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PRE 2010 DOCS
City of Fridley, Minn. BUILDING PERMIT Date: .... .... . Owner: .. . . ........ . . .................... Builder ......... ........ . ...... Address it — Address ....... . ... . .........__...._......._--•-_....... LOCATION OF BUILDING StreetWip't .................... ........ . ..... Part Of Lot Lot p1l.00*4 70 Block ..... . ..... I. -A6.. ................... Addition or Sup-Dl��,X ( Comer Lot ..... . ...................-••--.... Inside Lot . ................. Setback .. ............ Sideyard .......... .............. . .............. Sewer Elevation .................................... ................... ........................................ . Foundation Elevation DESCRIPTION OF BUILDING T _4e Used as, Front A/ Y --- Depth Height Sq. Ft. Cu. nPlIVIA4 ................... . .............. ....... . .. ........... Front ............ Depth .......... Height Sq. Ft. ........... . .. Cu. Ft . .......... ............ Type of Construction. Est. To In Completed ........... ....... ............................... ILE- THIS PER A17 D(:),- N`F AUTHORIZE VIOL:AT,. ION O1F Ai" Y,- GOVE","&ITS AND 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 $Vj .. . . . ........ . ...... permit is 'hereby granted to.. ---_.._.._.................7---------- .._---.. _ _ _._._ _..____�._. _..:::.. to o ............................ 7 ---------- 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 thereofi shall conform In all respects to the ordinances of Fridley, Wnnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ),,t�/"Zew�3ullding Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or wafer. U sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name „ ►' Builder AddressAddress LOCATION OF BUILDING No. Street Part of Lot Lot ,.9 S_Vg, Block _/ Addition or Sub.Div� - Corner Lot Inside Lour Set Back„- Side -Yard 6 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 es Depth =1.4 Height _1_!L16 - A Sq. Ft. �I�?i� Cu. Ft.,, dS -.I-'- Sq. Ft. Front Depth Height Cu. Ft. Type of Construction u Estimated Cost l�.� To be P '/ C5 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 S / % SIGNATURE &_k )'" �=& o (A Schedule of Fee costs can be found on the Reverse Side.) Application for Power Plants and. Heating. Cooling, Ventilation, .Refrigeration and Air Conditioning 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 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ 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. EDR Steam....... 8.00 $— Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR 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 GAS BURNER (up to 400,000 BTU) ....................... 5.00 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 FEE ROUGH FINAL �g;ad Dept. of Bldgs. Phone SII,). -4)-7470 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. Fridley, Ifflinn_ Owner v � Kind of Building Used as Zel& To be completed about e Estimated Cost, $ Old ew wilding Permit No. �� Permit No. DESCRIPTION OF WORK 10 HEATING or POWER PLANTS -Steam, of Wa , Warm Air—No� Trade Name dwe,2 26L Size NO- e4 2eg Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) By .� 4 z 2M 7.59 Business Phone rjff i . Apptication for Power Plants and'. Healing. Coding. Yentiletion..Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 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 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 80,000 BTU ....................... .................. 2.00 $ _ 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. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR 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 GAS BURNER (up to 400,000 BTU) ....................... 5.00 - GAS FITTING FEES: NO RATE TOTAL,,, 1st 3 Fixtures ...................... x $1.50 c 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 FEE ROUGH FINAL e7( 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. Fridley, blinn_ i' 19 AP 41 Z--) Owner Kind of Building'-X&� Used as To be completed about Estimated Cost, Old Ne . Building Permit No. � ��d Permit No. ,o DESCRIPTION OF WORK -S HEATING or P WER PLANTSte Hot WatQ, Warm Air—No Trade Nam Size No '.2-3 Capacity'05 Sq. Ft. E.D.R BTU H.P. Total Connected Load ,.1� 26 0 Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signed( By i� 42 1M 7-59 Business Phone No -"t (REMARKS—OVER) W � . FORMB S ' V L(i ONS �r ° � e Agk�EPARTMENTHEAT LOSS CALC T Weatherstrips .H.V.E. Construction No. Guide Windows Doors Reference Qq ,W Int. Wali , Ceiling Roof Floor Kind Yes—No Yes-1Vo 19 r ci I ... •a.•_o__ r e.....t, .i • wr..kh / V666r II Fl I Room Length Windows and rs—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack nq. ft. Width Height No. of Lineal ft. Area No. of pane of pane I lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane fights of crack sq. ft. tz�P �/ —z, x 9 Coef. Bta Infiltration Glass Coef.1 Btu Coe£ Btu I/,)[, Infiltration Glass Int. wall 1.2 '100 Exp. wall Net exp. wall Glass /1 2 4 - A 15 CIL 6 Exp. Wall, Floor ;Z6 O X573, Ceil. Net exp. wall Int. wall Floor a �® E Ceil. Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area / R-1,9— . Room I Length /I Width S— Height . Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack nq. ft. Width Height No. of Lineal ft. Area No. of pane of pane I lights of crack eq. ft. ZZ Coef. Bta Infiltration Glass Coef.1 Btu Infiltration Int. wall I/,)[, io Glass Int. wall Glass Exp. wall Net exp• will '100 Exp. wall Net exp. wall / /1 2 4 - A Int. wall Floor ja O X573, Ceil. Ceil. Total Btu. 7 6 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area m I sty% _ / R. I I .onot6 / 9 ® Width ® / Hekht Windows and Doors�rackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack nq. ft. y ZZ Coef. Bta Infiltration Glass va Exp. wall Net exp. wall 6 Int. wall E"6 wall Net exp. wall �16 Floor Ceil. o Total Btu. 1'/ 2 7- O Required sq. ft. E.D.R. or sq. ins. W.A. Leader area . LOW PARK, 1V &N. Insulation How Applied Width Height Windows and Doors---Crackage and Area Width Height 140.0t Lineal ft. Area No. of pane of pane lights of crack eq: ft. ZZ Coef. Btu Infiltration Glass d 713— � E"6 wall Net exp. wall �16 le o Int. wall Glass Exp. wall Net exp• will Floor / /1 2 4 - Ceil. Total Btu. / / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area m I Rums I Length / Width // Height Windows and Doors—Crackage and Area Width Height No.'of Lineal ft. Area No. of Dane of pane lights of crack sq. tt. Coef. Btu bmtmd6n o Glass Exp. wall Net exp• will 1761 3 / /1 2 4 - int wall Floor Ceil. Total Btu. (O J 4 u Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. Room 1 Length Width Height Windows and Doors—Crackage and Area Glass Exp. wall Net exp. wall Int. wall Flocs Total Btu. Required sq. ft. E.DJL,or sq. ins. W.A. Leader area Btu P®NM 8D HEAT LOSS CALCULATIO S BUILDING DEPAR Weatherstrips.E. Contraction No. ZCuidveaWindows Doors Out.. all 'Int.Wali Ceiling Roof Yes—No Yes-ios R.. Mnath % ® Width J 20—E66a[ 979, it �Fl Windows and Dors—Crackage and Area Glass Width Height No. of Lineal ft. Area No. of pano of pane lights of crack sq. ft. 3® 2b t Net exp. wall i Int. wall Cod. Bta Infiltration I A elo I g Glass Required sq. ft. E.D.R. or sq. ins. W.A. Leader i —1 I 1. _■ tOF 1.1 Exp. wall 6 16 Exp. wall Net exp. wall Net exp. wall 21L 16 10 Int. wall Ceil, //® 1161/®6 Net exp. wall Floor Floor iij,40 Ceil. ` .S' Cr Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area. �Fl.) Room l Length Width Am Windows and Doors--Crackage and Area Widtb Height No of Lineal tt. Area No. of pane of pane lights of crack eq. ft. Infiltration Glass Width Height no. of Lineal St. Area No. of pane of Mae lights of crack W. ft. Exp. wall t Net exp. wall i Int. wall Btu Floor Y6 Ceil. ;S Total Btu. hatrati6n Required sq. ft. E.D.R. or sq. ins. W.A. Leader i —1 I 1. _■ tOF 1.1 0 Floor I) Kind . LOU PAtK, MINN. Insaiation How Applied Height Windows and Doo, t�-Crackage and Area Width Height No.'of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height no. of Lineal St. Area No. of pane of Mae lights of crack W. ft. j 13 l i �- Btu Coef. Y6 IgfiltratlOII � CoeE Btu hatrati6n /Btu /° 2, 0 Glass � 6 S 16 Exp. wall Net exp. wall Exp. wall Net exp. wall Int. wall 1761 Floor 10 Int. wall Ceil, //® 1161/®6 Net exp. wall —.—. Floor iij,40 Int. wall Ceil. Floor Total Btu. I t3_ Required sq. fa E.D.R. or sq. ms. W.A. Leader area: r, n_ 1 t ---.L // Width /./ Heieht 17 Windows and Doors—Crackage and Area Width Height No.'of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area Na of pane ofmane lights of crack sq. it. j 13 l i �- Btu Infiltration Y6 Coef. CoeE Btu hatrati6n Exp. wall ` � 6 Glass 16 Int. wall Exp. wall Net exp. wall Int. wall j0Z 19 r_25 Floor 10 Floor Ceil, //® 1161/®6 Net exp. wall Ceil. �5 / 0 / ll Int. wall Floor Ceil. e! 11 Told Btu. 161'C-? Required sq. ft. E.D.R. or sq. ins. W.A. I.eader area t i Width // Height Total Btu. Required sq. ft. E.D.R. or sq. ins. WA Leader aiea - Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area Na of pane ofmane lights of crack sq. it. Windows and Dors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. �- Btu Infiltration Y6 Coef. Bta Infiltration?® Exp. wall ` � Glass 16 Int. wall Exp. wall Net exp. wall Int. wall Floor 10 Floor Ceil, //® 1161/®6 Ceil. �5 Total Btu. Required sq. ft. E.D.R. or sq. ins. WA Leader aiea - Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area Na of pane ofmane lights of crack sq. it. e. Coef. Btu Infiltration Y6 Glass 6 Exp. wall Net exp. wall 0 Int. wall Floor Ceil, //® 1161/®6 Total Btu. Required sq. ft. E.DJL,or sq. ins. W.A. Leader area I Application for Power Plants and. Healing. Coding, Ventilation, Reh igerMO... and Air Conditioning 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ... — .................. 2.00 $ 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. EDR 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 GAS BURNER (up to 400,000 BTU) ................ F.. 5.00 $ /0 00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $6 Additional Fixtures ................. 3 x .50 $ / 'S—p Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ - a ROUGH FINAL cq Dept. of Bldgs. Phone SU. 4-7470 T —s&C-- .s" 3 /n l - /,...r�z 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. Fridley, Minn_ La lg La Owner Kind of Building Used as To be completed about Estimated Cost, $ Permit No. �%` �� Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade N—p Size No Capacity. Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name s Size No Capacity Sq. Ft. EM.R BTU H.P. (REMARKS -OVER) 4 z 7M 7.59 Business Phone No City of Fridley �-,A �— ©o 39/J 6431 University Ave NE Fridley MN 55432 (763) 572-3604 or Fax (763) 502-4977 Water and Sewer Permit Application ❑ New Connection4UWtatand lity Line Repair/Relocation [:]Existing er Sewer Connection Date: t Job Address: %l— Name of Applicant (Plumber): Name of Property Owner: Existing Structure Permit # Permit Type: Sewer Fee: Water Fee: 40 — Meter Fee: Repair Fee: Relocation: State Surcharge: SAC Charge: Special Assessment Fee: Total: $_� Applicant Signature Inspector approval: Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See En ' eerin' Cost of Water Meter See Utility Billing SAC Charge $1675 State Surcharge 1 $ .50 Water Tap I See Engineering