AF - 46432, land Plonning • �€l��i��B���'�� • . 6675 Highway No.65 N.E.
� • �� Minneopolis�
land Survcying ���.���.,�p��d���.�� ��dC• Minn. ssosz
Soils Testing ���
Civil Engineering Telephone 784-6066
Area Code 612
, Municipal Enginecring Exlgineers 8L ..�7L1T'VG�g70iS
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\` ! � _i 4.l�OTIFY THE FRIDLEY ENGR
� Before digging call local utilities � '' DIVISIO�V REGARDING CURB'
TELEPHONE - ELECTRIC - GAS Etc. �` BEMOVAL AND REPLACEME�L�'r
� REQUIRED BY LAW � � � DR!v_Ew,aY ,OP_Ef�l_��� f
�� � .��' 30�
That part of Lois 3 and 4, Block 1; Swanson Terrace,
lying nor�herly of a line whiEh is parallel with and
80 feet south of the southerly line of 'Lots 1 and 2,
Block 1, Swanson Terrace, according to the plat on
file and of record in the office of the Registrar of
Titles; Anoka County, t�innesota; together with all
that vacated part of Hugo S�treet ]ying easterly of
the southerly extension of the west line of Lot 1
and the most westerly line of Lot 3, Block 1, Swanson
Terrace, and which lies northerly of a line parallel
with and 80 feet south of the southerly line of Lots
1 and 2 of said 81ock 1. . �
This is o true and correct represenration of a survey of the boundories of the land obove described and o(the
location of oll buildings� .if any� 9hereon� and all visible enc�oochmenti� if any� irom or on said la�d. This survey is
mode only in connection with o mortgage loon now, 6eing placed on the property and no liability is assumed
excepf fo the holder of such mortgage or ony other intereat acquired by the reason of such mortgage. It is
understood and ogree �T� m�numen h ve been Iaced,For the purpose of establishing lot linas or boundory
' co�ners. Dated fhis � da of �� A. D. 19�
' SUBURBAN EPlGIiV�EERIPIG, ItdC. .
� Enginee s , Sur�e�ors
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SUBJECT
City of Fridley ,
AT THE TOP OP THE TWINS g � I L D I N G P E R M I T
r
� �
� • COMMUNITY DEVELOPMENT DIV.
� �y-------�
r � � PROTECTIVE INSPECTION SEC.
1 = �
� �""1 � CITY HALL FRIDLEY ! 55432 NUMBER
�.---� • •'� s�a-5so-3a5o ' 910-F15
10B ADDRESS 180 HUGO STREIET N. E.
1 LEGAL LOT NOjj.tS � BLOCK � TRACT OR ADDITION
DESCR. 3& 4 1 SWAN50N
2 PROPERTY OWNER MAIL ADDRESS
REV
CLARENCE A. SP�RRE, 2644 - 14TEi
3 CONTRACTOR MAILAD¢RESS
SAME
4 ARCHITECT OR DESIGNER MAIL ADI�RESS
5 ENGINEER
MAIL ADDRESS
B USE OF BUILDING
RESIDENCE
7 CLASS OF WORK �
B1X NEW ❑ A�DITION
8 DESCRIBE WORK
9 CHANGE OF USE FROM
STIPULATIONS
DATE PAGE OF
f2_l o�_7S � �
P
r. 13134
RECEIPT NO.
%C�-�`�g
APPROVED BY
SEE ATTACHED
SHEET
ZIP PHONE
SOUTH, MINNEAPOLIS
ZIP PHONE LICENSE NO.
ZIp PHONE LICENSE NO.
ZIP PHONE LICENSE NO.
❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
0
TO
'� WARHING
PROVIDE HARD SURFACEDdRI�EWAY Betp� digging t�ll I�{ t�tiliti�s
SOD FRONT & SIDE YARDS {. *^'�' !"��j' <<�
�� � �CC 1 : �J.: � ... I},� • ..
SEE FIREPLACE AND WINDOW SPECIFICATIONS
NEED SECOND SET OF PLANS REQU����' �% �. �
SEWER: 8" VCP 20' W. of W. Property Line
No Existing Wye �� (��'F�����'; �� : �1-f��� ���R IIIIPRIN�G,
WA TER: 6' CIP 30' W. oi West � �
Property Line. ��� ����,� �� ���
Must be Tapped.
TYPE OF CONST
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTIIATING OR AIR CONDITIONING. FRAME
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS� OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UN
I HEREBY CERTIFY THAT I HAVE READ AND EXAMII4ED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. AL� PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WOFiK WILL BE COMPUED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GftANTING OF A PERMIT 3 2 ], 5(
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � $ 4 7. 9 S
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT � (DATEI
� ¢ �� �i° - ..5.� �-+�-.
cinninTi �oC nc ntAna[o i1C 11WNFR RI111 f1FR1 � IDATEI
- .�.
WHEN
so
STALLS
ICY GROUP OCCUPANCY LOAD
1,056 cu.FT21,120
OFFSTREET PARKING
IGARAGES
SAC CHARGE
$325.00
TOTALFEE
$389.02
�TED T IS IS YOUR PERMIT
AUG. 19, 197
DATE
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.
•APPLICATION FOR R�SI'DE.vTIA�, ALTL'RATION,
OR AllllITION. BUILDING P�R1�4IT
CITY OF FRIDLEY, h1INNESOTA
O�,1NER'S NAME:��%�1^�y71' - /�`o ��DY►Y��? BUILUER: ��J?% _ --
h AnnxESS : � ���r �
ADDR�S S : ��% �� —/ y' � �(�'P. �l .
- %��-��3, .
110 : . � S�REET : .� 01 P'a � •
��'�s �^�' • �
LOT: �`�`��" BLOCK: 1' ADDITI01�?: �iv��.Sc��v
CORNER I.OT : - INS IDE LOT :��,_SETBACK: SID�YAr.D :
Applicant a�tac�. �o this for� Tc�o Certificates �f Survey-of Lot and.pxoposed
building l.ocation .:rawn on these Certificates.
�
HESCRIPTION OF BUILDING
. . . �
Ta Be Used As : . . � '
P P ,1
��� Froni : L%�-f Depth : � '� � Height : � �� �� �G� r�,: `
. � i
: • : ������.�: Square Feet :��Cubic . Feet : Z � m ' �„f�
Cr�2�� Front :�� Depth : „�` � Height :�' J� s� y-�
. • . � Square �eet; � �'� Cubic Feet : . �i�� cD
Type of �Construction: ��-�.,+�i r� Estimated Cost:
To Be Campleted: ���V n �a /� i � . . � 3 �'s� e •
The undersigned hereby makes app-1�?c�c�� :�+� fox a permit for the work herein
specified, agreeing to do all worlc in stxict accordance with ttie CitS* of
Fxidley Ordinances and rulings of the Department oi Buildings, and her�by
declares that all the facts and representations stated in this application
8xe true and correct. -
,
, .� .
DATE i�" � r�i `? SIGNATtTRE - Ga'�vt.� ' d'`�`t-�--
•.(See 1{everse S3de Fox Addi�ional Infoxination�. )�
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�� I �Minneapoltd� NMnawh 55�32
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SOUth Dltlt�}" 69a6S1Y�
Ciuil Bs�Munidpd EnQinceru�g � Soi! Teatmp � Land 3wueyin8 � l.and PLann+n8 1101 CIiH qoad
Bumsvllls, Minrwaota �387
Certificate of � Survey for hEN�ET�{ C. 3PORR�
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Zhat part of Lots 3 and 4, Block 1, Swanson Terrace,
lying northerly o� a line which is para1121 with and '
80 €eet sou�h of the southerly ]ine of Lots 1 and 2,
Block 1, Swanson Terrace, according to the plat on
file and of record in the office of the Registrar of
Titles, Anoka County, Minnesota; toge�her with all
that vacated part of Hugo Street lying easterly of the
southerly extension of the west line of Lot 1 and
�he most westerly line of Lot 3, Block 1. Swanson
Terrace, and which lies no�therly of a line parallel .
with a,nd 80 feet souih of the southerly line of i,ots
l and 2 of said Block 1. -
! hsr�brcortifJr thof fhia is a fwf and correct.,�ep►essefallon of a wrvey oi fh• boundmf�s of the abev�
d�scrlb�d laad� aerd of the locafton of all buildingi �hereon� o�d nil visibls eneroacl+m�nis� if onr� froa+ er en
told lond. As survsred bp me �his ZS'Kday o1�L,Y .� A.D. �9�
� - SUdURdAN ENGINEERING, INC.
� (1�i3dt�5 �i'UCi ��lLO�`!'�I'11��3i . Eagin��rs Su�varors _
3�er� , � . �- '�-� �-,�..-.�._..::.
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C� ��Y OF FRIDLEY �• _ 465
.�pplication for Installation of water and 8ewer Service
T'his form to be completed before a tap is made to any eaasting water
or sewer line.
s Lot .�-�-`---�------ Block .---,-�------------- Ay�dition -- -- --- - � - - - --
Address
��.C�t�
Plumber ----(.l1.. -�--ll.G...����.� _._fCl�� ____C,,����
(this porbton of form to be completed by n requesting ta.p)
CHA.RGES TO BE PAID BEFORE TAP IS MADE — WHERE
ASSESSN�NT HAS NOT BEE1V T•�n AGAIl`aST PROPERTY
Sewer Connection fee
�Street patch _._
Water
Conaection fee
Meter deposit
Materials used
•Street patch �
� Where applicable
The above applies for all regular residential size
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IF LATER.AL ASSFSSMEIVTS HAVE BEIIV T•'N'•«•n AGAIlVST
THE PROPERTY, '�`�`•R-F WILL BE NO CHARGES OTFmZ THAN
CONNEG°1'ION PER,MITS AND ME�.'ER. DEPOSIT
The City will furnish materials for water service snd the plumber
will bill the City for sewer, not to exceed $3.00 a f�t or a maximum
of $60.00.
ASSF.SSMENTS TO BE 7'•�n
Water Lateral
Credit for material
Total assessment
Sewer Lateral
Credit for material
i ��
�_._--------------
�-------------.___._..._--
60.00
Total aQa�,.+ent $ _
- �%
Clerk's signa.ture --- - -����11.t..z.�--�--����-���)
I hereby authorize the above ta.p
1st copy—Public Works Director of PubHc Works
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Custom� Name
City
Dealer Name
Straet
City
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HEAT LOSS CALCULATION �° TEMP. DIFF. +'� .
Type Caiistruction � '� r �'�^'�' -
W indo�' �' � � Storm Sash
Walls �� �� ��� Ins.
Ceiling �°��' °°^ � y ns.
Floor �"� t�C' P? �� �"� �"3 .
Fl.�l;� Room�Length �� Width � Height FI.I �.�� �� Room�Length Width Hei ht
Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area
Width Height No. of Llneal ft, Aree Width Height No. of Llneal ft, Araa �
No. of pane ot pane Lights of crock , sq. tt. N�• of pane of ane Li hta ot ersck aq. tt. '
� a �c� s �e� .�a � .�_ ��.� ��
�=
I nf i Itration `" �
�E� � �
Ex�s. wall � f
Net exp. wall 6 �
Int. wall
Ceiling s
F loor s
Total Btu.
FI.� � t� Room � Length Width
Windows and Doors-Crackage and Area
No Width Heigrit No. of Urreat ft. A►ea
_ . of pane ot pane . Lighn of crock fc, ft.
Infiltration �, j
G lass 7
EXp. wan �� 6Z3
Net exp. wall , g
Int. wall
�eiling
F loor _
Total Btu.
Pr
FI.� �=-�` Room � Length ��' Width
--.,- — — - •
Windows and Doors-Crackage and Area
N� W�drh Hr.ignt Nu of Lineal ft. Area
� nt �yny nf n�nr. Liqhts of crack sq. ft.
� � � -� m°°__ _ °' _ � �___ � f
Infiltration �
G lass � - --- �
Exp. wall
---�-��------- � el
Net exp. wall � �
Int. wall
CeiJirg ^ S�
Floor __� ._ ��
Totaf Btu.
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0�
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Coef. Btu
� a° ;�
�/2� tS
.�
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I nf i Itrat ion
G lass
Exp. wall
Net exp. wa
Int. wall
Ceiling
Floor
�v
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Bt�
!� ��
O�Q
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v
S`6 ?
.3/S
Total Btu. �
FI.� Room � Length �' Width .� H
Windows and Doors-Crackage and Area
No. W�Oth Height No. of Llneal ft. Area
of pane of pana L hu of crack sq. h.
� �� .�6 � 9 � y
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I nf i Ftration
G lass
Exp: wall '
Net exp. wall
Int. wall
Ceiling
F loor
�r, � °
.._ � �".. .5 Total Btu.
�(� Height FI.��;��, � Room�Length ��7 Width
Windows and Doors-Crackage and Area
No W�dth Height No. ot Lineal 1t. Area
of pane of pane Lights of crack sq.ft.
a' i �" .� � ,�
--�-- —
Coef. Btu --- - --- --
�.� � ,� Infiltration
--- -----___ ---
j „� � Gfass
- -- -- --- -- - '
...,.. Exp. wall._ '_�' �
/�j Net exp. wall �'a
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%(jca� Ceilin�--
Tota! Btu_
Btu
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HEAT LOSS CALCULATION ° TEMP. DIFF. '. � �
Cusiomer Name Type Construction
�nY Windows Siorm Sash
Dealer Name Walls Ins.
S�� Ceiling I�s.
City F loor
FI.� �p Room � Length Width Height
Wir�ows and Doors—Crackage and Area
No, W'dth Height No. of Lineal ft, Area
o} pana of pane �i hts of crack sq.ft.
•�� �� C!
Coef. Btu
Infiltration � �" t��
G�� a% ! 3 SU
Exp. wall �, �
Net exp. wall � /S 6
Int. wall ---!
Ceiling � / ,� '7
Fioo� �/ 3 7/ ,S'
Total Btu. D �
FI.� D� Room � Length Width , Hei ht
Windows and Doors—Crackage and Area
No. W�dth Heignt No. of Lirreal ft. Area
of parro of pane Li Ata of creck aq.ft.
� / �
�
Coef. Btu I,
Infiltration j � �c� .
G lass � �' 9 O �
Exp. wall +..•�
Net exp. wall � L/,/
Ini. wall
Ceiling
Floor
TOLaI BLU
FI.) Room �
�
a �-79 �
i
y� � ��
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Width
W�r�ows and Doors—Crackage and Area
N � W�>1th He�qht No, ot Lineal ft.
. �� nanw nt pene Liqhts of c►aek sq. ft.
-�----- - - -- ��q.?�
; �
, Coef. Btu
Glass _ -
Exp. wail - _
Nlet exP- wall - _ �.
1nt. wall
Ceilirg -
F�
Toia! �t�.
FI.� Room � Length Width Hei ht
Windows and Doors—Gackage and Area
No. W�dth Height No. of Lineel ft. Area
ot pane of pene Li hb of crsck sq. ft.
--- --- Rv
Coef. Btu
Infiltration
G lass
Exp. wall
Net exp. wall
Int. wall
Ceiling
F loor
Total Btu. -
FI.� Room � Length Width Hei ht
Windows and Doors—Crackage and Area
No Width Height No. of Lirreal h, Area
of pane of pane Li hu of crack aq. ft.
Coef. Btu
I nf i Itration
G lass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor ,
Total Btu.
FI.� Room � Length Width Height
Windows and Doors—Crackage and Area
No Width Height No. ot Lineal ft. A�ea
01 pane of pane L�ghts of crack tq. ft.
Coef. Btu
I nf i Itrat ion
G lass
Exp. wall
Net exp. wall
-- Int. wall
-- Ceilir�
F loor
Total Btu.
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNIPIG APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUS7`iON AIR VERIFICATION
When realacins� an existinct fumace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastiGPVC and meets all current codes and manufacturer
speciflcations including sizing, length, number of elbows and termination. 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
include AGA GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the cuRent cades
and manufacturer's spec�cations.
When required to instrall a new combustion air, it will be sized and installed
to meet the current code� and mfinufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
VVher� i��allitua a� ventin� sv�em, th� undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes ()
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes.
No ( )
Yes ( ) No ( )
Appliance Tvpe and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input
Appliance #2 Type BTU Input
Appliance #3 Type BTU Input
Total Appliances Tdal Btu Input
Common Vent Type Vent Height
Fan Assisted or Nat
Fan Assisted or Nat
Fan Assisted or Nat
Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter,�in Type
Appliance #3 Vent Connector Height ft Length ft Diameter . ::in Type
ALTERATIONS:1Describe)
HEATING CO:
Signed By: Date :
Building
Inspections
763-572-3604
DATE �
SIT'E ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WTI'H
APPLICATION
PERNIIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATI4N
CIT�.' OF FRIDLEY
YOUR
❑
�
NAME: �
ADDRESS:
PHONE:
CoMPANY
CONTACT:
410
Permit No.�`C°v� z"� "
Received By: !
Date Rec'd: �� `� �
?.
STATELICENSE# � - MINN�$��, I�N 55408
2- 24- STA1'E ZIP
ADDRESS:
PHONE
'�SINGLE FAMII.Y ❑ TWO FAMILY
❑ NEW �EPLACEMENT
DETAILED DESCRIPTION OF WORK
FAX
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
PER MS 16B.665 the permit fee is a mi�imum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
unprovement, installa#ion or replacement of a residential fixture, excluding the fixtures. ('Ihis should reflect only the cflst of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 ° cost of labor x.05 =
FOR PROJECTS WHERE I.ABOR EXCEEDS $5 , FEES ARE BASED ON $10.00 PER FDCP[JRE, EXCEPT NOTED. FDCf[]RESc (IIdDICATE TOTAL
rrutv�Ex oF Eac� an.ov,� � 1� srz��ru �� O�
x
Equipment Installed . MFG: __ �`�� MODEL: �� 7
MFG: MODEL: SIZFJBTU
MFG: MODEL: SIZFJBTU
AJC $25.00 FIREPLACE (G14S) $15.00 GAS RANGE/OYEN $10.00
AIIt TO AIR EXCHANGEER $15 FIREPLACE (9J�D) $35.00 NEW GAS GRILL $10.00
BOILER $35.00 �FURNACE $35.00 GAS UNIT HTR $10.�
CHWWEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.W
DUCT WORK $10.00 GAS PIPING $10.�0 VENTII..ATOR 515.00
., ,�. � �. ..... _.. _ _.
Pernut Fee $ Number of fixtures @$10.00 x$10.00 =
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @$25.00 x$25.40 =$
Number of fixtures @ $35.00 � x $35.00 = $�
State Surcharge = $ 50
Tota1= $��
TI�S IS AN APPLICATION FOR A PERNIIT NOT VALID UNTIL PROCESSID
I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota-Construction Codes; that � understand this is
not a permit but only an ap lication for d work is not to start without a permit; that the work will he in accordance with the
approved plan um the of w'c r' s review and approval of
31QNATLJFLE OF APPLI �� a ATE
City of Fridley
Building Inspections Department
6431 �Tniversity Avenue NE, Fridley,. MN 55432
. 763-572 3604
FAX: 763-502-4977
REQUIRED tNFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICAT(ON HVAC
❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED F�R NEW/EXIS1fING HQM�S .:;. _ :
.. , . :,:� . �'a-t�i' .
1. Combustion Air (See note belo�vv-j� �'� .
a. Oil ar solid fuel IMC Chapter 7 with MN Amend.ments
b. Natural Gas or PropanellFGC Chapter 3 with MN Amendments
2. Make-up A.ir (See note below)
a. IIvIC Chapter 5 with MN Amendments
3. Ven.ting
a. Gas appliances IFGC Chapter S with MN Amendments
b. Fuel oth.er than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a: P�r Ml� F�e�gy Code 7670 or 7672
6. Duct Design Per lMC 1346.0603.2 � -�
a. ACCA Manua1 D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combusiion and make up air calcula.tions