AF - 46770� . . . �
City of Fridley, Minn.
BUILDING PERMIT N° 4 2 5 4
Date : ............ ..�.�._.._�.--���� .C_�...._.....-----------------
Owner : ................� � � ...................................... ........................--��- �� --�- ---- -� - -- . Builder
�
Address....._ ............................-••---......................................_....----....-•---------•---- Address .............................................................................................................................---....
L CATIO OF ILDING
/�% .
No. .L...l..._.._.�._.._..... Street ..... ..- - . ..__ _- �- - -� -�- -- - ................... Part o Lot ...
- - - -- --� -- • - .._.--- - -�-- -- -
Lot .....- ....�.......... . Block ...............� ......_........ Addition or Sub-Divisio ........_.......... ................_.. ---...._---.-
......_..... -
•- - ..
��G /� t� M
Corner Lot ...................... -..... Inside Lot .....�........................... Setback �.. ............
'-' ......... ..Slile}raTd �ti/...�..0 ..............._..._....'--.........-'---..
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used :
< <'i' t � � .r
< /�� �j / �/
- - o /� . cu. F�.°�l 3�
- ---- - -- - - ... - ...... Front �--....... �Depth �..1.-. 4' Height -�--/... - -.. Sq. Ft. /.. J
Q �! ` Q
_ - --
� � �- .. ....... Front � / : !�O Depth �� "_..c� Height ./.�....'.'� Sq. Ft. .�..l.�. Cu. Ft. .r��. A�. l
�'ype of Cons ction ......__..._...._ _ _........... Est. Cost_ ����...��.�'�.'. To be Completed .__._ ...............................................
In consideration of the issuance to me of a permit to construct ld
the proposed woa�k in accordance with the description above set f t in
ordinances of the city of Fridley. _
In consideration of the payment of a fee of $..��...�'�., pernut is hereby
�e, I to do
all ,Err�'se'ons of
.._.._...------•-------.___.._..----.----------------------.. to construct 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 of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buiidings
within the city limits and this permit may be revoked at any time upon violation of any provisions of said
ordinances. - - � / �
Building Inspector
NOTICE:
this permit does not cover the eonsfruefion, installafion for wiring, plumbing, gas Mafiny, sewa or wat�r. d� wn M tM
the Building Inspector for s�parah permits for thes� kems.
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HEAT LQSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A Gw� Conatruction No. Insulation �''
Windows I Door: Reference Out. Wall Int. Wall Ceiliag Roof Floor Kind How Applied
Yes—No Yes—No 19_
Fl.� Length / Width / Height '� Fl.� Room l.ength � Width � Height
Windows and Doors—Crackage and Area Windows and Doora—Crackage and Area
�Yldth He16ht No. ot Lineal tt. Area Wldtp Hel�ht No. 01 Lin�al ft Aras
No. ot Dane o[ Dane lights ot crack p. [t. No. ot pane ot Dans IIS6b ot craek p. tL
:� 1 ✓ � �� 2 6 �'
� .� Q �r . i�
Coef. Btu Coef. Btu
lnfiltration S In6ltratioa � g
Glaaa � / �� � /�
F�cp. wall ' � Fsp. wall
Net exp. wall � � �. N,�
Int. wall � In� wall
Ceiling �eZ Ceiling � :t
E'loor .� Floor � �'
Total Btu. Total &u.
Required sq. ft. E.D.R. or sq. ina. W.A. Leader ana R u�. ina. W.A. L.eader area
equired sq. k. E.D.R. or
� Fl.� R�m Length � w�a� ��i rk�� � � tt�m I�� / w�a� t��►� '
Windowa a rt--Crackage and Ana j�`' � p�rs--Crackage and Area
Wid h Hsl�ht No. ot Llneal [t. Area WIdtL Hat�ht No. o! Lineal ft. Area
No. ot Dans ot pane If�ht� o( cracic p. ft.
v �� � No. ot pan� ot pan� II�IIts o[ crack �Q. [t
y 2 �1 ic � 13 I�(
Coef. Btu
In6ltratioa �
Glass —
Fsp. wall
Net e:p. wall
Int. waU
Ceiling � �',t
Floor p c
Total Btu.
Required aq. ft. E.D.R. or sq. ias. W.A. L,eader area
Fl. Room � L.ength (S Widch Height
Wiadows an Doors—Crackage and Area
Wldth HelsAt No. ot Llaaal tt. Area �
No. ot pan� ot D�ee If�ht� ot crack p. tt.
✓� 3fl �lb� 3 _3s' .3s�'
Bcu
lnfiltratioa �
C.lass
Eup. wsll
Net esp. wail
lnt. wall
Cei�ing � � ;�„
Floor
Tbtal Btu.
Required sq, ft. E.D.R. or aq. ina. Q/.A. L.eader arca
In5ltratioa
Glass
Fap. wall
Net e�p. wal)
Int. wall
' Ceiling
Floor
Total &a
r�t��F �
��
Required sq. ft. E.D.R. or aq. ina. Q/.A. Leader area
Fl.� Room I L.ength Width ,3 �
Windows aad Doors—Crackage and Area
Wldtb HN�ht No. ot Lfneal tt. Area
Na ot oao� ot pan� Ilshb ot craek p. tt.
✓ 2 IG 1.��
r�_ � o $� 10
Coef.
Iu6ltration _ � �� 3
Glass
Eup. wall
Net exp. wall
Izct. waH
i,tiling
F7oor
Total &u.
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R�u�red w. h. E.D.R. or aq. ins. QIA. L.eader area
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HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatberatrips A.S.H.V. . Construction No.
Guide
Windowa I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind
Yes Yes 19_
Fl•� � E(��d Room Length Width Height Q Fl•� %; c C f� f_ J�i�
Windows and Doars—Crackage and Area Windows and Doora—Cr�
�Vldth Helght No. ot Llneal tt. Area Wldth He1shL No.
No. of pane ot Dane lights ot cnck �a. tt. No. o[ pane o[ Dane 11�I
✓� 3G �e Sl s'r i a ►� 7� y� r
Btu
PRIDLEY, MINN.
Insnlation �
How Apptied ,
k
� Width � Height �
e and Area
:Ineal [t. wraa
of cract q. tt.
lnfiltration 3 � Infiltration 3 '
Glass � D Glass ' �
Exp. wall Fsp. wall
Net exp. wall � � Net e:p. wall
Int. wall In� waU
Ceiling Z � Ceiling �
Floor ' Floor
Total Btu. - Total &u.
Required sq. ft. E.D.R. or tq. ins. W.A. l.aader area ` �� R � sq. �s. R/,p. j,��r ana
eqii sq. k. E.D.R. or
Fl.� � Pr [�� l.ength w�ach t��e � Fl.1 tt�m I�,� w�ach
Windowa aad Doors—Crackage aad Area -. Q/��� poors--Crackage and Area
Id h Hal�ht No. o( Lln�al tt. Ar�a Wldth Hel�ht No. ot Llneat It. Ana
No. ot pans ot pane Il�ht� ot crack p. tt. No. ot yae� ot pan� Il�hts o[ crack p. tt.
✓ !G ✓ 3 ��
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Coef. Btu
In6ltration 3
�,�. ,-s
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Net exp. wal) �
Int. wall
Ceiling 0 1 ',�
Fioor �
Total Btu.
Required sq. ft. E.D.R. or aq. ina. Q/.A. l.eader area
Fl. A Room � l.ength Width
Windows and rs—Crackage and Area
Width Hel�ht No. ot Llneal tt. Area
No. ot pan• o[ pans Il�ht� ot crack �q. tt.
✓
✓ � (• ` �.�. ��
Coef.
Infiltration �
C,lass
. �
Net e:p. waU
_i1nw�Ml�, Cj " �
Ceiling S
Fl,00r s''�
Tbtal Btu.
Required sq. ft. E.D.R. or �. iaa. W.A. Leader ana
� Net ap. wa11
� �
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� Floor '
Total &u.
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Btu
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Bc� I
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Windowa and Doors—Crackage and Area
Width Hel�ht Na ot Llneal [t. Area
No. ot D�ns ot pana li�ht� ot crack q. tt
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Coef. Btu
In6ltration
Glass
Esp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
k. ED.R or sq. ias. WA. L.eader area
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t �HO SE HEATING TEST RECORD '
kDDR�S3 I�o 1-�d�.`�G�►-��1 ��` APT.� F,L.O,O �C TY SUBURB � `
OG�tf,PANT OriNEr� �� �Jl �1 �
}l�AT:,L,035 DATE HTG. �NST.
Sfit.D BY INSTALLED BY
Ei�etricol Work By Gas Lin� Bp
TYPE-DF HEAT GA FA HW STEAAi SPACE HTR. UNIT MTR. OTHER
. AS DE IGN CONYERSION
MAKE MAKE OF BURNER
Mod.l Mod.l
S�rial Max. BTU Rotiny
'INPUT �Q MAKE OF FURNACE
Mod•1
THERMOSTA
1lalY�
Limit
L��urit S�ttiny�
Fan S�ttiny _
:Pilo� Typ� _
Pilot Mok• _
Pilw Mod�l _
,. G�ITROLS ��
�� H•at Pluy V�nt Si:•
� KIND OF UNER �- t!?F � NnuF
�D►uh Hood �Q.1611�L�►., R�yulolor �•--.--
�� Filt��s Sis• �� X�� Numbsr f
''17.�u Chimn�y Locotion Insid�v � Outsid�
� � � � � �� Chimn�r Construction � -
�
Smok� Bomb r� Wiring "�
Pilot Timiny %S �`+ v D►aft _� T�st Tap �
L.W. Cut Off Door Pressure �� Lfyhtiny (nst. �/
Pr�ssuN P�rcent CO2 � Oote T�st�d �
Input GFH� P�rc�nt 02 Compuny T�sfiny
Srock T•mp. PKUnt CO Nam� of T�st��
Fwm 235
. SuB�ECT P NO.
City of Fridley 2 9 017
AT TME TOP OP TME TWINS g � I L D i N G P E R M I T
r
; � RECEIPT NO.
� ; y ����� COAAMUNITY OEVELOPMENT OIV. �� �
r � � PROTECTIVE INSPECTION SEC.
1 ; �
i---•� �"'�'� CITY MAIL FRIOIE� SS132 NUMSEp pEV OATE P�GE Of �►vROVEO !r
L 612-571-3450 s�aF�s 3/16/99 / /
JOB ADDRESS 140 Hartman Circle NE
1 IEGAL ��T NO. 9LOCK TFACT OR AD0ITION SEE ATTACHED
oescA. 9 1 Sandhurst Addition SHEET
2 PROPERTY OWNER MAIL AOORESS IIP PMONE
Mark Knutson 140 Hartman Circle NE
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO
Four Season Roofing & Remodeling LLC 7930 University Ave NE, Fridley, MN 55432
• ARCMITECT OR DESIGNER MAIL AODRESS 21P pMONE LICENSE NO
795-9410 20128780
5 ENGINEER MAIL AODRESS 21P PMONE IICENSE NO
S USE OF BUIlO1NG
Residential
7 CIASS Of WORK
O NEW O AODITION O ALTERATION � REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof House & Garage (24 Sq) Tear-off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REOUIRED FOF EIECTRICAL, PLUM8ING. NEATING, TYPE OF CONST. OCCUPANCV GpOUP OCCUPANCV IOAO
VENTI�ATING OR AIR CONOITIONING
TMIS PEFIMIT BECOMES NULI AND VOIO If WORK OR CONSTRUCTION 2pNING SO. FT CU FT
AUTHOiil2ED IS NOT COMMENCED WITMIN 60 DAYS. OH IF CONSTpUCTION
OR WOpK IS SUSPENOEO OR ABANDONEO fOR A PERIOD Of 120 OAYS AT
ANY 71ME AF1ER WOpK IS COMMENCEO. NO DWLG. UNITS OFFSTpEET VARKING
1 MEiiEBY CERTIFV 7HAT I MAVE READ ANO EXAMINEO THIS APPLICATION 1 STA��S GARAGES
ANO KNOW THE SAME TO BE TRUE AND COppECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WILL 8E COMPLIED @
WITM WMETMER SPECIFIEO MEREIN OR NOT. THE GRANTING OF A PERMIT �2 � OSG W 1. O3
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pEqMIT FEE SAC CMA E
PAOVI IONS Oi ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
ST CT R TME pfpcOfiMANCE Of CONSTRUCTION $]�}.],rj Fire C�� $2.�6
� PLAN CHECK FEE TOTAL E
� � Lice $5 $82.84
S�GNATUpEO�CON7(7 QAOp�UT�+Op�ZED�GENT iD�rE, . N P P LIDATE ►� �OUR PER i
r �
4�
S�GN�IUAE 0� OWNEp��F OWNEpBWlDEi1� iO�fEi g�pG go r�arE
NEW
ADDN
ALTER
��
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPI.EXES R 1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/99
��
AD ��
�, � � ��
ConstructionAddress: I�� I-iu ✓'�- m� a �
Legal Descripdon:
Owner Name & Address: I�a f r ��; c.r� S� [� _ Tel. #
Contractor: e a . J i �• � M N L I C E N S E #�� 5 �..�%8b
Address: � .�v � �5 ��`� � . � � Tel. # ��5 ` � ���
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF Il1�IPROVEMENT
Length Width Height Sq. Ft.
�ng� Width Height Sq. Ft.
�ng� wld� HgdGround Sq. Ft.
Construction Type: t�toJ � Ce Fstimated Cost: $ ��
D �D S �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
• 3— � — APPLICANT: Tel. # 7 / S' < ��
DATE.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
(�ITY USE _ONLY
$ Fee Schedule on Reverse Side
$ a d jo .001 of Permit Valuation (1/ lOth%)
$ f, n 3 $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ $5.00 (State Licensed Residendal Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
•
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