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PRE 2010 DOCSCITY OF FRIDLEY �> z z 8- y APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE 3 G• �r,. %y GRAVITY WARM AIR: RATE TOTAL Job Address Furnace Shell & DuGct Work $12.00 $ Replacement of Furnace 7.00 7.00 $ $ Department of Buildings Repairs & Alterations -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $ / t ' �'� specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ Y. 0"o and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 $ facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 $ i , L Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn. 19_ � ° � r°^ -- � �U / STEAM OR HOT WATER SYSTEM: OWNER n ✓ Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ USED AS each addn. 50,000 BTU 6.00 $ % ®/ % /•% TO BE COMPLETED ABOUT QIL BURNER- to 3 gal. per hour $10.00 $ ry a j each add. 3 gal. per hour 10.00 $ ESTIMATED COST / l J GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ L. d / 7 OLD-pBUILDING PERMIT NO. PERMIT NO. (�r2 (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures _� x $ 3.00 $ 3_ j ✓ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ AIR CONDITIONING -\1 $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS & REPAIRS $ State Surcharge $ .50 TOTAL FEE $ L 9 . S-4 ROUGH INSP. REINSPECTION FEE Date s (.$10.00) FINAL INSP., - / - ? C Date APPROVAL FOR PERMIT;g r MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. loe Trade Name Iq 1.11, G. Size No. Capacity Sq. Ft. EDR /0S�u BTU HP Total Connected Load o G Kind of Fuel 4;_�5 , lo, BURNER - Trade Name Capacity Size No. Sq. Ft. EDR BTU HP Company y p p I ned By GEfl. SEGG�!',�K �9EP,,l�ir - ;o �Tti1 Tel. No. 1r,Ol XCNIA- MIN 5541 ` INNEAP04 . , 1 d HE4T LOSS CALCULAT9pi% !!!� *eat -heist ri psA•S.H.V.E. HEATING& AIR CONDITIONING CO. MI POLIS, MINN. + s Wires :�� ecmtrLetian No. DOOM Cut. wall 1�:1at6an Yes.._, Reference int. Mail Ceiling Roof c; do j Yes–No tB_ i How Applied ' FI t rs '� L Roam Length width ' f<'Jirxy,s and D - Heig,t yrs–Craekage and Area i F% d77`, Iii yrs Roan width % Height Vo. 3 of pane °;ghis Lf efalCiC• sq.ea y ` V'JtndGn&s slid DOLNS Cf-acka ! ge and Area 0. N,a. I W:.:.. t-,Pght . of of Linea ft. of pane r/y�:rh=s ! of crack sq. ft. I Infiitratior !Coefi Etu GlassCoef Infiltration Btu i Exp. wall Net exp. " . 4'�,S f p• wall Exp, wall �� - r Int. wall F Net ex p• +tea,; - Ceiling:rf a `f✓� Int, wall Floor � -�� � CeiIingr� Total Btu. Floor _ r Required say ft. a _E.D.R.oA. Total $tu.sq i W _ Leader area F1 s'r? oom Length width Required sq. ft. E.D.R. or sq. ins. W.A. f Height Lea area VJirldows and Doors–Crackage and Area j Fl. Room ? Length „ Width - No. E wiGd!{ Height Windows a Height NC• of Lineal ft. Area and Doors–Crackage and Area r of ane of pane fights of crack sq. ft. No, oDa l Height No. of Lineal ft. Area of pane lights of crack s t` �a ft. -27 tnfi ltration Coef Btu _ --Gly+ Infiltration P C Btu Exp. wall f / :. Glass CID _ Net exp, wat f 7f Exp. wa i 1 Int. wall Net exp. wall Ceiling 7 �. _ Int. wail — `floor °� `� <`? Ceiling Total Btu. Floor X'2 _ Required so. ft. E.D.R. orsq. ins. W A. Lea r area Total Btu. _ Required sq. or sq. ins. W.A. Rom Length �r Width "" HeightLeader area ftJindaws and Doors–Crackage and Area F1.� e,. 'S� R°°n' Length 1� wi dth Height " ofoeze i of pane No, of Line ft. i Windows and Doors–Cracks e sht5 i of crack Sa. ft 9 and Area No, w.drn { t of Carte<,gnt ; No.cf i Lineal ft. Area I ®n•s of crack sq, ft• 1 Rf i Itra t i a1 Coef, Btui # l bass l Infiltration ICSBtu . Walt i Glass c v exp. wail '` Exp. wal l17 �, i �. teratl —i f-- � -__ r,.� _I'-� 1'e1 exp, Wal! 4-11,ng �� - Int. wall Ced it iaf Btu. _ Floor fu+reC sa. 't. F.G a ,,. i `7 Total Btu:. HEAT LIM CALCULATIONS HEATING&AIR . ,, r t: 4, 1 , - I - , 6, � M V': L,'� !:,,I Weal 1%o- strips A.S.H. v.E• Construction No - - - - - - - - - - -- - - - - - I�ulation YNirtdaesJg Doors Gutde Out. Wall,Int. Wall Cell" Reference F on Roof Hoar Kind How Appg Yes --No Yes -No 19 i Room j L 4- ength r WII p7-. Height Ft, zcorn t Length Width Heipt VJin011 and Doors-Crackage and Area i Windows and Des-Crackage and area Height No. et Linea tt. e� j c' r -a -,e of pane lights ; of crac. sa. s+, + +;.�, 1 W�drh -� s -t i No. of tinea, h. Area of pane ' ;arm + lights of crack sq. ft. �. i � '' 1 'Coef 1 of i Itrat +sem !" i Glass Btu Coef: Infiltration i Btu r Glass Exp. wall , f ' 40 Exp. wall Net exp. watt Int. wall Net exp. wall Ceiling Floor�� Total Btu_ Int. wail Ceiling Floor Required sag- ft. E.D.R. or sq. ins. W.A. Leader area Total Btu. Required sq. ft. E.D-R. or sq. ins. W.A. Leader area FI. Room I Length Width Height FI.I - Rout Length Width Height E Windows and Doors-Crackage and Area No. Merh Height No. of Lineal ft. Area of re of pane lights of crack sq. ft. Windows and Dwrs-Crackage and Area € No. Width f+rgnt No. of Lineal ft. Area of pane of lights of crack sq. ft. l 6 Infiltration Glass Exp. wall 'vet exp. Walt Coefl Btu C Btu Inflttiattota Glass Exp. wall Net exp. wall Int. wall Int. wall Ceiling Ceiling Floor Floor Total Btu. Total Btu. Required std. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. EXJR. or sq. ins. W.A. Leader area Fl. Room ILength Width Height g Fl, Rron•i Length Width Windows and GLorS-Crackage and Area Height Windows and Doors-Crackage and Area No• W Cth Height No. cf Line alEi3 of pa;.a of pane lights of crack sq. ,• I W oth %,. � No. of Linea. ft_ Area of pane c' t: �-e lights of crack sq, ft. j iCoef, IrfiltratIon Glass i Exp, wall t 'Coef' Btu Btu } lrff i prat i or i , GlassI Exp. wail ? !vet exp. wali Niii exp, welt � _ I-tt. wal! lit. wall I Ceiling -� Floor ? -Ceiling r ' Floor` `�--- Total Btu. Renumed ", flE.D.R. or so. ins. W.A t P?ftPr 1fl Total Btu. GEO. SEDGWICK HTG. &. AIR COND. CO. HOUSE HEATING TEST RECORD ADDRESS 5d/1' CITY OCCUPANT VOWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Electrical Work By Gas Line By ~� '' ii fi TYPE OF HEAT GA_ FA_ HW_ STEAM SPACE HTR. _-UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE MAKE OF BURNER Model 10S 6 104- Model Serial Max. BTU Rating INPUT 0 MAKE OF FURNACE Model CONTROLS THERMOSTAT Heat Plug Valve " ifO 0 Limit 5/0 6 Y4 Limit Setting /R Fan Setting d® 130 Pilot Type Pilot Make Vent Size -S KIND OF LINER Zfl.;� SIZE 6 NONE Draft Hood &Z6L1 (_./_ Regulator Filters Size, ! r2_crz Number Chimney Location Inside 4"'0'- 1 Outside Chimney Construction Pilot Model Smoke Bomb Wiring Pilot Timing Y -® Draft CLQ Test Tag L.W. Cut Off- ��� 3 Door Pressure Lighting Inst. Pressure 3.7 Percent CO 90 X6 % �' Date Tested /V m — 7 Input CFH ! ®S Percent 02�•O �' 67 Company Testing Stack Temp. ���� Percent CO O.D c,`' C' ® Name of Tester Form 235 CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE �_ x $3.00 q. NO. RATE >, m % x m $ o _ x x N New Fixture, Old Opening Water $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU a y O 100,000 BTU to 199,000 BTU y 01 w C x Heater d1C C, -1 a+ k .� $5.00 N a Electric Water Heater H •� ro c to 3 o N u•.c+O4 ro $4 P. ovroi c x c' N .� 7 O 0 ci i0, z of 14 W to N toa ro ►+ o ❑ W C W W ro ro U W D ro S ro U.i -� ro +' O as lec N U 7 W m y 3 1st 2nd 3rd Sth (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE �_ x $3.00 PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures % x $3.00 $ Future Fixture Opening _ x $2.00 $ , 0-0 New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU �_ x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures �_ x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ • aS - - REINSPECTION FEE ($10.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicat' n are true and correct ey, Mn. , 19?_ OWNER P::12 /'/ 6 KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. ROUGH INSP. Date Company A(' Signed By Tel. No. 17('-V— Y7� FINAL INSP. 16 - -7- Z Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 City of Fridley SUBJECT kPE 113678AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • ______ COMMUNITY DEVELOPMENT DIV. r L PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 812-580-3450 910-F15 18/3/76 JOB ADDRESS 301 Liberty Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Spring Brook Park 2nd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE The Rottlund Co., Inc. P.O. Box 32082, Fridley, Mn. 571-2060 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESSzIP PHONE LICENSE NO. L" SAFETY CONTROL ZONE" VISION OR Pi ACE ANT, 6 USE OF BUILDING L)U JIM pLAN:g UT AP4 INORifl THING F a+ ResidentialpgoOF THE CITY OF 7 CLASS OF WORK 1 . NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ EMOVE 8 DESCRIBE WORK Construct a 28' x 36' Dwelling and a 28' x 22' Garage NOTIFY THE FRIDLEY ENGR. S PERRTE P`ER( IT5 REQUMED FOR WIRING, E VAL AND REpLAGEMENT REMOMO 9 CHANGEQFmE4fflNGv PLUMBING AND SIGNS.TO AT PENINGS' STIPULATIONS provide a hard surface driveway.Provide sod in the front and side yards. Provide a verifying survey before capping. Provide City with copy of truss design. SEWER LOCATION: 47' West of Manhole (W. Inv. 844.64) (Top Manhole 854.54 Approx.) WYE ELEV: 844.89 at centerline TOP OF FOOTING: 847.89 WATER LOCATION: Approx. 37 feet West of Manhole THE CITY OF FRND * DOES NOT GUARANTEE THL 'WARNING ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS. THIS DATA IS FOR INFORMATION PURPOSES ONLY AND Before digging call local Wi#ies PERSONS USING IT SHOULD VERIFY THE INFORMATION TELEPHONE • ELECTRIC - GAS Etc. ON THE SITE. rOUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood TP*ra-- THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 1104 + 512 21,304+5120 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $34, 585 $17.29 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $105.73 $350.00 STRUICTION O HE PERF RMA CE OF CONSTRUCTION. III of t9za> 7-7'/eY' , PLAN CHECK FEE TOTAL FEE L -7 26.43 $499.45 SIGNATYREOF CONTRACTOR 6R AUTHORIZED AGENT (DATE) HEN PERLY VALIDATED THIS IS YOUR PERMIT at ®� BLDG. INSP DATE • SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) m r 5ewec o 4#7 ' 4,jesr OF m I-1 pppoow 37' a). aG /4/1.4. S*o£ivxn R L'of v rv. /h. 1.4 vi.Vuw. Al •/�. x' 16 GvY� 8oV int,3. ?aP aoc Foorm) d. 84/17.89,. THE CRY OF FRIDLEY DOES NOT GUARANTEE ACCURACY OF UTILITY LOCATIONS AND ELEVATIC T DATA IS FOR INFORMATION PURPOSES ONLY 4 USING IT SHOULD VERIFY THE INFORMAT ON *E SITE ,1. CITY -OF FRIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, `-p-r' ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAME :df �F1Y 1,J 01 _ BUILDER: 7,1, II /,I c{ Chi , ADDRESS: ADDRESS : A O SOX 3 2 Dg:2--' NO:. .3®% STREET : �/, P r• %'"y Al. E. LOT: BLOCK:_ ADDITION:A`%ck-!a CORNER LOT: INSIDE LOT: SETBACK: 3,S— SIDEYARD:/,7 ! -1.- i ° Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: S 141,a .e #6 vS e- Front: Zg ` Depth: 36, Height: _A, Square Feet: // O Y Cubic Feet: 310 54 todA A Front: 2 $' Depth: Z Z Height: Square Feet; .;:& Cubic Feet• �, Z d Type of Construction: ry-A" -e- Estimated Cost: To Be Completed: AI/ors. 197k �✓�� �d The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. o DATE: `% % 74; SIGNATURE: iJv pS, v (See Reverse Side For Additional Information.) Xadeac c pry 0+rAt a of mit=s� ¢� , � EXTERIOR ENVEjLOAPE AVERAGL•' "U" C011IPUTATI014 — • <" "-.-- // ` 0 � S• M S T"v Epp O'tJ:3Ef:: DATE ___'7=_.15 - SITE ADDRESS. �0 � i.! lr�rX ST. _ PRONE: 6-7— Zo60 Total exposed wall area above floor = a. Total wall window area .....................•..........• I�9 b. Total door area ........ c. Totalsliding glass door area. ......................... d. Total fireplace wall area.. ............................ e. Total wall framing area (average 10%) ............... i f. Total ILM joist area ..................L--` 6.0 g •_-rN5vde%--e d gall area above CONTRACTOR: -j'h -e. %�OTi � U N �0 • N , h. /1ve f wall. Determine workin¢�q�iare footage of each 3` • 1. Total exposed wall area ...:.. _15 _y yj 1 sq. uIPTe floor.zN.s ............. j v r' - wall 2. Toal roof/ceiling area ...... 1 Ci of ,nn sq. ft. x .05 = Srd Total exposed wall area above floor = a. Total wall window area .....................•..........• I�9 b. Total door area ........ c. Totalsliding glass door area. ......................... d. Total fireplace wall area.. ............................ e. Total wall framing area (average 10%) ............... i f. Total ILM joist area ..................L--` 6.0 g •_-rN5vde%--e d gall area above floor f���t t2�s' .�v�t K.: T:..... . h. /1ve f wall. area above floor.^l5&47-J .............. 1. - a 3� 00 • wall area above uIPTe floor.zN.s ............. j v r' - wall area above floor =!�5u� °T`.�r.............. • . Total exposed foundation area = /f t,4f4 Ir.,l � D k. Total founc�ati.on window area ........................... 1. Ti'otal net foundation area above grade ................. _ 76.67-- Total 6-bZ Determine "U" value of each wall segment (e.g. window, door, each separate wall section) a. 9�5 9/ X "U" b. d. — X Hull _ A. 7d e. � �•X ];ull f . _ 9� • o o X "il" —2057 h. na X „U„ If item #3 is the sar►e as, j. �• o U X "tt" _ 0 — - _ �• 9'' or less than item #A, you have mtat tlic intent. Elf czBr C,00G (c) 2. 1. -7 G, C) z- X " -7 = 3. ................... To Lal _ Yv� v-� Exterior Envelope Average "U" Computation Total exposed roof/ceiling area = 400 m. Total skylight area ............................ n. Total roof/ceiling framing area (average 10%) ... / 00. $O o. Total net insulated roof/ceiling area........... 2'0 7.,2 O Determine "U" value for each roof/ceiling segment "U" _ M. X �j / n. /00, b 0 X stuff 'e),3 v .�. 6 o. 70 7, ao x ',U„ 4 ........................... Totai = 3 /. 7 L/ n,-- 1 —F A Page 2 of 4 If total of #4 is the same as, or less than #¢2, you have met the intent of SBC 6006 (c) 1. Alternate Building Envelope Design To utilize the total envelcpe system method, the values established by the items #3 and #4 shall not be greater than the sum of items ¢1 and #2. r 1. 3 3•�3 + 2. 50. V 0 = 2. _ 3. 324. #g +4. 31. %4/ � • J3-, 9 z T;' • OG2 U of (:S/aYA9e wAI �NT�rcor Arm f`r lM .i NTS, Jnr A rr /M • %Z ,jC/ IS. ) aha%rr - rr7� 7 Ao-- Ft 1AA • �"�� /y y8��' J3-, 9 z T;' • OG2 U of OAtJ/ Aye -A �NT�rcor Arm f`r lM 6 �' IS. ) Ao-- Ft 1AA • �"�� /y y8��' •06'7 / Uze 10% of opaque wall area for r f-rame construction EIALL FIG. 91 FRMB i TALL Page 3 of 4 Construction R -Value 1. Interior air film 0.68 2. l� cSI(ri-T ro ek ya 3.------------ j YAnn iN y y _ 3 4. I 5. IN !p 6. Exter br air f ilm 0.17 Total $ gS A� •��3 v 1. Interior air film 0.68 2. A 3. c3 yd 4. 5• L NSa/i'7Y Si�i.v 6. Exterior air film 0.17 Total /S J O /�, •abs v 1• Interior air_ film 0.68 2. 3. 4. 3a 5. �// J2 6. Exterior air film 0.17 Total , 7 , R U 1. Intorior air film 0.68 2. 3 Yi 3. a' 'D 4. �r 11,E • / % 5. 6. Exterior air film 0.17 Total / U e, li! i NOT)": Indicate 1.ne, r,v.31uc, dcntL and •_ ROOI'/CEILING 1'entEd Lleat flow r 1 up FIG. 5 Tamil"-��:�_._-�__::�_.=�•___�— `'�tc•r�-4.t^�� Meat_ flow up vented t T r a • .FIG. 7U • ... f 0 1� 26 WRI • Hent • flow up P�an of 4 Page 4 of 4 Construction R -V_ slue 1. Interior air film 0.61 2. 3. d.av 4. Exterior air film (still) 0.61 Total 3/. 77,'? '03/ fJ 1. Interior air film 2. 0.61 3 . ..L .11�t��l rf�T rL 7 7 4. Exterior air film (still) t Total •o36u I. Inside air film — 0.61 2, . 3. 4. 5. Outside air film - - 0.17 Total Note: Use additional sheets if more space is needed for details and calculations SUBJECT - P O. a City of Fridley 30923 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 i �_ �� __ COMMUNITY DEVELOPMENT DIV. n r PROTECTIVE INSPECTION SEC. tL � 1 ; i N ;O A REV DATE PAGE OF APPROVED 8Y 1 "'1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/9/00 JOB ADDRESS 301 Liberty Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Spring Brook Park 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jacqueline Barragan 301 Liberty Street NE 763-783-5888 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION] ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Interior alterations to basement 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. S BERATE PERMITS QUIRED FDR: BIG(; HEATING PL MWIRING SaG SEPARATE PERMITS ARE Rg.OUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,500 $.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL EE $ .25 SIGNATURE OF CON TRACTOR OR AUTNORiZED AGENT DATE- ENP P R LIDAT HIS IS YQJAELP IT SGNATURE OF OWNMIF OWNER B ILOER, iDATE 8406 NSP pA TE It NEW [ ] Ef%ctive 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 J BUILDING PERMIT APPLICATION Construction Address: -90% Legal Description: Owner Name & AddresszTel. # '7(0.x-,72'3 -6-S'R-d' Contractor. MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: ke/voot/ Estimated Cost: $ 7/3-0U . CSV Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT:ITel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ �x"�'/ • 00 Fee Schedule on Reverse Side Fire Surcharge $ j® .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge' $ $1100 per SAC Unit License Surcharge $. Driveway Escrow Erosion Control $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above Park Fee $ $450.00 Conservation Plan Review Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: . . n CITY OF FRIDLEY INSPECTION DIViSION Effective On May 10, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 30/ RATE SCHEDULE OWNER —,& Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas.Dpjer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. TOTAL v BUILDING USED AS_�j: ESTIMATED COST �rJ PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are'true and correct. $2,� HEATING CO,�- Signed DATE 7� Approved By Rough -In Date Final Date CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration 3. 4. 5. 6 Has no foreign objects lodged within Is securely supported Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of Yes () No ( ) Yes () No ( ) Yes () No ( ) Yes ( ) No ( ) All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent . Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On May 10, 1999 JOB ADDRESS_; OWNER TOTAL BUILDING USED AS�.�:`�, ESTIMATED COST PERMIT NO.__=�1 l DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units ircle One (Steam) (Hot Water) (Warm Air) $ Trade Name -sem + !` -_ _T_ Size No. BTU HP EDR $ Fuel „uL Total Connected Load Burner Trade Name Size No. $ BTU HP EDR $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are•true and correct. HEATING COG Signed DATE 0__� Approved By Rough In Date Final Date CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that.the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration- :: Yes O No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely. supported Yes O No ( ) 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Yes ( ) No ( ) Yes () No ( ) Yes () No ( )