PRE 2010 DOCSCity of Fridley
SUBJECT
P- RM14O19
AT THE TOP OF THE TWINS
PERMIT
BUILDING
RECEIPT NO.
L'______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
,1 -
1
CITY HALL FRIDLEY 55432
A r ".j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
4/21/77
JOB ADDRESS 1560-1564 73k Avenue N.E.
1 LEGAL
LOT NO. BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Lot 31, A. . #129, ex
. the N. h thereof & exc. the W. 92.75' SHEET
2 PROPERTY OWNER MAIL ADDRES
ZIP PHONE
Dennis Kugler Const. 8331 Terrace Road N.E., M ls. 784-4746
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
Residential (DUPLEX)
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
I�
WAMNO
Construct a 56' x241 Emiraq and two garages 24' x 26'
SEPERATE PERMITS REQUIRED
HONE - ELECTRIC - US �
9 CHANGEOFUSE FFjt EATING,PLUMBING AND SIGIR,
REQUIRED BY
STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side
yards. Provide a verifying survey before capping. Provide exhaust fan in
laundry area. Provide combustion air to furnace room. Insulate ceiling with
R-22 or better. Provide vapor barrier in ceiling.
NO SEWER OR WATER AVAILABLE AT THIS TIME
DRIVEWAY DEPRESSION: N/A
To C" of Poo 0016 NOT GUAM= rite
ACOUCT OF UMNY 1i CIIIIN A AND REVAT Ift
tNls DATA IS FOR INFORMAT ON PUPYOSES ONLY AND
teRSONS USING IT SHOULD VEMPY THE INFORMAMN
()" IRE SITE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-2
1392 + 600
33,456 Total
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
2 ISTALLS
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
$43,695
$21.85
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.
$133,82
$750.00
�
PLAN CHECK FEE
TOTAL FEE
3
939.13
SIGNATURE OF CONTRACTOR OR AUTHO XZED AGENT (DATE)
�H ROPE LY VALIDATED THIS IS YOU, PER
BLDG INSP
•,,t
,,
❑" TE
SIGNATURE OF OWNER IIF 0WNER BUIL 1 IDATEI w
Res
:tc.
W
asilidil►i 18,101 -1163 8 b gftl
.313 ?,%i' - 01SIT33A - A1,0113j 'I
, iV11 �sw 961 03FIt 3R eTIM 39 3TAM38
.2O;)l2' Gt4A ;)14:8MUJ4 ,DMITABH
leiT *KAlif►yi7r. TOR RUG vwA an
,?N®1f11M . 0M . %NOi004 1r11 NU Taimuzou
! A Y.4a� a �9�iJ� M9E A►J t�iG : ;}� �t AT,�® tlhT
MONAM110,40
.314 afft ! ►
z
—
-12
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: ��n n'iS tea} (ems BUILDER:.
Address: &.33 / "_�rra-cce IM Address: '
/�/d ®y Tel.. No.
c�7.3
No.: Street: %3IZ
LOT: .31 BLOCK: ADDITION: �vCi-1D,�5 s.. bcl
CORNER LOT: INSIDE IAT: �r SETBACK: SIDEYARDS:
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:
,
Front: S(oDepth:
Height:
Square Feet: 130 Cubic Feet:
d,
Front: zg Depth:
z(o
Heigh/t:
Square Feet: �Ot Cubic Feet:
6 000
/
Type of Construction: ��-arn� (U-) A
Estimated Cost: $
To Be Completed: 9'/77
/Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional info atio .
DATE: 3/30 /77 S`T GNATURE :
c
Stipulations:
aLL,0u
a jwjt,«,..e e. /ta�°y`' .
3.) Ak
648.
"U. t*./ 0%.00'
�u, ro 8
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any building or structure, or for any addition to any existing building or structure,
or for any alteration or repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x $11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with yL
6 inch depth; Driveway width plus 6 feet x $15.9*
X11 �•�:�Il�
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a.
point six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In -no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
PLTJ 43111161A Ism, 11` M
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
NTER & ASSOCIATES INC.
REGISTERED PROFESSIONAL • LAND SURVEYORS
Cert if icate
i Tele0um 561
SHEET 1 OF 2 SHEETS
SUITE 308
VILLAGE NORTH PROFESSIONAL BLDG,
7420 UNITY AVENUE NORTH
BROOKLYN PARK. MINNESOTA 55443
of 5u rvey
PROPERTY OF Dick Gregor
described as fol lows , See sheet 2 of 2 sheets for legal description.
----4
92.E a--/✓o�T�i live o/ f /Z
N N 1✓0. l Z9�
I
IBJ
rj
v� ► C7
P0a
vo
—92.75
d � N 0
Vj92.76
I hereby certify that this survey, plan, or report was prepared by tM or Scale : I inch Opole... 40teat
under my direct supervision and that I atn a duly Registered Land Surveyor • - Indiedee Iron Mseelnent Set
under the laws of my State of (Minnesota. I O - Indleeues Im Monument FawW
4vzzam�-91 djamg�a2 -
Date /O-Z�-7� Req No ��w�
t
CORIER WINTER & ASSOCIATES
REGISTERED PROFESSIONAL a LAND SURVEYORS
Certif icate
PROPERTY OF Dick Gregor
described os follows -
TNaOww 561.2506
Sheet 2 of 2 sheets
SUITE 308
VILLAGE NORTH PROFESSIONAL BLDG
7420 UNITY AVENUE NORTH
BROOKLYN PARK, MINNESOTA 55443
of Su rvey
Legal Description
Lot 31, Auditor's Subdivision No. 129, except the North
half thereof,
also except the west 92.75 feet of the south half of said
Lot 311
Anoka County, Minnesota.
1 hereby certify that this survey, plan, or report was prepared by me or
under my direct supervipion and that 1 am a duly Registered Land Surveyor
under the laws of the Stott of Minpetoto.
Date Req Mo
Scale: I ieeA
0' - Indigoes Ire" Mottttnttnt Sat
o - IMiealas Mat Iitotwow Fawn
go" .. ..POP .........IN Ma ....................
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
DATE .3 IZ-,T 1-7 17
PHONE: 705f- 4 74(ap
OWNER: ' Jca►n� i S k V� ✓�
SITE ADDRESS:
CONTRACTOR:
...V
Determine working square footage of each
1. Total exposed wall area....... 2240 sq. ft. x .17
2. Toal roof/ceiling area ...... ) 3¢ 4 sq. ft. -x .05 Z C:)
Total exposed wall area above floor
asha. Total wall window area........... ..............
b. Total door area ....... 40, BZ
c. Total sliding glass door area .........................
d. Total fireplace wall area .........
• e. Total wall framing area.(average 10�)... +V ..........�
f. Total rim, joist area .................................. / ® 71 Z -
g. wall area above floor ..........................
h. wall area above floor ..........................
is wall area above floor ..........................
js wall area above floor ..........................
Total exposed foundation area =
k. Total foundation window area ...........................
1. Total net foundation area above grade ................. 107. Z.
Determine "U" value of each wall segment
(e.g. window, door, each separate wall section)
✓a. Z'Z! X '-U"
�3. 40-07- X "U" _ 2-S, Z.
X "Ulf 5
d. X "U"
�37, �. X "v" . . �b •
Ci . X
h. Z& X
is ( /' X
null
orUn �3 _
°
"Un Q =
jx "U" _
. lee
k X "U" _
1. to 7'Cw X "U" s ,
3. .°...................°....... Total `on e
•
J -
If item #3 is the same as,
or less than item #1, you
have met the intent of
SBC 6006 (c) 2.
32-1
�3�y g
Exterior Envelope Average "U" Computation
Page 2 of 4
Total exposed roof/ceiling area
m. Total skylight area ............................
n. Total roof/ceiling framing area (average 10%)...
o. Total net insulated roof/ceiling area...........
Determine "U" value for each roof/ceiling segment
M. X "U" _
n X olUo0. _
X "Un
4.......... .................. Total Z Z =
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006 (c) 1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2.
1. + 2. _
! dn'
3. + 4. _
WALL SECTIONS
NO'fB: Use 10% of opaque wall area for
frame construction
,« v
FSG. #3
a
Construction R -Value
1,
Interior air
1.
Interior air film
0.68
z
2.
//z
S
4.
3
3•.
3 '/z
���� X /��
Lap
6.
Exterior air
film
•0.17
Exterior air film
0.17
-441)6.
Total
14.4 3
TOME111 EI.7 OF
= ��
FRAME WALL
1.
Interior air film
0.68
4.
I
e I
5.p
6.
Exterior air film
0.17
Total*
.14-43
1,
Interior air
meq.
film
2•
)0.68
4.
'/Z" E7, 6,,
13 �.
5.
���� X /��
Lap
6.
Exterior air
film
•0.17
Total
1. Interior air film 0.68
2. f --%%o vv0.4s-
3.
.45
3./ ZC' cam. l3/�� z,48
6. Exterior air film 0.17
• , e r • a
FIG: #4 Ilt is • ti �_ //!
)// /
°' •til � � ^X � .: �!/
NOU: Indicate tYPe, "R" 'value, depth and
placement of insulation.
VVIT
ROOF/CEILING
Vented
Heat flow
up
FIG. 15.
••in�j�s.•:u-l;�,e1_•/li���'._.':`t��'r='_r��>.tti'.�I.'4�-G+x�fayl
Page •4 of 4
Construction R -Value
1. Interior air film 0.61
2. `r�VV SvOV%10
•1
4. Exterior air film (still) 0.61 _
Total Z -o
1. Interior air film 0.61
2.
3.
4. Exterior air film (still) 0.61
Total
`4.l
Heat flour up ;-vented
- •FIG. #6 1. Inside air film 0.61
2.
-03• � 'u 3.
�.S i -A 4.
..�•vL1�"•'�'S
•"' 5. Outside air film 0.17
;:'r.=?=� •`:1 • •' ��• r =-�i Total
—.4 ¢ Note: Use additional sheets if more space is
needed for details and calculations
nog!--'PTICTID ,
e Hent ,
£low up • • , ;
P.M. #7 '
r
14
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 812)571-3450
Mr. Dennis Kugler
8331 Terrace Road
Minneapolis, Mn. 55432
Re: Final Inspection at 1560-64 73� Avenue N.E.
Dear Mr. Kugler:
A final inspection was made on August 23, 1977 of the above noted property
and the following items were noted which must be completed before the
construction can be finaled out;
1. Provide nuts on anchor bolts in garage.
2. Provide door closers on doors between garages and dwelling units.
3. Provide sod in the front and side yards.
4. Complete decks.
The above items should be completed by October 3, 1977 when a reinspection
will be made to determine compliance. If you have any questions on the
above items please feel free to contact me at 571-3450.
Sincer
K7-
DARREL G. CLARK
Community Development Adm.
DGC/mh
A
15-. w
�..
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432
TELEPHONE ( 612)571-3450
,V*
y' •y
�I
August 24, 1977
Royal Electric
6441 University Avenue N.E.
Fridley, Mn. 55432
Re: Corrections on Electrical Work at 1560-64 73i Avenue N.E.
Dear Sirs:
A final inspection was made on August 24, 1977 of the above address and
the following was noted which must be completed before the structure can
be finaled out;
Put running boards under Romex cables crossing garage
framing. Would be much easier to follow it in feeding light.
We will expect the above correction to be completed by September 2, 1977
when a reinspection should be called for to determine compliance. If
you have any questions on this item, please feel free to contact me at
571-3450, between 9:00 a.m. and 10:00 a.m.
Sincerely,
LEONARD EICHMILLER
Electrical Inspector
LE/mh
ti.
MINI.NL'4 FEE FOR ANY HEATING PERMIT IS $7.50
Ll 1 Y OF
FiU DLEY
�• APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
I'S -6 v
SAVITY WARM AIR:
RATE
ro'rAL
Job Address
F`arnace Shall & Llact Work
$12.00
$
R_?_ac.:-.ert 0= Furnace
7.00
7.00
$
$
Department of Buildings
Re_airs S•:,iterations-up to S500.JO
4.00
$
City o£ Fridley
& Alterations each add. $500.00
Tel. 14571-3450
EChANICAL WARM AIR:
The undersigned heraby makes application for a permit for the work herein
Furnace Shell Shell & Duct Work to 100,000 BTU
$12.00
$ �y.U`�
specified agreeing to do all work, in strict accordance with the City Codes
each add. 50,003 BT;;
4.00
$
and rulings of the Department of Buildings, and hereLy declares that all the
Re-iace=.ert of Furnace
7.00
$
facts and representations stated in thi's application are true and correct.
Repairs & Alterations -up to $500.00
7.00
$
S� % 19 7 7
Retairs & Alterations each add. $500.00
4.00
$
Fridley, Minn.
��� .1 ��� /Pr �� �•+,� T
IEA i OR IMT WATER SYST01:
OWNER �
/
Bailer & Lines up to 100,000 BTU
$13.00
$
KIND OF BUILDING
each a::cn. 50.030 BTU
4.00
$
} /
Boiler only up to 100,000 BTU
7.00
$
USED AS
each addn. 50,000 BTU
6.00
$
TO BE COMPLETED ABOUT G / 7 7
IL BU RN\EER- to 3 gal. per hour
$10.00
$
� �
each add. 3 gal. per hour
10.00
$
ESTIMATED COST
AS SURMBR- frc= 100„000 BTU to 199,999 BTU
$10.00
$
OLD -4�UILDING PERMIT NO. PERMIT NO.
(aver 2.99,999 BTU see Fee Schedule)
$
AS FITTING F' -ES:
1st 3 Fixtures .� x
$ 3.00
$ �'
DESCRIPTION OF FUPNACE/B;3RNER
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Z
_TR CONDI TT_ONING �;
$
Trade Name L �'� ��C Size ao. G/ Z J
AN H-=ATING SYSTEMS See Fee Schedule
$
NTILATING
$Capacity
S Ft. EDR��UUJETL H?
4•
.LTERATIONS $ REPAIRS---,
$
State Surcharge
$ .50
/
Total Connected Load 3 � / � % Kind of Fuel
TOTAL FEE
$ S 0 - S�
BURNER - Trade Name Size No.
G_ai INSP. REINSPECTION FEE
Capacity Sq. Ft. EDR BTU HP
Data 010.00)
Company
J.%= INS?.
Date
/�JJ
ANned By
PPR OL'Ar FOR PER. -OM -1
Tel. No.
MINI.NL'4 FEE FOR ANY HEATING PERMIT IS $7.50
HEAT LOSS CALCULATIONS CO- MINNEAPOLIS, MINN."
Weatherstrips
A.$.H.V.E.
Guide
Reference
19—
gFI.
Construction No. Insulation
Windows
Doors
Out. Wall
Int. Wall
Ceiling
Roof
Floor Kind
How Applied
Yes—No
Yes—No
F 1.Room7 Length Width Height
F!. Room Length Width Height
Windows and Doors—Crackage
and Area
/
Windows and Doors—Crackage and Area
No. Width Height No. of Lineal ft. Area
of pane of pane lights of crack Sq. ft.
No. Width Height
of pane of pane
No. of
lights
Lineal ft. Area
of crack sq. ft.
n
�
Coef
BtuCoef
Btu
Infiltration
Gf`
G
�
Infiltration
Glass
�j )
`
Glass
Exp. wall di�_M
Exp. wall
Net exp. wall IK
Net exp. wall
Int. wall
Int. wall
Ceiling
Ceiling
Floor IR J
'"
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Room Length l °� Width
Height
Fl. Room
Length Width
Height
Windows and Doors—Crackage and Area
L
i�
Windows and Doors—Crackage and Area
No. Width Height No. of
of pane of pane lights
Lineal ft. Area
of crack sq. ft.
W,drh Height No. of Lineal ft. Areaq.
No• of pane of pane lights of crack sq. ft.
�]
Coef B to
Coefj Btu
Infiltration
,3
ly j ,�
Infiltration
Glass f G
Glass
Exp. wall Z(t x
Exp. wall
Net exp. wall
`j
Net exp. wall
Int. wall
Int. wall
Ceiling —
Ceiling
Floor LF „4'
Floor
Total Btu. fj_Total
Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Room I Length l` _ Width 1L Height
FI. Room Length Width Height
Windows and Doors—Crackage and Area
L%-\
Windows and Doors—Crackage and Area
No. Width Height No. of Lineal ft.
of pane of pane lights of crack
Area
sq. ft.
No.
W�nth Height
of pane of pane
No. of Lineal ft. Area
of crack sq. ft.
—lights
Coef
B to
Coef Btu
Infiltration
4)1�
Infiltration
Glass
�.�
�"'_
\iL
✓ 1�-
Glass
Exp. wall
Exp. wall
Net exp. wall
l (
�e 1/3
Net exp. wall
Int. wall
Int. wall
Ceiling
--
Ceiling
Floor L
r
�/� -
— Floor —
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. Ins. W.A. Leader area 4
Required sq. ft. E.D.R. or sq. ns. W.A. Leader area
HEAT LOSS CALCULATIONS���� ��• MINNEAPOLIS, MINN.
Weatherstrips
A. S. H. V. E.
Guide
Reference
1 y —
Construction No.
Insulation
Windows
Doors
Out. Wall Int. Wall
Ceiling
Roof
Floor Kind
How Applied
Yes—No
Yes—No
]L
FI. Room Length Width
Height
FI. �G3'I Room
I Length Width))Height
n
VJind ws and
Doors—Crackage and Area
✓
VVindowsfand Doors—Crackage
and Area
C
No. Width
_ of pane
Height No. of Lineal ft. Area
of pane lights of crack ft.
sq.
No Width Height No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
Coef.
Btu
Coef
Btu
Infiltration
Infiltration 3; Li
�1cfC�
Glass
62)
G7�� L�
Glass
qe
100
dee90
Exp. wall N
Exp. wall
Net exp, we]l
4439
Net exp. wall
Int. wall
Int. wall
Ceiling r;2 Ll
2
Ceiling ia
32
Floor �
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. o oom Length Width
Height
FI. flJ^j Room
I Length ! Width
/7
Height
Windows and Doors—Crackage and Area
1
Windows and Doors—Crackage
and Area
i
No. Width Height No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
No W drn Height No. of Lineal k
of p ne of pane lights of crack
Area
sq. ft.
� q6"
Coefj
Btu
Coefj
Btu
Infiltration
Infiltration
-L�
G
Glass
Glass
3-3
-'b 1v
L�
Exp. wall C 2—
9
„n(
Exp. waII 7
Net exp. wall
Net exp. wall
Int, wall
Int. wall
Ceiling ��;
a
-L G�
Ceiling
I
Floor
ii
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. t ZC•iti r Room Length ` Width
l r?
Height
FI. .��^ r}C �ao�t
Length Width %`
Height
Windows and Doors—Crackage and Area
Windows and Doors—C
ackage and Area
No. Width Height No, of Lineal ft. Area
of pane of pane lights of crack sq, ft.
Width Height No. of Lineal ft. Area
No' of pane of pane lights of crack sq. ft.
n `
Coef
Btu
jCoef
Btu
Infiltration `>
�.
Infiltration
Glass
J
L,
�'�,_ �t
Glass
Exp. all ✓/�
Exp. wall
Net exp. wall
G'
��
Net exp. wall
Int. wall
Int, wall
Ceiling (�
3{•�I,'
S�
_Ceiling
Floor
Floor
Total Btu.
Total Btu.
7�
l t�
Required sq. ft. E.D.R, or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq, ins. W.A. Leader area
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
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Water
Heater
3
leC
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
A01- x
$5.00
$ f
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
1st
$
Electric Water Heater
_ x'
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
'$3.00
$
Additional Fixtures
x
$1.00
$
2nd
x
$x:0.00
$
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
3rd
$ 50
r/ L� �'}
TOTAL FEE
$ / L___1. J �J
4th
(R) = Future Connection Opening
(*) = New Fixture, old Opening
Connected with Sewer
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
_ x
$3.00
$ Lc) .CC'
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
A01- x
$5.00
$ f
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
_ x'
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
'$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$x:0.00
$
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ 50
r/ L� �'}
TOTAL FEE
$ / L___1. J �J
REINSPECTION FEE
($10.00)
Job Address �s(e®- c Y �3 j
Department of Buildings
City of Fridley
Tel. #571-3450
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 application are true and correct
Fridley, Mn. , 19
KIND C
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO. O�Ja,
Company
Signed By
Tel. No.
ROUGH INSP.
(, Date
FINAL INSP.-
.1 Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
s_ cv4r-3
Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
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
NO. RATE TOTAL
Water Heater - Gas** I
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
JOBADDRESS I (/2 AVC -C
0!5(0C))-
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.
DATE: .-5 20 U
OWNER I O�7S r U son
BUILDING USED AS
ESTIMATED COST PERMIT NO.
PLUMBING COMPAN t 11 r e,WOi-0
SIGNED BY TEL N0. 157) 31nF5134`
T
Approved By
Rough -In Date
Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF CO'
OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
3560 GP
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT; VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existina furnace, 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
BTU Input
specifications including sizing, length, number of elbows and termination.
Yes () No( )
The undersigned also verifies that the replacement unit is a listed assembly
Fan Assisted or Nat
and meets the current codes and manufacturer's specifications. This does
BTU Input
include AGA-GAMA Category I Central Furnace Venting Tables for fan:
Total Appliances
assisted and natural draft appliances.
Yes () No( )
The existing combustion air is sized and installed to meet the current codes
Vent Height
and manufacturer's specifications.
Yes ( ) No( )
When required to install a new combustion air, it will be sized and installed
ft Diameter in Type
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
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :