AF - 45973City of Fridley, Minn.
BUILDING PERMIT
.:_ � .
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Na �QL_ s�t .r-'-.,�
I,ot ��,�.___ &locx �_..'y!
Corner Lot __ !'_':'"�Inside I.ot
Sewer Elevatia�
N° 6046
�.�1�:.,P� �t __._.—,,.._- ���t—�
naaiton or suv-niv�ion�. .���d'ttL/�'"�!--
.— Setback �� _. Sideyard ��F.�-./�----
--.---._...._ Famdatioat IIevatfoa —._... ----
DESCltIPTION �F BUILDIPlG
�o/: usea . r 1
@' � _ t� / �} .}� /�f /!
7��".k,E- E'recret �,,,c..� Depth .c� �.._ H�t .�".L�_ `°acd. Ft. �,�c{ _.. C�a. Ft � ���. � .
—._...- -------✓""— k�o� . _ .__ Aepttt _�_(��{- /f€eight .__.. .... Sq. Ft —_ GSz. FA . ..__.
Ty�pe of Conatrucfioa .._ .._..___...�"�_.. Est Cost .F�.z.��.�:C-".."� To be Ca*n.PYete1 ..__ ..............._.�.._._.._.�
In conaSderation of the iasuence to me of a permit to construM the bullding described above, I agree to do
the proposed work 1n accordaace with the deeCriPtion abwe aet fortti and ia comPliance with all P�Bions of
o�dinanc� oP the city of Fridley. .
Ea ca�derattan of the Payment of a Pce of a�..�
to conahuct the building or
the expreas conditl� that ffiepe rson to whom it is gr+
�dnne fn, around and up� seid building, or az�y part •�
Fridley, biinnesota regaz'dinB lOCatiam, conatruc4on, a
wiHiln the city ]imits and tkds permft maS' 6e revoked
ordinance6.
—, Pe�t is herebY S+'8nted W—
litfon as descrlbed above. Thispe rmit is granted upon
d and his agents, eihpluYees and worlm�en, fn all work.
eof, shall conform fn all respects to the ordinantxs of
atio4 maznteneace� rePau' and movin6 of buildinSe
aqy ticce upan violatlotyQf aW' of the Prov3sions of ssld
�
I NOi10E
fib p��h dea pw eswr � eennrucetee. M�hlWbe fa vrkNO. pX�nW�W Yu h�ninY. aw�r er w�nr. B� wn ro sw
I, � IM Bulldtey In�pMer fsr ap�nM pamin kr IMN Pxe�. . .
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLBY, MI43NF,SOTA
Owner's NameL�,�T�'�_ 7/ C/fFSZ/_=.�° Builder ,�i��9�.
Addresa /o3F0 QU/N�h' iT A/.�: Address
LOCA ION OF BUII,DING
� �= N �o�
No. r�,_ Street ,�'U Part of Lot
Lot�_Block�_Addition or Subdivision �=tv - 6 S
Corner Lot v Inside Lot Setback 3S� Side-Yard�„Y � /D �
SSWBR ELEVATION FOUNDATIQN II,EVATION
Applicant attach to this form ltoo Certificatee of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as:
DSSCRIPTION OF BUILDING
Front�_Depth �;LHeight „� �%
Sq. Ft.� Cu. Ft. �d,.2�/�
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction �aQ�/!.) L Satimated Coat %�i 0'��
To be Completed ���J J��✓S
The underaigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordiaances and rulings of the Department of Buildings, and heretiy
declares that a11 the facts and representations stated 1n this application
are true and correct. .
U
(Schedule of Fee Coats can be found on the Reverse Side).
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�" H6AT LOSS C ULATIONS DEPARTMENT OF BUtLDiNGS ��� �
Weatheratrips A'S•H• • Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F7oor Kin
Yes—No I Yea—No ( 19� (
F1.� v�w Room Length � Width � eight � �.otF7.� , Ronm
Windowa an Doora—Crackage and Area Windowa and Doora�
Wldth Heig�t No. of Lineal [0. Area Wldth HE�6ht P
No. ot pane o[ pane lie�b af cnck ea. fL No. o[ wna o[ oana 1
G Z � � �' � d' �
2 �"1 0 � �-f �.. 3 0 !�
3 ° G ' �a Coef. Btu
Infiltration p f!p ,� � a-p
Glass J� So S^ a
£xp. wall �?(o
Net exP. wall ___ --__:_ o a a
' Int. wall
Ceiling
Floor m'7Gle /3 3 0
To�al Btu. / �� O 3 !9
Required sq. ft. E.D.R. or aq. ine. W.A. Leader arca
f El•� % Room� L.ength (e Width /� Heigbt �
Windowa and Doore—Crackage and Area
Glnsa
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Windowa and
ln6ltration
c��..
exP. Weu
Net e:p. wall
Int. wall' �
—�—
Ceiling L
Floor ti.
and Area
Btu
-:...-�-:,-.:_ � _ll
Coef. Btu
S�� �ia o
� � sa � �
�60 / �6on
ft. E.D.R. or aq. ins. W.A. Leader
3� I
MINNEAPOLLS. MIINN.
Insulation
How Applied
� Width /6 Height �
Area
In6ltration '1 b' S�
Glaaa /i'a
EaP. wall 2
1Ve�E esp. wall - /�it i
�n[. wa�{
Ceiling
Floor '�`� /.
Totat Bm.
Required aq. k. E.D.R. ot aq. ins. W.A. Leader area
� FI.���(3.t�.e, Roomll.ength Width/ ;
Windows and Daora--Crackage and Area
WIQt� Ae18Dt No. o[ Lineal [4 Area
No. of pane ot Du�e 11(bb ot crack ea� �t�
� !S/_ //_ 2 i� /O
In6ltration
Glaaa
Exp. wall
Net eap. walL
Int. wall
Ceiliug
Floor
Total Btu.
Na
/ 6
/o
V.A. IR8GCi 0IG8
j W�dch
and Area
neal [[. Area
'crack �Q.tt.
/ r / �
c,a� s � :
�P. Weu P
Net exp. wall ,} D ,
Int. wall
Ceiling
Floor �
Total Btu.
Required aq. ft. E.D.R. or aq. ins. WA. l.eadet area
R�
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City of Fridley, Minn.
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DB�; JUDTE 21, 1966
PERMIT
.P.�- 3�0 7�
N° 8896
�,: RICHARD P. OLSOft Builder S�._
--- ---....._..__.....__........—._.—
� _601_Glencoe Street N, S. Aadrew
_._ ...�.._...__._�... ----
Fridley, Minnesota 55432
LOCATIONI OF BUILDING
Na 601 _ 3� _„ GLENCOH STBEST NyE L. _ Part of Lot __._._ _..
Lot ._.�?-- Block _�._� Addttlon or 3ub-DivJsiau .—_ u; �a,-,3; ew Heighs� —
� n
C�aer Lot _?t Indde Lot __._._._ � Setback .— 3SdeYa� -_._�.7 6 -----
3eover Elevatlan
Famdatlan IIevatlon
DESCRIPTION OF BUILDING
To ee v.ea �.:
Det, Garage �t 22 ._ �y� 24 �i�t � 10 gq, �, 528 �, � �.,.280
� EYant ---- DeDth -- Iirisht Sq• Ft, ----- Gw. Ft' –.-.—
Type of Camsh�uMt� Fr��i_____ Fat Cost —_,�25?4.9_0 __ To be ComPleted —.---
Ea muidenUam of Tl�e faauanae to me d a permit to ca�sGVCt the buildin6 deecrfbed above� I s8� W do
tha D+'aD� waslc sn acaw�danoe with the d�iPtton above eet anfl in comPlfance wtth all Prwlsions of
a�amaaoe. os cbe acy ot m�tater. _S�� ���-----
I11 MMIQQP8iI06 Oi 1LB P�t OY 8�!B Oi i--�--.� p21'IIl1t 1/ hfTEbY Sl'BIItRd YA RT('HARII P�
oi.sox m caaeavcc cba e„ua� or saaia� a. aesc�teea abo�e. �sy�� c �. s�+� �
tl�e exp�'at oanditlwt that t6eper�on to whom !t L gi'anted ecd hia agenb. eynployees and workmm� fn all wa�k
�� �� �uPOn �� or aqY theieofa� na,hall aontoam fn all reepecb W the ordlneace�r go�f
�vlthin the db` limtb aod this Darmit may bs revotad at e4Y tlme upan vlolation of anY ot � of �a�8
ordlnanoe�.
CLARENCE BELISL& g� �p�Qy.
NOTIC6
1W �1 dw Mt wwr IM� e�nqMy YM�O�IMn fa rrMM. �h�nYY�, W MMhF w�wr a rr�tw. M wn N�
IIIw WNNy NywM� M�r�M � TM IMn Ilwr. � � �
_ :.
OWNSR'S
APPLICATI03G FOR BUILDiNG PERMIT
CITY OF FRIDI.SY, MINNBSOTA
ADDRBSS !a 6 I �� 6n-tr� , i{/�', ADDRESS¢_.t A., rL.B,
LOCATION OF BUILDING
N0. STREET !°��� � PART OF LOT �(6� �. �ium�n.
�'1� 2 BLOCK S ADDITION OR SIJBDIVISION S�� �., �y�� .L�.I,seiQi��
._� -
CORNER LOT ✓ INSIDE LOT SBTBACR /7 � le �� S�B&� �iLa+rs�•
SEWER ELIIVATION FOONDATI�i ELI3VATIOIQ ji�"" •
Applicant attach to this form Two Certificatee of Survey of Lot and propoaed
bullding locatiop drawn on these Certificatea.
To be used as
D&SCRIPfIOA OF BUILDING
Height O �•
Sq. Pt._ ��Q Cu. Ft. S2 �'P
Front Depth Height
Sq. Ft. Cu. Pt,
Type of Conatruction �fA�o� �Estimated Coat� C�o. �
�., ,
To be
�
The underaigned hereby makea application for a permit far the work herein
apecified, agreeing to do all work in strict accordance with the City of
Fridley Ordinancea snd rulings of the Depsrtment of Buildinga, and hereby
declarea that all tke facts and representationa atated fn this application
are true and conect,
DATE�rr,r.wt� 2 � � / g(u (s
t�
(Schedule of Fee COSte can be found on the Reverse Side).
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�HIMNEY AND STACK VERIFI ATION
The undersigned hereby verifies that t�e e�usting chimney or stack:
Yes (�No ( )
Yes (�/�No ( )
Yes ( �No ( )
Yes (✓�No ( )
1
7
Has been carefully examined
Is free from rust or deterioration
3. Has no foreign objects lodged within
4. Is securely supported -
5..
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Meets ali cwrent Code requirements for size
a�d total BTU's connected - - Yes ( No ()
Has total heating BTU's �c.tN
�-
All other $TU's _ ..7�,1� ��
TOTAL BTU's �
Has a linea been pmvided for water heater
Has combustion air been provided for water heater
Remarks:
` • :- i� ��i•
HEATING CO:
Signed By:
Date:
Yes ( ) No (✓�
Yes (� No ( )
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M14LER �IECWANtCAI
7E4i1 NOWTFIEN BI.VD. M.W.
RA6ISEY. MN b6808
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/�////��� NOUS HEATING TEST RECORD
AO�ORE5S u�� ��� � �a���e APT.J..�FLDOH GTY SU6UR8
oCCU�P�N7 • Ai�P OWNER �w7P
HEAT LP55 DATE NTG.-INST. .
SOLO BY INSTAL{.Ep BY
El���r��cai Wwk 8y ONa"�!�, P 1Qi'4--- --Ga• liw' 8r -- -- -
TYPE pp HEA7 GA._FA ti� HW—�STEAM �SPACE Hl'R. �UNIT HTR. —Oft1ER
AS qESIGii CONVERSION
MAK� ' ��r MAK6 OF BURNER
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corrTRa s
THERMOS7AT Hwl P�uy
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Llwit -- -----
l.lnit S�/tina �_.-- ----
Fan S�Iliny �--
AIIa� Typ� �.__.
Pllrt 141oic. -
p�{er IMad.l -�—
Pilot il�iny --- --
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KINP OF LINER - SIY6 NON@
�ra4� Hoad R�pul��nr -
Fllt+rs S{a• uum6rr_
4�Imn�y l.osmlan
Cj�lmn�r Cqnatr4qi4n
5qiqk� BarnE
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.T.sr Toy
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7991 UMFORM MECHANICALCODE
501-503
Part III
HEATING, VENTILATING AND COOLING
Chapter 5
EQUIPMENT—GENERAL
Scope
Sec. 501. Equipment shall conform ro the requirements of this code.
Fquipmen[ shall not be�installed or altered in violation of this code norshall Ihe
fuel input rate to equipmen[ be increased in excess of the approved BtWh rating at
the altimde where it is being used.
Defective. material or parts shalt be replaced in such a manner as not to
invaiidate any approval.
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ppproval
Sec, 502, (a) Ilow Obtained. Each appliance shall be approved by the building
oFficial for safe use or comply with applicable nationally recognized standards as
evidenced by Ihe Iisting and label of an approved agency. Appendix C, Reference
Standards, provides guidance as ro available nationally recognized standards.
@) Coroplying Desigo of Equipmeo[. Installers shall fumish satisfactory
evidence that the appliance is constructed in conformity with the requiremena of
this code. The permanendy attached label of an approved agency may be accepted
as such evidence.
Type of Fuel and Fuel Connectlons
Sec. 503. (a) General. Each appliance shall be designed for use with the type
of fue! to which it will be connected. Appliances shall not be converted from the
fuel specified on the rating plate for use with a different fuel without securing
reapproval from the building official and as recommended by the manufacturer of
either the original equipment or the conversion equipment. The serving gas
supplier may conver[ appliances in accordance with procedures appmved by the
building official without securing reapproval of the apptiance if propedy rela-
beled. �
An accessible approved shutoff valve shall be installed in the fuel-gas piping �
� outside of each appliance and ahead of the union connection thereto in addition ro
any valve provided on the appliance. Such valve shall be within 3 feet of Ihe �
appliance it serves, and in the same room or space where the applicance is located.
E7CCEP1'IONS: 1. Shu[off valves may be accessibly loca[ed inside or under an
appliance when such appliance can be removed without removal of [he shutoff valve.
� 2. Shutoff valves may 6e accessibty located inside wall heaters and wall fumaces
� listed for recessed installation where necessazy maintenance can be performed
wi[hout removal of lhe shutoff valve.
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�ConsuuctionAddress: �o�
Effective 1/1/99
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION /y? �� f� ��-� p�
— � - �sG
I.egal Descripdon: ° �� .
uOwner Name & Address: 9�.I�:Q oYU�rtQ� Tel. # �,/07-78'6 -S.3�J
\Contractor: MN LICENSEJI
Address: Tel. #
� Attach to this application, a Certificate of Survey-of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTi�R:
DESCRIPTION OF Il�IPROVEMENT
I.ength Width Height Sq. Ft.
I,ength Width Height Sq. Ft.
Length Width Hgt/Ground _ Sq. Ft.
Consuuction Type: Fstimated Cost: $
(Fee Schedule on Back) / /�/
Driveway Curb Cut Width Needed: °r/ Ft. + 6-Ft =�Ft x$ _$ 7 r-S '`� �
DATE: ��� i APPLICANT: �/.�J�,r.e �Q�� Tel. JJ 7 SG � Ss a I
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License 5urcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STTPULATIONS:
CITY USE ONLY
$ Fee Schedule on Reverse Side
$ .QOI of Permit Valuation (1/10th%'o)
$ $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$
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From: Glty of Fr�tllBy I o: 4k�"dtkf144a� I'age: lJb usL9:
Building
Inspections
763-572-3604
763-SU2-4977 FAX
sirt auuRSSS �
TH1S APPLICANT IS:
OWNER!
TENANT
MECHANICAL
RESIDENTIAL APPLICATIUN
CITY OF FRIDLEY
— U Yt
�DI e��oe .
❑OWNBR CON
NAMt: /`
ADDIL�SS CDO � L_TI �
,.�.,.�.. rl/ R _ �S31 _
1:41:[L F'M
Received By����
Date'R�c'd.'
l:V1YTILAGIVK WMPe�� .. .. .
CQNTACTPtRS � �;, �.•'."���
SUBMIT A COPY OF � ,. ;;
YOUR STATE STATB LICHNSH jja;e,,,,__p-', ,v � ti'� F�CP UATB
LICENSE W1TH 111O1�aP
AUURESS: C1TY STAT�_'LIP
APPLICATION pHONt HAX
PERMIT TYPE �SINGLr VAMILY ❑ TWO MAMILY
TYPE OE WORK: � NEw � ¢xvwctnn�Nr
DETAIL6D DESCRIPTIONOF
❑'lbWNHOUS�
❑ ALTERATIO WRkiMODtL
F'EE$ARIL BASED O!1510.00 PER FIX7'UItL�, XCEP7' WHL�fl6 VOTEO. FIXTUNEB: I�DICA'1'E "07'A VUN66ROF L�ACH ►B/L�LOW)
Eqni�ment lnctnlled MV6: � MOUtL: �3�j�O� j) Si'LF:1BTl1'/�T1�
MMO:�_ MOUEL: 14 RN,)C �� SI'LF:/BTU�_
325.IX1
TO AIR 87CCHANGEtR $ IS
LINER $10.00
MNG: MOUtL:
I+1ILEPLACti (CAS) S I5.00
Fl1itPLAC� ( WOOU} S35A0
�NU IW ACt $35.00
GAS DRYtR 510.00
SI'LF:/dTU
GAS RANCFJOVEN EIOAO
NEW CAS6RILL$10.00
CAS UNIT HTR$]OAO
POOL HkiATtR S35A0
VENTILA7'OR $ I5.00
THIS IS AN APPLICAT]ON NORA PtiRM1T-NOT VALID UNTIL PROCBSStiU
[ hcrcby appty for a building pa�mit snd I acknowledgc that thc infortnation abovo Gg complctc and accuretc; thet thc wodc will bc in
conformancc with thc ordinanocs and codaq oFthc City of Fridlcy and with thc Minncsota Conshvcrion Cod�.w; that I undcrRtand thic i�
not a pertnit but only an application fot e pcxmit and work is not M start without a pamiT, 8iat thc wodc will bc in sccordancc with thc
approved plan in thc cacc of all work which rcquiros teIvicw and approval of ple ,
SIGNATURtOVAP➢LICA�� 11J�� �b y� PKiNiNAME� D l�AT� —/O "�
Building Inspectiona Department
6431 University Avenue NE, Fridley, MN 55432
763-5�2-3604 FAX: '763-502-497'7