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CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E. FRIDLEY, MINNESOTA 55432 TO THE HONORABLE CITY COUNCIL: - - ----- 641 - 1 lg� h rewith submit_ b application for license to perform i�, wi in the City of Fridley, in accordance with the ordinances of said ity regulating the same. I am over twenty-one years of age. Submitted herewith is a Certificate of Insurance evidencing the holding of Public Liability Insurance in the limits of $25,000 per person, $50,000 per accident for bodily injury, and $5,000 for property damage, and a Certificate of Insurance evidencing the holding of Workmen's Compensation as required by law. NAME OF COMPANY N OF INDIVIDUAL ADDRESS s L���� CITY TELEPHONE NUMBER STATE MASTER LICENSE N0. ® (WHEN APPLICABLE) LICE1NE NUMBER AND TYPE IN NEARBY c CITIES OR VILLAGES ,p FEE $ CERTIFIC4TE OF INSURANCE: WORKEIEN"S COMPENSATION - PUBLIC LIABILITY y, RECEIPT NO. LICENSE NO. t; CERTIFICATE OF INSURANCE - WORKMEN'S COMPENSATION & LIABILITY ONLY This is to certify that the.,following policies, subject to their terms, conditions and exclusions have been issued by the named companies: Project _ Location — Owner-C,ity of Fridley6431 University Ave. N.E., Fridley, Minnesota Contractor Architect/ Engineer InsuredDakota-Minnesota C'r ,,,, ru: �o„Incgddressf�oute 5, Box 782, Stillwater The following named policies meet the minimum requirements of the specifications Yes ❑ No ❑. WORKMEN'S COMPENSATION: Policy No. WC -4 80 Inception Date .___ _ ` �9,�7 1 Expiration Date 8/1/72 Insuring Company t3itur�i-Worts :..qua' %� �' ��. Address6300 France Ave. So., Mpls Agent K]_ein r`Agen(n;, In: . AddressG iggs Miaway Bldg., St.Paul Coverage— Workmen's Compensation, Statutory Employer's Liability Limit $ 100,000 Locations covered PUBLIC LIABILITY: /9; - Policy No. GA -6307105 Inception Date 7 1. Expiration Date 8/1/72 Insuring Company B it aminot_iS C.ac-l_iait�7 Address 6800 France Ave. So. M ls. Agent Klein Agency, I11C . Address Gr'.ggs Midlkray B g . , st . Pau Type of Policy: Combination Comprehensive General -Automobile Liability Other ❑ Limits: 25''��'i� Bodily Injury $ _�__.Each Person and Property Damage Liability $ L00 000 Property Damage S � Each Occurrence AUTOMOBILE LIABILITY: Griggs Midway Bldg. $_5O1), Each Occurrence Policy No. — 5 Inception Date ___ $_2 Q -Q 000 Aggregate �7 Exppiration Date 8/1/72 InsuranceCorrtipany $ --10-0_,_1.0(Aggiogate Co.cf,. Address 3O France Ave. So., Mp s. Property Damage Auto $ 100, 000 Each Occurrence Klein ?'agency, Inc - o Personal Injury $ Each Person Limits of Liabil.�ty: Bodily Injury Liability $— — OR — Each Person S Each Occurrence 0 0 (; Each Occurrence Combined Single Limit $ Each Occurrence Property Damage Liabi I ity S ` 00 , o' ' I Coverage Provided (check applicable square): A ze s r nce epresentative Combined Single Limit S _ Each Occurrence Yes No Yes No Operations of Contractor [j.j ❑ Property Damage liability includes: Operations of Sub -Contractor (contingent) x'11 (l Damage due to blasting LJ Fil Elevators, if any LA ❑ Damage due to collapse ❑ Complcted`pperations Uxl ❑ Damage to underground facilities ❑ ContractualLiability (broad form) [A LlBroad Form Property damage: rnm Goveent I Immunity is waived U n premises and operations ❑ EIC contractual ❑ ❑c Exceptions: _ UMBRELLA EXCESS LIABILITY INCLUDING AUTOMOBILE LIABILITY: Policy No. Inception Date Insuring Company' Agent Limits of Liability: Single Limit Bodily Injury Liability Expiration Date Address Address Coverage is provided for operation of all owned vehicles and Property Damage Liability $ Each Occurrence AUTOMOBILE LIABILITY: Griggs Midway Bldg. [t Policy No. — 5 Inception Date ___ ST. PAUL, MINN. 55104 �7 Exppiration Date 8/1/72 InsuranceCorrtipany Bituminous �'as!1.1]_ty Co.cf,. Address 3O France Ave. So., Mp s. Agent Klein ?'agency, Inc - o Address Griggs � i wale r g . , t . Pau Limits of Liabil.�ty: Bodily Injury Liability $— 250, U0-0 Each Person $---500, 0 0 (; Each Occurrence Property Damage Liabi I ity S ` 00 , o' ' I __Each Occurrence A ze s r nce epresentative Combined Single Limit S _ Each Occurrence Coverage is provided for operation of all owned vehicles KLEIN AGENCY Yes 14 No O Coverage is provided for operation of all hired and non -owned vehicles Griggs Midway Bldg. [t ❑ Are any deductibles applicable to Bodily Injury or Property Damage ST. PAUL, MINN. 55104 [� ❑ If so, list. Yes — 100 P.D. Li. -1_, 645-0328 AGENT CARRIES ERRORS AND OMISSIONS INSURANCE o ❑ In the event of cancellation, non -renewal or any material change in the above olicies, f n days prior notice will be given to the arties to whom this certificate is issued. 9t. Dated at Paul, t✓ti n:, - on_ _5131/72 By - A ze s r nce epresentative Construction Industry Cooperative Committee of Mnuu a;nt,, Fenu t .I.C.C.- /01 ! eb.. 1961, Rav'Junu 1969 Printed by H.A. Rogers Co., 817 Marquette AN-- MW!- 4::H in!,! 41H W. I ,-h i. St. P -ml 721-44W; a Number Fixtures x $2.00 $ Future Fixtures, �^ x $1.50 New Fixture -Old Open._ x $1.50 !(o $O Catch Basin x $3.25 Water Heater -99,000 BTU x $3.00 Ground Run Old Bldg. x $3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: 1st 3 Fixtures x $2.00 Additional Fixtures x $ .75 Gas Range -199,000 BTU x $5.00 ReRairs &-Alterations See Description; Code State Surcharge .50 TOTAL FEE $f% 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 rulinf of the Department of Buildings, and hereby declare that all'the facts and representations stated in this app4-,L�ion are true and correct. City ®f Fridley r AT THE TOP OF.THE TWINS 4rL-^""-- COMMUNITY DEVELOPMENT DIV. I PROTECTIVE SMKCTION DRIFT. CITY HALL FRIDLEY 06432 TO THE HONORABLE CITY COUNCIL: i I LICENSE APPLICATION ' i Application For 0 License 1973 '-'"'�""-c I,�'�'✓` `I herewith submit �Q/y application for license to perform �ithin the City. of Fridley, in accordance with the ordinances of said City regulating the game. I am over twenty-one years of age. Submitted herewith is a Certificate of Insurance evidencing the holding of Public Liability Insurance in the limits of $25,000 per person, $50,000 per accident for bodily injury, and $5,000 for property damage, and a Certificate of Insurance evidencing the holding of Workman's Compensation as required by law. State Master License No. (When Applicable) Cities of Villages where Compapy presently Licensed; Name of Company Name of Individual/ to Contact 7 Ad rebs of Company city Zip Code 1-13 Telephone No, of Business Receipt No. License No, IV CERTIFICATE OF INSURANCE _ . Exceptions: This is to certify that the following policies, subject to their terms, conditions and exclusions have been issued by the named companies: " Project Location Insuring Company Address Owner City of Fridley, City Hall, Fridley, Minnesota 55432 Agent Address Contractor Limits of Liability: Single Limit Bodily Injury Liability Architect /Engineer Each Occurrence AUTOMOBILE LIABILITY: Insured Dakota— Minnesota Construction Co. , InAddress Route 5, Box 782, Stillwater The following named policies meet the minimum requirements of the specifications Yes ❑ No ❑. Insurance Company Httuminous Cas alty Cori WORKMEN'S COMPENSATION: — 8/1/728/1/73 Agent dein gem Inc.- Address rr igg s Midway g, Policy No. Inception Date Expiration Date Each Person Insuring Company Bituminous Casualty Corp. Address6800 France Ave. So., Edina - Property Damage Liability $ 100, OAO Agent Klein Agency, Inc. AddressGriggs Midway Bldg, St. Paul Each Occurrence Coverage — Workmen's Compensation, Statutory Employer's Liability Limit $ 100.000 Yes No Locations covered ® ❑ Coverage is provided for operation of all hired and non -owned vehicles KLEIN A G E RICY PUBLIC LIABILITY: 94136 8/1/72 8/1/73 Griggs Midway Bldg. ® ❑ Policy No. Inception Date Expiration Date 4. Insuring Company Bituminous Casualty Corp. Address 6800 France Ave. So. Edina in the abor policies, filwopda s prior notice will be Agent Klein Agency, Inc. Address Griggs Midway Bldg, St. Paul Type of Policy: Combination Comprehensive General -Automobile Liability By Other ❑ Construction Industry Cooperative Committee of Minnesota — Form C.I.C.C.-701 Feb.. 1961. Rev. ,lune 1969 '°'' Limits: Printed by H.A. Rogers Co., 817 Marquette Ave., Mpls., 338-7655 — 419 Wabasha, St. Paul 222-4476 E: Bodily Injury $ 250,000 Each Person Property Damage $100,000 Each Occurrence $ 500, 000 Each Occurrence $200,000 Aggregate $ 500, 000 Aggregate Property Damage Auto $ 100 000 Each Occurrence Personal Injury $ Each Person — OR - -''' $ Each Occurrence Combined Single Limit $ Each Occurrence Coverage Provided (check applicable square): Yes No Yes No Operations of Contractor ❑x ❑ Property Damage liability includes: Operations of Sub -Contractor (contingent) ® ❑ Damage due to blasting Elevators, if any] ❑ Damage due to collapse ❑ Completed Operations ® ❑ Damage to underground facilities © ❑ -' Contractual Liability (broad form) ❑ Broad Form Property damage: Governmental Immunity is waivedx❑ ❑ premises and operations ❑ contractual ❑ _ . Exceptions: UMBRELLA EXCESS LIABILITY INCLUDING AUTOMOBILE LIABILITY: y Policy No. Inception Date Expiration Date Insuring Company Address Agent Address Limits of Liability: Single Limit Bodily Injury Liability and Property Damage Liability S Each Occurrence AUTOMOBILE LIABILITY: Policy No. GA -6=16 Inception Date 8/1/72 Expiration Date 8/1/73 Insurance Company Httuminous Cas alty Cori Address 6800 France Ave. _So.. Edina Agent dein gem Inc.- Address rr igg s Midway g, �auT". Limits of Liability: Bodily Injury Liability $ 250, 000 Each Person $ 500,000 Each Occurrence - Property Damage Liability $ 100, OAO Each Occurrence Combined Single Limit $ Each Occurrence ` Yes No Coverage is provided for operation of all owned vehicles ® ❑ Coverage is provided for operation of all hired and non -owned vehicles KLEIN A G E RICY ® ❑ Are any deductibles applicable to Bodily Injury or Property Damage Griggs Midway Bldg. ® ❑ If so, list. $100 P.D. Liability ST. PAUL, MINN. 55104 . AGENT CARRIES ERRORS AND OMISSIONS INSURANCE 6 4 5 0 3 2 8 ( ❑ In the event of cancellation, non -renewal or any material change in the abor policies, filwopda s prior notice will be given to the parties to whom this certificate is iss ed. Dated at St. Paul, Minn. on 3%29/73 By Authol'i d nsurance Representative Construction Industry Cooperative Committee of Minnesota — Form C.I.C.C.-701 Feb.. 1961. Rev. ,lune 1969 '°'' Printed by H.A. Rogers Co., 817 Marquette Ave., Mpls., 338-7655 — 419 Wabasha, St. Paul 222-4476 KLEIN AGENCY, Y=. Yniu%ancE & Bonds GRIGG8 MIDWAY BLDG. 1821 UNIVERSITY AVE. ST. PAUL, MINN. 55104 PHONE 645-0328 March 29, 1973 City of Fridley City Hall Fridley, Minnesota 55432 RE: Dakota -Minnesota Construction Co., Inc. Stillwater, Minnesota Gentlemen: On behalf of Dakota -Minnesota Construction Co. and in connection with the renewal of their sewer and water license, we are pleased to enclose the following documents: 1. Properly completed application 2. Certificates of Insurance Sin rely, Frank H. Klein FHK:sks Enc 1. CC Dakota -Minnesota Construction Co., Inc. Number Fixtures — ' — x $2.00 $ %�{ p Future Fixtures x $1.50 3 °G New Fixture -Old Open. x $1.50 Catch Basin x $3.25 Water Heater -99,000 BTU x $3.00 3 ® 0 Ground Run Old Bldg. x $3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: 1st 3 Fixtures x $2.00 _ 00 Additional Fixtures x $ .75 Gas Range -199,000 BTU x $5.00 Repairs & Alterations See Description: Code State Surcharge .50 TOTAL FEE $ 0 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 declare that all'the facts and representations stated in this application are true and correct. Date P City of Fridley, N[inn.. 1 O 47 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUH DIMG PERMIT Date: Feb ,rua TSB, 97_ Owner: Springfield Homes Builder Springfield Homes 3713 Foss Road N.E. Address �_..........._Same _.,�. Address LOCATION OF BUILDING No. 5601^ Street ` Matterhorn Drive N.E. part of Lot Lot Block 7 _. _ Addition or Sub -Division —Innsbruck North Corner Lot ___.._. _ _ Inside Lot ._._..__X_Setback 35' Sideyard .31 & 1 1 ' Sewer Elevation _ Foundation ��e�vation ___.._ 'Y`-�+ Sout of M.H. Water 10 South of Sewer Service "Y" Ztevat;ton 974.36 DESCRIPTION OF BUILDING To be Used as: Dwelling Front 42 291 Att . Garage Front 24' Type of Construction Wood Frame Depth _ Depth 2 Est. Cost Height 2 Height 10' 39,067.56 Sq. Ft. 1172 & Cu.. r 24,432 i Sq. Ft. 62- 4 Cu. Ft. 8,040 To be Completed June 1973 Provide verification survey SAC Charge Paid$275.00 Prov&de a hard surface drive R to or Sysf•P"% G3G 133e In consideration of the issuance to me of a permit to construct the building described above, I agree tp do the proposed work in accordance with the description above set orth and ' compliance th all provisions of Ordinances of the city of Fridley. 19.54 State Surchetzge Inconsideration of the payment of a fee of $ 6 0. 00 , permit is hereby granted to Springfield Homes 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 ordimmees of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildffigs within the city limits and this permit may be revoked at any time upon violation of any of the provisions of Said ordinances. Building Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, . installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. APPLICATION FOR RESIDENTIAL, ALTERATION. OR ADDITION BUILDING PERMIT CITY OF FRIDLBYj MINNESOTA r OWNER S N BUILM : . ' /1 n ADDRESS: ADDRESS: � 21 j T ��( �4/l_ 1/0 s e &,OTi BLOCK; AAA TIOW11- LOT: I=IAE LOT: SETBACK: J� / SIDEYAR.D: f J Awliv=t attach to the ieaei_fa_ Certificates of Surv9X of Lot and proposed Imildtag location dry on hese Certificates, DESCRIPTION OF BUILDING Vo Be Used As,. Depths �l Z- Height: �o Square Feet4- I/ ��> Cubic Foet3 Front t qDepth : Height • Square Feet, '2 -Cubic Feet: Vic') Tyfa of Constructions e% �,e�.� ® Estimated Cost: $ 2 -� TM underreigned hereby makes application for, a permit for the work herein ppeal€ied# agreeing to do all work is attict accordance with the City of F Ad).ey Ordtvances and vuUW of the Department of Buildings, aid hereby +doolaxes that all the facts and representations stated to this application axe true and correct. y�Iq�G bar �rd1 2 � � $xGNATiTSE: (OftRevoree gids For AddiUonal in€ormatiou.) % ' , "` ' Land Planning SiNkeda" 6875 Highway No. 65 N. E. Land Surveying &Wineoi�ty Minneapolis, Soils Testing) nee Minn. 55432 Civil Engineering Telephone 784-6066 Municipal Engineering Engineers & Surveyors Area Code 612 Certificate of Survey for cM_I �lELi) "om'-S • CY s D N k - Drdinage drA Utility Easement LOT 3 ALO IL V 7 INNSBRUCK NORTH o Denotes iron monument Anoka Cowt°ityo 1 hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land, and of the location of all buildin s, th eon, and all visible encroachments, if any, from or on sold land. As surveyed by me this day of_,jt", 1. A.D. 1W SUBURBAN ENGINEERING, INC. Engineers Surveyors 5( -,ALE"- finch= 40fmCt M q3 lei f+�' �Z t �' So„ -t h ter: ���Z 5'/�F a for Power Plants and l�iegR HsaCoonng, YentitotioeR Rep rotioe sed - a✓� Air Conditioning Sydem and D*Wcos ; PARTIAL RATE SCHEDULE tet• of Bldg& Mm" SM -M GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .. $10.00 $ Replacement of Furnace ..... ..... 6.00 Repairs & Alterations—up to $500.00 600 Repairs & Alterations each add. $500.00 3.00 $--- -- MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ... ..$10.00 0 each add. 60,000 BTU .................... .. 3.00 i Replacement of Furnace 6.00 Repairs & Alterations --up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 .... .. &00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 5.00 Each add. 320 sq. ft. EDR Hot Water 3.00 OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 189,000 BTU) 8.00 D Q over 189,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures �_ x$ zoo $ o?, Q CJ Additional Fixtures x .78 $ Gas Range to 199,000 x$ 5.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH aY7i e City of Fridley: The undersigned hereby makes application for a permit for the work hereir 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 facts and representations stated in this application are true 7!mcorrect. Fridley, 1g Owner Kind of Building. Used as .. , To be completed about _ ._ O�! ! 3 cro-- Estimated Cost, Old- Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or PO PLANTS-6team, Hot Wa ,Warm —No Trade Name —Size No G 1 L Q,3 Capacity / , 3 7, o C) U Sq, n FD,R BTU H.P.. Total Connected Load dFQ ,—EE':�c Rind of Ftie BURNER — Trade Name Size No Capaci Sq. FL E.D.S BTU BbP: (REMARKS -OVER) CRONSTROMS HTG. &AIR COND., INC. Job Name D ib "10 Excelsior Boulevard, Minneapolis 16, Minn. j'?_ el • NEAT LOPS CALCULATIONS Job Address J A.S.H.V Weatherstrips . Guide Construction No. I Insulation Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes -No I Yes—No 19— I I Fl. Room Length l� Width Height �' �Fl.� Room Length /� Width �Ieight Windows and Doors—Craekage and Area Width Height No. of Lineal tt. Area No. of vane of Dane llBhte of crack Windows nil Doors—Crackage and Area. i L Width Height No. of Lineal t . Area No. of pane of Dane Ilghte of crack sq, ft. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .I Room I Lenath /6 Width 12 Heigh Windows and Doors—Crackage and Area / V Width Height of Lineal ft. Area No. of pans at pane lights of crank sV, ft. �.. ?11D 3 �,- �� G - y Y Coef. B Infiltration Coef. Coef. Btu Infiltration Floor �� Exp. wall '© ✓ Glass L6 l �' Floor];;[ S`m 3 S—a Exp. wall Ceiling - /01 S ? 0 Floor - )r, Net exp. wall 2 3 � �a 16 ( �� Int. wall Floor Ceiling Ceiling. //'K ij 9 0 Floor Lr/' 0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .I Room I Lenath /6 Width 12 Heigh Windows and Doors—Crackage and Area / V Width Height of Lineal ft. Area No. of pans at pane lights of crank sV, ft. �.. ?11D Glass 3 2— Exp. wall Coef. Btu Coef. B Infiltration Coef. 4451 ✓ I. <' Glass 3 Floor �� Exp. wall / L c/-, o Glass Net exp. wall 2 3 L6 l �' Floor];;[ Int. wall Exp. wall Net'exp. wall efX Ceiling - /01 S ? 0 Floor - )r, 9 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area , FA.1 Room I Lenath / '�— Width / 2; Height Windows and Doors—Crackage and Area , Coef. Btu Infiltration Width Height No. of Lineal ft. Area No. of pane of pane Ilghte o! crack sa. !t Glass 3 2— Exp. wall Coef. Btu Net exp. wall 32 1 .3 22 Coef. Ptu Infiltration 3 Floor �� v / L c/-, o Glass 3S0 L6 l �' Floor];;[ fry Exp. wall Net'exp. wall efX % (.— ) -r s) /01 S ? 0 Net exp. wall,? " _ Z 9 � �a Int. wall Floor Ceiling = Floor Lr/' 0 Tbtal Btu. (p ? Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Lenitth / _� Width Hettrht vim'° Windows and Doors—Crackage and Area Coef. Btu Infiltration Width Height No. of Lineal ft. Area No. of pane of pane lights of crack e4. [t. Glass Exp. wall Coef. Btu Net exp. wall 32 1 .3 22 Inc. will Infiltration Ceiling 77, Floor �� Glasses Total Btu.c� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Lenitth / _� Width Hettrht vim'° Windows and Doors—Crackage and Area Width Height No. of Lineal !t. Area No. of pane of pane lights of crack sq. tt. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack e4. [t. Coef. Btu Infiltration Coef. (Btu Infiltration Exp. wall 77, 77 Glasses Int. wall 3S0 Exp, wall l �' Floor];;[ -J" Net'exp. wall efX % (.— ) -r s) /01 S ? 0 Int. wall Ceiling Floor d �l a✓ Total Btu. Required sq. ft. ED.R. or sq. ins. W.A. Leader area W. Room I Una& ,0e/' Width -7 Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal !t. Area No. of pane of pane lights of crack sq. tt. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling �► A l �' Floor];;[ -J" Total Btu. �o Required°sq. ft. ED.R. or sq. ins. W.A. Leader area CRONSTROMS �HTG. & AIR COND., INC: Job Name— D-56. 4410 Excelsior Boulevard, Minneapolis 16, Minn. � � HEAT LOff CALCULATIONS Job Address_ ' -.rea erstrips A.S.H.V. . Construction No. ( Insulation Guide Windows Doors Reference Out. WaU Int. Wall Ceiling Roof Floor Kind How Applied Yes -No I Yes—No I9— I R_1 Rnntn I Length A Width C��- Heiaht II Fl_I Room I Length Width Heistht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of Dane of Dane Ilghts of crack sq. ft. 5 Coef. Btu Infiltration Coef. ,Btu Infiltration Net exp. wall c-- 7Z77—ID Glass Ceiling �7b Exp. wall Net exp. wan -5-, q. k L Int. wall 7 ?r Ceiling Floor �- Total Btu. I I V Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l MAP Room I Length Width /S Heittht sr Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. Coef. Btu Infiltration Coef. ( Ptu. Infiltrationyj Net exp. wall 7� 1 Glass Ceiling �7b Exp. wall Net exp. wall % L - Int. wall 7 ?r Ceiling Floor �- Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I / Fl.l Room I Length ® Width ®L__ Height X—' Windows and Doors—Crackage and Area . Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Coef. Btu Infiltration Net exp. wall a 1 Glass Ceiling �7b Exp, wall Net exp. waV ?o C. Int. wall Ceiling's �,��7, 7 ?r Floor 6� ! 1 btal Btu. Required sq. ft. E.D.R.=or sq. ins. WA. Leader area I ( i Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane 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 F1.1 Room 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 sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor II Total Btu. Required sq. ft. ED.R. or sq. ins. W.A. Leader area I Fl.I Room 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 sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int, wall Ceiling Floor I1 otai tstu. Required°sq. ft. E.D.R. or sq. ins. WA. Leader area CRONSTROMS.L HTG. & AIR CON D., INC. Job Nam D -7P 10 Excelsior Boulevard, Minneapolis 16, Minn. /—� NEAT LOSS CALCULATIONS Job Address J .S.H Weatherstrips AGuiddee. Construction No. � Insulation Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes -No I Yes—No 19_ I I t.envth / -) dth , tZo"HeiahtaP' II Fl_ Room I I onath 9 Width/2—®Heiaht / �-- Win ows and oors—boorsand Area Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of Brack sq. ft. E 3- T a �-d 1<. �Ij Coef-I Coef. Btu Infiltration el Btu A -� V ® Glass e�� s 1 4-0 Exp. wall �® d -a Net exp. waH /t P, s S 3 -27 e 2 � �,z e� z�, Int. wall Net exp. wak?..2 = 2.1} ® Ceiling Int. Int. wall r Floor Ceiling Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F.I Room ILength /9 Width /.3 —Height 4;'*- Windows Q Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of®pane of pane lights ofcracksq. ft. Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. 3- T a �-d 1<. �Ij Coef-I Coef. Btu Coef. Btu Infiltration vl" e'n Glass77 e�� Glass Glass Exp. wall _ �® 7 Exp. wall � �,z e� z�, Int. wall Net exp. wak?..2 = 2.1} ® 2- 2 - Int. Int. wall r Floor Ceiling Floor 2-d (� Total Btu. ft. E.D.R. or sq. ins. WA. Leader area 4 Room I Length Width and Doors—Crackage and Area . No. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling /2- �Vf Floor ® - - Tbtal Btu. n r A Required sq. ft. E.D.R. or sq. ins. WA. Leader area I Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of®pane of pane lights ofcracksq. ft. Coef-I Coef. Btu Infiltration Infiltration ` : �_ vl" e'n Glass77 e�� Glass ¢' Exp. wall _ 7 Net exp. wall /.?A / L. _ / S -L - 1Z--Vr � �,z e� z�, Int. wall Floor r""'� a Ceiling ® 2, . e, 3 � r Floor Ceiling j/ Total Btu. 6 v Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl.l A ;,- mom I Length // Height er Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef-I Btu Coef. Btu Infiltration ` : �_ ® l rI ' w"D Glass Net exp. wall/0.)( r;_ -ej— Exp. wall Ceiling /- p Net exp. wall, Floor Int. wall Ceiling j/ Floor -------- Total Btu. I 'Q V Required sq. ft. E.D.R. or sq. iiia. W.A. Leader area Fl.l Room I L.enath X f7--1Width Heiaht d�v Windows and Doors—Crackage and Area Width Height No. of Lineal ft Area No. of pane of pane Ilghte of crack eq. ft. Coef-I Btu Infiltration IA E--?, Glass Exp. wall Net exp. wall/0.)( r;_ -ej— Int. wall ` Ceiling /- Floor ITotal Btu. 3 S I,— r Required°sq. ft. E.D.R. or sq. ins. W.A. Leader area suBjECr IT � City of Fridley 3 2 9 9 8 AT THE TOP OF THE TWINS BUILDING PERMIT Ir I ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ®� j E E NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910 -FIS 8/20/02 JOB ADDRESS 5601 Matterhorn Drive NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 7 1 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Hylden 5601 Matterhorn Drive NE 763-571-6560 3 CONTRACTOR Home MAIL ADDRESS ZIP PHONE LICENSE NO Frontier EM Exteriors 7801 Bass Lake Rd, New Hope, MN 55428 763-971-0033 e ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20171644 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 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 @@ @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,787 $1 •39 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $83.25 Fire SC $2.79 STRUCTION OR THE PERFORMANC OF CONSTRUCTION PLAN CHECK FEE Licen $5.9.0,/ TOTALFEE $9 .43 e Z 2 SI NATURE OF COWRA .TOR AU HORIZED AGENT ID-ATE,HEN ROPE ALIDATED NIS IS YOUR PERMIT BLQC INSP rIATE S,GNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ J CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: z Legal, Description: Owner Name & Address: . I r X & l L4 b rte✓ Tel. # %G -S;21- Contractor 7/ -Contractor. /-r&9 MN LICENSE # 2 0 1 7l & VV Address: �� a/ t'S s (�0 / ��»/ ���, �ti �s�2� ___Tel. # 76 3 -Pl 0033 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Wi th Hgt/Ground _� Sq. Ft OTHER: Construction Type: e Estimated Cost: $ .2 /0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ i DATE: 8 2 APPLICANT: ` Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by 'Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 2C 2) STIPULATIONS: CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SGHEDULJE Residentjal Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 19/6 of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater 0 C Q09 7 b Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 5(G"3 U-Nc ,Fe Total d , ren 6! Owner. l � �l..R � x.11. $35.00 $ $10.00 $ $10.00 $ $10.00 $ $25.00 $V v Commercial)Industrial/Institution 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industriai/Institutionai State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR Building Used As Ze51 c�eoA e Ca ESTIMATED COST PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units t Circle One (Steam) (Hot Water) Air) Trade Name in Size No. BTU 'II �, C X� HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No. EDR The undersigned hereby makes application for a permit for the work herein specked agreeing to do all work in strict accordance with the City Codes $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE q— FAX �"-b �r Date Approv Rough -in Date Final Date 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 has been examined and is free from rust, deterioration, obstructions, venting is securely supported and flrestopped where required. Yes No( ) e and The venting system is plastic/PVC and meets all current odes 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 j�) Yeses` ) No( ) assisted and natural draft appliances. The existing combustion air is sized and installed to meet the current codes Yes () No and manufacturer's specifications. When required to Install a neva combustion air. it will be sized and installed Yes Cj, No ( ) to meet the current codes and manufacturer's specifications. When Installing a now venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's speafications. This does include AGA -LAMA Category I Central Furnace Yes () No Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors and installed an appliance has been removed from the common vent anvented Yes No( ) separately as per current odes. Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input , Fan Assisted yr Nat ABTU Input Fan Assisted or Nat Appliance #3 Type Total Appliances Total Btu Input 9� , � ' Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter _ in Type ft Length 1t Diameter in Type Appliance #2 Vent Connector Height J g ft Diameter in Type Appliance #3 Vent Connector Height ft Length HEATING COj