PRE 2010 DOCSCity of Fridley, Minn.
WELDING PERMIT N° ('5-968
Date:
Owner: Builder _.—
Address Address
LOC�4'I'lON }� UILpINCa
No. Street �w. �� Part t —
Lot_ Slock _ Addition or Sub -Di on
Corner Lot _ Inside Lot — Setback -WSideyard
Sewer Elevation ___ Foundation Elevation
DESCRIPTION OF BUILDING
To Used ar
/',..r..
Front Depth Height -- Sq• �•
4 Fro Depth Height Sq. Ft. ` Cu. Ft.
Type of nstruction �� Est. Co To 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 ail provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $"'" 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 part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any�^77io�of any of the provisions of said
ordinances.
wilding Inspector
NOTICE:
This permit does not cover the construction, Installation for. whing, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
i
Owner's
Address
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY. MINNESOTA
ress.
LOCATION -OF BUILDING
MMo. ! Street .i.,r_�_.e , Part of -Lot
Lot Block` Addition or Subdivision
Corner Lot IInside Lot—X—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:
Frontg4!-!!!!Depth Height
Sq. Ft. %�� Cu. Ft.
FrontDepth Height
S _ FtCu, Ft.
G�
Type of Construction Estimated Cos
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 -
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
Application for Plwnbing and Gas Feting Porn*
Dept. of Bldgs. Phone SII 4-7
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
yJ
TOTAL
Number Fixtures ....... ..............
x
$1.50
00
$�--
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
z
F
N
WATER HTR.
GAS
ELEC.
Water Heater (Up to 200,000 BTL)
...... x
2.00
$�
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
RATE TOTAL
1st 3 Fixtures ..........................
//NO.
x
O
$ % �5
Additional Fixtures ....................
x
.50
�
Gas Range to 200,000 BTU ..............
x
2.00
$
p
Base
1st
1
2nd
`
3rd
4th
• Future Connection Openings
Connected with
I
Sewer ❑
New .Fixture, Old Openings
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
RATE
TOTAL
Number Fixtures ....... ..............
x
$1.50
00
$�--
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
Water Heater (Up to 200,000 BTL)
...... x
2.00
$�
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
RATE TOTAL
1st 3 Fixtures ..........................
//NO.
x
$1.50
$ % �5
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE
City of Fridley:
r
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 applicatign are true and correct.
Fridley,
Owner
Kind of Building
Used as
To be completed about to,
Estimated Cost, $
OldNew. RVilding Permit No —` Pe N
Signe
I
By
Business Phone No
FINAL
42 2M
19A=2—
To
9 =2
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 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
STtAM o: HOT WATER SYSTEM
40 Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. .
Each add. 200 sq. ft. EDR Steam ......................
Each add. 320 sq. ft. EDR Hot Water ..................
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
8.00 $ &a
2.00
$
5.00
$
5.00
$
2.50
$
8.00
$
8.00
$
2.50
$
2.50
$
OIL BURNER—to 3 gal. per hour ....................... '. 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures .......... ........... x $1.50 $--4,57-0
Additional Fixtures ................. x .$0 $
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 SU 4-7470
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 true and correct.
Owner
Kind of
Used aE
To be c
Estimated Cost, $
Old—Building Permit No. ` (O Permit No. d
DESCRIPTION OF WORK
k.-
Estimated
.
HEATING or POWER
team, Hot Water, Warm Air—No
Trade Nam
r
Size No ,A0ql0 0
Capacity
Sq. Ft. E.D.R. 1"2a/AV-29 BTU H.P.
Total Connected Load
Kind of Fuel
BURNER — Trade 'Nam
' Size No-���
Capacity
Sq. Ft. BTU H.P.
S011111AN HEATING & SHEET METAL
9419 CENTER DRIVE N.
Signed IN E.
By
. 42 sea
Business Phone
(REMARKS -OVER)
D-36
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. Wall I Ceiling Roof Floor Kind ow ftlied
No I —No 19, s
/ F1.1 oLenitth/ / Width / HeiahtC- / II / Fl.I Room I Lemrth /// idth //� Height,f�
om i � /" 3
Windo and Dors—Crackage and Area
--- a a,
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft:
Width Height No. of Lineal f . Area
No. of pane of Dane lights of crack sq. ft.
—
`ZCIAO
p
Coef. Btu
Coef.
Btu
Infiltration
Glass
Infiltration
zP742
Exp. wall
Int. wall
Glass
Net exp. wall
t/v
�'
7006.)—
Int. wall
Floor
Ceiling
Ceiling
Net exp. wallZ
zlQ
�iloor
.20 p ego
-notal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
tea„ , Room I Length -2j f Width /%/ Height ,P/
Windows and Doors—Crackage and Area
--- a a,
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft:
Wld h Height No. of Lineal ft. Area
No. of pane of pane light's of crack eq. ft.
—
`ZCIAO
y
Coef. Btu
Coef.1 Btu
Coef.
Btu
Infiltration
Glass
Exp. wall
ex y
Int. wall
Glass
Ceiling V 5P
�'
y
Exp. wall
Floor
Ceiling
y
Net exp. wallZ
Floor
Int. wall
Ceiling
,p
0
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
fFl. om I Lenath/ 3- Width 7/ Height d/
indows and Doors—Crackage and Area
--- a a,
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft:
Z Z—
/ 2
Coef. Btu
Coef.1 Btu
Infiltration
�� y
ym
Glass
Exp. wall
ex y
Int. wall
Net exp. wall
Ceiling V 5P
e
Int. wall
Net exp. wall
Floor
Ceiling
y
49
Floor
1 btal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
--- a a,
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. it.
/ 2
Coef. Btu
Infiltration
Coef.
Btu
Infiltration
INUF
ex y
Int. wall
Glass
Exp. wall
Ceiling V 5P
e
Floor
Net exp. wall
Floor
®
y
Int. wall
Ceiling
Floor
Total Btu. 1,,5 y
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 100
FU _ Room I Lenath /. Y Width /®o' Height ,-?/
Windows and Doors—Crackage and Area
--- a a,
Width Height No. of Lineal ft. Area
No of pane of pane lights of crack sq. ft.
31 oea
Coef. Btu
Infiltration
1,Av
Glass
Exp. wall
Net exp. wall
ex y
Int. wall
Ceiling V 5P
/,0 V3,9 O
Floor
Total Btu. I d1WA___
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
f ml o__ i t vra.t. 9i u_: -Lf cbe
- --I ------ • ---o-- „� -- -- -
Windows and Doors—Crackage and Area
--- a a,
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
WW
Coef. Btu
Infiltration I AP/ 50.1
1,Av
Glass /�- 41
Exp, wall
Net exp. wall
Int. wall
CeilingAa
Floor
1 otal Btu.
ft. E.D.R. or sq. ins. W.A. Leader area I /—/
e
SUBJECT
City of Fridley
313 3 6
AT THE TOP OF THE TWINS
BUILDING
PERMITEC
_ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
77Z
1 . �
CITY HALL FRIDLEY 55432
Nume"
REV
DATE
PAGE OF
APPROVED 8V
j
L „ 612-571-3450
910-F15
8/23/00
JOB ADDRESS 6517 Lucia Lane NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
2
1 Don's 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Evina Timo 6517 Lucia Lane NE
763-557-9964
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
PTL Contracting 2526 N Ferry St, Anoka,
MN 55303
763-323-7400 5294
a ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION j7 REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (28 Sq) Tear-off
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 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 ORDINANC S GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
GOVERNING
$2,447
$1.22
WITHWH HEREIN OR HE GRANTING OF A PERMIT
DOES NOT RES ME TO GIVE AUTHO I TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIO OF ANY OTHER ATE LOCAL LAW REGULATING CON-
$83.25
Fir SC $2.45
ST RU TIO OR HEP RFOR N CONSTRUCTION
PLAN CHEC4FE
TOT L FEE
Licens$5. 0
$91.92
SIGNATURE OFCON ACTOR OR AUTMQRij ENr IDATE.
E�PVALIDTHIS
.•8e `1f�AiE
IS RPERMIT
S,GNATURE OF 0INNERof OWNERBUROERi iDATEi
e
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND UPLEXES R-1 AND R-2
BUILDING P IT APPLICATION
Construction Address:
Legal Description:
A
Owner Name dress:
Contractor. `%_4--
Effective 1/1/2000
612-572-3604 Bldg Insp
.� Tel. #
MN LICENSE # ✓�—�—�
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: L ng gWithHgt/Ground_Sq. Ftt..-�OTHER: P.PnnFef� � � �t_' �V`"�'—
U
Construction Type:%G Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. 6 t= F $ _ $
DATE: C� a 2 OD APPLICANT: Tel. #
CITY USE ONLY - Call (612) 572-3604 for Permit Fees If mailing In application
Permit Fee
$ 83�,�S-
Fee Schedule on Reverse Side
Fire Surcharge
$ �5 .001 of Permit Valuation (1/10th%)
State Surcharge
$ /. J-
$.50/$1,000 Valuation
SAC Charge
$
$1100 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
STIPULATIONS:
Building
MECHANICAL
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Recd:
DATE .. YOUR E-IvjAIL ADDRESS
SITE ADDRESS C ( (��
THIS APPLICANT IS: ❑ OWNER AONTRACTOR
PROPERTY
NAME:
��Ct/e
OWNER/
ADDRESS: CITY_ STA ZIP
TENANT
PHONE:
CONTRACTOR
COMPANY NAME:
SUB1%1IT A COPY OF
YOUR STATE
CONTACT PERSON' STANDAR D HEONG 8 AIR CM -01 M110NING
STATE LICENSE 41�A11>14KE STRr
LICENSE WITH
ryry�A
ADDRESS: P061gg..� p�N 55408 STATE ZIP
APPLICATION
PHONE FAX
PERNIIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK'
❑ NEW PLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK Cc GPS
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) 3 SIZEBTU�
�
Equipment Installed :MFG: FG: MODEL:
MFG: d``x`11 MODEL: SIZE/BTU OE it
MFG: MODEL: SIZEBTU L
$25.00 (GAS) $15.00 GAS RANGE/OVEN $10.00
_L'C —FIREPLACE
_AIR TO AIR EXCHANGEER $15FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
FURNACE $35.00 GAS UNIT HTR $10.00
_BOILER $35.00
LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
_CHIMNEY
DUCT WORK $1000 GAS PIPING $10.00 —VENTILATOR $15.00
. i .. ... o. ..
=Y71'r .. . ,,.�. . .
���` E
. k, .aG.. >
.l:_��,... U. "„4;�?!'.roN��
�
Permit 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 $25.00 = $-_l . �L
Number of fixtures @ $35.00-7—x$35.00 = $,g—'sem
State Surcharge = $50
Total = $�
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 thf Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an applic r or not Io start without a ermit; that the work will be in accordance with the
ecrequirteeview
approved plan in the case of w ' d approval of plan
SIGNATURE OF APPLICANT
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter I with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN 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. Fuel other 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_ Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a_ ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations