AF - 45129�
City of Fridley, Mi.nn.
BUILDING PERMIT
Date: October 10, 1967
N°
� ��� � 7
9502
Owner: _.__Thomas R. A�th _. �_ g��r ..... C._.._Eldon.__Peterson.
Addxess ...__.._..._:....... .. ......._......_._ _-----------_ Address _.._.._2908 _132nd_...__Ave.•._..N.�:...�^_�.�....._...._.........___.._.
._..._..._.....--•---..._._. _. _. -�-- - � -
Anoka, Minnesota
LOCATION OF BUILDING
No. ..__5 241.__._.. Street ...__.._._F i l lmore S t. ft. E.._-------•-••---•-- ---•-•--.. Part of Lot • ...................--•-..._..._.._.........--
Lot ....._..._ll._....__..�_ Block ._...._._.._._�._......_....._......_.._. Addition or Sub-Division ..--.------Horizon Heights_...._.._--------_...__.._.._
4 �
Corner Lot ..._----_......_....._ Inside Lot ••--•--....._X._.__._...-----. Setback .__.._._0.._...-----.---....... Sideyard ----......___-•-------_._._.._.--••-...__.._.._...___._.._
SewerElevatiaai .___......_._._1..005_,35.._..._...._.__._......_-----........ . . ------..---.._..._1008.35.___..------..._. _. __._.._
Top of Footirg
DESCRIPTION OF BUILDING
iTobev��:
Dwellin�_._...._...._.. Front _.48�..__ Depth _.26.�---._ Height .._16.-�-.--..... Sq. F� ._1248._ Cu. Ft19,968
_.__..._._.__.__......._._.__...._ Front __.___.........__ Depth _.__...----•--•
. Fieight .....----•-•--....__ Sq. Ft. _..__...__..._. Cu. FL ._.._._.__._._
Type of Construction _..._.._Frame..._.--•.._._.__...--- Es� Cost ........._�20,_000........._........ To be Completed ...................._......._..._._....._.__
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SEWER LOCATION - 161' North of Manhole
WATER LOCATION -4' North of Hydrant
In consideration of the issuance to me of a permit to construct the buildin described above, I agree to do
th� propoaed work in accordance with the description above f a�d co lia ce with all provisiona of
ordinanoes of the city of Fridley. —
$100.
In consfderation of the payment of a fee of �._..__.._30. 00___� ��t � hereby granted to._._._ �.� Eldon _�
_Peterson_ to construet the building or addition as described above. This permit is granted upon
the �express condition �that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances o�
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buil�ings
within the city limfts and this permit may be revoked at any time upon violation of aay of the provisions of sa�d
ordiaances.
CLARENCE BELISLE �.. BuildinS �P��
NOTICE:
7'his p�rmit do�s not wv�r flu eonslrupion, inshllalbn fo� wirfny. plv�►in0. oas h�atiny, snw�� or wat�r. B� wn to sM
1h� duildfeg Imp�eMr for s�parab �mUa hr th�n ihms.
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APPLICATZON FOR BUTLDING PERMIT
CITY OF FRIIiLEY, MINNESOTA
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LOCATION OF BUILDING
tJO. �►-'� �'� J STREET �.,.P.�,,,e,� ��� _ PART OF LOT I(.
LOT BLOCK � ADDYTION OR SUBDIVISION ��/��e� ���-��
CORNER LOT INSIDE LOT 5�.��zgETBACK �d � SIDE-YARD`1 5' '
SEWER ELEVATION �� s�3 � I�OUNDATION ELEVATIQN �� � n,,p„t�
S � f�' ! � � ' °�i � � 3 - ��e
Applicant attac to t is orm Two Cer ificates of Survey of Lot and proposed
building lacation dra� on these Certificates.
`7� � ' � . °� .�"�`r.�.,"� _
DESCRIPTION OF BUILDING
To be used as;
,.
� Front�Depth�Height � '
Sq. Ft. $� Cu. Ft. / /� / �e�
: �.
Front Depth Height
Sq. Ft. Cu. Ft.
T e of Conatruction � �
yp �h,�p Estimated Cost �O, DD„� '-"
� �
To be campleted �� % � J9'� $�-
The undersigned hereby makea app].ication for a permit for the work herein
specified, agreeing to do all work fn strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representationa stated in this application
are true and correct, � ��'
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DATE 1� SIGNATURE ����`/�-L.�,,�. GZ �'�ji
(Schedule of Fee Costs can be found on the Reverse Side)w
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HEAT LOSS CALCULATIONS DEPARTMENT OP BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V. . Construction No. Insulation
Guide
Windows I Doors Reference Out. Wall Int. Wall CeiliAg Roof Floor Kind How Applied
Yes—No Yes-No 19_
Fl.� oom � Length Width � Height F1.� Roo L.ength Width :?� Height
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
�Vidth Helght No. ot Llneal [t. Area Width Height No. ot Llneal ft. Area
No. ot pane ot Dane IiBhta ot crack sp. it. No. of pane ot ➢ane Ughts ot crack sq. tt.
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♦ � l � � •�---__— -
Coef. Btu Coef. Btu
In6ltration , S" �
Glass
.
Exp. wall
Net exp. wall
Int. wall
Ceiling � �
Floor
Total Btu. .
Required sq. ft. E.D.R. or aq. ina. W.A. Leader area
F7•� � oom � Length a Width f a-�–Height
Windows and D�rs--Crackage and Area ��
WId1h Hel[ht No. ot Lineal tt. Area
No. of pane o[ D`ne lfshts ot crack p. tt. '��
� v,o o, /
�3 / . . 1
_ Coef. Btu
In6ltration
Giasa �
Exp. wall
Net exp. wall � '
Int. wall
Ceiling v �
Floor
Total &u.
Required sq. ft. E.D.R. or aq. ins. W.A. L,eader area
� Fl. Room � Length °d.- Width / d Htight
Windows and Doors—Cracltage and Area
W1dth Halght No. ot Llneal tt. Area
No. ot p�n• ot Dane Il�ht� ot crack �q. ft.
I
�s � . 10
Coef. Btu
Infiltration
Glat� S
Exp. wail
Net e:p. wall
lnt. wal!
Ceiling
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H Ipor
Tbta� .�3tu.
ft. E.D.R. or aq. ins. W.A. L.eader arca
Infiltration
C�lasa
� Fap. wall
Net ezp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. l.eader area
FI.I ` 7► m( l.ength Width Height
Windows and ` rs—Crackage and Area
Wtdth Helght No. oL Llneai ft. Area
No. ot Dane ot Dane ll`hts ot crack eQ. tt.
.2 � � < < o 0 0 �'y
,d � , 1?
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Glaaa
Exp. wall
Net exp. wall
Int. wall
Ceiling
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Total Btu. f r) c'
Required aq. ft. E.D.R. or aq. ina. W.A. Leader area
FI.� Room I Length ) 3 Width Height
Windowa and Doora—Crackage and Area
W1dtA Hel�ht No. ot Llneal [t. Ares
No. ot pans ot paoe tl�ht� ot crack �a. t4.
O�— � . � �
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In6ltration G .0 �S n �1'�l ,.
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F.acp. wal)
Net exp. wall
Int. wall
Ceiling
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Total Bt .0
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3ohn�ville Electr�e CQ.
1380 lU9th Ave. �S. 1�.
Minneapolis, I�i.�xue�o�a
D�sar Sir: /
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Ttse house at �241 F'il lmore St .�t . E. rcqe�ire� a 15A Amp Sexvic� .
Please chan;e from lOt} to 150 At��s� .
�'r�� tera��s��.:�� ��r��.�c� �y 2�J �.i��x�� S�r���. �� �.� si�,��sa��aal� "s'�ap�.
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Elec tr3�ea1 7Cnspec �o�
City of �ridley
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Braastad Blectric
�oute 5
Anoka, Minnesota
C I T Y 0 F F R I D L E Y
6431 University Ave. N. E.
Fridley, Minnesota 55421
�ugust 5, 1968
RE: �RMIT SAORTAGE ,
5241 F,�jmnr$ Qc ��j R
Gentlemen:
Your permit for the above captioned address was short
the following:
10-20 OutZets $6.00
Short$1.00 on Furnace 1.00 ,
Diaposal � 3.00
��10,00
We would appreciate it if you would kindly give Chis
matter your prefer�ed attention. When sending in the above amount,
kindly place it on�a regular Minnesota State Affidavit so that we
may properly process this permit.
Thank you.
Yours very truly,
LEONARD EICHMILLER
Electrical Inspector
City of Fridley
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sue�EtT RMIT NO.
City of Fridley 31 10 9
AT THE TOP OF TNE TWINS g U I 1�. D� 1 ,� P E ��1 � 1 T
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; � iiECCC IPT NO.
� ; y �_�_� COMMUNITY OEVELOPM�NT OIV. � �
1 � � PROTECTIVE INSPECTIQN SEC.
� . .
� � �"'1 � CITY HA�L ff110LE� 55132 NU46Ep pEV O�TE P�GE Oc �>vAOVEO 8r
ti..__Jl: �.� 612-571-3450 9t0-Ft5 6/27/00 / /
JOB ADpRESS 5241 Fillmore Street NE
t LEGA� LOT NO. BLOCK TpACT OR AODITION SEE ATTACHED
oesca. 11 4 Horizon Heights SHEET
2 PROPEFTY OWNER MAIL ADDRE$$ 21P PHONE
Thomas Arth, 5241 Fillmore St. NE 571-7790
3 CON7pACTOR MAIL ADDRESS ZIP pHONE IICENSE NO
Builder One The Home Doctor, 12 West 35th St., Mpls., Mn 55408 612-824-5165 9085
l ARCHITECT OR DESIGNER MAIL AODRESS 21P PMONE UCENSE NO.
5 ENGINEER MAIL ADOpESS ZIP PMONE LICENSE NO
6 USE OF BUILOING
Residential
7 CLASS OF WORK
❑ NEW [� ADDITiON ❑ ALTERATION p REPAIR O MOVE O REMOVE
BF���R���� 22' Addition with f lat roof
9 CHANGE Of USE FROM TO
STIPULATIONS
Stipulations -See attached plans.
SEPARATE PERMITS ARE RE�UIREO fOR ELECTRICAL. PLUMBING. HEATING, TYPE OF CdMST. OCCUPANCY GFOUP OCGUPANCY lOAO �
VENTI�ATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONS7RUCTION IONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCEO Y�1ITNIN 80 OAYS, Oii IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONEO FOii A PERIOD OF 120 DAYS AT
ANY TiME AfTER WORK IS COMMENCED. NO DW4G. UNITS OFfSTREET PARKING
1 MEAEBY CEqTIFV TNAf 1 HAVE READ ANO EXAMINEO THIS APPLICATION 1 STA�LS GARAGES
ANO KNOW THE SAME TO BE TRUE ANO COppECT. ALL PROVISIQNS Of LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TVPE OF WOFiK WIL� BE COMP�IED @
WlTH WHETMER SPECIFIEO MEREVN OA NOT. TME GRANTING OF A PERMIT W4O � 123 .�O � �ZO .00
DOES NOT PRES ME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CNARGE
PROVISIONS OF ANY OTHER STATE OR IOCAI lAW REGULATING coN• �552.85 Fire SC ��FO.IO
STRUCTI R PE ORMANCE OF CONSTRUCTION
PLAfi CMECK f EE TOTAL F EE
� o�Z G??� Licens $5.0 $617.95
-_ S�GN� • E OF CONCFACiOAOp �UTHOAIZEO �GENT �•iE� MEN PRpP AUO TE TMIS IS VC]yR� IT
/
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ALTER ( j
16�21 FR�'1 CITY QF FRIDLEY
TO
cmr oF �wa.�r
SINGLE FANqLY AND pUpLEXEg R-9 ANp R
Bl11LDiNG RERMIT APPL1CATiON
8245165 P.@2f02
Effecctive
{T63) �T2
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c�o� �: �'� 4rl' fi /�o� �Ti�ee 7� /Il. �. 3 .
Le�i Dsscxiption:
Ow�er hlame 8 A�itf�ss: J'an �� Toin Gl���i „_„ Tel. #'7G 3- 571— i Z�!'O
Coritrador. �ul �0�� 4�1�2 'T�8 /h%me ,uo�tCn MN LICENSE # g ���
A�: �a �7- �-rh sT�.�T- r��is. in�r �-s�o� T��. ��fa �ga�- sic�'
LiVIN6 /►REA:
GARAGE AREA;
DECK AREA:
OTHER:
Atiach to tttis appiication, a Certifiqtte of Survey of t�te
lo�, witt� the p�roposed construction draNm on d to scale.
� DESCRlPTlON OF IMPROVEM�IT
o�� �J� I' � �'�a/Lc�
��+ � � _��r �sM �"� sq. �c.
le�gtt► V�dttt � He�ght � Sq. F�
Length � �N�dth � HgttGrour�d "� ^ac�. Ft
��a- �a3, �
Cor,smaction Type: �i'ame �.�+,t r�o� Esamated Cost: $�(o� o�o
Drnreway curb Cut v�idth Needed• Ft + s Fc = Ft x$ _� /i�a
on�: �� ApPUCAKr• ��3 -� T�. u l�l a- 8'a �f � S/ lo.�'
CtTY USE Ol+N.Y - Ca�li (763j 5T2�60+t for Permit Fee.s if ma�it�g in applic�tion
Pertnit Fee 3� so2 ,� S Fee Schedule on Reverse Side
Fire Sucr,t►a�ge � `iD , 1 D .001 of t�emm�itt valuafivn (���oth%}
State Surchar+ge $ 0?0, Q'� $.50t$1,0�0 Valuation
SAC Charc�e $ $110Q per SAC Unit
license Sun;harge $ . S, �$5.00 (Stafie Lioensed Residentiat Contractors}
�riveway Escxow $ Att. "A" oc AIt. "B" Abotire
Erosion CoMrol $ $450.00 Coriservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewec Main Charge S Agreement Nevessary j j Not Neoesssary [�
TOTAL
STtPUlATIONS:
S ��'�� APPROVED SUBJECT TO CONFOI�MANCE
`�0 APPLI C ES AND O�DII�AN�E� ,
Bi� i3G 1N��rE�i't��
�TT� OF FRZD�,�Y; r.:T�Ta���jx�
TOTAL P.82
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GENERAL PRAGTiGE
(612) 824-5165
(612) 721-399'f (MOME)
GUSTOM PRESCRIPTIONS
TO MAKE YOUR HOME
I.00K ANO FEEL GOOD
1'l WliT 3STM STREET 57A7t #t9085
MINN[APOLIf, MN SS408-4303 M�NN[w�OLiS X4699
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12 WEST 3STN STREET ST�Te x9085 ;
M�NNEAPOLIS. MN 55408-4305 MINNEAPOLIS M469S
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10731 MISSI.SSIPPI BOULEVARD N.W.� COON RAPIDS, MINNESOTA Telephone
421-6340
Certificote of Survey: C, �LOON PETERSON B UiLDERS '
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-133.94—
Lot 11, Block 4,
Norizon Heights
Anoka County, MiRnesota
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—'Q DENOTES iRONS
1965 - I 54 -7
1 HEREBY.CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THEBOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND 7HE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN-
CROACHMENTS, IF 1WY, FROM OR ON SAID LAND.
AS SURVEYED BY h1E THIS......�ra.....DAY OF..... October ........................A.D. 14.�%......
N. C. HOIUM AND ASSOCIAT INC. LAND SURVEYORS
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^�,..s ��! 4 ,.\1".�.�t . �i
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.
�aw�t ve M pEwwnds p�r Nnssi ioN (PL�
�
'1'Jl� �oist Allowable Unitorm Load — �'loa�
'Jo� reaction (simple sp�j exceeds 120016s„ web �ifleaers are requked at hanper
L08d t�p8City 8►SSUmeS no �mpOSite �Ction provided by Sheathirlj}. �atwiu. VYeb atitferrere may be requtred fw other cor�dk+oas. see note 3 betow.
Thase values retlect the rt�o�t rest�tive of simp� �an or mui6pfe span epplicadorts.
Web siilfer�rs are recp�ired if the �des of the haager da not iaterally su�ari the TJIe joist top fiange. Web stiffeners are also requi�ed at att'TJI�'!55 dF
]aist hanger bcations where ja�t reactians exceed 1200 pounds.
�R JOIST SQiNG: �
To sizs a Joist br use � a tloor, it is necesssry ta checic both live bad and total bad. When live load is not shown, total load wit{ control.
Total Load column limi�s joist detlecttan to U240. Live toad nolumn is based on joist deflection �rf U48fi.
For Uve bad deAec2fon Nmits of U3H0 {mit�mt�m c�de txiteria), multipiy valus in live load co�umn by 1.33. The resuking tiva load shall not exceed the
total bad shown.
� TC3 PlF CQNVERStON TABLE
fn pounds per N� icot (PLF?
Page 15
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Form for use with Minnesota Rules paR 7670.0475, Subp.2
1� 2 Family Residential "Cookbook" Method
linimum Criteria: �-�' � ` j-1 �%rr� 'iL�.
CI i` nY' '�7 v �• r•Y,,;-- . n,�
Rim Joist: R-19 insulation �und�io�r�J�ins�lated�g�a�?� �ir space, wood or vinyl frame
Entry doors: 1-3/4 inch solid wood with storm or better
STEP 1 Window 8� Door Area STEP 2 Caicutate area as a percent of walt
Total Window 8� Door Area Sq. Feet Box A(window & door area)divided by Box B(total
WINDOWS (including foundation windows): wall area) times 100 equals the window and
Dimensions Qty Area door area as a percent of wall area (BoxC)
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33.400
15.865
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0.000
0.000
0.000
0.000
0.000
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49265
DOORS:
._ ,, :�,t`�>�.3 °d�6.6 .�"a :�:`�(li� � "�'f�76 ;?
-� , . �_ ,G),0 , r.�, � �, p;AO� � �; :�:�0� �_�;
0.000 0.000 0.000 0.000
Total Doors Area 18.876
Tota{ Area of Windows & Doors
Total Wall Area in Sq. Ft.
Wall Total Perimeter Height
66.000 1.000 8.080
0, 000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
Box A 68.141 x100= 12.
Box B 533.280 Box C
STEP 3 Design Features
�SEMBLY OPTION
FRAME WALL:
STANDARD FRAMING
ADVANCED FRAMING
VITY INSULATION
SHEATHING:
LESS THAN R-5
R-5 OR MORE
-I
-
R- 19.000
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NDOWS(EXCEPT FOUNDATION WINDOWS):
U-FACTOR U- 0.020
68.141 From the table, determine the maximum percent
BOX A window & door area for the design options selected
and enter the value in box D below:
Area
533.280
0.000
0.000
0.000
`�Q .�.P:PLTC!��'u� �:,�;�wS k�`d� 0���'C�S
.UUiLi�.�l•d'�r.i' 11.�ai'��Rj".�ililV.Ll
cz�rY QF k�R�DI,EY . r:: � ��?��_� so�r.a
18.800
BOX D
Box C must be less than or equal to Box D
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Exterior Envelope Thermal Transmittance Worksheet
SITE ADDRESS
BUILDERS ONE
FORM COMPLETED BY:
FRANCES M
�. Insulated Area
o Framing Area
o Skylight
L Other
a�
c
�, Average U-Fa�tor B
� Repuired U-Factor (f
10.86194247
Enemv Code):
ci
C�Z•�iY��IiL
AREAR ` Sq. FA I U-Factor I x Area r_
484 435.600 .022 9.593
48.400 .026 1.269
.000
.000
.000
.000
.000
A 484.000
iA 484 C
D
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B 10.862
Insulated Area 2 411.811 .044 17.920
Framing Area z 53.328 .092 4.915
Windows ' 49.265 .020 .985
_ Doors 18.876 .170 3.209
_ Rim Joist .000 .044 .000
� Firepiace Wali .000
� Above Grade Foundation Waii .000 .057 .000
Foundation Windows .000
� Patio Doors .000 .360 .000
�, Other .000 .000
�, .000
o .000
Q .000
x .000
W .000
Totals E 533.280 F 27.030
Average U-Factor F 27.02966474 /E 533.28 G .051
Required U-Faetor (from Energy Code): H .110
If C is greater than D, or G is greater than H, revise the design as necessary to meet the envelope
criteria of the Energy Code.
1) U-factor for skylight and window must be determined by the National Fenectration Rating Council Standard 100-91
or ASHRAE 1993 Handbook of Fundamentals, Chapter 27, table 5.
2) Thermal Transm'dtance of opaque components (including integrally insulated masonry and metal stud framing)--
use part 7670.0450, subpart 4.
Assembly R and U-Factor Forms
ASSEMBLY ROOF AT FRAMING
Material (Describe) Thickness R-Value
interior Fitm Coefficient .610
Sheet Rock .560
Ceiling Member 4.350
Insulation 32.000
Exterior Film Coe�cient .610
Total Assembly Thermal Resistance 38.130
Assembly U-Faator {1 /Total R) .026
ASSEMBLY WALL AT FRAMING
Material (Describe) Thickness R-Value
Interior Film Coefficient .fi80
Sheet Rock .450
Stud 6.870
Sheathing 2.070
Siding .610
Exterior Fiim Coefficient .170
Total Assembly Thermal Resistance 10.850
Assembly U-Factor (1/Total R) .092
ASSEMBLY RIM
Material (Describe) Thickness R-Value
Interior Film Coefficient .680
Insulation 19.000
Rim 1.890
Sheathing 2.070
Siding .610
Exterior Film Coe�cient .170
Total Assembly Thermal Resistance 24.420
Assembly U-Factor (1/Total R) .041
ASSEMBLY
Material (Describe) Thickness R-Value
Interior Film Coefficient .680
Sheet Rock .560
Insulation 44.000
Exterior Film Coefficient .170
Total Assembly Thermal Resistance 45.410
Assembly U-Factor (1/Total R) .022
ASSEMBLY WALL AT INSULATION
Material (Describe) Thickness R-Value
Interior Film Coe�cient .680
Sheet Rock .450
Insulation 19.000
Sheathing 2.070
Siding .610
Exterior Film Coefficient .170
Total Assembly Thermal Resistance 22.980
Assembly U-Factor (1/Total R) .044
ASSEMBLY BLOCK
Material (Describe) Thickness R-Vatue
Interior Film CoefFcient .680
Concrete Block 1.280
Optionaf Insulation 11.000
Stud 4.350
Exterior Film Coefficient .170
Total Assembly Thermal Resistance 17.480
Assembly U-Factor (1lTotal R) .057
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GENERAL NOTES:
• Design reaction includes all loads on the joist. Design shear is computed at the face of supports including all loads on the span(s). Allowable shear may
sometimes be increased at interior supports in accordance with NER-200 and these increases are reflected in span tables.
• The reaction values above are based on an assumed minimum bearing length of 1�/i" at ends, 3'�Z" at intermediate supports.
• The following formula approximates the uniform load deflection of �(inches):
For TJI�/15 DF, TJNl25 DF For TJI�/55 DF
and TJNl35 DF Joists Joists
22.5 wL' 2.67 wL= 0=�• EW�� + d x �= Southern pine (SP) TJI� joists may be
�- ei + d x �o� directly substituted for the corresponding
depth and series of Douglas fir (DF) TJI�
w= unitorm load in pounds per lineal foot d= out to out depth of the joist in inches joists listed within this guide.
L= Gear span in feet EI = value from table
f�WR �V S r //�9 Q. � .7 ��%�� (' � �� /T�-sf/il%R+�Ki ���Y �' • M /I.O�T � � 1 �0 � / �
I A e iS �.r �bisT �ew�e c+n��i,,1��ro~�Dor
f�lir Roo-� SiPe c ts . p 9
PRODUCT DESCRIPTION
� �1'/2,
1'h"
�
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or 11'/a"
�
1 Yz°
TJN/15 DF Joists
Top and bottom flanges of
t'/z" x 1 Yz" Microllam� lVL with
�" Performance Plus� web.
� � 13/a
1'/2"
�
3�8„ 9'/z", 11'/a",
14" or 16"
�
1'/i'
TJI�/25 DF Joists
Top and bottom flanges of
1�/a" x 1 Yz" Microllama LVL with
31a" Performance Plus� web.
�{ � 25/,s'
I 1 Y2�
�
3/8 � 11'/s",
14" or 16"
�
1 Yz"
TJI�/35 DF Joists
Top and bottom flanges of
25hs" x 1'/2" Microllam� LVL with
�/e" Performance Plus� web.
Page 18 � f
., ..
�{ � 3Y2�
I 1'/2„
�
„ 11'/e",
�/,s 14" or 16"
�
1 Y2"
TJI�/55 DF Joists
Top and bottom flanges of
3'/i' x 1 Yz" Microllam� LVL with
�/�s" Performance Plus� web.
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� SuB�ECT � .
City of Fridley 33194
AT TME TOP OF THE TWINS g U I L D 1 N G P E R M I T:
r
� •
� � •
� ; y _�'�_ COMMUNITY OEVELOPMENT DIV. �� ^/
r � � PROTEC�IVE INSPECTION SEC. /
� _ �"'� � C►TY HALL FRIOIEY SS132 NUMBEN pEV O�TE o�GE OF �vnqOV£D Br
�""'�� ,�� 763-571-3450 9�0-Ft5 10/21/02 � �
JOB ADORESS 5241 Fillmore Street NE
t LEGAL �OT NO. BIOCK TRACT OF ADDITION SEE ATTACNED
DESCR. ,LL 4 Horizon Heights SHEET
2 PROPERTY OWNER MAII ADDRESS ZIP PHONE
Tom Arth 5241 Fi�lmore Street NE 763-571-7790
3 CONTRACTOR MAIL ADOHESS ZIP PHONE LICENSE NO
Renewal By Andersen 1920 Co Rd C W, Roseville, M13 55113 651-264-4777 20130983
� ARCMITECT OR OESIGNER MAIL AODFiESS ZIP PHONE LICENSE N0.
5 ENGINEER MAII ADDFESS 11P pHONE IICENSE NO
6 USE OF BUILDING
Residentia�
7 CLASS OF WOFK
p NEW O ADDITION ❑ ALTERATION C� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace or.e patio door within existing opening
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in ail s�eeping rooms and on ali �eveis of the dwe�I�ng
per Section 310.9.1.2 of the 1997 Uniform Building Code. Cau�k and f�.ash a�1
exterior openings.
permit inspection Cards
Will Be Mailed
To Homeowner To Post
TVPE OF CONST. OCCUPANCY GROUP OCCUPANCV 1,OAD
SEPARATE PEfiMITS ARE REOUIqED fOR ELECTRICAL, PLUMBING. MEATING.
VENTI�ATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. fT CU FT
AUTNOFiIZEO IS N01 COMMENCED W�THIN 60 OAYS. OR �F CONSTqUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PER100 OF 120 OAVS A1
ANY TIME AfTER WOqK IS COMMENCEO NO DWIG. UNI7S OffSTREET PARKING
I HEFEBY CERTIFV THAT 1 HAVE READ ANO EXAMINEO THIS APPLICA710N 1 STA�LS GARAGES
AND KNOW THE SAME Tp BE TRUE ANO CQRRECT. All PROVISIONS OF LAWS VALUA?ION SURTAX
ANO OROINANCES GOVEANING TMIS TVPE OF WORK WILL BE COMPLIED @3 � 7OO � L. HS
WITN WMETHER SPECIFIED HEREIN Op NOT THE GRANTING Of A PERMIT 'P
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL THE pEqMtT FEE $AC CMARGE
PROVISIONS OF ANY OTMER STATE OA LOCAL lAW REGUTA?ING CON• @83 . 2S Fire SC �3 .%O
STRUCTION OR JME PERFORMANCE OF CONSTRUCTION `P
PLAN CMECK FEE TOT L FEE
Licens $5.0 $93.80
$�GNpTURE O� CON7R�CTOpOR �UT�OA�2ED AGENT �O�TE� NEN ROP � VALIOAT TNIS IS YOUQ F1MIT
Y ��
S�GNAIUAEO�OWNEQ��FOwr+EABU��DEA� �D��E� g� iNSp f�p
v ;�'- ♦ I
r�w t �
ADDN
ALTER
�l
[l
Effective 5/10/99
CITY OF �`RIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BiJII.DING PERMIT APPLICATION
�onstruction Address: � J a� �i � �11' �� C�CS�!-e„ �- � � , �, .
Legal Description: �
Owner Name & Address:Tp m���-j,� � Tel. # 7�3,5} �-3�%Q
Contractor:; ���� �u A�.�xS.e, MN LI�ENSE # o"lO l?j09 ��
Address: J9 a� CAv�x`� 1t oo.d C. W�.��:'�,c�s�c..��l �'f`(1t� 5�S il� Tel. #(c`�1 • alo4 �y��
Attach to this application, a Certificate of S�uvey of-t�e
lot, witfi the �roposeci �canstr�ctinn drawn-on it to scale.
DES.CItIi�`:�'iflN OF �N�P�4�ME3�T'T _ '
LNING AREA: Length
GARAGE AI�,EA: Length
DECK AREA: I,ength
OTHER: �� c-, �
Construction Type:
Driveway C�.irb C�t Width Needed:
Width Height Sq. Ft.
Width Height Sq. Ft:
Wicith Hgt/Ground Sq. Ft.
�,.�.. _ �'�.._. _ • 1 � � . __._ 1. - -
.
o � .
Fstimated COSt: $ ���'OO a�
Ft. + ti Ft = Ft x$
_$
DATE: �io�•�C.�.• 0 APPLICANT• rr�n.c��r�1 Tel. #_ 9�j2� •3Li,5•(�O�i�-
�
Permit Fee
Fire Sur�liarge
State Surcharge
SAC Charge
Lic�nse Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIl'ULATIONS:
$_.����_
$ 3 • �.-
� I • ��-
$
$ �: 6 0
$
$
$
$
� g� �
�
CITY USE ONi,Y
Fee Schedule on Reverse Side
.OJ1 tsi Permit Vaiu2iion (li IOih�lo)
$.50/$1,000 Valuadon
$1050 per SAC Unit
$5.00 (State Lxcens�d Residential Contractorc)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMOPI VENTs VENT CONNECTUR AND COMB�I3TION AIR VERIFIGATlON
When reqlacins� an existins� furnace, the undersigned hereby verifies that the
venting has been examineci and is free from rust, �terioration, obstructions,
and is securely supported and firestopped where required. Yes,n� No (}
(
The venting system is plastic/PVC and mee#s ali current codes and manufacturer
specifications including sizing, length, number of elbows and terminatian. Yes�; No {)
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
incfude AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existino combustion air is sized arrd installed to meet the cuReat codes
and manufacturer's specifications.
Wnen required to instal{ a new combustion air. it will be sized and installed
to meet the current codes and manufacturer's specifications.
Ye�'� No ( )
Yes ( ) No��}.�
Yes�
When installins� a new ventinsf svstem, the undersigned hereby veri�es that
it is a listed assembiy and meets the current cades and manufacturer's
speafications. This does include AGA GAMA Category I Central Furnace
Venting Tables for fan assisted and natura( draft appliances. Yes 1',�'/
Is the common vent and vent connectors sized and instaUed coRectly after
an appliance has been removed frorn the oommon vent and vented
separately as per current codes.
No ( )
No ( }
Yes ( ) No ( )
Aaaliance Tvpe and SizelCommon Vent and Vent Connactor Information
Appliance #1 Type �'f +� BTU lnput _�!�_ Fan Assisted or Nat ���"
qpp�iance #2 Type BTU tnput Fan Ass9sted or Nat
Appliance #3 Type BTU lnpui ___,__ Fan Assisted or Nat
Tota! Appiiances Tdal Btu input _______r__
Common Vent Type � Vent Height l� t Diameter �O inches
Appliance #1 Vent Connecto� Height �ft
Appliance #2 Vent Connector Height ft
Appliance #:i Vent Connector Height ft
�/�ew
Length �ft Diameter � in Type �
Length ft Diameter in Type
Length ft Diameter in Type
�iC � �`e � �j�. �. � �
Y� I"e�I ���i�-�1 y �V\
HEATING CO:
� �l ��
�b
�1�S�CCt10riS
7�3-572-3604
STfE ADDRESS ,_:y
THIS APM,[CAid'C IS:
TENAI�TT
SUBMTT A COPY OF
YOUR STATE LICF.I�iSE
WITH APPLdCATION
PROPERTY TYPE
TYPE
�E oF
BUILDING
1�►ESIDENTIAL APPLICAT�UN
CITY OF FRIDLEY
� • � ��
STATE
a Bas�nrr rzxzsx
o DECx
i❑
DESCttttsE wox�c amvG �
s� o� n�xov�rrr
NLIMBFR OF SQUARES
�
PROPOSID S[ZE:
PROPOSm EffiGKT:
YOLIR �MAILADDRESS
��• � 1[��[!
:����� _I� .1 � ��
�-7�,�._���.��;;✓ �
-- - — — -- --- ---- ------
• r�
• ��i
■ � i�� �.— � i � � ;--
■ ��• ■ �� i i
■ u ■ ��r.i�:
❑ HOUSE ONLY
O HOUSE 8t CsARAGE
❑ ATTACi�D GARAGE
❑ DETACi�FD GARAGE
Permit No.:
Received By:
�ASIIKFNT RF1V[OD 3NC SuR
1. Fncisdng �loor Pfaa
2. Pmpased floor plan
3. list of sriuctural members to be used
F�
��G PDR NEW CONSTRUGTION INCLUDING DECKS,
❑ Vinyi p��
����n� • ❑ Trim ADDiTiONS. � PORQiES SUBMIT:
[� Ot6er O Tascia i. Site PladSurvey sfawing th� existing stn�tures
and ProPosed PI'o.lxt,
W�p� Z. Two sets d' c:�str�tion ptffis
W F�CISTIN(i OPENINGS �Yes ONo L()CATION OF WINDOWS 3. Fleagy Cslculatioas
OR FOR NEW OPFNWGS-DESCR�E SIZE OF
OPBNWG CHANGES & ' .
TYI� O� WINDOW TO BE INSfAL�D NUMSFR OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERiALS:
--- - (USING��SL 1997 U.RC FEE SCHEDUI.E)
Permit Fee
Plan Review
Fire Surcharge
Sru+cbarge
Liaense Swcharge
SAC Charge
Curb Cut FscnQw
Erosion Control
Park Fee
Sewer Main Charge
Total Dae
$ �
$
$
See Back Pgge for Fee Schedule
b596 of Bu'tlding Permit Fee
.0016mes the total job valt�ation
.0005 x Pernut Valuation 1Vlitumum $.50
55.00 (State Licensed Residen6al Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
_�t+6ft= ftz$21=$
5450 Conservation Plan Review
Fee Determined by Enginceripg
Agreement necessaty ( ) Non Necessa�y ( )
THIS LS A13 AP!'UCATION PDR A PFRNIIT-NOT VALID UNTI[. PROCESSID
I heneby apply for a building permit and i acknowledge that the informatiion above is complete and accurate; that the work will be in
conforn�ance with the ordinances and codes of the City of Fridley and with the Minnesota Const�tion Codes; that I understand this is not a
permit but only an appli " a permit and work is not to stait without a permit; that the work will be in accordance with the approved
plan in the case af ail rk req ' view ap at of pians, j
SIGNATURBOF ,•���.��.1/%1'/� aanJrusu�c�Ql�lf�>\/ l�i(i��.,....r: �