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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 1 LOT 4 I 1 I I Qt IFHARP) K.--- BLANK T#29909 LOT 5S. I 1 � 1 l t e 4s4o BANKE TRUST CO. OF CA. IJSE 1 - CERT. �7�37 ' A I -OT 7 1 I I I 2 i w 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