
Residential
7 CLASS OF WORK
�i NEW O ADDITION O ALTERATION O fiEPAlii O MOVE O REMOVE
8 DESCRIBE WORK
Repiace 2 windows within existing openings.
9 CHANGEOfUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Caulking and flashing for all exterior openings.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING, HEATING.
VENTILATING OR AIR CONQITIONING. - � � �
THIS PERMIT BECOMES NULL ANO VOID If WORK Op CONSTRUCTION 2pNING SO. FT CU FT
AUTHORIZED IS NOT COMMENGED WITHIN 60 DAYS. OR li CONSTRUCTION
OR WORK IS SUSPENDEO OF ABANDONEO fOR A PER100 OF 120 OAYS AT `
ANY TIME AFTEf; WORK IS COMMENCED. '' NO DWIG. UNITS OfFSTREET PARKING
I HEfiEBY CERTIfV TMAT 1 HAVE AEAO AND EXAMIN�O THIS APPLICA710N STA�LS GARAGES
AND KNOW TNE SAME TO BE TFIUE ANO COFiF1ECT. ALL PROVISIONS OF LAWS yALUA710N SURTqX
ANO ORDINANCES GOVERNING THIS TVPE Of WORK WI�L BE COMPUEO $2 317.00 �1.16
WITM WHETHEfi SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pEqMIT FEE SAC CHARGE
PROVISIONS Of ANY OTMER STATE OR IOCAL LAW REGULATING CON• $83.25 Fire SC �Z.3Z
StRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE TOTAI F E
$5.00 $91
S�GNATUQEOFCONCFACTQpOq�UTMOR�ZED�GENT �O�TE� E PRO l AUOATE� HIS IS VO R PERMIT
� �
S�GanTUFE O� OWNEA��F OWNEp BUi�OERi � �D�iEi �� B G� �ti5� � � ���
M �
�[ l
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF ERIDLEY �
[] SINGLE FAMILY AND DUPLEXES R i AND R 2
BUILDING PERMIT APPLICATION
�onstruction Address: ��� � t�7.`Z . [.,l y �j'}' . � . . .
Legal Description: �
Owner Name & Address: C.1.�isc cl p�,cg_T' Tel. #�'�03•�'� 0• 3a�
__��
Contractor:; PELLA WINDOWS & DOORS MN LICENSE #�
Address: 15300-25TH AVE. N. STE. #100
PLYMOUTH, MN 55447 Tel. #
Attac �63-745-1400 e .Of t$e
LICENSE #20165884 y
LIVING AREA:
GARAGE AREA:
DECK AR.EA:
OTHER:
lot, v _ . - -- - - --- _ _ .. . .: to scale.
. DESC��fii OF ���b�E �'1VIENT _ . � �
Length Width Height � Sq. Ft.
Length Width Height Sq. Ft:
Length � Widtli �� Hgt/Ground Sq. Ft.
^.� — A _ - - "1 _ . � _ � _ . I t- • — A _.•c�l .,.� �n/M'
Construction Type: Estimated Cost: $ a_���' �
Driveway Ctiirb C�t Width Needed: Ft. + b Ft =_ Ft x$ _$ �
DATE: �• Su� • Oa APPLICANT: Tel. # ��o+� 3�� �d� 7"
Permit Fee
Fire Surcliarge
StaLe Surcharge
SAC Charge
Lic�nse Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �
� a3
$ ��e
._....
$
$
$
$
$
$
$
'�3
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.so/$1,000 valuation
$1050 per SAC Unit
$5.00 (State Li.cens�d Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary ( ] Not Necessary ( ]
� �'3 �L
Building
Inspections
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
DATEJ —f, / /T � /
SITE ADDRESS _�ip D
THIS APPLICANT IS: ❑ OWNER
CITY QF FRIDLEY
PROPERTY OWNER/ Nq�:
TENANT ppDRESS: - `
CONTRACTOR
Permit No.: ��`1
Received By:
7��+o n o,. �a .
YOUR E-MAIL ADDRESS k a..,r i C m� n n�.s�-+�-- � u s e v• C v m
CITY
SUBMIT A COPY OF STATE LICENSE � o� %%3 4�^^" EXP DATE 3I�1 �
YOUR STATE LICENSE ADDRESS: SSSS -�'L- CITY
WITH APPLICATTON PHO� qsz � 935 • qlv�e g p,q� �SZ • 93.5 • 9s'
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
❑ TWO FAMILY/NEW CONSTRUCTION
q ADDITION ❑ GAR.AGFJSHED
0 BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
� SWIMMING POi
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Viny!
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS es �No
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
❑ REMODELII�IG
rn� �
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
OSoffit
❑ Trim
❑ Fascia
O�DRAIN TILE
0 OTHER
WIDTH HEIGHT
LO 10 OF W WS
.��-rv �ov r - rP�' a
t.ri n.,mfiu nF wn.mnavc �
ATE_ZIP
A� � 553`�3'
F�
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of strncturaf inembers to be used
FOR NEW CONSTRUC7'iON INCLUDING DECKS,
ADDITIONS. & PCTRCHES SUBMIT:
i. Site Plan/Survey showing the existing structures
and proposed project
2. Two sets of construction pians
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(LTSING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S J�, 5S � OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Gontrol
Pazk Fee
Sewer Main Charge
Total Due
$%�5, J See Back Page for Fee Schedute
$ - 65% of Building Permit Fee
$ �. .001 times the total job valuarion '
$ �.�,y .0005 x Permit Valuation Minimum $.50
$ �. UD $5.00 (State Licensed Residential Contractors)
$ $I550 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ /�9 f3/ Make checks oavable to: Citv of Fridley Attach
THIS IS AN APPLICA7'ION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acl�owledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Pridley and with the Minnesota Construcrion Codes; that I understand this is not a
permit but oniy an appiication for a permit and work is not to start without a permit; that the work wi11 be in accordance with the approved
plan in the case of all work whic r quues r v w a d p oval of plans.
SIGNATURE OF APPLICANT PRINT NAME � 1UU � �' VV! � DATE � /✓ I
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