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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT Date: - —., .._ C Owner: Address N° 266 Builder ..- e _...................... .. __ ...._......_...:_.. ..__.._.._.._.. _ __ Address---_...__..._.._.........___.._.._.._..._..._._. ._.__ _ _._.._.._.._.___ ...00AT N , OF BB�UILDING No. _..._ ._-------- Street __. .._.'E':_. ._. � .,...._._.._.._... Part of Lot ....._.._.. _— _.._ ....._..... .._... _ _ Lot .......... A............... Block ._---...- .............._.......... AFIdition or Sub -Division ......_ _.:.. ....�°�.��:?�-�.._ e me + Corner Lot .......................... _........ Inside LotX ............................ Setback .��_....��........a.._........ ideyard Sewer Elevation .....__ .......................... :......_...._............._......._...._......._...._........ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: p _ -- Front!..!...' Depth�.._�� Height .- f.=.. Sq. Ft. l f.T Cu. Ft. °�....t.....__. -�.=on Front ) .4.. v Depth AV:t".0 �h++tgg��- _°.e_A Sq. Ft. Cu. Ft. Type of .................... _....... - .................... ........ Est. Cost.113I1 . L7tt.........._.... 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 of the city of Fridley. -.).(............ ....... _..._.. .__._.._..._...._._.___. __..» _..._._ .___....__..._._ In consideration of the payment of a fee of $..^ :.'::.:.._9-' 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 violation of any of the provisions of said ordinances. .0 Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. w` APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builder Address ddress LOCATION OF BUILDING No.r.. Street 75 -Part of Lot Lot Block_.� Addition or Sub.Div. Corner Lqt,... 'Inside. 'Lot Set Back 0 Side -Yard "Y SZM?'K3VATIO.N:' FOUNDATION ELEVATId Applicant attach to this form Certificate of Survey of Lot And proposed building location. DESCRIPTION OF BUILDING To used as:' Front �/_/z G Depth Height Sq. Ft./�-, Cu.Ft./ on Depth2- Height. ��__2_ Sq. Ft Type of Constru .. . I .; I : ** To be comoleted �'-' "Ft -i ated Cost/z. The undersigned hereby makes application for a permit for the.work herqGn specifiedp agreeing' -%6 66, all w6rk. --iff, strict accordance with the. City Ordinances and ruling of the Department of Buildings, and hereby declares that all the.facto and representa- tions stated in this application are true and correct. DATE SIGNATURE., J, -u, (A Schedule of Fee costs can be found on the Reverse Side.) P City of Fridley, Minn. BUILDING PERMIT Date: Owner: _. _.... Builder Address.._. Address _. .._. _. N4 4651 bOC/ATION OF BUILDING No. _..__.. Street 4-3-0 ------ ...._............._..._......._ Part of Lot .__ ........ ._.._ _. .. �y4-7-----_---- Aor Sub -Division Lot Block....._......ition _..._ ... Corner Lot ------ -- ---------••---...... Inside Lot . ............ Setback ..... � ........._._.... Sideyard ...... .......-- .-............. ... - Sewer Elevation To Used �; .. Mins _. ......_ Front FroType oftruction . Foundation Elevation ESCRIPTION OF BUILDING Depth eight --••--.. Sq. Ft. .i! .�':•CU. Ft. . Depth ..... H"^ eigh�, _.. Sq. Ft.: _............ Cu. Ft..._ f . P -_------..t. st... tl.' . To be Completed ............ _....__........................ r� ALYTI� THIS PERMIT DOE.:; NOTTU ORI_ZE VIOLA T . ICN OF ANY PI, A -I -E LAND COVENANTS AND BUILDING RESTRICTIONS. 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. ��rr In consideration of the payment of a fee of $�If..............., 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 violation of any of the provisions of said ordinances. 17 �{ 1 Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 0 4 APPLICATION FOR BUILDING PE DW CITY OF FRIDLEY, MINNESOTA Owners Name Builder Address ,,,®. ciz, -2-7—"dress LOCATION OF BUILDING No. of Lot Lot 42- Block___, Addition or Sub.Div. e , Corner Lot! side Lot Set Back�`%> Side SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BU11DING To be used as: t-x� 0 ja� Frontes Depth x- /r'Height . Sq. Ft. /--:2 ZCu. Ft.aa C Front/c Depth a- Height Sq. Ft. -; 2 6 Cu. Ft,© / SV Type of Construction ,„ Estimated Cost . zZe-) To be 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 / — J SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side,) HARVEY A. CARTWRIGHT ANQKA COUNTY SURVEYS HENNEPIN COUNTY SURVEYS MINNEAPOLIS SURVEYS 8410 PALM STREET N.W. SUNSET 4-7899 OWNER INDUSTRIAL — JUDICIAL BUSINESS — TOPOGRAPHICAL CITY LOTS — PLATTING .Andy Hohn r, veno CA�TWRSG� & OLSON LAND SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 326 PLYMOUTH BUILDING FEDERAL 8-6721 HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA dourbepor'g Cerfitkatt COMBINING THE RECORDS OF J. E. HILL, CIVIL ENGINEER ESTABLISHED 1898 C. F. SANDHOFF CIVIL ENGINEER ESTABLIS14EO IBM JAMES NELSON SURVEYOR ESTABLISHED 1968 METROPOLITAN LAND SURVEYORS. ESTABLISHED 1951 I hereby certify that this is a true and correct.representation of a survey of: Lot 12, Block 5; Edgewater Gardens as sur veye d by me this 2 5th day oV April, 19 64. A r�AT �A ?' ._AAAA ° GARTWRItiHT AND, OL90N I OIL City of Fridley, Minn. BUILDING PERMIT N°s 14 7 Date: f.- / j - Z�VO &j/A 4 Owner: Builder Address Vf-Address -,,,,,1 CATION OF BUILDING No. street art f t Lot "_ Block Additi r Sub -Division Corner Lot — Inside Lot —is's� Setback - `� S14K dd7____— — Sewer Elevation Foundation Elevation DESCRIPTION BUILDING 2 KUnd / Front Depth ght Sq. Ft. 1�`'IF` Cu. Ft. Fro Depth ight.0or F't. Cu. Ft. ction Est. Cost To be Completed In consideration of the issuance to me of a permit to construct the building described above I agree to do theproposed work in accordance with the description above set forth and in compliance with ail provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $t' ; + Penote5 \101 I hereby certify that this is a true and correct representation of a survey of: Lot 12, Block 5, Edgewater Gardens as surveyed by me this 26th day of April, 1960. SIGNED / e° c. .. -..i Y. C RTWNIG r i. ol �D> OL9ON . ' r L., HARVEY A.`^CARTWRIGHT C w & J. E. HILL THE RECORDS of J. E. HILL. CIVIL ENGINEER ANOKA COUNTY SURVEYS ESTABLISHED 1898 NENN WIN COUNTY 8 LAND SURVEYORS MINNEAPOLIS SURVEYS MINNE C. F. SANDHOFF 8410 PALM STREET N. W. REGISTERED UNDWR LAWS OF STATE OF MINNESOTA CIVIL SHED B ER ESTABLISHED 1908M SUNSET ,4-7586 LICENSED MY ORDINANCE OF CITY OF MINNBAPOLId OWNER - JAMES NELSON 328 PLYMOUTH BUILDING FEDERAL 8-6721 SURVEYOR INDUSTRIAL —JUDICIAL HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA ESTABLISHED 1988 BUSINESS — TOPOGRAPHICAL ��ftt METROPOLITAN LAND CITY LOTS — PLATTING oilg SURVEYORS. ESTABLISHED 1881 Andy Hohn ` Invoice 21295 705/23 + Penote5 \101 I hereby certify that this is a true and correct representation of a survey of: Lot 12, Block 5, Edgewater Gardens as surveyed by me this 26th day of April, 1960. SIGNED / e° c. .. -..i Y. C RTWNIG r i. ol �D> OL9ON . ' r L., APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA owner's Name Builder19_e_"__./ Address 4/ i 4121 S_�X Address _4'-7 LOCATION OF BUILDING C s No. Street L S� art of Lot Lot % Block _ Addition or Subdivisi K_.v Corner Lot Inside Lot �,� Setback �',,�� ,,,,_Side-YardlQ, SEVIER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING ./ 6 Dentb = JC Sq. Ft. �/J 1, Cu. Ft Front, Depth Height Sq. Ft. Cu. Ft. Type of Construction_ Estimated t-41 Lo— r__ - r 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 ruling of the Department of Build- ings, and hereby declares that all the facts and,: epres®stations stated in this application are true and correc . 6 f� DATE / / � � SIMIATURE (Schedule of Fee Costs can be found on the Reverse Side). o..0 City of Fridley Application for Plumbing and Gas Fitting Permit DePL of Bldgs. Phone SII 4-7470 1 DESCRIPTION OF WORK Fl-- Number, z Number, Kind and Location of Fixtures Location y I NO. RATE TO�AL Number Fixtures ....... .............. x $1.50 $ / 0 0 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. 8a� C U Q[ <3 �U' °d�O $ U0' F N WATER HTR. GAS ELEC. Base v $ GAS FITTING FEES: NO. RATE TOTAL � v 1st v 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings I Connected with Sewer � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TO�AL Number Fixtures ....... .............. x $1.50 $ / 0 0 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... .................. .. x 3.25 $ ` d Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 19� Owner 116 Z-/ 5'a'4-- Kind of Building )E Used as To be completed about Estimated Cost, $ Old—New. Building Permit No (o 1717 Permit No. Signe By Business Phone No ROUGH /0 9 ' `0 -Z-' FINAL Description ................................................$ TOTAL FEE $¢ ' 42 sM r Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Derives 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 $ y each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ 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 $ V 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 $ �/ L / I AIR CONDITIONING $ •`�� FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SII 4-7470 Loc.tio 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_ S /� g 19 _ Owner Kind of Building 1"O� Used as`� To be completed about Estimated Cost, $ Old—�New�uilding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Named,-t.,;,.r �� ? -- f, Size No �,9—'9®® Capacity Sq. Ft. E.D.R L �` ° /BTU H.P. Total Connected Load <� y�� Kind of Fuel )U - BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe By uu N b`2 E�-�1-���� 42 2M Business Phone No Compliments of North Central Public Service Co., TWAT LOSS CAMATIONS � — 6'��� a L DEPARTWMT OF Weatherstrips A.SJLV.E. Construction No. Windows I -Doors I Reference I Out. Wall lint. Wall) Ceiling �I FL Room I Length ,9 y Width / Height pa Windows and Doors—Crackage and Area and Area No. No. Wldth of pane Height of pane No. of lights Lineal ft. of crack Area Alf 76 3 Coef. Btu Coef. Btu Infiltration Btu AID 4 Glass Vit) Coef. Btu Infiltration Exp• wall &, Exp. wall m f y ® 3 P /Y O Glass af Net exp. wall WO D //000 Exp. wall -Y y= zza / !<, o Floor Net exp. Wall D Int. wall Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Int. wall and Area Ceiling Width Height of pane of pane No. of Lineal ft. lights of crack Ceiling eo —3q o D A) Floor (0 Total Btu_ Total Btu. 42, OF 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. ;,, J JeARoom I Length / R3 Width JC/ Height Windows and Doors—Crackage and Area No. No. Width Helght of pane of pane No. of Lineal ft. lights of crack Area sq. ft. 29 A (�/ a 1 Alf Coef. Btu Coef. Btu Infiltration Btu AID 4 Glass Vit) 3 d e Glass 0-0 Exp• wall qa Exp. wall m f Exp. wall Exp. wall af Net exp. wall n D Ceiling Int. Wall Net exp. wall B �" / !<, o Floor /0 D Int. wall Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Windows and Doors—Crackage and Area Ceiling Width Height of pane of pane No. of Lineal ft. lights of crack Area sq. ft. eo —3q o D Floor Total Btu_ /3-060 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I IF � Fl. I j,4 [, r—O Room I Length C/ Width 1 Height Windows and Doors— Crackage and Area Doors—Crackage and Area No. Width Height No. of of pane of pane lights Lineal ft of crack Area aq. tt Area sq. ft. 29 A (�/ a 1 Alf Coef. Btu Infiltration Coef. Btu AID 4 Glass ,? ,,/3 Glace 0-0 Exp• wall qa Exp. wall m f Exp. wall Net exp. wall Int. wall Net exp. wall Net exp. wall n D Ceiling Int. Wall / B �" / !<, o Floor Total Btu. 3 Total Btu. I: Required sq. ft:. E.D.R. or sq. ins. W.A. Leader area L -- M -C I / Fl. Insulation Floor Kind How Applied /3,,,1 Room I Length /,3eWidth Ih—" Height !V Windows and Doors—Crackage and Area No. Width of pane Height No. of of pane lights Lineal ft. of crack Area sq. ft. Area sq. ft. Coef. Btu Infiltration 31 ,? ,,/3 Glace Glass P & O Exp. wall m f Exp. wall Net exp. wall Net exp. wall (, Int. wall Int. Wall Ceiling Floor Ceiling Total Btu. 3 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Windows and Doors—Crackage and Area No. Width Height of pane of pane No. of Lineal ft. lights of crack Area sq. ft. eo 9 3 Coef. Btu Infiltration 13 nJ Glass 3 Exp. wall al y X— ✓(� Net exp. wall A a d.7 i /V Int. wall Ceiling Floor u �; Total Btu. P s - Required sq. ft. E.D.R. or sq. ins. W.A. Leader area l FL oom I Length--,_ Width t- Height Windows and Doors—Crackage and Area Iq `� 17 ! - 'i l Width No. of pane Helght oElpane No. of lights Lineal t. of crack Area sq. ft. Coef. Btu Infiltration ,,/3 Glass Exp. wall Net exp. wall Int. Wall Ceiling Floor Total Btu. �-O Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Compliments of North Central Public Service Co., CITY HEAT LOSS CALCULATIONS TOWN DEPARTMENT OF BUILDINGS VILLAGE Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows Doors Reference Out. Wall WallHj_eiling Roof Floor Kind How Applied Yes—No I Yes --No 19.. jInt. II I 9 Fl. Room I Length " :i- Width /3 Height 7 Room I Length Width Height Windows and Doors—Crackage and Area (� No. Width Height of pane of pane No. of lights Lineal ft. of crack Area sq. ft. Area sq. ft. Coef. Btu Infiltration Coef. Btu Infiltration Btu Infiltration a Glass Exp. wall b Exp. wall 7 k ¢I yr Net exp. wall Net exp. wall Exp. wall Int. wall 0'q joy j! ® O Ceiling Ceiling Floor`/ �� a Total Btu. ,� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Windows and Doors— Crackage and Area Total Btu. No. Width Height No. of of pane of pane lights Lineal ft. of crack Area sq, ft. Windows and Total Btu. and Area No. Width of pane Height of pane No. of lights Lineal t. of crack Area sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Coef. Int. wall Infiltration Ceiling Glass Floor EXP. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Windows and Dooms—Crackage and Area Int. wall No. Width Height No. of of pane of pane lights Lineal ft. of crack Area sq. ft. now Total Btu. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area. No. Width of pane Height No. of of pane lights Lineal ft. of crack Area sq. ft. Coef. Btu Infiltration Coef. Btu Infiltration Exp. wall Glass Net exp. wall Exp. wall Int. wall Net exp. wall Ceiling Int. wall Floor Ceiling Total Btu. Floor —E-1 Room I Length Width Height Windows and Total Btu. and Area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Windows and Doors--Crackage and Area No. Width of an Height of pane No. of Lineal Pt. lights of crack Area sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area —E-1 Room I Length Width Height Windows and Doors—Crackage and Area No. Width of pane Height of pane No. of lights Lineal t. of crack Area sq. ft. Coef. Btu Infiltration Glass EXP. wall Net exp. Wall Int. wall Ceiling now Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Effective Date May 1. 1988 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Job Address r / ^ 6 5 / w �. z , Department of Buildings City of Fridley Tel. 0571-3450 RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 S Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($1S.00) TOTAL FEE $m,5-0 The undersigned hereby makes application for a Permit -for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this a0lication,are true and correct Fridley, Mn. �cV , 19 d a OWNER Q/1 U t7i A 17 n KIND OF BUILDING _ t Arn USED AS ( J /I ) .ip l • A S TO BE COMPLETED ABOUT ESTIMATED COST I O�( as OLD - NEW BUILDING PERMIT NO. ROUGH INSP. Date FINAL INSP. Date Company Signed B Tel. No. APPROVAL FOR PERMIT `x/iv9 0 ?1INIMUM FEE FOR ANY PLUMBING PERMIT IS E15.00 PLUS THE $.50 STATE SURCHARGE M tr c w v Water 01 a N wed � of F aroi 'y C bg d rixi ¢ W tp Heater C 3 M 8 .0 .i Cf CW u v t i U t) r� 3 o w U.. U ' K 3 m U O W 5 Elec 1st 2nd 3rd 4th EH (R) - Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 S Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($1S.00) TOTAL FEE $m,5-0 The undersigned hereby makes application for a Permit -for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this a0lication,are true and correct Fridley, Mn. �cV , 19 d a OWNER Q/1 U t7i A 17 n KIND OF BUILDING _ t Arn USED AS ( J /I ) .ip l • A S TO BE COMPLETED ABOUT ESTIMATED COST I O�( as OLD - NEW BUILDING PERMIT NO. ROUGH INSP. Date FINAL INSP. Date Company Signed B Tel. No. APPROVAL FOR PERMIT `x/iv9 0 ?1INIMUM FEE FOR ANY PLUMBING PERMIT IS E15.00 PLUS THE $.50 STATE SURCHARGE (oyy CITY OF FRIDLEY INSPECTION DIVikION 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 o / JOB AD Effective On January 1, 2002 RATE SCHEDULE�( 4 > l OWNER Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $� r'f 3 (Side Vent-- Fill Out Back) ESTIMATED COST l�• CO PERMIT NO. l Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range �_ $ 10.00 $ 1 No. of Heatin UnitsI T Ci c e One (Steam) (Hot Water) arm Air Gas Dryer $ 10.00 $ �rTrade Name QU�£ Size No. BTU 10 1000 HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel _ Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Ind'ustrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE o representations stated in this application are true and correct. $ ` DATE /�, MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HE TIN=J]e1?1e1�'Q1JftbJe 1 i/ (111 REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 g L # PLUS THE $.50 STATE SURCHARGE Signed FAX # 53 REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date written permission from adjoining property owner. THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When re In acing an axokunrj f iranep, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. The venting system is plastictPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. The existing cnmh ,s inn air is sized and installed to meet the current codes and manufacturers specifications. When required to install a new cnmhus+inn air.itwill be sized and installed to meet the current codes and manufacturers specifications. -Yes (j No O- Yes P�'No ( ) Yes VrNo( ) When installing a new venting nystnum, the undersigned hereby verifies that it is a listed assembly and meets the current codes and, manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (,)No Is the,common vent and vent Connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. YesnWo ) Appliance #1 Type F ua4yi BTU Input 'Xi 000 Fan Assisted or N - Appliance #2 Type IAJ,4 4,u ff fiC BTU Input Fan Assisted or at Appliance #3 Type BTU Input Fan Assisted or at Total Appliances - Total Btu Input ff i Common Vent Type 13 ` 19?A t Vent Height 1$ Diameter b I inches Appliance #1 Vent Connector Height ( ft Length )- ft Diameter in Type j Appliance #2 Vent Connector Heightr i -- It Length =ft Diameter in Type a Appliance #3 Vent Connector Height ft Length ft Diameter in Type ek) Z - s l• znaz-e r--/7-5ALl( HEATING CO: 044vAkif QvP,1 Signed By: 0 Z- N /} DEC -10-2002 20;43 Center -Point Minnegasco it I614T4 WORKSHEET 07UM OUS@ John Steffen 1 Minnegalsco TOO Wast Linden Avenue. ►Wlnnespolis, Mn SM03.1187 PNone. 612-321-5590 Fax: 612-321.8503 612 321 5550 P.04 c� t GS & LA*y i0J. E , FR;o Iliy f M4 TS yJX Printout certified by RCCA to meet all requirements of Manuel J 7th Ed. w trl !" litS�i t Rttggn1-Salle gesroenital" 5.5.15 RSR30570 2002-gvr-10 20:2200 C:UVIy Dt menlellNrlghisotl 4tl�AClTempieteV 681-2 Way NE Prldley.rsr Page 1 MANUAL. J: 7[n t0. Name of room Entife House whole hpISe TiCeIngs lengthof exposedwell 130.0 fi 13Q.0 ftRoomdimensions 25,0 x 0.0 it Condit. Option 8.0 ftj d R heaticool NO a Htg� (�Chlg} Aq8.0 ��g (®11 tClg Area cjg Area Hlg Cig EXPOSURE NtgµT 8 4� ((t��a HV 17 Gross a 12 6.3 2.3 1040 •«• "•• 1040 E7 Exposed and b q C 1 46.9 11.5 9.3 0.0 260 390 •°'° rrr. "" 2 0 390 ""-" ''•' ° '* "'"' °'°° """ partitions d 0.0 0.0 0 e 14 13.2 2.6 0 f 16 6.8 0.0 0 ..r. rrrr 0 6 Windows and a 2A 4p33y.7 "" 137 5987 "" 137 8987 «_°' as OOis 0.0 '" i t°"• $ D «« rrrr .wr Hestin 9 G D Q d 0.0 or.r D D .... «.re .... 01 o 7 Windows and North Sze 48 '"« "« 1467 4fb ° 148® °� :.r. glass doors NE/NW 0.0 0 0 6 CoolingSE/aW 90,0 011 .rrr 39 0 44 ... 391 «.. 0 ..., South 49.6 48 2381 48 2381 °'°• ""'" 01 6 Other doors a 10F 29.4 8.2 42 1236 344 42 1236 344 b O.D 0.0 0 0 0 0 0 0 C 0.0 0.0 0 0 0 0 0 0 9 Net a 12 J.9 2.3 9.3 861 7129 1 1984 2427 exposed b 14 260 12199 24 7 260 12199 walls and 0 16A 11.5 0.0 390 4485 Q 308 4489 0 partitions d 0.0 0.0 0 0 0 0 0 0 a14 13.2 2.6 0 0 O 0 0 0 f 15 6,8 0.0 0 0 0 0 0 10 Ceilings 16 44 O0p.�g2q IODS Dq0 4416 2208 1000 4416 2208 b p 0 d o.o ( Q.4 0 o 8 p0p p0p 0 0 0 0 0 0 11 Floors a 21A 2.2 0,0 1000 2208 0 1000 2208 0 (Note: room b 1.0 p pp 8 ppp 0 0 0 0 0 0 0 0 0 pl3nmeter of 0.0 0 D 0 Is dlspt, d 0.0 0.0 0 0 0 0 Q Q I for slab a 0.0 0.0 0 0 0 0 u V floors} f 0.0 0.0 0 0 0 0 0 0 12 infiltration a 5$.0 6.9 179 10379 1241 179 10379 1241 13 Subtotallassa6+8..+11+12 .... 48040 '"" "°" 4$040 -- I Lass external heating ►ler 0 r+rr rif4 0 s°.e tett r°!° I tRr7M °hrr Less transfer ,M•r 0 °+a. ar.+ DI Ouap�redistrlbutlor, 0 r•°•0° 0 •'• rrr. t4 •• a •-w- 16 Total lose 0 13+14p ••°• 48040 °"°2°0p •ft" 48040 **"" "°"' �'° "« '••' 16 Int. gains: Ap�1 ie( 1188 4 1 ""° 1� 17 Subtot RSH otA p7+..+12+ '°"" ""°' 18438 «rr "`r 19438 °r" °•" """ `"" Lees external tooling Mw rare 0 rrw rwr r11RR rrne rrw rrrr L a$S transfer nr° srw d nw rrw. I rr+r «.. rrra o..a 18 Coolingredistribution Duct •° °°® r..r rrrr ra.r 0 18 20 gin Total R§ 98in= 17+18}`P'LF Air 1.00 °'•• '""' 18438 1.20 °ia° a" 184 � ••� r"" requi ( } 988 986 886 Printout certified by RCCA to meet all requirements of Manuel J 7th Ed. w trl !" litS�i t Rttggn1-Salle gesroenital" 5.5.15 RSR30570 2002-gvr-10 20:2200 C:UVIy Dt menlellNrlghisotl 4tl�AClTempieteV 681-2 Way NE Prldley.rsr Page 1 Building PLUMBING Permit Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATEa7 YOUR E-MAIL ADDRESS SITE ADD SS Sit aS QUM61f Arturo Salinas Lopez THIS APPLICANT IS: ❑OWNER CONTRACTOR 8165 1/2 WAY NORTHEAST PROPERTY NAME: Fridley,MN 55432 OWNER/ ADDRESS: 6123091121 7E ZIP TENANT PHONE: CONTRACTOR NAI,,M: NORBLOM PLUMBING CO, STATE LICENSE # O& S ((; d'),ry�Q SUBMIT A COPY OF YOUR STATE ADDRESS:STATE ZIP LICENSE WITH PHONE F l APPLICATION PERMIT TYPE )(SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK gr," &AaJe.✓ l%a�t✓ PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00; whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This.should_reflect only.the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to. $500 = cost of labor X.05 = .MR3'ROJEM WHERE LABOR EXCEEDS-i00;TEES ARE BASED ON $10.00 PER FIXTURE,EXCEP7MM- REN TE.:FTXR:_.(iND1GATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV _FLOOR DRAINS —SHOWER _ WATER PIPING _ —BATHTUB _ GAS PIPING jw m crirumm) _ SWMANG POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) --LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION —DISHWASHER WATER METER OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = State Surcharge = $ .50 Tow -L3 .SD 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 ap . tion 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 f ork whir equines review and approval of plans, SIGNATURE OF APPLIC PRINT NAME Jfl#OI4 140% DATE /,7 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977