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City of Fridley, Minn.
BUILDING PERMIT N° 3077
Date: ...............
Owner G� Builder
Address . rO . Address .. iR Rtn 0 . ®.............. .................
LOCATION OF BUILDING
No. � < Street . ..................... Part of L�ot................................
Lot ....... Block.`�......... ;.... Addition or Sub-Division��`!�?44!.V''?ssy%t�
Corner Lot ............ Inside Lot ............ Setback /..... Sideyard
DESCRIPTION OF BUILDING
To be Used as:
...... .. Front �4.f. Depths-*&'=. Height, Sq. Ft. l.C�./.°� Cu. Ft. ........
... Front Depth . ��Heeight ........ Sq. Ft. .. �!C /Cu. Ft. ........
14pe of onstruction ...... F.st. Cost ; .a t�' . I. sJ�o. s .. To be Completed .. fir.
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in ompliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.. °�!o ...., permit is hereby granted to??�!K.....
......................... 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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
ding Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate�,permits for these Items.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Eftective Date May I, 1988
re�
Job Address
Department of Buildings
City of Fridley
Tel. 5571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley. Mn. v , 19c�w
OWNER
KIND OF BUILDING � e ': ._„ ..,., ._ � �-•..`_ � �`tiS.l : i � G�.o--��:_s
USED AS
TO BE COMPLETED ABOUT
RATE SCHEDULE ESTIMATED COST
PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT NO.
New Fixtures $ 5.00 $
Future Fixtures $ 3.50 $ company
Old opening, New Fizture S 1.50 $ signed By 2905 GARFIELD AVENUE SCAU T°1
Beer Dispenser $ 4.00 $ MHNMEAPOLIS, MINNESOTA
Tel. No.
Slow Off Basin $ 5.00 $
Catch Basin $ 5.00 $ �.
Rain Water Leader $ 5.00 $
ROUGH INSP. 6z
Hydraulic'Valve $ 5.00 S Date
Sump or Receiving Tank $ 5.00 $
Water Treating Appliance $ 7.00 $ FINAL INSP.
Hot Water Heater $ 5.00 $ Date
Gas Range $ 10.00
Gas Dryer �_ $ 10.00 $ +Q,C6 APPROVAL FOR PERMIT
Back Flow Preventer Required. . . Yes ( } No ( )
Type $ 5.00 $
ALL OT(iI:'..S AND/OR REPAIRS AND ALTERATIONS
iMINIMUM FEE FOR ANY PLUMBING PERMIT IS x15.00
t of value of Fixture or Appliance $ �® ,®�
PLUS THE $.50 STATE SURCHARGE
State Surcharge $ .50
Reinspection Foe S
($15.00) TOTAL FEE $GJ , 5� .
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1st
2nd
3rd
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(R) - Future Connection Opening
Connected with Sewer
(*) n New Fixture, Old Opening
Water
Eftective Date May I, 1988
re�
Job Address
Department of Buildings
City of Fridley
Tel. 5571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley. Mn. v , 19c�w
OWNER
KIND OF BUILDING � e ': ._„ ..,., ._ � �-•..`_ � �`tiS.l : i � G�.o--��:_s
USED AS
TO BE COMPLETED ABOUT
RATE SCHEDULE ESTIMATED COST
PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT NO.
New Fixtures $ 5.00 $
Future Fixtures $ 3.50 $ company
Old opening, New Fizture S 1.50 $ signed By 2905 GARFIELD AVENUE SCAU T°1
Beer Dispenser $ 4.00 $ MHNMEAPOLIS, MINNESOTA
Tel. No.
Slow Off Basin $ 5.00 $
Catch Basin $ 5.00 $ �.
Rain Water Leader $ 5.00 $
ROUGH INSP. 6z
Hydraulic'Valve $ 5.00 S Date
Sump or Receiving Tank $ 5.00 $
Water Treating Appliance $ 7.00 $ FINAL INSP.
Hot Water Heater $ 5.00 $ Date
Gas Range $ 10.00
Gas Dryer �_ $ 10.00 $ +Q,C6 APPROVAL FOR PERMIT
Back Flow Preventer Required. . . Yes ( } No ( )
Type $ 5.00 $
ALL OT(iI:'..S AND/OR REPAIRS AND ALTERATIONS
iMINIMUM FEE FOR ANY PLUMBING PERMIT IS x15.00
t of value of Fixture or Appliance $ �® ,®�
PLUS THE $.50 STATE SURCHARGE
State Surcharge $ .50
Reinspection Foe S
($15.00) TOTAL FEE $GJ , 5� .
r
Receipt #
Fee: $
APPLICANT
CITY OF FRIDLEY
62
Effective 10/7/93
Tel. # 57l ,? 7/3
Address
PROPERTY OWNERS
NAME UA 011A err Tel. # 5- 71-1? %/S',
Address s-oys- 3&- 5m 0(5- 53-`e24
0r.-_31
Address
Lot I
LEGAL DESCRIPTION OF PROPERTY
Block i?,w ' Addition �
Tel. #
DESCRIPTION OF LAND ALTERATION
Value of Work: $ Starting Dater Completion Date. � � `Z
Source and Composition of Fill: �„ �< / / o �,� z J Z
16;CC6✓c)t6/ v.v iRP r� 4i�I 4� ✓s r� ie / cs� 4 cin,
PURPOSE OF LAND ALTERATION
ATTACHMENTS. TO APPLICATION
The following plans, drawings, calculations, bonds and/or statements may be required by the Public Works
Department:
[ ] Half -section map or sketch of property showing all adjacent property indicating the existing buildings
and/or structures.
[ ] Grading plan showing existing and proposed finished contours and evaluations.
[ ] Drainage plan showing existing and proposed drainage structures, stabilization walls, retaining walls,
cfibbing, dams, or other protective items.
[ ] Calculations for and approximate quantities of excavation and/or fill required.
[ ] Signed statement from the property owner accepting responsibility for the operation and granting
permission for land alteration/mining'operation.
[ ] Statement to be attached to deed advising of potential need for soil tests prior to any construction
on lots where additional fill material. has been placed.
[ Rice Creek. Watershed District Approval.
[ ] Soil Borings
[ ] Other
STIPULATIONS
READ BEFORE SIGNING APPLICATION
surety bond or certified check in .the. amount of $ ($% of value of work to be
completed) -must be submitted after approval of application and prior to any work commencing. This
bond or check *is to ensure satisfactory performance and compliance with the below stated
stipulations. The surety bond or check shall be kept active until the completion of work and/or
expiration of permit and can only be released by written notification of the City after a satisfactory
final inspection has been performed by the City.
2. All access and street frontage of the land alteration site must be controlled by a fence, a minimum
of four (4) feet in height. All entrances must have gates that are capable of being locked.
3. Only rock, sand, gravel, dirt, or similar natural earth fill is permitted. No concrete, asphalt, or
demolition wastes will be permitted as fill unless a demolition landfill permit is first obtained from
Anoka County.
4. Operations shall be limited to daylight hours and shall not interfere with the health and safety of
surrounding residents and the premises shall be maintained at all times so as not to create a
nuisance.
Stipulations Continued
5. Any explosives used must be done so in accordance with Chapter 212, subsections 212.07.5A, .513,
.5C, .5D, and .517. of the Fridley City Code and any other applicable standards, e.g. Federal, State,
Industrial, etc.
6. At the end of each season's operations and no later than the last day of December each year, the
site is to be left in a neat and orderly condition, with maximum slopes of 2:1 with no overhang or
vertical banks and with a level bottom.
7. On the Friday of each work week, or when required by the City, material from this operation that
is found to exist on City streets shall be cleaned to the City's satisfaction by the applicant.
8. Upon completion of land alteration operations, the land must be left according to the plans and
contours submitted with this application and planted with suitable vegetation to prevent erosion.
9. Upon completion of land alteration operations or • expiration of this permit, an inspection will be
made by the City of the premises and adjoining streets. Any damage found to have been caused by
these o ations will be c ec by the applicant upon notification by the City.
Date:
App n 's ignature
Date:
Prop Owner's Signa f ffre
Date:
Property Owner's Signature
FOR CITY USE ONLY
Recommended for Approval By: '� Date: 7%z/�9�/
Approved By: �� G � Date: 7
PERMIT EXPIRATION DATE:
01
SuBjEGT
P
City of Fridley
2 8 309
AT THE TOP OF THE TWINS
BUILDING
P E R M I T
r
RECEIPTIJO
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r E PROTECTIVE
I
NUMBER
REV
DATE
PAGE OF
APPROVED r
CITY HALL FRIDLEY 55432
612-571-3450
910415
10/19/98
10B ADDRESS
5045 3rd Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
14
4
lCarlson's Summit Manor So.
Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Jankowski
571-9713
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
4 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
❑ NEW O ADDITION O ALTERATION REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 35 S Tear -off
9 CHANGE OF USE FROM 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 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
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
$2999
$1.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$74.75
Fire SC 3.00
PLAN CHECK FEE
EE
TOT;425
7
SIGN iuRE O CON'RACTOR uT.I ED AGENT IDATEI
EN ROP
VALIDAT IS IS YOUR PERM
BL IN$D
O� r
fIAfE
-4--GN a E OF OWNEROF OWNER BUILDERI IDATEI
01
r
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �P va g3o
ConstructionAddress: �1i
Building
BUILDING
Permit No.: 0 ICU0 _
Inspections
RESIDENTIAL APPLICATION
Received By: ?
763-572-3604
CITY OF FRIDLEY
Date Rec'd'
763-502-4977 FAX
MAY
I EFFECTIVE 1-1-2010
REM
DATE �fT 610 YOUR E-MAIL ADDRESS
SITE ADDRESS 1+15f
7i1 -f2f ye e- 'F )'ij jg yx' MAITHIS
__50
APPLICANT IS:
V] OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: J OLV _-S, P 1; n &,
ADDRESS: 5()465 Vr 5t3fer-17 CITY 2rijl-P Y
STATE"ZIP 66,if 37,
TENANT
PHONE:JA5I) 32S– lb67
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
9TWO FAMILY STORIES_
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK Rl SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR X REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
I .
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
SIVinyl
ADDITIONS.
& PORCHES SUBMIT:
�Sofflt
I .
Site Plan/Survey showing the existing structures
11 Aluminum
11 Trim
and proposed project.
El Other
!11 Fascia
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
FOR WINDOWS
– PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE
SIZE OF
MANUFACTURE STICKER ON WINDOW,
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
OCCUPANCY
$ (.11'/ ly 5- See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ .001 times the total job valuation
$ 7 .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ Make checks Davable to: Citv of Fridlev Attach
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 perm' and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of or requires review and approval of plans.
,�
SIGNATURE OF APPLICANT 1 PRINT NAME y '�"i�L� Y i V DATE _r�> —C(P _
SYSTEM SIZING SUMMARY
system: System 1 p rT �/ {� Bieck Load 3.05
Location: Minneapolis, Minnesota d e[� 3 (Pjl ! March 03, 2011
Prepared by: Healy's Consulting 77 Page: 1
TABLE I. SVJNG DATA(COOLING
Time
Sensible Ton
Total Coll Load
16,676 BTUhr
Load Ocean
August 15:00
Sensible Coll Lead
13,839 BTU/hr
Outdoor Db/Wb
92.0/75.0 F
Total Zone Sensible
12,924 BTU/hr
Coll Conditions:
2)
Supply Temperature
53.0 F
Entering DbIM
71.1/61.7 F
Supply Air (Actual)
822 CFM
Leaving Db/Wb
SSA/54A F
Supply Air (Standard)
798 CFM
Apparatus Dewpdat
$4.2 F
Venn Air
0 CFM
Bypass Factor
0.050
Direct Exhaust Air
0 CFM
Resulting Zone RK
62.%
Rehoat Required
0 BTU/hr
L09
1.33
10) August 13:00
LOS
Total Can Load
139 Toa
Floor Area
650 "ft
Sensible Coll Load
1.13 Ton
Overall U -Value
0.112 BTU w1sq"
SQFT/ron
467.75
Vent Air
Vent Air
0.00 CFM/sgft
0-00 Mulpenon
Cooling
Coollno
25.65 BTUAhr/sgft
TABLE 2. SIMG DATA
TIN
1-27
Heating Coll Load
21,129 BTU/hr
Hosting
32.51 BTU/hr/sgft
Ventilation [mad
0 BTU/hr
Heating
1.27 CFM/sgft
Total Zone Load
21,129 NM/hr
Floor Area
630so
Ventilation Airflow
0 CFM
Overall U:Valae
0112
Supply Airflow
822 CFM
VentAir
0.00 CFM/sqft
Vent Air
0.00 CFM/Person
TABLE 3. INPUT DATA
THBR
Location
Mbmea *U% Minnesota
Data Saurce
Carrier Defaults
Summer Dry-Buib
92.0 F
Latitude
44.9 Degree
Coincident Wet -Bulb
75.0 F
Elevation
834.0 It
Dally Range
210 F
ABLE 4. VMUT AC
TE
System Nems
System 1
THERMOSTAT SETPOVITS
Type
Cooling (Oeca
70.0 F
System Start
9:00
Cooling (Unocc.)
78.0 F
Duration
14 hrs
Heating
70.0 F
SIZING SPECIFICAUONS
RETURN ALR PLENUM No
supply
FAN
ventilation
Conflgaration
Blow-Thru
Exhaust
Stade Premon
1.50 In. wg.
FACTORS
Coil Bypass
0.050
Safety (Sens)
0%
Safety (Lstent)
0
Heating Safety
0%
Time
Sensible Ton
Tota! Ton
Time
Sendble Ton
Total Ton
1)
August 15:00
L13
139
6) July 16:00
L09
133
2)
August 16:00
L14
US
7) July 17:00
L07
L31
3)
August 14:00
L12
136
8) July 14:00
L06
130
4)
August 17:00
Ul
L34
9) September 13:00
L09
L29
5)
July 15:00
L09
1.33
10) August 13:00
LOS
L29
SYSTEM SIZING SUMMARY
system: system 1
Locatton: Minueapols, Minnesota
Prepared by: Healy's Consulting
TABLE 6. ZONE SIZING DATA
Max. Cooling Design Airflow
Sensible Rate
Bek Load 3.05
March 03, 2011
Page: 2
Max. Heating Design Flow
Load Rate
Zone Name (BTU/br) (CFW Design Time (BTUIhr) (CFW
1stFlr 12,924 822 August 15:00 21,129 -
Total: 822 Total: .00