PRE 2010 DOCS•
CJ
rCity of Fridley, Miran. • *��
BUILDING PERMIT N® 6524
Date: K
4
Owner: Builder
Address Address
ff
�P BUILDING
No. Street �.�/ 5� _� — P of Int
Lot _ Block Addition or Sub -
Corner Lot _ Inside Lot !� -Netback S
Sewer Elevation — — FouUdation Elevation
DESCRIPTION OF BUILDING
T _ _
&X Lsa Front _� Depth ,s � Height lt#n _ Sq. Ft. t.� Cu. Ft.
nt Depth Height Sq. Ft. Cu. Ft.
Type of Construction y'_ Fist. �✓��o 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 of the city of Fridley.
In consideration of the payment of a fee of $ ., permit is hereby granted to_._.
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, constructllon, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon viola�tien of any of the provisions of said
ordinances. _ / 1
Building Inspector
NOTICE.-
"
OTICE:" permit does not cover the construction, Installation for whine, Plumbing, gas hesog, sewer or water. Be sore to see
the Building Inspector for separate permhs for these Items.
APPLICATION FOR BUILDING PERMIT
`CITY OF FRIDLEY, MINNESOTA
OWNER' S NAN1X7/BUILDER Fre°
ADDRESS,J �a /, '(. ADDRESS r ee
LOCATION OF BUILDING
No. Street Part of Lot
Lot Block Addition or Subdivision_% Oar
Corner Lot Inside Lot Setback Side Yard
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:
f Front Depth Height
Sq. Ft. , Cu. Ft. .5 IE�, 20'
Front Depth Height,
Sq. Ft. Cu. Ft.
Type of Construction �� Estimated Coat .� ® e
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. 1167
DATE SIGNATURE
(Scbedule of Fee Costs can be found on the Reverse Side).
suedEcr
PER12'719
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R
11 • COMMUNITY DEVELOPMENT DIV.
�--'---,
J����
e PROTECTIVE INSPECTION SEC.
7
1 �
� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
'•' 612-560-3450
910-F15
9/18/74
JOB ADDRESS 5360 6th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5, 6,
15
lHamilton's Addn. to Mechanicsville SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Richard Blank 5360 N.E. 6th Street
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
garage
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
add 16' to existing garage (16 x 22 addn.)
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WIRING#
HEATING$ PLUMBING ANQ SIGNS.
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
352
3,520
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 TYPE OF WORK WILL BE
WITH WHETHER SP CIF EDNING H REINIOR NOT. THE GRANTING OF AOMPLIED PERMIT
$1,865.60
.93
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
6.50
f
PLAN CHECK FEE
TOTAL FEE
$7.43 r
SIGNATURE OF CONTRACTOR OR AUTHOR("ED AGENT (DATE)
✓J -
W N P OP L ALI TED THIS IS YOUR PERMIT
5C INSP XDATE
SIGNATUREOFOWNERIIFBUILDERI (DATE)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME • ge BUILDER:
ADDRESS : ,rJ G 6 • /y 4-:- ✓JV . ADDRESS
NO : STREET •
LOT: ADDITION: e447
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:
Qom! 4 /J✓z & _ Front .12- Depth: l (. Height: 16
Square Feet: .� �� Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: yam✓ Estimated Cost: $
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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.)
I, owner of the property located.
at 03 c 6 ��CT
have no objection to the City
allowing the construction of a_Cto be located at
5 Uoa 4) rL lgTwiLhout the required certificate of
survey that the City ordinarily requires for all new construction.
Signed
Address
Date
Witness
r
r
�
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On March 1, 1996
In � ( 61 r
ater eater
0o u o. Gas r W H
Wash tria:k»;:;;:. FI r OOh:.:. A t Cale:;.;.... M sc,::
Stories Closet Urinal TuVi.. Shower `Snk Tray )=auht Drain gastn Washer 'Apps Range <j=1xt Gas Elec
..
Basement
.
Floor 1..... .
... ...........
...... . ...... .
............. .. .......
::
Floor 2
.... . ................. El
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas** 411__
NO. RATE TOTAL
—I
Gas Range** _
Gas Dryer** _
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
16•
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS �
1.5% of Value of Fixture or Appliance
State Surcharge $ .50
TOTAL FEE $ o°4.54
JOB ADDRESS 52 6 C & r 6
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.
f/ //3 '1996
Owner P . e— 14-ro-2_'-) &a""{ .7 7 d� —0 Ira. -
Building
s
Building Used As K �_ S
Estimated Cost PERMIT,, NO.
PLUMBING COMPANY —TO 7q°U ��
SIGNED BY y TEL N0.
Approved By Rough—In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
01
SUBJECT
PE
City of Fridley
9846
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
' • COMMUNITY DEVELOPMENT DIV.
/� p1
-- - _____
"
� � PROTECTIVE INSPECTION SEC.
Y Uy 7
1 i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
;
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/9/99
JOB ADDRESS 5360 6th Street NE
1 LEGALLOT
NO.
BLOCK
ADDITION
SEE ATTACHED
DESCR.
5, 6
15
ITRACTOR
iami 1 ton's Addition to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Richard Blank
572-8069
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Cedar Pointe Const. Inc. 2200 W. 66th St. Ste 182
-
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof house and garage 28 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
2447
11-22
DOES NOT PRESU ME.R9 GIVE AUTHORITY TO VIOLATEQR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF,*KY TM R TE OR LOCAL LA ULATING CON -
R CTION T P O ANC F CONST N
$83.25
Fire SC $2.45
PLAN CHECK FEE
TOTAL FEE
ice a SC $5.00
1$91.92
NATUA FCO •RAC TOP 0AAUTMO EO AGENT (DATEi
EN OPERLY LID TED T SIS YOUR PERMIT
_
1-9-99
S,GNATURE OF OWNER,IF OWNER BUILDER, iOATE.
SLOG -NSP -
0AIE
01
NEW [ I Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: j� 6
Legal Description:
Owner Name & Address:,, ' ,zo
Contractor: �/�� �i� '"� MN LICENSE #
Address: ,�-� �,� i
�,-. o .rf�Z� Tel. # (al Z-,) 7Y9— 79 Y9
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: V , W/idth Hgt/Grounnd Sq. Ft.
OTHER: l) 4�h �S ' G
Construction Type: Estimated Cost: $ 7
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
31
DATE: 4 APPLICANT: Tel. iolz ,;Pg9 791 -
Permit Fee
$ (0)3.Z-
(")3.Z-Fire
FireSurcharge
$ - S
State Surcharge
$
SAC Charge
$
License Surcharge
_
$ - O O
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ ��
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
SUBJECT
City of Fridley
30763
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
_ COMMUNITY DEVELOPMENT DIV.
'O
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910 -F15
3/24/00
JOB ADDRESS 5360 6 Street NE
1 LEGAL
LOT NO,
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5,6
15
1 Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dick Blank 5360 6 Street NE
572-8069
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Four Season Construction Co Inc PO Box
32033, Fridley, MN 55432 786-4039
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
2456
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW jl ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct an addition to dwelling (10' x 13')
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notation on plan.
SEPARATE PER41ITS
WARNING
REOUIRED FOR. -
WIRING
P HEATING
Before dipping call for
tUNIBING AND SIGNS
all utility Iodetl®ns
454-0002
.
SEPARATE PERMITS ARE REOUIRED 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
$28,000
$14
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS O OTHER TE OR LOCAL LAW REGULATING CON-
$422.55
Fire SC $28.00
TRUCTION R TH P NCE OF CONSTRUCTION
PLAN CHECK FEE
License C $5.0
TO FEE
469.55
SIGNATURE OF CON'RACiORO MORIZED AGENT IDATEI
MEN PR VALI A THIS I OUR R
i
BL G IN So jV 4r)A I'E
S,GNATURE OF OWNEROF OWNER BUILDERI IOATEI
NEW [ l Effective 1/1/2000
ADDN [ j CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: lGg [A,4Tel. #
Contractor: an Txgc� ' MN LICENSE # -00*g e
Address:_ .i�r SC V4cLlPDX) ��Zk3x--7 Tel. # - a -D��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. FL
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER:
Construction Type:
9JA ALG' -All 5 Q LEstimated Cost: $ gp'00,�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$
DATE: 31 APPLICANT: Tel. #,66 - 7&36 —116,0 -
-10,0 -CITY
CITY USE ONLY -
Call (763) 572-3604 for Permit Fees If mailing in application
Permit Fee
$ %-;7•SS Fee Schedule on Reverse Side
Fire Surcharge
$ .226- 60 .001 of Permit Valuation (1/10th%)
State Surcharge
$ /fes $.50/$1,000 Valuation
SAC Charge
$1100 per SAC Unit
License Surcharge
$ ,r do $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 $ /,S -S
STIPULATIONS:
Form for use with Minnesota Rules part 7670.0475, Subp.2
1 & 2 Family Residential "Cookbook" Method
SITE ADDRESS
CITY
5360 -6TH STREET N.E.
FRIDLEY
BUILDER
DATE
FOUR SEASONS
2/16/00
Minimum Criteria:
Rim Joist: R-19 insulation Foundation Windows: Insulated glass, 1/2" air space, wood or vinyl frame
Entry doors: 1-3/4 inch solid wood with storm or better
STEP 1 Window & Door Area
Total Window & Door Area Sq. Feet
WINDOWS (including foundation windows):
Dimensions Qty Area
DOORS:
0.0001 1 0.000
0.000
0.000
Total Doors Area 0.000
Total Area of Windows & Doors 24.890
BOX A
Total Wall Area in Sq. Ft.
Wall Total Perimeter Heiaht Area
STEP 2 Calculate area as a percent of wall
Box A (window & door area)divided by Box B(total
wall area) times 100 equals the window and
door area as a percent of wall area (BoxC)
Box A 24.890 x100= 9.428
Box B 264.000 1 Box C
STEP 3 Design Features
ASSEMBLY OPTION
FRAME WALL:
STANDARD FRAMING X
ADVANCED FRAMING
CAVITY INSULATION R- 19.000
SHEATHING:
LESS THAN R-5 X
R-5 OR MORE
WINDOWS(EXCEPT FOUNDATION WINDOWS):
U -FACTOR U- 0.320
From the table, determine the maximum percent
window & door area for the design options selected
and enter the value in box D below:
18.800
BOX D
Box C must be less than or equal to Box D 11
Assembly R and U -Factor Forms
ASSEMBLY ROOF AT FRAMING
Material (Describe)
Material (Describe)
Thickness
R -Value
Interior Film Coefficient
.680
.610
Sheet Rock
.450
.560
Ceiling Member
6.870
4.350
Insulation
2.070
44.000
.200
Exterior Film Coefficient
Exterior Film Coefficient
.610
Total Assembly Thermal Resistance
50.130
Assembly U -Factor (1/Total R)
.020
ASSEMBLY WALL AT FRAMING
Material (Describe)
Thickness
R -Value
Interior Film Coefficient
.680
Sheet Rock
.450
Stud
6.870
Sheathing
2.070
Siding
.200
Exterior Film Coefficient
.170
Total Assembly Thermal Resistance
10.440
Assembly U -Factor (1/Total R)
.096
ASSEMBLY RIM
Material (Describe)
Thickness
R -Value
Interior Film Coefficient
.680
Insulation
19.000
Rim
1.890
Sheathing
2.070
Siding
.200
Exterior Film Coefficient
.170
Total Assembly Thermal Resistance
24.010
Assembly U -Factor (1/Total R)
.042
ASSEMBLY ROOF AT INSULATION
Material (Describe)
Thickness
R -Value
Interior Film Coefficient
.680
Sheet Rock
.560
Insulation
44.000
Sheathing
2..07
Siding
.200
Exterior Film Coefficient
.170
Total Assembly Thermal Resistance
45.410
Assembly U -Factor (1/Total R)
.022
ASSEMBLY WALL AT INSULATION
Material (Describe)
Thickness
R -Value
Interior Film Coefficient
.680
Sheet Rock
.450
Insulation
19.000
Sheathing
2..07
Siding
.200
Exterior Film Coefficient
.170
Total Assembly Thermal Resistance
20.500
Assembly U -Factor (1/Total R)
.049
ASSEMBLY BLOCK
Material (Describe)
Thickness
R -Value
Interior Film Coefficient
.680
Concrete Block
1.280
Optional Insulation
Stud
4.350
Exterior Film Coefficient
.170
Total Assembly Thermal Resistance
6.480
Assembly U -Factor (1/Total R)
.154
Exterior Envelope Thermal Transmittance Worksheet
SITE ADDRESS
Insulated Area 2
CITY
.049
FORM COMPLETED BY:
DATE
26.400
ASSEMBLY
2.529
FLOOR
AREA
AREA
Sq. Ft.
24.890
U -Factor
U -Factor
x Area
_
Doors
.000
.170
,�.
Insulated Area
130.000
.022
2.863
c
Framing Area
130.000
.020
2.593
C
Skylight
Above Grade Foundation Wall
.000
.000
L
Other
Foundation Windows
.000
.000
.000
-�
Patio Doors
.000
.000
a,
Other
.000
.000
.000
N
.000
.000
c
.000
_
CL
.000
_
Totals
A 260.000
B 5.456
(D
Average U -Factor B 5.45606308
/A 260 C
.021
v
Required U -Factor (from Energy Code):
I ID
.026
F
If C is greater than D, or G is greater than H, revise the design as necessary to meet the envelope
criteria of the Energy Code.
1) U -factor for skylight and window must be determined by the National Fenectration Rating Council Standard 100-91
or ASH RAE 1993 Handbook of Fundamentals, Chapter 27, table 5.
2) Thermal Transmittance of opaque components (including Integrally Insulated masonry and metal stud framing) -
use part 7670.0450, subpart 4.
Insulated Area 2
212.710
.049
10.376
Framing Area 2
26.400
.096
2.529
Windows '
24.890
.320
7.965
_
Doors
.000
.170
.000
_
Rim Joist
19.000
.044
.836
Fireplace Wall
.000
y
Above Grade Foundation Wall
.000
.154
.000
Foundation Windows
.000
.000
-�
Patio Doors
.000
.360
.000
Other
.000
.000
N
.000
c
.000
CL
.000
X
.000
LU
.000
Totals
E 283.000
F
21.706
Average U -Factor F 21.70563319 /E
283 G
.077
Required LI -Factor (from Energy Code):
H
.110
If C is greater than D, or G is greater than H, revise the design as necessary to meet the envelope
criteria of the Energy Code.
1) U -factor for skylight and window must be determined by the National Fenectration Rating Council Standard 100-91
or ASH RAE 1993 Handbook of Fundamentals, Chapter 27, table 5.
2) Thermal Transmittance of opaque components (including Integrally Insulated masonry and metal stud framing) -
use part 7670.0450, subpart 4.
1
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BANKE TRUST CO. OF CA.
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2000
Reinspection Fee $47.00/Hr SIGNED BY TEL N0.
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Approved ByRough-In Date Final Date
State Surcharge $ .50 MINIMUM FEE40R ANY PLUMBING
TOTAL FEE$ �Urs� PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
JOB ADDRESS 5 3 b 0 u'r� /U E
New Fixtures
$ 7.00
The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture
$ 4.00
specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser
$ 5.00
and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin
$ 7.00
and representations stated in this application are true and correct.
Catch Basin
$ 7.00
p
Rain Water Leader
$ 7.00
' ? —/, , 2000
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Owner
Water Heater -Electric
$ 7.00
Water Heater - Gas**
$10.00
Building Used As
Gas Range**
$10.00
Gas Dryer**
$10.00
��11
Estimated Cost PERMIT NO. ®e 6
Back Flow Preventer Required ( )Yes
() No
Type
$15.00
PLUMBING COMPANY �e W6 ( ITV Z
Reinspection Fee $47.00/Hr SIGNED BY TEL N0.
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Approved ByRough-In Date Final Date
State Surcharge $ .50 MINIMUM FEE40R ANY PLUMBING
TOTAL FEE$ �Urs� PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No
The venting system is plastic/PVC and meets all current codes 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
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 () 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-GAMA 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
Appliance #2 Type
Appliance #3 Type
Total Appliances
_ BTU Input
BTU Input
_ BTU Input
Total Btu Input
Fan Assisted or Nat
Fan Assisted or Nat
Fan Assisted or Nat
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)
HEATING CO:
Signed By: Date :
CITY OF FRIDLEY INSPECTION DIVISION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Effective On January 1, 2000
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ 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 an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$ a�5,s o
pp DATE Go f2 I fa000
HEATI 0 `� or�.•c,.
Signed TEL # ((2- 111' 73
461
Y./
Approved By Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
JOB ADDRESS 53 ( 0 ro*L .,Z, 4, E .
OWNER FOOS- —(:7�So'►s Cm -t iA �J
Rate
$ 30.00
TOTAL
$
((��
BUILDING USED
ESTIMATED COST #SOo-oa PERMIT NO.
$ 10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ 10.00
$
Trade Name Size No.
BTU HP EDR
$ 25.00
$
Fuel Total Connected Load
Burner Trade Name Size No.
$-L% 0
BTU HP EDR
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ 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 an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$ a�5,s o
pp DATE Go f2 I fa000
HEATI 0 `� or�.•c,.
Signed TEL # ((2- 111' 73
461
Y./
Approved By Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes 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
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 () 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-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes �4,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
HEATING CO:
. v.1 J*t &., 1
Signed By: Date aeo®
Effective January 1, 2003
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 -, APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
FAX (763) 571-1287
'B ADDRESS c3L ��.S�T �' cr
JO
RATE `SCHEDULE
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
OWNER K(A-Pb`' 8,49 -AJ
BUILDING USED;AS J_ AJC
ESTIMATED COST 'o�� PERMIT N0.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units -. Circle One .(Steam) (Hot Water) (Warm Air)
-rade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
-'.BTU HP 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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEAT INGS a10C-P-1®'e,
Signed
FAX #
DATE_
&A-)7PA<_T0i.'S 7 A
Approved By Rough -In Date
e,e VSrw L/
TEL #
Final Date Q11119-3
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Residential Rate -
TOTAL
Furnace Shell and - Duct Work, Burner_ -
Also Replacement -Furnace $ 30.00
$
'(Side Vent 4iIL06t Back)
Gas Piping (Needed_wii:h new furnace, $ 10.00
$
but not replacement)
Gas Range - $ 10.00
$ `
Gas Dryer _ $ 10.00
$
*Air Conditioning Alf Sizes $ 25.00
$ ..
All Others/Repairs 8`Alterations (LIST ON BACK)
1% of Value of Appliance or Work
$
}
Commercial/Industrial
1.25ajo of Value of:Appliance: or Work
$
State Surcharge
$ 50
_ TOTAL FEE
$
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
OWNER K(A-Pb`' 8,49 -AJ
BUILDING USED;AS J_ AJC
ESTIMATED COST 'o�� PERMIT N0.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units -. Circle One .(Steam) (Hot Water) (Warm Air)
-rade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
-'.BTU HP 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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEAT INGS a10C-P-1®'e,
Signed
FAX #
DATE_
&A-)7PA<_T0i.'S 7 A
Approved By Rough -In Date
e,e VSrw L/
TEL #
Final Date Q11119-3
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE