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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N° 5 i o� Date: Owner: Builder _ _ Address Address _ — _ _ _ Address ° ell ,L1 BUILDING No...Street Lot �, —. __ Block _ Addition or Sub -Division Corner Lot Inside Lot Setback deyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T eU fFty t Front � Depth Height l .� Sq. Ft. Cu. M;4A.411,9 Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. a __ 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 all provisions of ordinances oP the city of Fridley. t„ 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 time upon viola of of the provisions of said ordinances. , „ A 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 Nems. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, IOTA Owners Name LOCATION Builder Address Address ,/6V Z,/6V- LOCATION OF BUILDING No. // Street Part of Lot Lot �� Block . �/ " Addition or - � ._......�. Corner Lots side Lot�Set Back Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: . -- Front _ _ Depth ` Heights.. Sq. Ft.]FCu. Ft. Front Depth I%ight Sq. Ft. Cu. Ft. Type of Construction r tima.ted Cost 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. DATE �/Q��� SIGNATURE :j�� (A Schedule of Fee costs can be found on the Reverse Side.) 0 0 MlNDEnFNGDcEF-.RlNcy CO.,INC. ENGINEERS AND SURVEYORS LAND GU13VEYINo CIVIL & MUNICIPAL ENGINEERING 6418 -SGT" AVENUE N. MINNEAPOLIS 27,MINN. KE 7- BG37 4C(piritiilatolife N6 !i 1pirw4 R' c-JUt ,.�'�"r �R TOM JILV I5 SOILS TESTING LAND PLANNING ' I e_ i 17 nr'i'g-----�------- ...----'----- ' e LOT 25 BLh\. `121 UPLAND ,Iran ADYN. WE HEREOY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE OE5CRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF NMY, THEREON , AND NLL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON sA10 LAND. MINDER. ENGINEERING CO., INC. DATED T%15 DAY of i � C � A.0.1'59 ENGINE R$'e ANQ_ URVF.70R5 by � % ,�—� Appiicatian for Power Pkmts and Heating. Cooling, Ventilation..Rehigeration and AirConditioning 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 $ CH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ _ `N Replacement of Furnace §.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. IDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. IDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule I O GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ a .►' 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 FFE $�� ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 Location 6 1 -�; a sty -t:-A veAc 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. j Fridley, Minn � 19 V a \ a Owner 1� r i 1 u 1 Kind of Building\rCA/KY�.®� Used as Iteb , � �•� To be completed about !6- siA b' A Estimated Cost, $ Old—N�uilding Permit No. ®":� ® Permit No. �� ✓ DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Wallo Trade Name -!>'e--1 = Size No G, �%� C+ � Capacity Sq. Ft. E.D.R BTU_t�L�L�Ci�� H.P. Total Connected Load V 4 . Q q 6- Kind of Fue G �- BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R. BTU H.P. (REMARKS—OVER) Sigaecl—� Gt. SS Cz a h C---, By .19D.42 2M 7.89 Business Phone No MEAT LOSS CALCULATIONS DEPARTMN't OfF'UKir ON(iF® A -� ; �` '!c ��7•,:<fRIDLEY, MINN. __ Weatherstrips l ? Cw t Vindows Qtor Re t, rc i > t' i }rl �.ji. .hindFlow _ - How Applied +l!.. fit. :in I }ieif�hl i I ` !.d '. _. _ m } Pndth ..rtdth ' iRrx WjndrravIiand C•: .. k.. e i Are.; �.ncl,w', arld [mors ---C rac}tage aad Area _ •t Ar"a h t• - tl., k..[Aria .i tir:v a k a f( I .. 4 i ' r Btu lcoef I Infiltration C�. l ', C }r::..l t•,• "Z 1 cc . -�•� �." ---- - - . _.. _ _....__ ...� - --- r ...._. _S _. ._ - -_ _ —. f_ 55 Net exp. wall Net cas, }nt. wall — 1 f . , I Gelling Floor Total Btu. Vit,: Required sq. ft. E.D.R. ate&i2e: ,rred sn. {S E f1.!?. lir -.q In;. W.A.}.endo atenl — ----- ---- - - -- 7Z -1 _ •-- - —__ F1.1 , Ai Room! Length ix'__ Width { t HetgtJ i1r'iclth _IIeig}tt <<, Windows and Doom -4 rackage and Area 414`13And and Area --- Ntf tih ti el phl ".a -f "r +..n' ft. �A•ea ! .�' .. ti - }!. :1 •�eni fl Aroa Nn_ or pane t•f pa e : iflhte t. . rnek -aq Pt- - .._ _- i y _ -r i,z rlxr to I •�f _rat k -- - i : - �... y __.. - 1 �•� L t. ja II ,_ I t z t, 7 M 14 ,A t c'°' iF. Coef. Rt.0 - - _ Coef. Btu .'. ' Infiltration , ,• ; . „ , L (Z _ i Glass Net exp. walk ''„r 'v aii Int. wall Ceiling i 7 . l'},)Ui t t , total Btta. 6 Required <() ft U -I -i? or sq. ins. W.A. leader Area ; F2e,;u,ee i ft. F -D R, or •.i its.-, W.A. leader area j F i- �)-L.i1_._Room 1 Length _ - y Width civ' t P 4.! Rr•,,•r. f i s •th 4 Width 1 lcight Windows and Df(+rs-Crackage• ar-6 Area } WAidkwt and Drriri,-r-1c.kigr! e..M. Area }V Ydth He:•. , N, of T r,lnex it —... ._ -j-;• . _.._.. u��.a 1 ,ti th i Npirtt, T A : r r,••eh'tt. T Area No. of Dane or r,ane !l,thte ' of crack a, ft i ''-- `.•t nt'raek ad. Pt. _ .._._ '-_-^--�_—__.<<.'_' � _...f rent 14 �..` — C'oe_f.' Btu Oef.j f3tU lnh}trate®fl P lass ` _.. "'� t._ V L _ i . h.,tp. wall �ar • ,,a� -- —-�—__..._ Net exp. wall ! ~. s . t wall — A — 1 1 • • 0 City of Fridley, Minn. BUILDING PERMIT Builder _ _ -- Address l 91 Me N° 6439 lvo. � �� street 5 LO BUILDING T O r=���_-_� _ _,G _ _ _ Part of Lot Lot Block Addition or Sub- on Corner Lot _ Inside Lot Setback ideyard Sewer Elevation ____ — Fo . dation Elevation DESCRIPTION OF BUILDING T as:_ Front Depth _ Height Z40 Sq. F JLCu. –� W Fro t Depth Height __ Sq. Ft.. _ Cu. Ft. Type of Construction :t. CZ 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 aboveset forth and in compliance with all provisions of ordinsnoes of the city of Fridley. .' In consideration of the payment of a fee of $ �� , t is hereby granted 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 vi on of any of the provisions of said ordinances. 1 ---Nn A / / NOTICES This permit does not corer the construction, hnstallMlon for wiring, plumbing, gas heating, sewer or water. Be sure to see tin Building kqm for for mparift peraft for these herds. v APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNED. ° S NAME _tCLA ►tib ADDRESS 6 / 5 I e $;-A h725 9, ADDRESS LOCATION OF BUILDING /f No. 1 ��f ' 5� -Street Part of Lot-_ p Lot .2 Block Addition or Subdivisions L4 � 2_ Corner Lot Inside Lot--4.Setback Side -Yard SEWER SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; 0 S/ / r'���a Front Depth Height e),OA44 Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost 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 R IGNATiTRE i,si�(� (Schedule of Fee Costs can be found on the Reverse Side). SUBJECTMIT NO. City of Fridley 12260 AT THE TOP OF THE TWINS PERM BUILDING RECEIPT NO. `U -y ------ COMMUNITY DEVELOPMENT DIV. INSPECTION r r PROTECTIVE SEC. 1 i = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L•"' ,�J 612-560-3450 910-F15 7/30/73 JOB ADDRESS 6151 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 2 Upland 2nd Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Lonnie Burgess 6151 - 5th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Doughboy Pools 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK Install 40' x 16' Swimming Pool 9 CHANGE OF USE FROM TO STIPULATIONS See Attached memo from Health Inspector TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Steel/Vinyl THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R-1 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 $1,200.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .60 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $9 OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE .60 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) HEN PROPERLY VALID ED j*H1j IS YOUR PERMIT (2. . INSP - �DATE SIGNATURE OF OWNER IIF OWNER BUILDER)IDATEI APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: O/t/ici/t^ 4,R Gf- .SS BUILDER: n cy R Q y ADDRESS: % i STS �j r& 1.( C X ADDREss NO :. G 1 Sl 7" SJ:. STREET: LOT • BLOCK • % ADDITION: U p 4,4/!'5j 1 CORNER LOT: INSIDE LOT:_SETBACK: SIDEYARD: 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; S WiM/,v /tau L T Front: i Depth: [� t -Q ( Height. Square Feet: Cubic Feet: Front• Depth: Height: Square Feet; Cubic Feet: Type of Construction: _91 /- K V1A'pAA Estimated Cost; To Be Completed: I U_J = '_ A 5, - The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in st#ict 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: SIGNATURE: c �� (See Reverse Side For Additional Information.) C) / of 01 W :te. VIV suseEcr PERM151'70 City of Fridley AT THE TOP OF THE TWINS PERMIT ' i. BUILDING RECEIPT O. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. o � � 1 i � ' / -•1 CITY HALL FRIDLEY 55432 �•"• �'� �.1 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 5/2/79 JOB ADDRESS 6151 - 5th Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 2 1 Upland 2nd Addition SHEET 2 PROPERTY OWNER MAILADDRESS • ZIP PHONE Lonnie G. Burgess 6151 - 5th Street N.E. 571-2195 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE x 8 DESCRIBE WORK Construct a 21' x 16' Addition to House 9 CHANGE OF USE FROM TO STIPULATIONS Provide combustion air to furnace area. Provide fire alarm. - WMNINCP Bim' drggmg call Iocat utI SEPERATE PERMITS REQUIRED FO R WIRD , TELEMONE - ELECTRIC - GAS HEATING,' PLUMBING AND SIGNS, REQUIRED -'BY LA TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 336 4032 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 $8,500 $4.25 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST TION OR THE PERFORMANCE OF CONSTRUCTION. $51.00 " PLAN CHECK FEE TOTAL FEE 12. 8.00 SIGNATUREOF CMM,0fOR OR AU ORIZEDAGENT (DA E) WHE PROPERL E S IS YOUR PERMIT ZVID �)NSP DATE SIGNATURE OF OWNER (IF OWNER BUILDERI (DATE) 01 W :te. VIV CITY OF FRIDLEY , APPLICATION FOR RESIDENTIAL BUILDING PERMITS tNEW, ALTERATIONS, ADDITIONS,' OR REPAIRS) OWNER: /,D,,y G e cwl &G S S BUILDER: S �/ Address: 615'1 .4 S r i1 Address: Tel. No.:�Z/�_ No.: street: LOT: _ �.�' BLOCK: —?�— ADDITION: 0 21 -AA( CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS: 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: f -cd / T/ y^/ Front: Depth: / Height: 1 Z Square Feet: 3 G Cubic Feet: aI %,e Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction:y& o FR A NAL' Estimated Cost: $ 7o Be Completed: N d ly s Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side„for additional information. DATE: ^ Stipulations: 4 0 I Goo T,14,0 a �I 9CL00.0- cs. , 06,%6u4T) V. AtI�,. ; P � ►ot V-4 H E. Determine the "U" value of each segment (1-9) and multiply by the area as follows: 11. x „u„ 12. , ®yam x „ „ 3-sem 2. x „U,l _ 'lull 4. X '"U" _ 7. x .,u., , 8. x "U" _ ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. x "U" _ 11. x „u„ 12. , ®yam x „U,l 30 ii2j` J2,'fy ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV , ,1►' G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I Sj'Z 3 (, + Item II &2(a J. Add Item III + Item IV K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. By: DATE: ENERGY CONSERVATION SUPPLEMENT.TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). it is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB LOCATION: 6f s / q' 17fd / A 1-Y OWNER/CONTRACTOR: ADDRESS: '�� �'�i S r �J7 PHONE: Y, .7—/ % ./ A. Determine the Total Exposed Wall Area as follows: 1. Total wall window area z 2. Total door area 3. Total sliding glass door area1,OC� 4. Total fireplace wall area 5. Total wall framing area (average .10 a) 00 6. Total net wall area above floor(average 900);5. 7. Total rim joist area Subtotal: Total exposed wall area above floor y79, s� 8. Total foundation window area -- 9. Total net foundation area above grade '3 S', 3 Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALL AREA B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = Item I l �y C. Determine the Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area 11. Total roof/ceiling framing area (loss) 12. Total net insulated roof/ceiling area 30 2,� GRAND TOTAL EXPOSED ROOF/CEILING AREA ---23- 0 D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = Item II �f10 Ste!. FT. OPAQUE WALL @.17 = 3 �3 •a 3��. FT. CEILTNG @.OS S2. FT. UNVk'i4T CLG. x.10 y I -,TALL ETU IOSR/HRR./SQ• FT./ 001, r a n A E\Tl. k13R ENVELOPE AVERAGE "U'l COMr L"TA1'10�4 i (TSA bo suLim.itted with building pAzrmit appli ".1-0 L or two family dwel l i!10 - OwnerAll other _ Sit,, Address `. Contractor Contractor Date: phone Tr1NM FT. Of EXPOSED WALL. + +, + + + + + +above grade_ _ 33 liar ft TC)TAL EXF ?SED WAL L ARBA OPAQUE.'WALL Covs€ RUCTION : ` "U" value x area OU,l x sq.' ft. (A) "U"s/ZX x sq. ft. 3.vy = 3,, 39 (U3 fA1 Detail reference St urs ta��);rr v _ "U" OG x sq. ft. 3 1's'•?S' - ,2 / yy (U) (A) from. "L'" 043x sq. ft. [,SZ /�_ ('U) .(A) attached sh ets 11�1V0 t,1.aa-1_ ,I U., , y x sq. ft. 33 y 2- !�o-, GU {u', ! ) lout' x sq. ft. - (U) (h) .,U„ x sq. ft._ _ (U) .(A) WINDOWS:. "UR value x area „U„ _ (U) (A) Make & type x sq. ft. flu" ^S'x sq. ft J) Al " q ,;- a ,j-<_a� r,� "lies X sq. ft. _ (U) (n) .,U.l x sq. ft. _ (.U). (A) DOORS: "U" value x area "U" - _ (U) (A) Make & type x sq. ft. ,► ,,� JTrr £ I,Ull ` /2pl x sq. ft. (A) "U" x sq. ft. _ (U) (A) It - TC3TALS S/ 3,91 Sq . ft . S'S'. TOTA'Ir (U) (A) VAZ..L'g'S. S'�� U� _ �(Ps�. AVG. "U'l DIV WED -BY TOTJiL WALL AREA ,S')3i 9' I .17 Avg. "U" Valuel. State Code ROOF/CEILING: ' 33G,0 v sq. ft. "U" Deti1 refelce from x U .o. sq. ft. sq. 'ft. '3v7 - aand sheep. s s t"=fl �t r� 1 cz .�a ++--x "U"fix -Z_ - sq. ft.S ?� _ ,a ti:5r (U} (A) Describe onings "U'' x sq, ft.T- .sq. i L) (A)+ x TOTALS -11(a o U -Sq. ft. AVG. "" as : Avg.. "Un Value, state Codec Vented A6 Avg. "U"' Value, State Gude, Vhventeq ' MINNESOTA `LNERGY.CGDE MAXIMUM THIS BUILDING ESTI-MATED. x 4' BTL' LOSS THIS BUILDING BT?3- Loss N Ste!. FT. OPAQUE WALL @.17 = 3 �3 •a 3��. FT. CEILTNG @.OS S2. FT. UNVk'i4T CLG. x.10 y I -,TALL ETU IOSR/HRR./SQ• FT./ MILLWORK C�JMPA^; r a n A 4 WALL SECTION.'; NOTE: Use 10% of opaque wall area for frame construction Cl) CIS BASIC LSALL 06 FIG. #1 TOPWIET'i OF . N FRA 'T TALL sill seaie Periph-ral Fl F r M-NDATION WALL t � a i " ::0 " I I SLAB ON GRADE Exterior air film 0.17 -0.17' Total #full fluff NOTE: Indicate type, fR" value, depth and placement of in-4ulation. construction R7Va I u,, !�-Valae, 1. Intexior air film U.68 0.68 3. _4 inches soft wood BOO ,7 4)'A.1; 4. 5. 6. Exterior air film .Total fluff }"'hull 1. Interior air film 0.68 0.68 2. f 'S 2, I C/� - 3. 4. 5. 6. Exterior ai---. film O.i- D.17 Total fluff 1. interior air film o.68 2. 3. 4. 5. 6. Exterior air film 0.17 0.17 Total Holt fluff 1. Interior air film 0.68--' SLAB ON GRADE Exterior air film 0.17 -0.17' Total #full fluff NOTE: Indicate type, fR" value, depth and placement of in-4ulation. ROOF/CEILING Feat Flow UP Vented FIG. # 15 r 1 FIG. # 16 Heat Flow rip FIG. # 7 Vented 4 0,�L y, H Flow 7p Fir. 3 Construction k -Value 1• interior air film _ 0.61 0.61 2. 3. V /A/ 4. Exterior air film (still) 0.61 0.61 Trotal 2,7S 1. Interior air film 0.61 0:61 2. 3. Cord Depth 3 ` i r 2 ` ='fAZ dJ 4. � - 5. Exterior air film (still) 0.61 0.61 Total 1 / 1 1. Interior air film 0.'61 0.61. 2 3. 4. Exterior air film (still) O.bl 0.61 Total 1 1 null x = "Urt . 12 1. Inside air film 0.61 0 61 2. - 3. 4. 5. outside air film 0.17 0.17 Tv mal - 1. 1 .1 U71 trr :USe tadditional. 817�� �:y if mre _;pace is r.eeded . for detal = arrl ca? dation-s . Energy Use Form 4 Estimate 'No. A met:,.Qd to fiqui c "Lill Vil I UL18 fol' `" I I s and ctii Ii nos, 1,) wit;', _State' of Minnesota reuT cote "Energy k-onservi-ition it. New !<,Iildincjs, AdditiOns aili RcnnodL'Ied EIC -Me -'Its Of Buildi­qs". This :odcn to be offe...-tivc lanuary 30, AW76. Window Areas, Door Lite lnsul.iL-c3 Glass Area, _Iptscial fllsula`cd Glass Areas N,,�TE: Unit Quantity--Numhmr of units ill (IXX-�UV S91=1, r-1111-2, SQ FT p S'etc- 1, , Zl­ 1, 7 T rVTOTALTOTALQTY DESCRIPTION UNI 1 QTY f T 1 MAAV/)� AA_,rvgLa_ LJINIO-Odu q� PL 'S Z_ C/ TOTAL WIND,71; S2UARE FEFT a9k 91 flu's Rated :ntry_Doors Doors With Insulated Siass Figure Glass Area W 1':indcws Entry Units With Side Lites List -_':'_;.-Ie Lite. only Separately -Double Door Fquals 2 x Single ,)TY DESCRIPTION UNIT Qi'_ SQ, FT/TINIT- TOTAL SQ FT lt�NDEM FALU,ON-OR,K COMPANY co V9 A2 JAILa -Side Lites DC -;'.:7' .13'�J,APE FEET ,)oor '"C" .1-ating "'':'fir I. S;) FT z -'d -de Lite-- "U" Ra ted TDTA.L FEET TIT ET Q ­_i FEVT JO 5 . WALLi1'Jt' f i. ^»:i AM:A C'OMPUTATIUNS Stand�rd _.. �..' ! itis i . , .lat.r �,0>' 5ij. t .,ti. ! G. .x `�' 1 �F:. ft r.a.11=�e % sq. ,ft. ;wall f."Mea stud t:..11 _._ 1. 1 .tss= i' .! in. 1't:. x lit;, t. wall= sq. ft, wall Other stud �c•_:r: F;�l. ?:L:�tes=� _ sq. !`t. "lin. ft. -- lin. ::. wa1.1=_.sq. ft. wall (3Itl.er stud wal: incl. !dat:es= _ sq. f �..`iin. ft . x -lin. ft. t.•, sq. ,ft wall Flate Aria --wail area incl.-.iQ.:ng hi:ee wall ar�2a :30. ft.. _ 30 total s_::i'.<.'•li area �f� '_ sc. ft.. stud and F,iat•� percent allowed by state. Rim, Joist Lir. ft. rim joist S3 �: _��/ s:3. ft./lin. ft. rim joist = �9g2 sq. ft. rim joist Lin. ft. ri:n io_st x sq. ft./lin. ft. rim joist = sq. ft. rim joist Lin. ft. r1r. =.ciS x sq. ft./lin. ft. rim joist = sq. ft. rim joist Exposed Basement Block Inches above brads 8 x .0833 x _lin. ft. wall = 3,f32sc. total ft. blo ': inches above arae x .08:3 x lir:. ft. wall = s;. ft. .block Inches above sdc x .0;= x lir_. ft, wall = sl. f}. block _ Inches above -grade x..0235 �_ x lin. ft. wall = sa. ft. block Inches above grade x_ .0833 x lin. ft. wall = s= ft. block Inches above grade x .0833 x lir.. ft. wall = s_. ft. block Incanesabove grade x .'0233 x lin. ft. wall = ft. block Inches above race x .0833 x lin. ft. wall = it. block Net Wall Areas Total stud( area SF�g, �7 Basement block area �32 ;ess windows ` ' �Q.Q$ Plus area well Less Sours' Less windows Less ..pati o d. :-r; p,Uv_ Less doors i --ss stud and Less fireplacL, L, ss firevl-.­_ TC 'A or Cord r.,t1^xbc_x of C: y �, jc;i �.s _. x _.� i¢:'::�It'rt =/ total ii ... (--,f _^_3s .:r joists ;+ l.ear.gt,r, _' . _ . total !1n. ft. 'i,I. ex of '•1r'ris or �. joi:;t t' _ x length - total lir.. ft ft Sa. ft. Tai fiZ yifil t / of 4 . s 0 SUBJECT P City of Fridley 5 6 7 0 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 4Py-3 r J CITY HALL FRIDLEY 55432 NUMBER REV7 DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/6/97 JOB ADDRESS 6151 5 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 2 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don Habig 6151 5 Street NE 571-8118 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Reroof House (21 Sq) Tear-off 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Residential 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 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ $1,751 $.88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC. $1.75 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION `P56.75 PLAN CHECK FEE TO^L FEE 9.38 U.SIGNA TRACTORORAUTHORIZEDAGENT IDATEI N RO VALI GUREOFCOI D THIS IS YOUR P RMIT%'r P 0 NER oF OWNER BUIL I IDATEI BIAG INSP 4A TE NEW [ ] Effective l/ 1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:6p 1� ( wf � -48t. Legal Description: L©� as , `mac a (JPIA"r-r, . e9"o pco ti i Owner Name & Address: �k p;N,N t, Tel. #6 iP't 119 - Contractor: Ow t4 -22 MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 21-1�- nry� . sQ — � 1 r ro � - �1 f -AQ- b:P Construction Type: Estimated Cost: $ 1'7S-1 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 1 tP 9 '7 APPLICANT: Tel. # 5--) 1 l CITY USE ONLY Permit Fee Fee Schedule on Reverse Side Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: $ .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 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 [ ] SuentT City of Fridley 27867- AT THE TOP OF THE TWINS BUILDING PERMIT r DIV. ECEIPT N COMMUNITY DEVELOPMENT PROTFIR�C 6� 1 i � NUMBER REV DATE vAGE OF APPROVED By CITY HALL FRI 32 612-571-3450 910-F15 9/18/98 JOB ADDRESS 6151 5th St NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 2 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Smith 586-9724 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rick's Roofing & Siding Inc 183 Clevelan Ave SE New Brighton 55112 633-6395 3566 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION REPAIR O MOVE O REMOVE O B DESCRIBE WORK Reroof house & garage (25SQ) 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCE OVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,142.00 $1.07 WITH WHETHER P CIFIED HEREIN NOT. THE GRANTING OF A PERMIT DOES NOT PR SU E TO GIVE AU RITY TO VIOLATE OR CANCEL THE PERMIT SAC CHARGE 2,14 PROVISIONS F NV OTHER ST OR CAL LAW REGULATING CON. Fre SC STRUCTION R HE PERFORM E OF NSTRUCTION $74.75 ifibaffi PLAN CHECK FEE TO F E Licens C $5. $82.96 & NA RE OF CONTRACTOR OR AUTHORIZEO AGENT IDATEI N P OPE ALIDAT PERMI/ �1�10UR - SSG TORE OF OW NER iIF OWNER BUILDS RI IDATEI BLO INSP GATE NEW [ ] Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: S-'`d�E K.< Owner Name & Address: # S o — 70 "51 Contractor: MN LICENSE # Address: /0'3 biz Tel. # lep' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: r,_ Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 DATE: �` l �� APPLICANT: Estimated Cost: $� (Fee Schedule on Back) Ft x $ = $ Tel. #G-?-�-(��sJ� TOTAL $ •94 STIPULATIONS: / CITY USE ONLY � Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ _ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ O $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 $ •94 STIPULATIONS: SEPARATE PERMITS "QUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. r CITY OF FRIDLEYPERMIT .: 2004012�43�' 6431 UNIVERSITY AVENUE NE ' FRIDLEY, MN 55432 DATE ISS /02/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 61515 ST NE PIN : 143024340075 LEGAL DESC : UPLAND 2ND ADD : LOT 25 BLOCK 2 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL AN AIR CONDITIONER. # A/C UNITS I VALUE OF APPL OR WORK 0 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 2400 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 0.00 0.00 CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE GAS RANGE FEE 0.00 ANOKA, MN 55304- GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 5910 0.50 25.50 OWNER ANN GARBOW 6151 5TH ST NE FRIDLEY, MN 55432 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 pres a to give authority to violate or cancel the provisions of y o r state or local law regulating construction or the pe orm a of construction. Applicant Date Bldg Insp D= SEPARATE PERMITS "QUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �iTY OF FRIDLEY BUILDING INSPECTION v 9 3431 University Ave NE 9=ridley, MN 55432 L 763-5723604 FAX 763-571-1287 -, 9 D RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES TMJ $35.00 $ $10.00 $ Gas Range $10.00 $ Gas Dryer $10.00 $ *Air Conditioning -All Sizes $25.00 $-9S .Q0 VvC� U iY1eA O3q All Other Repairs or Alterations (List on Back) } 1% of Value of Appliance or Work $ a Minimum Fee $15.00 for Residential or 5% of cost of Y . Improvement whichever is greater on work less than $300.00 i z) Commercial/industriaVlnstitutional 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/industrial/institutional Y State Surcharge $ .50 i TOTAL FEE $ A5,S'D v REINSPECTION FEE $50.00/HOUR di *Air Conditioners can not be placed in side yard without written approval i+ from adjoining property owner - copy to City N N FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESS Lal 5 Owner 4h n an2�--a LA -D Building Used As Reas l a e e - ESTIMATED COST $,5Z400,00 PERMIT ISO ' L d43 - DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Burner Trade Name BTU Total Connected Load HP Size No, EDR 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 hereby declares that all the facts and representations stated in this application are true and correct. CENTERPOINT ENERGY MINNEGASCO HEATING CO 13562 CENTRAL AVE NE BLAINS, MN 55304 Signed e� Tel # 763-757-6202 FAX# 763-757-6701 Date % oZq-6y Approvei Rough4n Date Final F0, d ld101 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 ftrestopped where required. Yes No( ) The venting system is plastiatPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (y) 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 (x) No ( ) 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 verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA 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 Size/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) CENTERPOINT ENERGY MINNEGASCO HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed By: ) Date: 7 -';Z H IPV'gISL 01 A31G T 8=1 d0 .1M WON -1 q?: T T b002—L2-8ckl CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 YAX: (763) 571-1287 ADDRESS 61515 ST NE PIN 143024340075 LEGAL DESC UPLAND 2ND ADD LOT 25 BLOCK 2 PERMIT TYPE ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01244 R 4't DATE ISSUED: 08/02/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL AN AIR CONDITIONER. # INSPECTIONS 1 APPLICANT CENTERPOINT ENERGY/NIINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304 - OWNER ANN GARBOW 6151 5TH ST NE FRIDLEY, MN 55432 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 wort 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 of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 5910 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 3uilding $ Q-1 9- `S' BUILDING Permit No.: inspections $ Cl RESIDENTIAL APPLICATION Received By: 763-572-3604 $ S-00 CITY OF FRIDLEY Date Rec'd: s )ATE YOUR E-MAIL ADDRESS Erosion Control ;ITE ADDRESS fo Park Fee $ Sewer Main Charge $ Total Due THIS APPLICANT IS: ❑ OWNER NTRACTOR PROPERTY OWNER/ NAME: ADDRESS: 41CITY 'e�/' ± STATEAAZIP Sly ;X TENANT PHONE: 4/1 - l- 8 M CONTRACTOR NAME: KL 6k STATE LICENSE # 9,6191OR R EXP DATE3/31 I,)? yh ' S SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 7 ✓� CITY + STATE��iILIP WITH APPLICATION PHONE bL;:JJ 4W FAX - 7?YJQ PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH j1it00F E3 DRAIN TILE ❑ DECK ❑SIDING 13 OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR M3ZEMODELING DESCRIBE WORK BEING DONE: �I p�� 61T g pyo � 66 z 4J 1 A-lw SIZE OF I1-APROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFWG ❑ HOUSE ONLY NUMBER OF SQUARES MOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: IZDETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 3 1 Cl-- OCCUPANCY TYPE Permit Fee $ Q-1 9- `S' Plan Review $ Fire Surcharge $ Cl Surcharge $ ('P 0 License Surcharge $ S-00 SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ l (1 . See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable to: City of Fridley 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 permit and 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 'ch�reeqquui're1, review and approval of plans. 4'4-L-% SIGNATURE OF APPLICANT N PRINT NAME &I tlh DATE aI4