AF - 41815City of Fridley, Minn.
BUILDING PERMIT
Date: � ��� _
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Owael�:�"' '��lf�� �.� s r`.�='� f�i` 4`;�` Builder -�r+��
Adciress Addrese
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� L�CATION OF ILDING
No. �°��L 5treet ���''� �`' ,���i Part Lot �
,� . � �
Lot �y���_ Slock Additian or Sub-Divisign - �, �
,�. » ,�/� ,�
Coraer Lot _ Ins3de Lot Setback � f Sideyard -�.:5� �_�-
Sewer IIevation — - - - ----- Foundation IIevation
� DES�RIPTION OF BUILDING
To Used � Front �sr.� � Depth �� iieight �� S�l� � ��%�� � � ' �
- � ,,t�� � �
Fro� � Depth ��.,�..�TeiBr►t � � �1• � �F"'7" Cu° Ft
Type of ction_ � Est C�..,�t�� �� - To be Completed
In consideration oE the issuance to me of a permft to construct the buflding described above, I agree to do
the proposed work fn accordance with the description above set forth aad in compliance with all provisiona of
ordinances of the dty of FricIIey.
�
- ,��''-�..°
In conafderation of the payment of a fee oP $���"""�� , P�t is hereby graated to
to construct the building or addition as -.described above. This permit is granted upon
the express condil3on that theperson to whom it is granted and his agents, ennployees and worl�nen, in all work
done in, around and upon said building, or anypart thereof, shall conform in all respects to the ordfr►ancea of
Fridley, Minnesota regardin� lceatton, conatruction, alteration, maintenance, rePair and moving of buildinga
within the dty lianits and ttus permit may be revoked at a�y time upon violation of aay of the provisions of safd
ordiaancea. .�° , ,�f �''� `�
Buildia8 Inspector
NOTICE:
'Ihis psrmit doa aot eovsr t6s coedrnelioe, lestallalloa te. �a �t�t+u�a �a h..��, aAw� e� w�r. B� am to as
tM Bnildie8 lesp�etoe for aparm p�rmtts fee Hiea tf��
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APPLICATION FOR BUILDTNG PERMIT
CITY OF FAID%EY, MIl+INESOTA
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LOC�TION OF BUILDiNG
No. Street .��,,�� �Part of Lot
� y �
Lot��-�2 �"��-0� B�ock � Additian or Subdieiaioa ��.� �...,.-�.,:_ ��,-�
Corner Lot In�ide Lot � Setback Side-Yard
�EWER ELE9ATION FOUNDATIOIV II�EVATTON
Applicant attach to this form Z'wo Certificatea of Survey of Lot and proposed
buildin� location drawn on �hea� Certificatas.
DESCRIPTION OF BUILDII3G
To be used as: , �
, �
Front � � DepCh � Height
Sq. Ft. /�� %� __,Cu. Ft.
Front Depth Height
�q. Ft. Cu. Ft.
Type of Construction ,� } Eatimated Coat �� �
To be Completed�
The undersigned hereby�makes applicatioa for s permit for the work hesein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinauces and rulings of the Departmeat of Buildings, and hereby
declarea that all the facts and repreaentations atated in this application
are true and correct.
DATE -
�1 � "� SiGNt�TURE � ��:� `
(Schedule of Fee Costs can be fouad on the Reeerse Side).
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BUILDTNG PERMIT FBE SCHEDULE
Section 2. The Inspector of Buildin�s shall, before isauing any permit for
tche e:eceion of any building or structure, or for any addi�ion to any exist-
ing bu3.lding or structure, or for any alterations or repaira to any exis�ing
building or st�ructure, upoa application therefor, require the paymen� by the
applicant for such permit of feea to the amount herein below set forth and
in �he manner herein provided Co-wit:
Z.1. For aay such permit for the erection of any fire-proof building, other
than a garage�, warehouse, factory or graia elevator, or for the esectioa of
any fire-proof additian, for similar occupaacy, to eny exiatiug building
shall be ae the rate of $1,k0 for each one thousand cubic feet, or fraction
th�reof, in such cubical contents. - - _
2.2. For aay such permit for rche ereceion of any fire-proof garage, warehouse,
iactory or grain elevator, or for the erection of any fire-proof additioa,
for similar occupancy, to any existing building sh�ll be at the rate of $1.25
for each one thousand cubic feet, classified as B1fireproof°t by Sectioa 502 of
the Atilnneapolis Building Cade.
L�OUSES
2.3. For aay such permit for the erection of any non-fireproof building other
than a garage, warehouse, factory or grain eleva�or, or any noa-fireproof
addi�ion, fo� sfmilar occupancy, to any exiatiag buildiag - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. Eor any such permit for the erection of any non-fireproof gara$e,
warehouse, faatory or grain elevator, or for the erec�ion of any non-fireproof
additioa, for similar occupancy, to �.ay existing building or for each such
building or �ddition - niae�y cents ($0.90) for each one �housarad cubic feet
or fraction thereof, in the cubical contents thereof with a minim� of $4.00.
For the purpose of computing feea for building permits, the cubical can-tents
of aay buildiag or addition to a uniform height throughout by multiplying the
ground area covered fram a point aix (6) inches below the floor line vf the
basement or cellar to the average heigh� of the upper surface or to the
average height of the roof surface of the main gable of a pitched roof.
Z.S. For repairs or alterations to an exis�3ng struceure, the fee aha11 be
at Che rate of $3.00 per each Fiv� flundred Dollars ($500,00) or fr�ction
thereof in the cost of all proposed work.
2.6. In no case sha11 the fee charged for any permit as aet forth in
Section 2 be�less th�n $4.00.
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*. HEAT �ASS CALCULATIONS DEPARTMENT 0� BUILDINGS ��' �
� Weatherstrips A.S.H.V.E, Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind
Yes—No I Yes—No 19—
�yj�7.� /C�0'7? e Room � Length /� Width %�{ Height �i.t�'l.) � ae� • Room � Le�
Windows an Doors—Crackage and Area Windows and Doora—Crac:
�Yidth Helght No. of Lineal ft. Area Wldth HetBht No. o�
No. of pane o[ pane li8hta of crack eq. ft. No. of pane of pane Ilghte
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�/ �/,� � u / G L/ �/�/
Coef. Btu
Infiltration � S/�+ � 3 � e
Glass (,�, �/ S p 3� e� �
E:xp. wall �'(-
Net exp. wall /9 io /' 9-� �
Int. wall
Ceiling
Floor S� /� 3 ���
Total Btu. 0°1 �t o—��
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
�1.� " .��e-e��,��oom ( Length i� Width % '/ Height �
Windows and Doors—Crackage and Area
Wldth HelBht No. oY Lfneat ft. Area
No. of pane ot pane llghte ot crack eq. tt.
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f �- � G � /� / 9 /J'
Coef. Btu
Infiltration �° '� `%� , 3 � �
Glass � � .� � �� t--�+
Exp. wall � �' 8°
Net exp. wall / �l� ��' / � �' r
Int. wall
Ceiling
Floor f(o� /S � �� �
Total Btu. fr•� �C'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
�'�j,�l. �`� � Room � Length /� Width � Height c�'
I
Windows an oors—Crackage and Area
Wfdth Helg6t No. ot Llneai ft. Area
No. of pane of pane Ilghta ot crack eq. Yt.
/ �l� ?�' °�' � `�-- / `/
Coef. Btu
�: Inhltration / 9' '%l� 7G Cs
Giass / `� �� �% �''�"�'
i Exp. wgll °l
i Net exp. wall �/�' S��
� Int. wall
� Ceiling
�
fFloor G� �
� Total Btu.
� Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
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Infiltration
Glass
E.gp, wall
Net egp. wall
Int. waU
Ceilin�
����� %
1VIINNFAPOLIS. 1VIIMV. II
Insulation
How Applied
3�
and Area
neal it. Aras
' crack eq. ft.
� 3 `7
Coef. Btu
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s �- I �a
Floor 5< /S � t' �
Total Btu. /� �'�`"
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
�%�/f�Fl.� �, � Room � Length // 2 Width / 2 Height
Windows and Doors—Crackage and Area
Wldth He1Bht No. oi Lfneal ft. Area
No. of pane oL pane lighte ot crack eq. ft.
� � �J . ?rl e. Z '� '� � "�I
Infiltratioa
Glass
Eap. wall
Net esp. wall
Int. wall
Ceiling
F7oor
Total Btu.
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/�S�' /� � 0 7 �
IRequired sq. k. E.D.R. or sq. ins. W.A. Leader area
�,�` FI.� ' Room I Length `—!-/ Width ;
Windows and Doors—Crackage and Area
Wldth Height No. 01 Llneal [t. Area
No. ot pane ot pane Ilghts oY crack ea. it.
� f o'°�- � / l
i � � � �- / 7 /
Inhltration
Calass
Eap. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
�
�oef. Btu
<� /� �o O
i c± i / � �
ih i77�
��y �� '�3%e�
CnSr9!?
� Required sq. ft. E.D.R. or sq. ins. WA. I.eader area
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_J' � HEAT �.OSS CALCULATIONS DEPARTMENT
Weatherstrips A.S.H.V.E, Construction N�
Guide
Windows Doors Refereace Out. Wall Int. Wall Ceiling
Yes—No I Yes—No 19—
Q�FI.� c'�L � oom � Length /�/ Width l Height
Windows and Doors—Crackage and Area
�Ytdth Helght No. ot Llneal f. Ares
No. of pane of pane lighta o[ crack eq. ft.
i � f� / / �- f °7 / /
In6ltration
Glass
Exp. wall
Net egp. wall
Int. wall
Ceiling
Coef. Btu
A � �c
�e� �.�'PG+
Floor /�/C� /$ '? / �
Total Btu. �G' � t�
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
F1.� Room � Length Width Height
Windows and Doors—Crackage and Area
Wfdth Helght No. oY Ltneal ft. Aiea
No. of pane ot pane llghte ot crack eq. !t.
Coef. Btu
In6ltration
Giass
Eap. wall
Net exp. wall
Iat. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. Room � Length Width Height
Windows and Doors—Crackage and Area
Wldth Height No. of Lfneal ft. Area
No. ot pane of paae lighte ot crack eq. ft.
�
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
H loor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
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SUBJECT - �� O.
City of Fridley . 1442
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� Ly �����'�
r � � PROTECTIVE INSPECTION SEC.
1 . �
� � /'�'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�.---� ' �-� si 2-sso-aa5o 910-F15 10/17/77 � �
JOB ADDRESS 547 Fairmont Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 22,23 & part24 I Riverview Heights SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Charles Datko 547 Faizmont 5treet N.E.
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Hank�Duevel Const. 9307 5th Street N.E. 784-7859
4 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 X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 1�'8" x 14' Addition
9 CHANGE QF USE FROM TO
STIPULATIONS
Insula,te floors with R-19 batt i,nsulati.on to meet energy code for
t,his addition.
Bef �a�����
SEPERATE PE#�N9iTS R��il9FtED FOR MIIRING, ore d��ain� c�,t io; ,; �;�;,;a;,�
TELEPHO�i�E ' L�,iLt.?i;:'.. ^ �, ,..1 o,a�o.
�E�Tii��, i�L���i�l� A�lD SiGOVS. REQU���� ��v,� �s�.,�,,
�
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCI F1'31IIC.'
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S7 i O4S $3.52
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � $26.9Z
,,s . PLAN CHECK FEE TOTAL FEE
\/ � $30.44
��
SGNATUREOF ONTRACTORORAUTHORIZEDAGENT IDATEI � WHEN PRO RLY VALIDATED THIS IS YOUR PERMIT
w �J t� � J� qa�—��
SIGNATUREOF OWNERIIF OWNER BUILDERI IDATEI BLDG 1NSP nATE
� ci r � ur t'ItlllLtY '
��
AQPLICATION FOR RESIDENTIAI. BUILDING PERt�IITS �� ��
(iVEW, ALTERATIONS, ADDITIONS, OR REPAIRS) ��° J��`,�,
'r (/
owr�R: C:1�A,� �� � �-r� '
Addres s: � y', �� 2M 0 h�T
�07 -�� /
� �p . r �
� �r �
BUILDER: `�'�N ��uc �JJ � ` �6�1��� � �,
� _`� �F
Address : ��� � "' . �• 1�`�- r� `��{�9 .
Tel. No. : %� �� d S .( til�1��
�
. No. : 5�Z Str eet : '�"A t �2.w�o �
LOT: SLOCK: ADDITION: ,
CORNER LOT: INSIDE IAT: �_ S;'TBACK: SIDEYARDS:
Applicant attach 'to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates. �
DESCRI PTION OF BUI LDI iVG
To Be Used As:
f �i • � 1 c� '
'�qwo� �� Zoo t� Front: �� 8 Depth: `t . .� Height: ��t
Square Feet: � Cubic Fest: 2� Z p$ 3
Front: Depth: Height: -
' Square Feet: Cubic Feet:
6-�
Type of Construction:
�M � Fstimated Cost: $ _��O � �
. 7 0 �✓� �
qo a�s �'
7.b Be Completed: Alt. A Alt. B
Proposed Driveway Width If yew Opening Is Desired s" � $ S
(SEE REVERSE SIDE OF SiiEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work i.n strict accardance with the City of
�%Fridley Ordinances and rulings of the Departm t of Buildings, and hereby
��' d lares that all the facts and representati sta.t d in application
re true and correct. See reverse sid or dditi al i ' n.
DFsl'E: � ' � ! ( � SIGNATURE: - _
Stipulations:
� .�,.i� iFrx .r� i � ,„a,
�'!
/� ;/ / _ �.. .
s
�
i/ . .__... >...... W .. ....
/ ...... .-.. ,...... .. .. . ' .
�/ . � . . :. . s".-. . . . ,.. -. � _ _ _ . J
I
ii� � i / �
� ,� , , j
,� � ►
, _ .. ._
�
s' , ?� .,, � � ' y � ��
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.
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.�,�
. 1 � ��x a�
BUILDING PERt'IIT FEt SCN�DULE
SECTION 2. The Inspector of Buildings 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 repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single ramily Homes and Garages: $4.00/1,000 cubic fe:et.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete C�rb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$11.75
Alternate B: Removal and replacement of conerete curb and
. " gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$15.40
�: 1 1 � � � � • � �
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determi.ned by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the celiar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars ($500.00) or fraction thereof i.n the cost
of all proposed work.
In•no case shall the fee charged for any perrqit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
� . "' VERIFICATIO�V OF F�uNn TION
NOTE: Permits �or construction will be issued a mini.uaum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructEd will be required before proceeding with the framing.
C�RTIFICAT nF �GCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for tahich a building permit has been issued; and
sai.d structure shall not be used or occupied tuitil a Certificate of Occupancy has
been issued. .
■177�7R�'R�rAn�f�J���1�1<lr �I�l�lt��.�� .�..,,.:� r� �.�rc�••�n..�,_�,��.r�t
a►K���:��,i..:sa�.��_:.r[���a IU�IfR���� xr►n5u-�-- ,—��_-=ir�.a��t�
.. �. ;.�_- a�
.� r,... ,��. ��.�.
� Y���` �
i r.��■■
� r■;■�■ �
Y��.
ii�'�� �:
�I�I�11�'� Y
�[�k,� �.
��1_ lft I
■'��;� I
��,i�,�i �� 1
��� ��� i� i
UrK�� �r I
■�, �.i� i
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Y �■�ih'��
■rrurr u,
�����r �i�■:
■����ri��R��
iw.:.:::�:
■�����
w��
s �� �. �� Page 1 of 4 .
e � EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNiER: ��A� ES J A��O DATE `� - �9 — � /
SITE ADDRESS :�-, PHONE : sI S�''O � O,
CONTRACTOR: N ��,�� �` CQ-� S � i
Determine working square footage of each ��� � y
1. Total. exposed wall area...... �Z� sq. ft. x_ .17 = ��
2. Toal roof/ceiling area ,..... ��oL sq. ft. x .d5 �_ �
Tota1 exposed wall area above floor =
z'
a. Total wall'4vindo. area• ........................e....... �
b. Total� oor are ...:.. ..-.• ��_
c. Tatal 3r� gla��door area . ................. ��4 ..�
d. Total fireplaceiwall area ........................e....
e. Total wall framing area (average IO�s) .................. Zp �-
f. Total rim joist area •-• ................a..... ��
g• wall area above.floor ..........................
h. wa3.1 area above floor .........................
i. wall area above floor ..........................
7• wall area above f].00r .. ......................e
Total exposed foundation area.= 'ij 1}'•�
k. Total foundatian window area ........................... — ��
1. Total net foundation area above grade ................. � '= y., �
�� i
Determine "U" value of each wall segment
(e.g. window, door, each separate wa1Z sectionl
a. ✓�� g ��U�� � �� _ � �
_ �
b. �� X ��U�� ' � �1 = %�e �
c. �� X��U�� l� Z = l D.,r�i
d. � � � X
e. �� x
f . �✓�i x
9-
h.
i.
]-
k.
��U�� . G � _
„U„ , � �- _
„U„ , 1��_ _
X „�„ _
X "U" _
X "U" _
X "U"
�
X "U" -
ZZi�
y3�
, � ��
1. X �,U�� _
3 . ............................. Total _ i � .
.� a
i
�'�, z �f
�/�•��
�� �
If item #3 is the same as,
or less than ite,n #I, you
have met the intent of
SBC 6006 (c) 2.
_�
Exterior Envelope Average "U" Computation
4
Total exposed roof/.cei.ling area = Z� i
m. Total skylight area ............................ �— O^`
n. Total roof/ceiling framing area (average l00)... Z� �
o. Total net insulated roof/ceiling area........... �,(,�,
�
Determine "U" value for each roof/ceiling segment
IA. X °U° _
n. X ��U�• -
O. X "U" _
Page 2 of 4
4 ........................... Total =
If total of #4 is the same as, or less than.#2, you have met the intent af
SHC 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.
1. + 2. _
3_ + 4. _
0
� -4
WALL SECTIONS
NOTE: Use 10% of opaque wall area for
fxame construction
FRAP'!E i dALL
.r,�._..�._v..(�
c
FSG. #3
�- � ,� ' G ` � �..�._
. ' � - . s �-�- �
� �. c
c- � = , -! � • Z; :
Page 3 of 4
Constructian R-Value
1. Interior air fi].m 0.68
2 - 1'a" s(�►ter aoc.�c
� �� ,,..._ t.�
3. S
� 4• 1�Zy s�t�NlC �,Sc�'�2t?E
.
5. !/L�� 3acluEEe. G CEDAt, s�S �
6. Extermr air film 0.�.7
Total
��Z
1. Interior air film 0.68
�
2 . ��a � ' s kOte�T RociC,,
h
s. 3�S F• ��.Iwss w,�p�u �ACk
4: ��`2$�5z 'F�� I�F� rt �
5. ''�s `` R!►�KU` i� E�DMt.. �►*W Ki�
6. Escterior air film 0�.17
Total
B ��"�
1, Interior air film 0.68
2. 3 �a F. 5�(atS
s. ZX �o R�••� Zotsi
4. �'s�� �i•l`EINT!
5. 'I� ` rfpeic� E CE011�, f i�A.kLS
6. Exterior air f il.m 0.17
Total
A ��
1. Interior air film 0.68
2. I�� ST�?R�o�LM
3. 8 V �� O c.k,$ ,
4. �-- O —
5.
6. Exterior air film 0.1?
Total
, . . � e . � . . � a
` � t
. . �.r �ra�' � � r ° � _ ` '
_^ �r� � :; . ,
!l(.� = , � . ' `� . ►
/<( ! • ' �
--, ' b • . � 11 J —
,-. , _ , --
(<< . . I, • . � , ' ! /(/^ j, t
FI6.. #4 !!( � ' C> � �//
. � .�
. ` � � . X _._- - r' // ��
• r r // � %! � ._- (/( � �
NOT�r'.: Indicate tyne,� "?t" 'value, depth and
placer.�ent of ins��l at; �-, _ —
.q
�
ROOF/CEILING
�
. / ��
'�,"`i"^'� ��J
! � l.
�� •�:�� � � '�'C"
� � � �� I j ��r�'t�,
�- j �Y C
�.. � , 4� tI� �: ��.
• � r.I?T � �'_ - '� ' � �
��ente�i
_ � � � j' , � .
�J
fleat f low
up • � •
FIG. �5 � '
�
Page 4 of 4
Constntction R-Value
1. Interior air film 0.61
2 . �/L . S:► F.�a,T �.
i
s . (�'�z ` R - aZ � �
4. Exterior air film (still) 0.61
Total
1. Interior air fiZm 0.61
2.
3.
4. Exterior air film (still) 0.61
Total
� }:e�r flo�s up � . , ;•venLeci•
_ .FIG• #k6 .. - . . �� - 1. Inside air f ilm _ 0.61.
- � • - --- ----._.__ ,._ : :-- - •- - 2 � ��Zn ��yw oo �
. � � ' � � 15� _
� _`' �; 3 . ��+- � PAPA t�l{-
�s�0�'Q.4'�i��� �t. � S��wC►��'1
� t �=� ^9�`�'.�•"��•..L. �`.�: i�
• ,�Ja�a�•..�--L •• •~• •• • �/\ 5. Outside .air film �•Z�
w'Ji4��j%:_r�'i_ •::4i :� ��'..✓�� ° {
A,;;:;�%-;.;, :j.,.;,... =��� __� . Total
f�� i'�� . . � .
•-./ '�` �� Note. Use additional sheets if more space is
����� n �!�'� � i%/:. needed for details and calculations
. _- I
• N�i?-S '�:T� � . . _ '
. . . . •� , •
� . � � Ment � � � . �,
, � � �low up . . - ,
. ; .. .
�"xr,. 1�7 . . . .
.
sue�ecr
c�ty of Fr;a�ey
�
AT TNE TOP OF THE TWINS g � i L D I I� G P E R M I T
:�
� • COMMUNITY OEVELOPM�NT DIV.
� � �: ------�
r � � PROTECTIVE INSPECTION SEC.
1 . .
� _ �"'1 � CITY MALL FRIOLE� 53132 NuMeEp pE�
�'""� � �'� 612-571-34b0 910-F15
lOB ADDRESS 547 Fairmont Street NE
t LEGAI ��T N0. BLOCK TRACT OR ADOITION
DESCfi. 22 � 23 I Riverview Heig;
2 PiiOPERTY OWNER MAIL ADpR�S$
Laurie Ensley 547 Fairmont Street NE
3 CONTRACTOR MAIL AODRESS
Bjorkstrand Com anies Inc 4116 Diamond Dr Ea
4 ARCMITECT OR DESIGNER MA1 ADDRESS
S ENGINEER MAIL ADDRESS
8 USE OF BUILDING
Residential
OAT6 PAGE OR
2/16/99 / /
PER�T,I�Q,..
89 6
�
�J 6
�PVnOVEO er
SEE ATTACNED
S SMEET
21P PHONE
785-2762
21P
ZIP
PNONE LICENSE NO
-5598 8676
PMONE LICENSE NO.
PNONE LICENSE NO
7 CLASSOFWORK 0 N� Q ADDITION O ALTERATION ❑ REPAIR O MOVE D REMOVE
x
8 DESCRIBE WORK
Reroof House & Gara�e (25 Sq) Tear-off
9 CHAN(3E OF USE FROM
TO
STIPULATIONS Underlayment must comply with the State Building Code.
' ' TYPH OF CON:
SEPARATE PERMITS ARE REOUIRED FOFi ELECTFICAI. PIUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOIO If WORK OF CONSTRUCTION 20NING
AUTHORQED IS N01 COMMENCED Vy(ITHIN 80 DAYS. OFi IF CONSTpUCTION
OR WORK IS SUSPENDED OR ABANOONED FOp A PERIOD OF 120 DAYS A7
SC.
ANY TIME AFTER WOFK IS COMMENCED. NO DWLG. UNITS
I HEREBV CERTIFY THAT I HAVE REA� AND EXAMIN�O THIS APPLICATION 1 STALLS
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WILL �E COMPLIED 2 142
WITM WMETHER SPECIFIED HEREIN OR NOT. TNE GRANTING Of A PERMIT � �
DOES NOT PiiESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEI TME pEqM17fEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON• $74.75
STRUCTION OR TME PERFORMANCE OF CONSTNUCTION
/� PLAN CHECK I
� �sn_ � � / �--�� Lic��
GTUAE
aGENT iO�TE�
P - �
$5
OUP OCCUPANCVLOAO
CU FT
�FFSTREET PARKING
IGARAGES
iURTAX
�1.0%
iAC CMA E
Fir C $2.14
'OTA F 'E
2.96
IS I� Ufi P�f MIT
f� /
C `
r��tE
F�-16-199'�
••�'•• 4 J
,�nN I ]
�� [ �
Le�al Desaription:
12��2 FROt�! CITY OF FRIIILE''r' TIJ ti51��2c3r-Jr p�dC,•Gjc,
d'iiLR:t1VG 1P1/�J
c� oF ���r
SINGLE �'A�,Y ANZI DUPLE�CES R-1 AiV'D R-�
BtJ�DING PERMI�` ,A��LTCATIOI�T
�7 l�l'�Bd� 1 S(��
q��� �
�o ��
f)wger Name 8c Address: �iu �c �'� � d�J Lc -��/7 �� � +: r►� �
� ,. _ o r�f.5�2 e.Q, Tel. # �/�- - �5— � ��
CQnfiractor: P — � MN LiCENSE � �� ��
Address: �` ��� T/� ��n r.l� i`� � G� 0�l rJ ,%h i`aU N P Sd T�� Tel #�� �- flS'� •S SPS��
�--, -
' At�a�h ta this agpli�atavm, a. Certificate af Su.r�ey of �Tue
lot, with the prop��ed ea�st�uctacr� draum on it to scal�.
I,I�Tl11Trx �iREA�
C�RACE A��i:
DECS AR�i;
QT�ER�
AEu�CR1PT�ON OF IIV�RO�'�N�.I'dT
��g#�i � '4Jidth I3eight Sq. Ft. - -
T�e�t, 'WidtL� Height _ __ . Sq. Ft.
L'�ir�b, _ �iiidtk� ^ A �gUGround � _� Sq' F� .
� .�
_ �,
�onstruct���. °�ype: � �st�nate�t Cost: $ c�/��
(Fee S4hedule o�z Hac�1
�'tveway G�xl� Gut Width ATeEde�i: Ft. + 6 Ft = Ft x$ ��
�ATE� ��� �%��''
?e�lmit Fes
yire Sur�harg�
�tate Surcharge
�AC Char�e
:ic�ns� Surcharg�e
ariveway �'sacow
so�ian Can�o1
�arb Fee
�ew�r Maia C�.a�rg�
TOT�A.L
iTIP'ULATI�I'�S:
�iPFLICANT: ,�i.<.�Jl � p�,,,.,�.� Tel. � �o S�-�� • -S� ��'
CITY iJSE 011iLY
$ ,� Pee Scb�xiule on Reverse Side
$ • ( .OL�1 af Pennit Valuatian (i/lOth�)
$ % D % $.SU/�1,000 Valuatiaa
$ $iOSO per SAG Unit
$ �� C3 D $S.tlO (State Li;.�nseel Residena�l Coutra�ctors)
$ Alt. ��A�� or Alt. ��" Abo•re
S $450.00 Ca�rnservation I'tan Review
$ � Detecnained by E�gir�ee�I.�,g
$ Agre�me�t'oiec�ssary I j Not Necess�,rY []
� . �
Building
Inspections
763-572-3604
763-502-4977
SITE ADDRESS �
THIS APPL.IC.�NT IS:
PROPERTY
OWNER/
TEN�l1�iT'
CONTRACTOR
SUBMIT A COPY OF
YOURSTATE
LICENSE WITH
APPLICATION
PE T]CPE
�E oF woRx:
MECHAI�ICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
� OR'NER
COMPANY NAh�: •�►a� iva� u ��cau� �y a� ru� van n��w� �n �v
CONTACT PERSON:
�
STATE LICENSE # R17 ft7d.7� DATE
ADDRESS:
PHONE
,�
O TWO�RIb�:�-
❑ NEW �EPLACEMENT
�� -
DETAII.ID DESCRIPTION OF WORK
FAX
— � �ev��o�s�
O ALTF.RATIOI�UREMODEL
Pernut No.:
Recei��ed By
STATE ZIP
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTID. F1XTIlRES: (INDICATE TOTAL NUMBER OF EACH BELOR�
Equi�ment Iffitalled MFG: MODEL: Sffi�BTU
MFG: __��� ty?�� MODEL: ��� SIZFJBTU O)�
A/C �25.Q0
AIIt TO Ailt EXCFIANGEER $15
BOII ER �i5.00
Ci�NIlVEY LINER $10.00
MFG: MODFd,:
FII2LPLACE (GAS) $15.Q0
�FIREPLACE (WOOD) $35.00
F[7RNACE $35.00
AS DRYER $10.00
GAS PIPING $10.00
SQF/BT[J
GAS RANGF/OVEN 510.00
1VEW GAS GRILL 510.00
GAS I71VPf FTl2i $10.00
FOOL HEAIER 535.00
THIS IS AN APPLICATION FOR A PERT�IIT-NOT VALID UNTII. PROCESSED
I hereby apply for a building pemut and I acl�owledge that the information above is complete and accurate; that the work will be in
confoimance with the ordinanc des of the Citv ley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an ap cation or rmit an ork ' ot to start withqut a permit; that the wo�will be in acco� with the
approved plan in the case f all�vo c_ 'ew approval of p�s . ,, /- )
E��}e �� Ili� 7 :;��] �
City of Friclley
Buiiding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
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City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERNIIT APPLICATION HVAC
.__1 NEW HOMES/ADDITIONS ��EXISTING HOME IJ MAKE-UP AIR
REOUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Naiural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a Gas appliances IFGC Chapter 5 wit� MN Amendments
b. Fuel tYther than gas IMC Chapter 8 with MN Amendments
REOUIREI) �OR NEW �IOME5
4. Heat loss �i coaling load per room
a. Reqaired on new Construction IMC 1346.0312
5. Ventilation
a. Per NIN Energy Code 7670 or 76'�2
6. Duct Design Per IMC 1346.0503.2
- - - a. AC�A 1VI-anuat D — - -- --- ---- -
NOTE: Centerpoint Energ,y Mechanical Code GuiBelines soft�vare may be us�l for
combustion and mak�up �ir calcalations.
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