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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT NAs 12 Date:• % .+r..r: 1► Owner: Builder Address Address r IPC 4N • BUILDING No. .. Street Lot _ _ __ Block _ , _ Addition or Sub -Division . Corner Lot Inside Lot Setback -��—_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To A Usedae Front Depth height _ Sq. Ft. Cu. F Depth eight Sq. Ft. Cu. Ft. Type of Construction r Est. Cost' 9 7�•- T be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of 2 49 - ' permit is hereby granted to 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' hereof, shall conform in all respects to the ordinances of Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings within the city limits and permit may be revoked at any time upon violatig�i of any of the provisions of said ordin Building Inspector NOTICE ThIs peemtt does not ewer the eonstrue8oe, hntaffedan for w1ring, phumhfna, on hoatino, sorer or wafer. Be sun to see the BWMiaa lespator for separate pwmhs for than hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name�(" L(' 1 ��. L. �. Builder Via d V' ,� � � ®V► S� �` Address Address ® LOCATION OF BUILDING _ 1 No. 2- S Street Part of Lot Lot 3 _BlockAddition or Subdivision lr j o l.� ► h L S Corner L-ot_Inside Lot--4—Setback �� Side -Yard SEWER ELEVATION FOUNDATION ELEVATION 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; °�-�--1- —Front 3 Depth a 5� Height Sq, Ft. Cu. Ft. 1s,A ci Front Depth Height Sq. Ft. Cu. Ft. Type of Construction �°(1('j VVi Q,)_ Estimated Cost/ !0®C� <>_ To be Completed 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. DATE go �� SIGNATURE60A l (Schedule of Fee Costs can be found on the Reverse Side). '? MIow" 8.8446 r TWIN CITY TESTING AND ENGINEERING LABORATORY, INC. ENGINEERS AND CHEMISTS '��'� 2440 Franklin Avenue - St. Paul 14, Minn. *10�, REPORT OF: INVESTIGATION OF EXCAVATION e RESIDENCE PROJECT: 5225 LINCOLN DATE: September 49 19,62 FRIDLW 'MINNESOTA REPORTED O: FURNISHED BY: Edwards Construction Gomparwyy COPIES TO: Building Inspector 4805 Idaho Minneapolis, M i.nnesota Fridley, Minnesota LABORATORY No. 6.619 On Axigust 31, 1962 we investigated the building site at 5225 JAnooln St., Fridley, Kizmesota. The building dte` was excavated and laid out for a split-level house. The norththal.f of the site, :-upper. level, was filled with brown sand mixed with some reddish brown loamy sand. The south half, lower level, was excavated to the natural ground, mostly dark brown to brown sandy loam wl h was saturated to approximately 18" by, recent r" ' all. Four hand -auger borings were put down, two in the upper level rind' two in the lower level, and two field densities were taker in the fill of the upper level. LOGS OF BORINGS: Boring No. 1, located at N.E. corner of upper level. 0 - 31 Fill, brown sand mixed with reddish brown, lorry sand. Boring No. 2, located at i.W. corner of upper level. 0 - 31 Fill, brown sand. Boring No. 3, located at N.E..00rner of lower level 0 - 41 Brown sandy loam Boring No. 4, located at S.W. corner of lower level. 0 - 21 Black sandy..loam with some organic matter saturated with water. 21 - I Dark brown sandy loam 3 4I Brown sandy' loam The field density (see attached report) was 96 and 97% of the Standard Proctor density, 95%' field density of the fill should be acquired for normal footing loads. In the lower. level Portion, the bearing capacity of the sand loam soil was reduced by the water saturated condition. This 2 foot saturated layer of black sandy loam should be removed and replaced by compacted sand -fill to, give a uniform sandy soil laer to support the entire building, Compaction of this sandy fill to 95% density would be easily achieved by a vibratory compactor, AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL REPORTS ARB SUBMITTED AS THE CONFIDENTIAL_ PROPERTY OF CLIRNTS. AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS, CONCLUSIONS OR EXTRACTS FROM OR REGAROLNG OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL Twin City Testing and Engineering Laboratory, Inc. By '� TWIN CITY TESTING mm ENGINEERING LABORATORY, ENGINEERS AND CHEMISTS 2440 Franklin Avenue - St. Paul 14, Minn. REPORT OF: Density Tests of Compacted Fill - RESIDENCE ; , PROJECT: 5225 LINCOLN FRIDLEY, MINNESOTA REPORTED TO:Edwards Construction Company' 1805 Idaho Minneapolis,,, Minnesota LABORATORY No. 6 - 619 Test Method: Test Number: MIowAY 21.6446 INC. 1 Irv, DATE: September 4s 1962 COPIES TO: Building Inspector Fridley$ Minnesota, ASTM Designation: D 1556-58T 1 2 Type Soil: Brown Frown medium medium sand sand Location: 13' South and 41 East 15' South and 1' West of Northwest corner of Northeast corner Elevation: approximately 2► above approximately 2' below. street level street- level . Dry Density: —i Basis ;y!/cu-ft- 107 1.08 Overall Basis TWcu-ft- ii5 115 ,roctor Density: 7�� ) Basis/cu.ft. 111.5 111.5 Relative Density: (--,,%4). Basis (o) 96 97 Specified Density: -Basis. ,,) 95 95 (+ 4) material: 18 6 Moisture Content: (,) 8,0 6p0 Remarks: These tests were taken at the above locations on august 318 1962. AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES. ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR- IZATION FOR PUBLICATION Or STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS It RESERVED PENDING OUR WRITTEN APPROVAL Twin City Testing and Engineering laboratory, Inc. By f MlowAY 5-6446 TWIN CITY TESTING AND ENGINEERING LABORATORY,,,, INC. ENGINEERS AND CHEMISTS V� i d"' 2440 Franklin Avenue - St. Paul 14, Minn. 1h . +� �REPORT OF: PROCTOR MOISTURE DENSITY TEST RESIIENCE PROJECT: 5225 LINCOLN FRIDLEY, MINNESOTA f DATE: September !t, 1962 REPORTED To -Edwards Construction Company FURNISHED BY: 4805 Idaho cOP1E8 TO: Building Inspector Minneapolis, Minnesota Fridley, Minnesota LABORATORY No. 6-619 SLE NUMBERt 1 TYPE, SOILt Brown medium sand METHOM Standard Proctor, ASTMsD 698-58T Method 11A" OPTIMUM MOISTURE: (-, Basis) % 13.3 MAXIMUM DENSITY: Basis) Lb. cu.,ft. 111.5 REMMS: This sample was taken from the above jobsite by Twin City Testing and Engineering Laboratory, Inc. -on August 31, 1962, AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL REPORTS ARE SUBMITTED As THE CONFIDENTIAL PROPERTY OF CLIENTS, AND AUTHOR- IZATION FOR PUBLICATION Or STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL Twin City Testing and Engineering Laboratory, Inc.. ■■■■r■■■■■■■■■■■■t■■■sa■■■■■■■■■■■■■■■■■■■■■�■■■■■■■�im■■■■■■■■■a■■■■■■ ■■■■■■■■■�■■■■■■■■■■■■■■■■■■■■ria■■■■■■■■■■■■■■■■■�■■,�■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■��■��/■■■■■■i■■■■■■■■■■i■■■■■■■��■■■■■■■�■■■�■■■ii■■■ ■■■■■■■■1r■■■■■■■�■Iii■■■■■■■t■■■■■■■■■■■■�■■■4■■■■1■■■1■■■■■1\\■■■■■■ ■a■■■■■■■■■■■ru■■■■■■■s■■■■■■■■��■■■■■��■■■■■■■■■■■■■■■■■�■■■■ ■■■■■■■■■■■r�■■�■■��■■■t■��■■■�■■■■■■■■ice■■■■■■■�■■■■■■■s■�■■■■■■■■■■ ■■■■■■■■a■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■[■■■■■■■■■■■�r■■r■■■i■■ TWIN CITY TESTING AND ENGINEERING LIABOUTORY, ENGINEERS AND CHEMISTS 2440 Franklin Avenue - $t. Paul 14, Minn. P REPORT OF: INVESTIGATION OF EXCAVATION RESIDENCE „ PROJECT: 522-5 LINCOLN FRIDLEY,'MINNESOTA REPORTED'PC�`�"'��"� Edwards Construction ComparjV 4805 Idaho Minneapolis, Minnesota LABORATORY No. 6-619 DATE: September 4, 19,62 FURNISHED BY: Mlowmf 88446 INC. 0 rip � � m COPIES TO: Building Inspector Fridley, Minnesota On Attttst 31, 1962 we investigated the building site at 3223 Lincoln St., Fridley, Mi.amesota. The building site was excavated and laid out for a split-level house. The north,,half of the site, :uPPer level, was filled with brown sand mixed with some reddish brown loamy sand. The south half, lower level, was excavated to the natural ground, mostly dark brown to brown sandy lova wh h was saturated to approximately 18" by.., recent rilibf'all. Four hand -auger borings were put down, two in the upper level, and' two In the lower level, and two ' field densities were taken in the fill of the tapper level. LOGS OF BORINGS: Boring No. 1, located at N.E. corner of upper level. 0 - 31 Fill, brown sand mixed with reddish brown loamy sand. Boring No. 2, located at N.W. corner of upper level. 0 - 311 Fill, brown sand. Boring No. 3, located at N.E..00rner of lower level, 0 - 41 Brown sandy loam Boring No. 41 located at S.W. corner of lower level. 0- - 21 Black sandy loam with some organic matter saturated with water. 21 1 Dark brown sandy loam A :4 1 Brown sandy loam The field density (see attached report) was 96 and 97% of the Standard Proctor density. A 90 field density of the fill should be acquired for normal footing loads, In the lower level .portion, the bearing capacity of the sandy loam soil was reduced by the water saturated condition. This 2 foot saturated layer of black sandy loam should be removed and replaced by compacted satmi'fill to` give a uniform sandy soil layer :to support the entire building, Compaction of this sandy fill to 93% density would be easily achieved by a vibratory compactor. AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURBELVEB, ALL REPORTS ARE SUBMITTED AS THE CONrIOENTIAL PROPERTY OF CLIENTS. AND AUTHOR- IZATION FOR PUBLICATION Or STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS 18 RESERVED PENDING OUR WRITTEN APPROVAL Twin City Testing and Engineering Laboratory, Inc. By f TWIN CITY TESTING AND ENGINEERING LABORATORY. ENGINEERS AND CHEMISTS d'wa.o'°�sy 2440 Franklin Avenue - St. Paul 14, Minn. REPORT OF: Density Tests of Comnacted Fill, .,-...� MIcwAY 5-6446 INC. -t4W RESIDENCE PROJECT: 5225 LINCOLN DATE: Septer4ber 4., 1962 FRIDLEY, MINNESOTA REPORTED TO: Edwards Construction Company' COPIES To: Building Inspector 1805 Idaho Fridley, Minnesota Minneapolis., Minnesota LABORATORY No. 6 - 619 Test Method: Test Number: Type Soil: Location: Elevation: Dry Density: Basis ;r/cu.ft. ASTM Designation: D 1556-58T l 2 Br own medium sand 131 South and 41 East of Northwest corner approximately 21 above street level 107 Overall Basis '%cu -ft, ii5 Brown medium sand 1.51 South and 11 West of Northeast corner approximately 21 below street. level, . 106 115 Proctor Density: Basis�=/cu.ft . 111°5 111.5 Relative Density: (-#+ . Basis (,) 96 97 Specified Density: Basis . �) 95 95 (+ 4) Material • (%) 18 6 Moisture Content: (,) 800 6.0 Remarks: These tests were taken at the above locations on August 31., 1962. T14 AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES. ALL REPORTS ARG SUBMITTED AS THE CONFIDENTIAL PROPERTY OF C41ENTR. AND_AUTNOR. IZATION FOR PUBLICATION or STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL Twin City Testing and Engineering laboratory, Inc. By MIDWAY 5-6446 TWIN CITY TESTING me ENGINEERING LABORATORY, -,INC. Nc6& ENGINEERS AND CHEMISTS >" s"' 2440 Franklin Avenue - St. Paul 14, Minn. REPORT OF: PROCTOR MOISTURE DENSITY TEST RESIDENCE sS� PROJECT: 5225 LINCOLN FRIDLEY, MINNESOTA ,. DATE: September lis 1962 REPORTED TO:Edwards Construction Company FURNISHED BY: h805 Idaho COPIES TO: Building Inspector Minneapolis, Minnesota Fridley., Minnesota LABORATORY No. 6-619 SAMPLE NUMBER: 1 TYPE ,SOIL: Brown medium sand m METHOD! Standard Proctor, ASTM:D 698-58T Method "A" OPTIMUM MOISTURE: Basis) 13.3 MAXIMUM DENSITY:. (-hQ4 Basis) 5 b. cu.ft. in. RMS: This sample was taken from the above jobsite by Twin City Testing and Engineering Laboratory, Inc -.an ,august 31, 1962. AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES. ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIEMT8. AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL Twin City Testlnq and Engineering Laboratory, Inc. By r __ ■►11A�r�\■■�1��■�1■t1■■i�Y�■■f�f��■■��r�1�1■�Yr■■Ur�rr��li�r�i�1��i ■>■�r��■��t��tt��l��t►■1��■1�r��■■��<r■r��I��r�M��r�r��i�rf ■■r■�t■1■■��r�t■��■i��■1�1��■■■�t��■■t■■��<rrl��,t1��r�r��■\��r■ ��■�■�l■t1�i��■R1��r��►1�■■��iilr�trt�r��■■��1�rt��wr��■ ■�t■1�tt��■\��■■r��i��■t�t■��i�■t■t■>��s��r�■��A��S��1rr��■ ■■i�1��■■A�■t�■��\■err■�\��t��■■r■\■r��1��■■■■�r��■\��■r��■ ■/■X11■■�<■��f■■it■��11��■■�<r�■�r��r�1��r�1(■■��■ ■�l■r��\1t��It��s��t��■■��■■�11��t■■�r��1r�1■r<r��f�■ :::::::::::::�:C:��::',C�::C�:::::::::C:::::C:::::C::::::::::'•:C�:::�: ....�....�...................�................o.......................� ■■\i■■��■�t��<L��■■��r■��t■wi��■■��r��t��■■■■Ir��rl��r.V��r■ ■�■■■■■■■■■..■�A■■.■■■■■■.■�■■�■■�■r�.■��.��■�i��.■■■��■ i��■■�At\t■��1�■i'��I■11■■■�\1�t1�r■■��rt��r��1rt��t<r��■ 1�i�1��1��■■w�r�■■��1■t■�/■�L��■'fir■■i��t■■r��r■/��/�■ ■��■■1t■�■��t■\■ ■1��i■■t■■ft��r�t��rrlr ■rr��t■■r�»��f�rx City of Fridley Application for Plumbing and Gas F•rtting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location 1 NO. RATE TOTAL Number Fixtures ...................... ii $ Future Fixture Opening ................ x 1.20 /yam• eS'i� $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... (0Z •F `N WATER HTR. GAS ELEC. x 3.25 $ 6613 - Base 1st 2nd 3rd 4th • Future Connection Openings Connected with Sewer KA * New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... —� x $1.50 $ Future Fixture Opening ................ x 1.20 /yam• eS'i� $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn. �® 19_U Owner Poe Axo.® Kind of Building Used as Z)W IC -A4 dmf To be completed about / "1—a—v - Estimated Cost, $ AS Old w. B - ding Permit No. CD / � Permit No. Signe Business Pho a No. e % –rlr-r® ROUGH dl GAS FITTING FEES: NO. RATE TOTAL FINAL 1st 3 Fixtures .......................... x $1.50 $ % NCO Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS --Refer to Code Description ................................. $ TOTAL FEE $ e z 2M /z Lye Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .. 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 pp �� $--2— Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour . ..................... 5.00 $ e over 3 gal, per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 6 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ............ x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SII 4-7470 l City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are �e and correct. Fridley, Minn— /V inn �v� 19LP 3 9 Owner syi Kind of Building Used as To be completed about Estimated Cost, $ /3 ® ® / ew uilding Permit No. �2 �� % Permit No._ opt oZ to �--J DESCRIPTION OF WORK BEATING -or POWER PLANTS—Ste HoDWate>arm Air—No Trade NamP Size No� Capacity Sq. Ft. E.D.R �j ® BTU H.P. Total Connected Load 2 Kind of Fuel 9%i� BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R I BTU H.P. (REMARKS -OVER) 42 iM Business Phone HEAT LOSS CALCULATIONS DEPARTMENT OF UILDINGS MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling I Roof Floor Kind How Applied e No 1�N 19— F1.1 Room Length �j Wi th .,2 Height Fl.� Room Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Z it Coef.1 Btu Infiltration / / Q Coef. Btu Infiltration Net exp. wall Int. wall (; 14 0 Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Lenath Width Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. az 44 it Coef.1 Btu Infiltration Glass JCoef.j Btu Infiltration Net exp. wall Int. wall (; 14 0 Glass Floor To / 3 2 -,TO Exp. wall /0 4! f S� X D Net exp. wall /d Ceiling j s Floor 37 x a-(" Total Btu. I(off / $ 2�- Required sq. it. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Heisfht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq.ft. lCoef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Heistht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp: wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I 1' 1),36 9 ,�� ` e., HEAT LOSS CALCULATIONS V DEPARTMENT OF BUILDINGS . MINN. T1 Go Luusau Siva Windows Dc Yes—No I Yes. Windows and Doors—Crackage and Area Doors—Crackage and Area l Width Height No. of Lineal ft. Area No. of pane or pane lights of crack sq. ft. 38 3Z �. v , .2000 Exp. wall Coef. Btu Coef. Btu Infiltration e6o Glass f 150 // 6 6) Glass -Ox 8 ImL 0 Net exp. wall 157120 Exp. wall /,5'70 Int. wall Int. wall Net exp. wall Q 0 S12.0 Floor Floor Int. wall 57 Floor Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I /,f '&&tQ M F1.1 1W Room l Length // Width /0 Height 9 Windows and Doors—Crackage and Area Doors—Crackage and Area Ab Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No.of pane of pane lights of crack sq. ft. �. v , .2000 Exp. wall Coef. Btu Infiltration Infiltration Am e6o Glass f 150 SS® Exp. wall(/ -Ox 8 ImL 0 Net exp. wall 157120 /6 /,5'70 Int. wall Int. wall Ceiling Q 0 S12.0 Floor Floor U.;.ht S9 57 Total Btu. 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area j 5,xv M R.l '9-- 77-- Room I Lenath Width / 44 Heiaht J? Windows ag Doors—Crackage and Area Ab Width Height No. of Lineal ft. Area No.of pane of pane lights of crack sq. ft. �. v , .2000 Exp. wall Coef. Coef. Btu Infiltration 46 P-0 0e-0 Glass 40 5,0 A00-0 Exp. wall ImL 0 Net exp. w Net exp. wall /6 /0 / Int. wall Ceiling Ceiling 0 S12.0 Floor Floor U.;.ht S9 57 Total Btu. 4? 70 Reouired so. ft. E.D.R. or so. ins. WA. leader area I 2A &w Windows and Doors—Crackage and Area Ab Width Height of Lineal ft. Area No. lig of pane of pane lights � of crack eq. ft. .3 / 3 ; �L /QV �` .2000 Exp. wall Coef. Btu Infiltrations Net exp. wall 46 /2-000 Glass Int. wall 5'0 .2900 Ceiling 0 Net exp. w Floor /6 .23*0 Int. wall Total Btu. Ceiling Z, /n S12.0 Floor / A U.;.ht S9 Total Btu. 1 9(o ir® Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl.l ' /4' 'Room I Length Width /Z Height Windows and Doors—Crackage and Area Wldth Height No. of Lineal ft. Area No. of pane of pane ltghte of crack eq. ft. �.Z 2. 1 7 2-4, 0 0 Infiltration Ab j S11-0 Glass �` .2000 Exp. wall Coef. Btu Net exp. wall .2 / Z Int. wall Glass Ceiling 0 : 't900415 Floor R Total Btu. 6 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / e TV"M I A .o 7 D_ 11 - ...1. 1 h W.AtL / A U.;.ht S9 UE Windows and Doors—Crackage and Area Width Height No. of Lineal Area No. of pane of pane lights of crack eq. it. Coef. Btu Infiltration .2 09#6 Glass Exp. wall (j Net exp. wall 6 Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1)•56 s n s HEAT [ASS CALCULATIONS DEPARTMENT OF BUILDINGS M. MINN. iiA.S.H.V.E. 16Weatherstrips Guide Construction No. Insulation Windows Doors Reference 11 Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied Yes—No I Yes—No 11 19— X432 Rnnm I Lenath C' Width /A Heiaht V II �f' Fl_I _ Room I Length )S— Width 16 Height AP Windows and Doors—Crackage and Area C)Width Width Height No. ofLineal f . Area No. of pane of pane lights of crack sq. ft. 18 '38 Coef. Btu Coef. Btu Infiltration Infiltration 10 Glass 3 ("' S® Exp. wall J" 0 0 0 Net exp. wall I 8 A70 Int. wall Net exp. wall e Ceiling is' -0 0 Int, wall Floor e�' A160 Total Btu. I8 fo p Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1°""Fl.1 7 S_ Room l Lenath -? Width /_ Heisrht S� Windows and Doors—Crackage and Area C)Width Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. O �t J Coef. Btu Coef. Btu Infiltration Infiltration O Glass 3 ("' 0 Exp. wall gor-► J" 0 0 0 Net exp. wall �0� /00--0 Int. wall Net exp. wall e Ceiling is' -0 0 Int, wall Floor e�' �0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I 1 I�E7 U- Room I Lenath I l Width I A Height 9 Windows and Doors—Crackage and Area C)Width Heightof Lineal ft. Area No. of pane of Dane lights of crack eq. ft* O �t J Coef. Btu Infiltration Coef. Btu Infiltration Infiltration 3 3 3 ("' Glass j 3 2-0 J" 0 0 0 Exp. wall / Q + toy, �0� /00--0 Exp. wall Net exp. wall e 1 1 is' -0 0 Int, wall e�' L Ceiling ogle,® Int. wall IX9® Floor 0 Ceiling 0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I /® r Windows and Doors-Crackage and Area ��r�(�/ �//)� LO Width Height No. of I.Lineal ft. Area No. of pane of pane lights of crack sq. ft. O �t J Coef. Btu Infiltration Coef. Coef. Btu Infiltration 3 3 Fee) 40 j 3 2-0 Glass Ceiling ZD 51 /00--0 Exp. wall Net exp. wall %90 1 1 P j Net exp. wall e�' L % 0 V Int. wall 20 Floor AA 34 41A Ceiling 0 f s`Q f? / 0 Floor Ir 226,00 Total Btu. (0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I zo IdeLt -7-M.I Aed Room I Length W Width /6 Height,? Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eQ. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. /g �► Coef. Btu Infiltration Coef. Btu Infiltration ,2 410 Fee) Glass Int. wall Ceiling Exp. wall / O X 43 Net exp. wall )39 1 1 P j Int. wall Ceiling q0 20 Floor AA 34 41A 0 Total Btu. i Y° Required sq. ft. E.D.R. or sq. his. W.A. Leader area F1.I Rnnm I Length Width Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eQ. ft. Coef. Btu Infiltration Glass - Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ..a , � _ i ,.J.ij_.L.I APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 RATE TOTAL $12.00 $ 7.00 $ 7.00 $ 4.00 $ Job Address Department of Buildings City of Fridley 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 $ specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ and rulings of the Department of Build!.ngs, and hereby declares that all the Replacement of Furnace 7.00 $ facts and representations stated in. this application re true and correct. Repairs & Alterations -up to $500.00 7.00 $ P Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn. , 191 STEM OR HOT WATER SYSTEM: OWNER Boiler s Lines up to 100,000 BTU $12.00 $ KIND OF BUILD G each addn. 50,000 BTU 4.00 $ t Boiler only up to 100,000 BTU 7.00 $ USED AS each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT OIL BURNER- to 3 gal, per hour $10.00 $ each add. 3 gal. per hour 10.00 $ ESTIMATED COST GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ OLD - NEW BUILDING PERMIT NO. PERMIT NO. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ DESCRIPTION OF FURNACE/BURNER Additional Fixtures X $ 1.00 $ Gas Range to 199,000 BTU X $10.00 $ HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. AIR CONDITIONING $ Trade Name size No. FAM HEATING SYSTEMS VENTILATING SYSTEMS See Fee Schedule $ $ e� Capacity Sq. Ft. EDR BTU *4:&- HP ALTERATIONS & REPAIRS State Surcharge $ .50 Total Connected Load Kind of Fuel TOTAL FZS r BURNER - Trade Name' Size No. ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date ($10.00) � ll Company '1 FINAL INSP. Date Signed By APPROVAL FOR PEP -141T Tel. No. MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3bU4 YAX: (7b3) 571-1287 ADDRESS 5225 LINCOLN ST NE PIN 253024210061 LEGAL DESC MARIAN HILLS LOT 3 BLOCK 3 PERMIT TYPE HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-02111 DATE ISSUED: 11/18/2004 VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A # A/C UNITS 0 VALUE OF APPL OR WORK # GAS WATER HEATERS 1 # GAS DRYERS # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S NIINNEAPOLIS, MN 55408-2173 (612)827-4033 OWNER ERNSTER THOMAS M & BARBARA A 5225 LINCOLN ST NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time atter work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel provisions of any other state or local law regu onstruc on or the performance of construction. Applicant ,' Date / / Bldg HEATING PERMIT MINIMUM FEE GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT WATER HEATER - GAS TOTAL SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 300 0.00 0.00 0.00 0.00 0.00 0.50 35.00 35.50 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT R 96 awrcrc NUMI:51=11 Ur t-UCTURES TO BE INSTALLED ON EACH FLOOR ..... Wash.om...,. Floo r . Gas Water Heater Sto ri es Urinal Shower Tray Drain .I�• .- il.�...:.:....:::.:.::-:: Washer Range Gas Elec Baseme I Floor 00 1 Floor r2 Floor 3 Y< =>>= :::} Floor 4 . PLUMBING FIXTURE RATES: NO. RATE - TOTAL JOB ADDRESS . pts &W UVtni New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** I Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE I& 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 Building Division. and herebv declares that all the facts and repre ERNSTER, TOM a and correct. 5225 LINCOLN STREET NORTHEAST FRIDLEY, MN 55421 (763)502-0718 OWNER BUILDING USED AS_S! egrlc s� (1 (� .20 09 ESTIMATED COST q6 O oto PERMIT NO. PLUMBING COMPANY No rbk OV \j SIGNED SIGNED BY TEL NO. N12) $27-51033 Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15-00 or 5% OF COST $ -3,Sb OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "*PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY. FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 plastic/PVC and meets all current codes and manufacturer specifications 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 Furnace Venting Tables for fan .assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes O C When required to Install a new combustion air,, -it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When Installing a new venting system, the undersigned hereby verges that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) 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. Yes () No ( ) Appliance Type and Slze/Common Vent and Vent Connector Information Appliance #1 Type BTU Input _ Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height _ 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: (Describe) HEATING CO: Signed By: Date CITY OF FRIDLEY PERMIT NO.: 2005-00002 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/04/2005 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 5225 LINCOLN ST NE PIN 253024210061 LEGAL DESC MARIAN HILLS LOT 3 BLOCK 3 PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A PERMIT WAS ENTERED INCORRECTLY UNDER HEATING DATED 11/18/04 # ELEC WATER HEATERS I VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) 300 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE 0.00 NORBLOM PLUMBING CO PLBG FIXTURES (NEW OPENINGS) 0.00 2905 GARFIELD AVE S PLBG FIXTURES (EXIST OPENINGS) 0.00 MINNEAPOLIS, MN 55408-2173 WATER TREATMENT APPLIANCE 0.00 (612) 827-4033 WATER HEATER - ELEC 35.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 ERNSTER THOMAS M & BARBARA A PLBG REPAIR/ALTERATIONS 0.00 5225 LINCOLN ST NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55421 TOTAL 35.50 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions f any other state or local law regulating construction or the erfo nce of construction. Applicant Date �} Bldg ns/—gjo"- Date - SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE YOURAADDRESS , SITE ADDRESSo7 /�C d /J 5�'f / r THIS APPLICANT IS: ❑ OWNER Il3C6NTRACTOR PROPERTY OWNER/ NAME: � S TENANT ADDRESS: &crrY 7l ® STATE ZIP PHONE: 159334 INSPECTION REPORT CITY OF FRIDLEY MINNESOTA If no correcti, violation of tl C corrections as caneu iur. . You will be in nd make kTE CITY ri;lv f STAT�dZIP 3�f yy 9 ❑ DRAIN TILE ❑ OTHER 12w/ HEIGHT Sq. Ft. BASEMENT REMODELING SUBWT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ST OF LABOR AND MATERIALS: )ULE) PANCY TYPE. ?ee Schedule rmit Fee tal job valuation — Minimum $.50 ttion (1/10%) ed Residential Contractors) it (Plans to MWCC for determination) ftx$20=$ Plan Review Engineering ry ( ) Non Necessary( ) ble to: Citv of Fridlev Attach Stiuulations VALID UNTIL PROCESSED above is complete and accurate; that the work will be in Minnesota Construction Codes; that I understand this is not a ,rmit; that the work will be in accordance with the approved C? -� d K- e 'P DATE Building $ , �i ® BUILDING Permit No. Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Fire Surcharge CITY OF FRIDLEY Date Rec'd: DATE YOUR E-MAIL ADDRESS $5.00 (State Licensed Residential Contractors) SITE ADDRESS $ $1450 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR ft + 6 ft = ft x $20 = $ PROPERTY OWNER/ NAME: A15 $450 Conservation Plan Review ADDRESS: 5-2—Z57— Ll 1-10004 CITY $ TENANT Sewer Main Charge PHONE : �7& 3 -S>z--0-7`i Z Agreement necessary ( ) Non Necessary ( ) CONTRACTOR NAME: r ° l��eQl�s 17Q� fJ z 64gray STATE LICENSE # Z 3 Seo y l(p EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 22(325 SST CITY T:� STATEI IP_ Vb WITH APPLICATION PHONE CQ (Z- 3ZS -! FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ wINDovs ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE RDECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:W ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH pQo WIDTH LA HEIGHT Sq. F ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: 36 - (, V (USING THE 1997 U.B.0 FEE SCHEDULE) OTAL JOB VALUATION S �� OCCUPANCY TYPE Permit Fee $ , �i ® See Back Page for Fee Schedule Plan Review $ a 1 65% of Building Permit Fee Surcharge $ e (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ 3 .001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1i1 �0-1 Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge 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 I understand this is not a permit but only an application for a permit apd work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w ' equ' s r iew and approval of plans. SIGNATURE OF APPLICANT PRINT NAME DATE3 /�®S� [C. . cU; �f� SAF i�yy'