PRE 2010 DOCSDate:
Owner:
Address
City of ]Fridley, Affim.
BUILDING PERMIT
May 22, 1967
John. - Beeirmw Backiner
7410 Van Buren
Builder Same
Address Same
N° 9266
LOCATION OF BUILDING
No. 7410 8 Street _ MEN Van Buren _____ Part of Lot
Lot X 7 Block 5 Addition or Sub -Division .Y _, 7I Sub #1
Corner Lot ._ Inside Lot _ Setback -- Sideyard �.
Sewer Elevation
To be Used as:
Garage -extend tpront 22��
Front —
Type of Construction _ Frame
Foundation Elevation
DESCRIPTION OF BUILDING
Depth 22' Height 10, Sq. Ft.
Depth Height r Sq. Ft.
— Est. Coat— 400.00__._...... — To be Completed
Cu. Ft
Cu. Ft.
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 fo and in compliance with all provisions of
ordinances of the city of Fridley. , A- j
Buckneideration of the payment of a fee of S 5.00 permit is hereby granted to John
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 time upon violation of any of the provisions of said
ordinances
CLARENCE BELISLE Building Inspector
NOTICE:
This pernth does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be vire to we
the Building Inspector for separate permits for these Items.
I
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME ,� BUILDER���'�,
ADDRESS/� ,rDRESS
=
LOCATION OF BUILDING
NO. STREET � � a � PART OF LOT
a
LOT % BLOCKS ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT
SETBACK
SEWER ELEVATION TOP OF FOOTING
SIDE -YARD
Applicant attach to this form two certificates of survey of lot and proposed
building location drawn on these two certificates.
DESCRIPTION OF BUILDING
moo,; be Used as:
;f! e'-� Front Depth Height %d e
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction L'4 7� Estimated Cost 1 '
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 ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
r)
rk�:
(Schedule of Fee Costs can be found on the Reverse Side).
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� � � rpt' y � �' ¢� _ _ 18+m -_ ._��,�.,,z
CITY OF FRIDLEY INSPECTION DIV.
Effective On January 1, 1991
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 `)"! 1 l� a
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work
Residential
Rate
TOTAL
herein specified agreeing to do all work In strict accordance with the
Furnace Shell and Duct Work, Burner -
city codes and ruling of the Building Division, and hereby declares
Also Replacement Furnace
$ 20.00
$
that all the facts and representations stated in this application are
�•
true and correct.
Gas Piping (NBeded with new furnace)
$10.00
$_-ELL 0O
OWNER
Gas Range
$ 10.00
$
BUILDING USED AS
Gas Dryer
$10.00
$
ESTIMATED COST PERMIT NO. 11139
"Air Conditioning - All Sizes $ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $
CommerciaUlndustrial
1 % of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
"Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units 1 Circle One (Steam) (Hot Water) 0 Car-m-7�-A-1§4,
Trade Name Size
BTU 7g, Ve4 0 HP_ EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
STANDARD HEAT>If►f AND AIR MMff DNBtG M
4 0 t°.'EST LAKE S `1iEET
HEATING COMPANY M1N1`1'_^.P0uS, WA 65408=29M
Signed By, �, o Tel No.
Approved By Rough -In Date Final Date " ) ��_ C/3
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CRINNEY 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
( )
No
( )
3.
Has no foreign objects lodged within
Yes
( )
No
( )
4.
Is securely supported
Yes
( )
No
( )
5. Meets all current Code requirements for
size and total BTU's connected Yes ( ) No ( )
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
STANDARD HEATING & AIR CONDITIONING CO.
SERVING THE TWIN CITIES SINCE 1930
I
HEAT LOSS CALCULATION FOR BUCHNER
92492 MARKB
----------------------------------------------------------------------
BASEMENT LENGTH 30 WIDTH
----------------------------------------------------------------------
24
HEIGHT 8
WINDOWS & DOORS - CRACKAGE AND
AREA
WIDTH HEIGHT NO, LIN FT AREA
NO. PANE PANE LIGHTS CRACK
SQ FT
2 24 36 2 40
30.3
COEFF
BTU 108 R.FT
INFILTRATION ,,,,,,,,,,,,,,,,, 40
20
800
GLASS ..............................
30,3
50
1515
EXP WALL ...........................
108
NET EXP WALL ........................
185,7
11
2042,7
BELOW GRADE,,,,., 6 ................
648
5
3240
CEILING .............................
0
0
0
FLOOR ...............................
720
3
2160
VENTILATION....,. 0 ................
0
0
0
TOTAL BTU .................................................
----------------------------------------------------------------------
9757.7
MAIN FLOOR LENGTH 30 WIDTH
----------------------------------------------------------------------
24
HEIGHT 8
WINDOWS & DOORS - CRACKAGE AND
AREA
WIDTH HEIGIiT NO, LIN FT
AREA
NO. PANE PANE LIGHTS CRACK
SQ FT
8 55 26 2 195,3
190.1
1 94 55 2 43.8
78.9
2 32 80 D 37,3
35.6
COEFF
BTU 108 R.FT
INFILTRATION ................. 276.4
20
5528
GLASS ..............................
304.6
40
12184
EXP WALL ...........................
108
NET EXP WALL,,,,,,,,,,,,,,,,,,,,,,,,
559,4
11
6153,401
BELOW GRADE.,,... 0 ................
0
5
0
CEILING .............................
0
0
0
FLOOR ...............................
0
0
0
VENTILATION,..,,. 0 ................
0
0
0
TOTAL BTU .....................................
----------------------------------------------------------------------
„ ..........
23865.4
SECOND STORY LENGTH 30 WIDTH 24
----------------------------------------------------------------------
HEIGHT 8
WINDOWS & DOORS - CRACKAGE AND AREA
WIDTH HEIGHT NO. LIN FT
AREA
to. PANE PANE LIGHTS CRACK
SQ FT
2 55 26 2 48.8
47,5
COEFF
BTU 108 R.FT
INFILTRATION ................. 48.8
20
976
;LASS ..............................
47.5
40
1900
;XP WALL ...........................
108
STET EXP WALL,,,,,,,,,,,,,,,,,,,,,,,,
384.5
11
4229.5
IELOW GRADE....,. 0 ................
0
5
0
'FILING .............................
720
8
5760
"LOOR............... I., ... . ..... ..
0
0
0
ENTILATION...... 0 ................
0
0
0
"OTAL BTU .................................................
12865.5
"OTAL BTU OF ALL ROOMS/FLOORS....................................... 46488,6
410 W. LAKE ST. 1072 PAYNE AVE. q
MINNEAPOLIS, MN 55408-2998 ST. PAUL, MN 55101-3892
612/824-2656 C:EA�TINGANDAIRCONDITIONING,CO 612/772-2449
serving The Twin Cities Since 1930"
ORSAT TEST RECORD
ADDRESS `� ✓`� j`' ,��- ,� CITY s,Z,, o I -0 -
OCCUPANT tic `--v' �� Vie. OWNER `S:A-„._..
DATE HTG. INST. INSTALLED BYu�-tr��:t�-��-
GAS LINE BY
TYPE OF HEAT: GA FAHW STEAM SPACE HTR. UNIT HTR. OTHER
GASSIGN
MAKE i //z C' p MAKE
MODEL Cts A® Af�f P fie/` MODEL
SERIAL ,;Z aC200 3� MAX.
INPUT MAKE
CONTROLS
THERMOSTAT -�lW HEAT PLUG '
MODEL
VENT
VALVE KIND
LIMIT< 9 DRAFT
CONVERSION
F --BURNER
BTU RATING
OF F ACE
SIZE _3
OF LINER A �_SIZE_- `:__NONE
HOOD REGULATOR'
IMIT SETTING ,� ��� CHIMNEY CONSTRUCTION
LTSETTING��/ ' p� �s.-� DRAFT . r ate” TEST TACTYPE v; 5,, �- LIGHTING INST.
MAKE 9'z Y-21,
L
NG 1 rii r-gA
PERCENT CO2 DATE TESTED
PERCENT 022, Ste`
lVa PERCENT "C0 NAME OF TESTER
r
HOUSE 'HEATING TEST RECORD
ADDRESS APT. FLOORITY SUBURB ky
OCCUPANT OWNER b�, ,C
HEAT LOSS DATE TG. INST.
SOLD BY� d,—® x V:q! INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
CONVERSION
Model
CONTROLS � ®®
THERMOSTAT /Meat Plug w Vent Size
Valve 7C.10PAr KIND OF LIN R SIZE
Limit Draft Hood dZRegularor
Limit Setting o Filters Size9t®+� (dumber
Fan Setting ®;,® ,8 Chimney Location Inside Outside
NONE
Pilot Type ;t Chimney Construction ®�
Pilot Make ple
Pilot Model Smoke Bomb Wiring
Pilot Timing - Draft c Test Tag J=& "ems
L.W. Cut Off Door Pressure Lighting Inst.
Pressure Percent CO2 Date Tested 51- R NY r & 6
Input CFH Percent 02 Company Testing
Stack Temp._ Percent CO (� Name of Tester
Form 235
GAS DESIGN
MAKE
MAKE OF BURNER _
Model
®
Model
Serial
iY.2
Max. BTU Rating —
INPUT—
0 0
MAKE OF FURNACE
CONVERSION
Model
CONTROLS � ®®
THERMOSTAT /Meat Plug w Vent Size
Valve 7C.10PAr KIND OF LIN R SIZE
Limit Draft Hood dZRegularor
Limit Setting o Filters Size9t®+� (dumber
Fan Setting ®;,® ,8 Chimney Location Inside Outside
NONE
Pilot Type ;t Chimney Construction ®�
Pilot Make ple
Pilot Model Smoke Bomb Wiring
Pilot Timing - Draft c Test Tag J=& "ems
L.W. Cut Off Door Pressure Lighting Inst.
Pressure Percent CO2 Date Tested 51- R NY r & 6
Input CFH Percent 02 Company Testing
Stack Temp._ Percent CO (� Name of Tester
Form 235
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MEG;
MECHANICAL
Permit No.:
Building
Inspections
RESIDENTIAL APPLICATION
Received By:
/
763-572-3 4
CITY OF FRIDLEY
Date Recd: ��
DATE l YOUR E-MAIL DRESS
SITE ADDRESS
THIS APPLICANT IS: 0 OWNER CONTRACTOR
PROPERTY
15.$35
$15.00
ADDRESS: TY STA IP
OWNER/
TENANT
PHONE:
COMPANY NAME: SWARD HE
CONTRACTOR
SUBMIT A COPY OF
CONTACT PERS 410 WEST LA
Pk%, MN 55408
YOUR STATE
STATE LICENSE # 2�tl24� STATE ZIP
LICENSE WITH
ADDRESS:
APPLICATION
PHONE FAX
PERMIT TYPE
°„SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
0 NEW ^XPLACEMENT 0 ALTERATION/REMODEL
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK
PER MS 16B.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
only the cost of labor )
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect
Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor_x .05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500 ES ARE BASED ON $10.00 PER FDCTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)IV
_�_,, r,�r.• , nnn e MODEL: C) SIZEBTU
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MEG;
- MODEL:
Jl/ W151 U
MFG:
MODEL:
SIZEBTU
GAS RANGE/OVEN $10.00
A/C $25.00
AIR TO AIR EXCHANGEER $IS
FIREPLACE (GAS) $15.00
_FIREPLACE (WOOD) $35.00
NEW GAS GRILL $10.00
GAS UNIT HTR $10.00
$35.00
,FURNACE $35.00
POOL HEATER 00
_BOILER
CHIMNEY LINER $10.00
GAS DRYER $10.00
15.$35
$15.00
~DUCT WORK $10.00
GAS PIPING $10.00
_VENTII-VENTILATOR
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 = $
Number of fixtures @ $35.00 :7: x $35.00 = $�. Ill
State Surcharge = $ .50
Total = $
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
NA
RMA
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXIS.T_IN_,45, H< QMI_S
1. Combustion Air (See note
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropanevUGC 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