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PRE 2010 DOCSCity of Fridley, Minn. N° 9978 • BUILDING PERMIT Date: — Oct. 10, 1968 • • Owner: Roland Zacharias Builder Same _ Address 1387 66th Ave. N. E. Address _ Same LOCATION OF BUILDING No. .._._13 87 Street _ _ 66th A e,, , N. E. _ _ � _ Part of Lot Lot ._..__...2._.._..__ Block ^Addition or Sub -Division _ Dennis Addn. Corner Lot ._— Sewer Elevation Inside Lot Setback --_ Sideyard -- Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Addntogaarage int _ _ Depth Height 10 ' Sq. Ft. 341 (U, Ft, Front Depth _ _ Height _ Sq. Ft. Cu. Ft. Type of Construction _ _ Frame Est. Cost — $11 Q„_QQ______ 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 coFnpliance with ill provisions of o / I n�inances of the city of Fridley. C,/ In consideration of the payment of a fee of $ 6.00peL - is hereby granted to Roland Zacharias 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 buildinirs within the dty limits and this permit may be revoked at any time upon violation of any of the provisions of d ordinances. ��.�' B Inspector �Clarence Belisle., NOTICE: This permit don not cover the construction, installation for whine, plumbing, gas heating, sewer or water. Be sun to see the Building Inspector for separate permits for these Items. f �; ,�� __: r �. r 1 �' C S. � a y pl/tAls Were rto y � y r hd'4v eVe r/ G.®v�J T (p Gk i T®,dvTTo6cssf, 9, //o�,• :sr TT,wy 1 Fr: dle oo 1017/6$ �8 42 /Zyo, goo /i D I'��i�J � ft�h�F•`�s { 'F APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNEFc @S NAMEZ d/ c zfjGb, rr,'�s BUILDER ADDRESS 1392- 6 T" ZiLLe &16� , ADDRESS LOCATION OF BUILDIBTC- NO a -126Z STREET G C rti /dv e , 111E-- LOT 11LOT BLOCK ADDITION OR SUBDIVISION COR -'\M LOT INSIDE LOT--A—SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form. Two Certificates of Survey of Lot and proposed building location, drawn on these Certificates. To Be Used As: r® DESCRIPTION OF BUILDING el �� h Front Depth Height Square feet _J 141 Cubic Feet Front Depth Height Square feet Cubic Feet Type of Construction �Zd Q �� Estimated Cost To Be Completed % /?& The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application a -re true and correct. DATE lc� /d Z-, sf SIGTTNATURE--�W (Schedule of Fee Costs can be found on theev rse Side.) 0 SUBJECT PERMIT NO. of Fridley 23699 AT THE TOP OF THE TWINS BUILDING PERMIT [7/ Ir?City �` COMMUNITY DEVELOPMENT DIV. tr ----_PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF CITY HALL FRIDLEY 55432 612-571-3450 910415 JOB ADDRESS 1387 66th AVE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 DENNIS ADDITION SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ROLAND ZACHARIAS 1387 66th AVE FRILDEY MN 55432 571-8814 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D & B HOME IMPROVEMENTS 1568 BALLANTYNE IN SPRING LAKE PARK MN 784-0922 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING RESIDENTIAL 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE xx 8 DESCRIBE WORK REROOF HOUSE & GARAGE (23Sq) TEAR -OFF 9 CHANGE OF USE FROM TO STIPULATIONS `.. UNDERLAYMENT MUST COMPLY WITH THE STATE BUILDING CODE. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED 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 I 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 $2,890 1.45 WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE ROVISION OF ANY OTH TE OR LOCAL LAW REGULATING CON- $74.75 FIRE SC 2.89 S CTIO HE PER O MA E OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE ah5---LICENSE SC 5.00 $84.09 SIGNATURE OF CO ACTOR OR AUTHORIZED AGENT ID EI WHEN PROPS 7 VALI TED THIS IS YOUR PERMIT SIGNATURE OF OWNER, IF OWNER BUILDER, (DATE) L09f INSP DATE NEW. [ l Effective 8/l/95 -NEW. [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit ApplicationWIS-1 ConstructionAddress: a Z % �/-�V'� a1 �E Legal Description: Owner Name Address:^�1� ;� Tel. # � Contractor•G"leg"L`yu. / _ MN LICENSE # d %-7-7Z_ Address: ytJ G L Tel. # — ®i Z Z Attach this application, a 'cafe of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Length Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback _ Type of Construction: Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. DATE; — �— '?S:APPLIZ kNj T� Side Yard Setbacks Estimated Cost: $�� ; (post on Back) W. y a, WA , 1 -,Al CITY USE ONLY Permit Fee $ S2" Fee Schedule on Reverse Side Fire Surcharge $�y�% .001 of Permit Valuation (1/10th%) State Surcharge $ %, -A5_ $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ 00 $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 $ �` STIPULATIONS: ?02 SUBJECT IT NO. City of Fridley 3 032 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. MoPoe i L ; r'�',', CITY HALL FRIDLEY 55432 NUMBEA REV DATEPAGE OF APPROVED BY -_-• L J\ 612-571-3450 910415 10/1/99 JOB ADDRESS 1387 66th Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 Dennis Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roland Zacharias 571-8814 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Dave Wiger Const. 901 Rice Creek Ter NE Fridley 55432 572-8403 8392 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ROX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construction of 201611 x 141 family room 9 CHANGEOFUSEFROM TO STIPULATIONS See stipulations on plan. Permit issued subject to submittal and approval of energy calculations. WARNIN Before digging call i0r all utility locations SEPARA rE 454-0142 PERMITS REQUIRED �'oR W IN% HEATIN, REQUIRED BY LAIN, PLUMB 1NG AND SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 '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 $15,000 $7.50 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- TR $251.25 Fl SC C HE-eERFORMANCE OF CONSTRUCTION $15.00 PLAN CHECK FEE TO FEE V Licen C $5. 2 8.75 SIGNATURE OF TRACTOR OR AUTHORIZE D AGENT IOATEi H PR Y VALIOAT THI$ IS YOUR P/ERM �5- - g INSP MATE S,GNATURE OF OWNER,IF OWNER BUILOER, IDATEI ?02 NEW [ ]' Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 V- Construction BUILDING PERMIT APPLICATION 0 b Address: x,367 of 0'r Legal Description: Owner Name & Address: lQoL4AJ0 Tel. # Contractor: DINE l V / a 0?- MN LICENSE # Address:_ 70/ �>rjr CgAgrt— 7F�c� Tel. # 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 o�©.� Width If Height8 Sq. Ft. 02? 7 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ".O 1S X !y MA X G3 . SS = Construction Type: Mill `LY eA Estimated Cos . Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Plq VIE W/ (FAP, Tel. # 6'70? 7-0TOTAL $ d 7� • � A/� / �`l �l / (,C / � y17 i r7-,4 L / Q r�r��Z� L 6F STIPULATIONS: CITY USE ONLY Permit Fee $ o �,; �� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 7 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 00 $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 [ ] 7-0TOTAL $ d 7� • � A/� / �`l �l / (,C / � y17 i r7-,4 L / Q r�r��Z� L 6F STIPULATIONS: 1400 a 7'idAJ 7d hkWf d�e PoL4.vO of ate® S'V "P' -t/l,e ®1�®I'v��0 f%011 Tia �✓ #4 s eA)`,►4po4.jr c - T/1irs /�� e.s 7h'F Y fp's/jG,' Cao LAF Plfo eY 7'fff _ /4a /Nf 0 sQ <T, //✓/ lJOo w r 6 F pda,? Oet # 11 T1 �iNA9d 4a W,e,gro-FA? s.R, pp» e- ( NE FWOAlr MW O lxjr LJ I e� ST�� L / NSA e � T�� a°°�2. l� '",4r4FS tWd TO dLU W/NOdWs 5'7(2-8'ya3 MINNESOTA ENERGY CODE II1-2 Family Residential Building RESIDENTIAL "COOKBOOK" WORKSHEET Applicant Name 040160 k!/&,2 Phone Date Statement of Compliance: The proposed building design represented in these Building Official Use Applicant Address l'?ieIF Cr��'�it %��'�' documents is consistent with the building plans, /7"Re specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Building Address: 13 8r 7 616 RA7 ,S'SS�3�7 requirements of the Minnesota Energy Code. 12% ' 14% t 18% 20% Applicant/Engineer 1v111vI1VIUMI KEVUIKL':1Y LIV'I'S for "Cookbook" Option: Entry Doors 1-3/4";solid wood w/ storm Ceiling with energy truss R-38* door o'r equivalent Foundation Windows Insulated Glass w/1/2" gap in Ceiling with low heel truss R-44* wood or vinyl frame Ceiling -no attic R-38 w/ R-5 sheathing *Insulation Performance at Winter Design Conditions Window and Door Area 100 x - _ % As % of Exposed Wall Area Window/Door Area Gross Wall Area Window/Door Area MAXIMUM WINDOW U-VATATFS! J. Rini joist R-19 Floor over R-24 unconditioned space WINDOW U -VALUE : Source: NFRC or ASHRAE 1993 Handbook Check Wall WALL TYPE MAXIMUM WINDOW AND DOOR AREA % OF EXPOSED WALL AREA Type Used 12% ' 14% 16% 18% 20% 22% 24% 26% 28% 30% 32% 34% TYPE A 2x4 framing, R-13 insulation, sheathing R-7 or greater. 0.55 0.47 0.41 0.36 0.33 0.30 0.27 0.25 0.23 0.22 0.20 0.19 TYPE B 2x4 framing, R-15 insulation, sheathing R-5 or greater. 0.52 0.45 0.39 0.35 0.31 0.28 0.26 0.24 0.22 0.21 0.20 0.18 TYPE C 2x6 framing, R-19 insulation, sheathing less than R-5. 0.48 0.41 0.36 0.32 0.29 0.26 0.24 0.22 0.21 0.19 0.18 0.17 TYPE D 2x6 framing, R-19 insulation, sheathing R-5 or greater. 0.56 0.48 0.42 0.37 0.34 0.31 0.28 0.26 0.24 0.22 0.21 0.20 TYPE E 2x6 framing, R-21 insulation, sheathing less than R-5. 0.51 0.43 0.38 0.34 0.30 0.28 0.25 0.23 0.22 0.20 0.19 0.18 TYPE F 2x6 framing, R-21 insulation, sheathing R-5 or greater. 0.58 0.50 0.44 0.39 0.35 0.32 0.29 0.27 0.25 0.23 0.22 0.21 s u,u ,-- U-11W111a 11JLWJJUIaI{UIIJ UI UIC Values In me t:nergy L uoe, tart /t) /0.0475. Supp, 2. This is a summary only. Other requirements may apply. See the Minnesota Energy Code. 2/s 96 Questions? Call Department of Public Service Information Center at 612/296-5175 or 1-800/657-3710. xc�. MINNESOTA ENERGY CODE 1-2 Family Residential Building EXTERIOR ENVELOPE U -VALUES WORKSHEET Applicant Name: Phone 7 Date Statement of Compliance: 4tar0 wlaER .f707-8 Yo3 T i W The proposed building design represented in these documents is consistent with the Applicant Address: etc, '�' �L�r �, �� building plans. specifications. and other calculations submitted with the permit application. The proposed building has been Building Address: /�r7 44 A W J e� designed to meet the requirements of the 11 Minnesota Energy Code. Required U -Value from Energy Code: ® 0.026 Applicant/Engineer Assembly - Ceiling/Roof Area (Sq Ft) - U -Value U -Value x Area Ceiling/Roof (Total Framing and Insulation Area) ��- ..�� ' Mlyj 7 A Ceiling/Roof (Total Framing and Insulation Area) 62,111 Skylights / Other Totals 1D Average U -Value: OO 7,,Cr=10 �� QQ , �� ( = OO x ® _ Required U -Value from Energy Code: ® 0.026 Assembly -Exposed Wall Area (Sq Ft) U -Value U -Value x Area Wall (Stud and Insulated Cavity) 62,111 �S / Wall (Stud and Insulated Cavity) Fireplace Wall Rim Joist 0 Windows �� p Doors - Above Grade Foundation Wall Foundation Windows Other Totals OO 71. Average U -Value: OO + © �6 Required U -Value from Energy Code: ® ./y6 OO 0.110 @ _ © x O = TRADE-OFF PROCEDURE: If OO is greater than ®, or ® is greater than OO , revise the design as necessary to meet envelope criteria of the Energy Code. If the total of OO +OO UZ is less than or equal to the total of OO + po 0J, then the design meets Energy Code. 1 Wood frame, metal frame, masonry U -Values are found on the Wall U -Values Tables. Calculation eouations are on no t t-15 of the chile 2 U -Value for skylight and window must be determined by the National Fenestration Rating Council Standard 10091 or ASHRAE 1993 Handbook of Fundamentals, Chapter 27, Table 5. This is a summary only. Other requirements may apply. See the Minnesota energy Code. 2/5/96 Questions? Call Department of Public Service Information Center at 612/296-5175 or 1-800/657-3710. Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dak"'MT: DATE Zd % U --7 YOUR E-MAIL ADDRESS SITE ADDRESS /.3 r7 /o L THIS APPLICANT IS: >OWNER ❑CONTRACTOR PROPERTY NAME:_94J 2 A,s OWNER/ ADDRESS: Id e7- l,1.�A /%& /�G= CITY �L' : ��%ti STATE TENANT z TENANT PHONE: CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE ADDRESS: CITY STATE—ZIP— LICENSE TATEZIPLICENSE WITH PHONE FAX APPLICATION PERMIT TYPE (,(SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW [�&PLACEMENT DETAILED DESCRIPTION OF WORK r PER MS 16B.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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 BATH SINK/LAV _FLOOR DRAINS SHOWER _ WATER PIPING —BATHTUB _ GAS PIPING cNr•.rn c'nrtn•i:Nsh.) _ SWIMMING POOL _ WATER SOFTNER ($35) —CLOTHES WASHER _ KITCHEN SINK _ _ WATER CLOSET _ BACKFLOW PREY. ($15) _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANJ,'t�� PRINT NAME Rd /,d,cLj ZA4A tg;6t�5 DATE `a 10 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 e Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANJ,'t�� PRINT NAME Rd /,d,cLj ZA4A tg;6t�5 DATE `a 10 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 CITY OF FRIDLEY INSPECTION DIVISION 10, 1999 Effective On May 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS /3 !f % e / Th /�,�a lklz RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Pipi g Needed with new furnace, /but not replacement) Gas Rang Gas Dryer 'Air Conditioning - All Sizes All Others/Repairs & Alterations (UST ON BACK) 17o' of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ 10.00 $ 25.00 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. OWNER_ Ph J,- 1 7 , 4' Ar_i-s BUILDING USED AS /TOW,. -e- ESTIMATED ESTIMATED COST PERMIT NO. 13 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade 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 L__ .50 rulings of the Building Division, and hereby declares that all the facts'and 'Z -SD representations stated in this application are'true and correct. HEATING CO Si Approved By DATE Rough -In Date Final Date TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes O No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CE I EY AND STACK VERIFICATION -' The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes O No ( ) 3. Has no foreign objects lodged within : Yes O No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes O No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: o-40/ TY OF FRIDLEY INSPECTION DIVISION rU 131 University Ave NE 1\2 idley. MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, ® i3.572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES a - F2 RATE 5 ssidential -umace Shell and Duct Work, Burner %iso Replacement Furnace (Side Vent - Fill Out Back) .mas Piping (Needed with new furnace, but not replacement) Sas Range Sas Dryer Air Conditioning - All Sizes %II Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work a 3mummial/Industrial E2 L.2596 of Value of Appliance or Work LL 0 it L) I' v Effective On January 1, 2001 JOB ADDRESS I39: `ld / ll•-� OWN ER_ Od Il�� XI UV UV I_04 Rate TOTAL BUILDING USED AS dpad �j � C� — $ 30.00 $ ESTIMATED COST 001 lJ � PERMIT NO. $10.00 $ DESCRIPTION OE, FUjiNACE AND OR'BURNER r $ 10.00 $ No. of Heati7NF�H nits Circle Circle One (Steam) (Hot Wate100 $10-00 $ Trade Na Size No. BTU P EDR $ 25.00 $ Fuel Total Connected Load. State Surcharge TOTAL FEE INlttitiilYl FEE FOR ANY HEATING/CODUNG/VENTILATION EFRiGERATION/AIR CONDITIONING PERMIT IS $25.00 LUS THE $.50 STATE SURCHARGE INSPECTION FEE $47.00/Hr Sir Conditioners can not be placed in a side yard without i ritten permission from adjoining property owner. N Go I filwo 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. BLAINE HTQ. A/C ELEG Mt= 9:27 0 13562 CENTRAL AVE. N.E. HEATIN� ANOKA, MN 553 % er, ;Z 7-40W Z-, Signed ----- TEL # , Ice Approved By f 2::!7- Rough -In Date D COMBUSTION AIR VERIFICATION Final Date /6 ✓��-� APRMance Type and SjWCommQn Vent and Vent Connector Information Appliance #1 Type BTU Input �OJM Fan Assisted or Nat ,LL42:L' Appliance #2 Type BTU Input Fan Assisted or Not 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 03 Vent Connector Height � ft Length R Diameterin Type ALTERATIONS: (Describe) BUME RYE A/C (ELECT.. 190. 13562 CENTRAL AVE. N.E. HEATING CO: ANOKA, MN 55304 signed By: e"- Date TOTAL P.02 SEP -20-2001 14!53 FROM CITY OF FRIDLEY TO 7576701 P.02/02 COMMON NEM', VENT CONNECTOR ANDCOMBUB'TION AIR 1JERIFICATION When replacing an exiatina furance, the undersigned hereby verifies that the vomiting has been examined and is free from rust, deterioration, obstructions, and Is securely supported and firestopped where required. Yes W No { ) The venting system Is plas#*WC 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 manufacturers specifications. No( ) Yes Y\) When required to fs#all a now corn ustion air, it will be sized and Installed to meet the current codes and manufacturers specifications. Yes "x No ( ) When inetailing a new venting system, the undersigned hereby verges that it is a listed assembly and meets the current codes and manufacturers spedflcations. This does Include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented Yes (yNo ( ) separately as per current codes. APRMance Type and SjWCommQn Vent and Vent Connector Information Appliance #1 Type BTU Input �OJM Fan Assisted or Nat ,LL42:L' Appliance #2 Type BTU Input Fan Assisted or Not 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 03 Vent Connector Height � ft Length R Diameterin Type ALTERATIONS: (Describe) BUME RYE A/C (ELECT.. 190. 13562 CENTRAL AVE. N.E. HEATING CO: ANOKA, MN 55304 signed By: e"- Date TOTAL P.02 Building $ ! 'za 5 B€JILDING Permit NO. I° Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: ' 763-572-3604 Surcharge CITY OF FRIDLEY Datff&:SEP 763-502-4977 FAX $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) EFFECTIVE 1-1-08 $ DATE 2 D YOUR E-MAIL ADDRESS $ SITE ADDRESS Park Fee $ Fee Determined by Engineering Sewer Main Charge $ THIS APPLICANT IS: ❑ OWNER I ONTRACTOR Total Due PROPERTY OWNER/ NAME: 1t ADDRESS: CITY STATE-ZIP- TATEZIPPHONE: TENANT PHONE: NAME: CONTRACTOR ADDRESS: C'ViITY C STATE ZIP SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE " PROPERTY TYPE EYSINGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR A on ❑ RE ODELIN ^ ® o 6-C DESCRIBE WORK BEING DONE: U SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING® ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used, PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit , 1. Site Plan/Survey showing the existing structures ❑ Aluminum 11 Trim and t. proposed project ❑ Other ❑ Fascia Z. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 12W — . OCCUPANCY TYPE Permit Fee $ ! 'za 5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ v Make checks payable to: City of Fridley Attach Sti ulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that thinformation ove is plete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construct des; that ders is is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accord ce with ved in all work which req ire re and appryo�val of s. SIGNATURE OF APPLICANT PRINT NAM)✓ � G /y! I to I C S DATE APPROVED BY DATE