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� UO�:�LD H. DEUTSCH
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. LO.fYD SURVEYUR �lJr%.. °. ��t�h .°.ve.zua Sou�h
• MINNEAPOLIS, MtNNE50TA 55406,
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I rereby_ certify thc.t this is � ; 1� ��i
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of a sur�ey of the Ioca-tion o° th� `'�1 .
ex_istine buildin� foundatio� or� �?�s � �^�`-' �� �
land d�scribed hereon. As survcyed by�� �1.!
m� �iiE i�i;n-6a�� ai liece�ber, iy ji. �c, :%�. ,-��' �
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I 7�ereby.aerti�r th�it the Llat heMeon is � tras and cnrreo� rapa�esvnta�tion c� . .
� r. �urtrv3► of th� boun��ri�s of Lo�.g. 21 c��d 22i B2o�k Ds ZZIVER �'IE'+Y �I�r3'PS � . �
- �.ncka Co��y, �dixt:�esota, �s surveyod t►y �a th� �nd d�;► �,� �!ar�h, ?�•
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City of Fridley, Mirm..
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDIl\TG PERMIT
Date: _�ecember 10,,,�71
/ .._ _...� �.- ...
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p��; Tr,�-Co �3u.ilders Inc euilder � Sam —
�d� 7561 Van Buren Street N.E. �d� Same _
LOCATIOiV OF BUILDING
No. S S S —.... Street K i mhA �? S tr.ae t N.E- Part of Lot
Lot �1 �._�,�_a;_____.�� Block n Addit3an or Sub-Divisian Ri�s�pn�ip�+ N�'iaht�--9dditiott
Coraer Lot ._�._..._._._ 7�side Lot X Setback 35 � Sideyard 7-0' & 13'
� Elevaidon 854.87 SS7.87 (Apn�ox. ) _
Wye Top of Footing
DESCRIPTION OF BUILDING
To t� v�a �:
nwp11 ing Front 26' Depth 40 � Height 20 � Sg. Ft. 1024' �, �^�, 20� 480'
�..._ Front .._ Depth Hei�t Sq. Ft Cu. Ft.
Type of Construction Er�e �, �� �$17,459.00 To be Completed �rch, 1972
Stipulations: Provide a verifying survey before fra.ming. Provide a hard surface drive.
WATER LOCATION: 23 feet N.E. of Ma.nhole 11 feet N.E. of Sewer Service
SEW'ER LOCA�ION: 12 feet N.E. of Manhole
. ,
In consideration of the issuance to me of a permit to construct the building descia'bed above� I agree to do
� proposed work in accordance with the description above set f and in co�mplian� witAh a11 Prov3sion8 of
Ordinances of the city of Fridley. �r � A /.b1 i�'�- /�
In consideration. of the payment of a fee of $�$...Q4 , permit is hereby granted to Tri-Co B� s
to construct the building or addition as described above. This permit is grant,�d u�n,
the express condition that the person to whom it is granted and his agents, employees and worl�en, 3a �Il Work
done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinaacee oF
Fridley, Niinnesota regarding lacation, construction, alteration, mai.ntenance, repa3r and moving of bwllaiIIgB
vyithin the city ]imits and this permit may be revoked at any tune upon violation of any of the provisions of S�id
ordinances. .,
'��%�'�� �-�%� � �,�,a�ng �ns�ectpr
CI,ARENCE BELIST.F
NOTICE:
This permif does aof cover the consfrueHon, tnstapallon for wtrin8, plumbin8� 8es 6eafing, aswer or water. Be urro to �
t6s Building InspaeFor for aepareta permits for these items. "
�
_ • . �
` APpLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME; Tri-Co. Buildere Inc. BUILDER: ��-Co. Builders Inea.
AADRESS : ADDRESS : 7561 Van Buren �'t. Bi.E,
No:, 555 s�r.�r: ximball st. �,�.
LOT: 21&22 BLOCK: D ADDITION:_ _��.�er View Hight�
CORNE$ L(n: INSIDE LOT: x SETBACK: 35' SIDEYARD: 10' &13�
Appli¢aa� attach to thie form 1�ao Certificatea of Survey of Lot and proposed
buildiag location drawn on theae Certificatea.
HESCRIPTION OF BUILDING
To B� Used Ast
�House Front: 26� Depth; 40' Height: ��
Square Feet : 1024 Cubic Feet : � �'� '' � E=?�
� s�
Front: Depth: Height:
Square Feet; Cubic Feet:
�rpe of Construction: Wood Fra.me Estima.ted Coat: $�`� �
-� �
To Be Campleted: 1'�P 7�
s
The underaigned hereby makes applicativn for a permit for the work h�rein
specified, agreeing to do all work in attict accordance with the City af
Fridley Osdiae,ncee and suliaga of the Department of Buildings, and hereby
decla�ces that all the facts and repreeentations stated in thie application
are ttue and corxect.
-Co Builde�Ino
�ATE: $IGNATURE : 83'=�
(See �tevaxee Side �'pr Additional Iafosa,ation. ) % � ` ��` ` � � �
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�BUILDING PERMIT FEE SCHEDULE "
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of aay building or atructure, or for any addition to any existing
building or structure, or for any alteration'or repairs to aay existing
building or_st7cucture, upon application therefore, require the payment by the
ap�licaut �or such permit of feea to th� amouat herein below set forth and in
the manner herei.n pravided to-wit:
UNIFORM BUILDING COAE: Tqpe 1, 2� 4-_$2.15 for each one thousand cubic
feet, ox fraction thereof, in su�h c�bical contents. �pe 3� 5-$1.85 for
each oae thousand cubic feet.
ADDITIONAL INFORMATION
For the puspoae of computing fees for building permita, the cubical conteate
of auy building or addition, ie determined by m�xltiplying the ground area
cavered from a point eix (6) inches below the floor line of the basement
or the cellax to the average heights of the upper surface or to the average�•
height vf the roof euxface of the msin gable of a pitched roof.
For repairs or alterations to an existing structurey the fee shall be at the
rate of $3.00 per each five huadred dollars 4$500.00) or fraction thereof in
the �ost of all propoaed work. '
Ta no case shall the fee charged for any pe=mit ae set forth in Section 2 be
less than $5.00. '
VBRIFICt�1TI0N OF FOUNDATION
NOTE: Pestaite for �onstruction will be issued a mini�m of 24 hours fram the
ti.�e of application, to allaw for proper review of the proposed structure and
of the coastruction eite.
A Ce7rtified Survey of the lot, ahawiag the location of the foundation, once it
has beea consttucted, wil.l be required before proceedin� with the framing.
�ERTIFICATE OF OCCUPANCY
Appl�.catioa for a Certificate of Occupancy ahall be made ten (10) daye pxiox
to the use or oceupancy of any etructure fox which a building permit has beea
issued; and said structure shall not be used or occup�ed until a Certificats
of Occupaacy has beea isaued.
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MINNEAPGLI6 LICENHED
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DONALD H. DEUiSCH
LAND 5URVEY�R
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PHONE:
1��-55 ° 2l�th A�enue s ou'th
MINNEAPOLIS, MINNE50TA 554�6
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a sua��;� o�' �;l�e '�o�d�rias of Lo�s 21 �d 22, B�ock D, RIVER VYEtJP HEIGHTS,
Azao}� C���►9 &tir�i�so��, �� survey�d by me �Eh� 2�d d�y og Mms�eh, Y969.
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Building
Inspections
763-572-3604
763-502-4977 FAX
D.�.TE { ��
SITE ADDRESS _
THIS APPLICAN7IS:
PROPERTY
OWNER/
TENANT
CONTRACTO�I
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PE�t1VIIT TYPE
TYPE OF WORK:
MEC�-IANICAL
RESIDENTIAL APl'�ICATION
CITY OF FRIDI,EY
❑ OWNER
COMPANY NAME: "a'
CQNTACT PERSON: FI_
STATE LICENSE �
1'OLTR E-M.4II. AUDRESS
�.
)NTR.4CTOR
� '� • �, cin
� Hea ing & A.C.
l Joswick
EXP DATE
Permit No.
Received By:
4�9
Date f��
sr.
C�
EwDx�s�221 Universit,y Ave N E cirYFridley sTarEMN z�55432
PHONE 763-572-0459 Fax763-572-0164
�INGLE FAMILY ❑ TWO FAMII.Y
❑ NEW �REPLACE141ENT
DETAILED DESCRIPTIOAT OF WORK
❑ I'OVi'NHOLTSE
O ALTERAI'IUNiREMODEL
FEES ARE BASED ON �10.00 PER FItiTi?RE, ERCEPT WHERE NOTED. FIkTi?RES: (INDICATE TOTAL NL?AIBER OF EAC'H BELOR')
Equipnient Installed ti1FG: ivIODEL: SIZE.BTU
MFG: I�III�O MODEL: �� y' 5IZEBTU D�• �
_�` !
MFG: MODEL: SIZE BTLT
4rC SZ5.00 _FIREPLACE (GAS) 515.00 _GAS RANGErOVEN S10.00
_AIR TO .9IR EXCHANGEER 515 FIItEPLACE (WOOD) 535.00 _NEVV GAS GRILL Sl0.00
_BOILER S35.00 �FURNACE S35.00 GAS IJNIT HTR S 10.00
_CHIININEY LINER S 10.00 . GAS DRYER S 10.00 POOL HEATER 535.00
_DUCT �VORK 510.00 " _GAS PIPING Sl0.00 ��ENITLATOR S15.00
Number of fixtures cr $10.00
Number of fixtures (2 $15.00
x � 10.00 = $
x$15.U0=�
q�+ �O
Number of fixtures (cr� $25.00 � x�25.00 =$� d�,� •�"
cn
Number of fixtures (n� �35.00 � x�35.00 =� 3'S•
State Surcharge = $ .50
FEE $3,i,.50) Tota1= $ 1��.
THIS IS AN APPLICATION FOR A PERMIT-NOT VAI,ID UNTII, PROCESSED
I here�y apply for a build'uig permit and I ackuo��vledge fliat the informatiou abo��e is complete and accurate; that the work will be i►i
confonuance widi the ord'uiauces and codes of the Ciry of Fridley and witl� the Muinesota Consmution Codes; that I understand diis is
not a pernut but only an ap ication for a pernut and work is not to start without a peruiit; that the work will be in accordance with tl�e
approved plau in the case of 11 work w i r ' s revie�v aud approval ofplaus�
SIGNATLTRE UF-APPLICANT PRINT NAME �, DATE ���^ O
PLEASE
TE PERNIlTS ARE
City of Fridley
�ufldin� Inspeciions IDepartment
6431 Uiuversity Avenue NE, Fridley, M11e11 55432
7b3-572-3604 F'AX: 763-502-497?
��
— - ----_ -� __ _ _ _. �ity ofFri�ley $�esidential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
�SIDENTIAL PERMIT APPI,ICATION HVAC
= NEW HOMES/ADDITIONS u EXISTING HOME - MAKE-UP AIR
REOUIRED_ FOIt NEi�V/EXISTING HOMES
1. Gombustion Air (See note below)
a. Oil or solid fuel IMC Cliapter 7 with MN Amendments
b. Natural Gas ar Propane/IFGC Chapter 3 with 1VIN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Ftiel other than gas IMC Chapter 8 vvith MN Amendments
REOUIRED FOR NEW IiOME5
4. Heat loss & cooli�lg load per room
a. Required on new constniction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 767.2
6. Duct Design Per IMC 1346.0603.2 �
,_ a AC.C�l�Ianual D-- - ------- ---- - —
NOTE: Centerpoint Energy Mechanical Code Guidelines sofiware may be used for
combustion and make-up air cRlculations.