PRE 2010 DOCSori
-iJ
P. tj
ii
J3
x
GAS
A.'
z
x,
-4
L7
dAj
N -i
.� ,i
'
�
� s i _
i
t
dAj
N -i
6l�
City of Fridley, Minn..
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUEWING PERMIT
Date: - maw 94. 1972.
Owaer: —_crown- RPa 1 +-jr Builder C- .7 - Corporation
,Addregq _4919 Ccmntral AvPnua N ,E, Address 701 Columbia Boulevard N.E_
LOCATION OF BUILDING
No 1143 Street - 75th Avenue N.E. Part of Lot
yot 10 Block 3 Addition or Sub -Division Don's 5th Addition
Corner Lot Inside Lot X Setback 35' — Sideyard 5' & 10'
/P0yb0VElevat1on 884.44 / bybj( / ? (High Water Table)
-]'sive Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front 61'-6 'Depth 27 Height 20' Sq. Ft. 1057' Cu. Ft. 212140'
Garage_ Front _ 211-6 1 Depth _231 . Height — _ 10 Sq. Ft. __49-4.1Cu. Ft. 4940.:1
Type of Construction Wood_FraTMr' Est. Cost _ $x,101 To be Completed
Stipulations: Provide verifying survey RX before capping and provide a hard surface
driveway.
Agreement for storm sewer signed by Crown Realty.
WATER LOCATION: 10.2' N.E. of Sewer Service SEWER LOCATION: 214.5' N. of Manhole
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 ance with all provisions of
ordinances of the city of Fridley. J i
10.05 State
In consideration of the payment of a fee of $--AL-QO permit is hereby granted to C- 7 _ rnrnnrat-i on,
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 building
Within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
(L"
i
c:
wilding Inspector
CLARENCE BELISLE
NOTICE:
Tbis permit does not cover the construction, installation for wiring, plumbing, gas besting, sewer or water. as sure to sae
the Building Inspector for separate permits for these items.
N
s
0
Me VIZ. 14
1(hol MCLUDED)
loo
4
99 7-
Ilivs VOW < Ryle
J%ndarson and lone M. Anderson* his
tlescribed property situate in the St,ite
",it p -Art of the !JW -1/4 of the NL -1/4 of Sec
-
• r1lie-,01t.-I de.-iCrilked as follows: Commencing
distance of 287.36 feet North
id
i tz. tvA vF,o .(-)t;-Ih line of S,"
I
ihe.
-7 Z
7-,!
A
Me VIZ. 14
1(hol MCLUDED)
loo
4
99 7-
Ilivs VOW < Ryle
J%ndarson and lone M. Anderson* his
tlescribed property situate in the St,ite
",it p -Art of the !JW -1/4 of the NL -1/4 of Sec
-
• r1lie-,01t.-I de.-iCrilked as follows: Commencing
distance of 287.36 feet North
id
i tz. tvA vF,o .(-)t;-Ih line of S,"
I
ihe.
-7 Z
7-,!
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: Crown Realty BUILDER: C.J.Qorp.
ADDRESS: 4219 Central Ave.NE. ADDRESS: 701 Columbia Blvd. NE.
NO: , ,3 STREET • 7 S
IAT: 10 BLOCK: 3 ADDITION: Dons 5th - Add.
CORNER LOT: INSIDE LOT: X SETBACK: 35 SIDEYARD: 5 - 10
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:
Residense Front: 61, 6" Depth: 27' Height: .20
Square Feet: 1057 Cubic Feet: oZ /, I A4 6
Garage Fronts 2116" Depth; 23' -Height:
Square Feet; 494 Cubic Feet: 'q9'1®
C2O,/O�
Type of Construction: Frame Estimated Cost: '$
To Be Completed: 9/1/72
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
C.J.0
DATE: 5 A /7 2 SIGNATURE
pres.
(See Reverse Side For Additional Information.)
( IJ
Ulp'
io.OS
AGREEMENT WITH THE CITY OF FRIDLEY
WHEREAS, Crown Realty is the fee owner of Lots 103,11,12 and 14,
Block 3, Don's 5th Addition.
WHEREAS, these lots contribute storm water to a low point located
near the Southwest corner of Lot 12, Block 3, Don's 5th Addition.
NOW THEREFORE, Crown Realty agrees to install a 8 inch storm sewer
line from said low point to a catch basin located near the Southeast
corner of said Lot 12 prior to or during the construction of any future
homes on Lots 11, 12 or 14, Block 3, Don's 5th Addition as indicated on
attached drawing.
' l�ou4h Iou o1 41x Nor4h %VC4 �u4 441c Sad 451 Ecco lit¢ NWI!/ idle 11E'/ a� bio 12 -To+
w b9' S 7' �� • E.
r
• }• 4v, pnrnH•t �, Its Weti1 tine KN'/; Mt �f• .}- � � Illfj ' � ;
(NOT INCLUDED)
WO
• �-aE � `JO I50 � — _(� / T� J; .111.} �4T s'r. �`',�Q�A\ a � i X89•}I�IS'W � S ' I.S , j
•' L y , , b �11'19'1N ' � I'
lints Pero4d M,Hi tF,l 5cu4, lyle °i AW 4 14F 1 6.156• yl'p V] '
_� 09 w V\
� .
t,,I • _.._ � � - � Fa.t 4aA a 1 � — .1+ • v � � �
119•tl,K W '^i r y �tibaa•A 4�b'� -a" 56f'•'ll li'SV. 4 56'r-WWvl
-. —? _ ISO y ..) a v ti LaJ w � '- S `
3 1 I Q f 6i r a 1"
.f. 3 r i IC
ti�",�• to..� W S' . - *r•'ol -_ >ISof97y, - ib9•f1'if 1t1.
110
%19111,^-• �I r.- 41! N7, ,S-w. --
----815
L' Cy \ i 5 ' w 7 v r ------ •- — ti"� j W LOO,
115 - -
.► I ;' "' d 569' �i • �5' w - , I a }
ICS 4-
Lu
r10 4 70 {1
•'' f� 1' 6
b ' 69'.b.�rB0 64 I, 15 �.t'b i4•bl.1�15,04' p SI 1 ,O102 17 .
81.5
x 7115-T"
S b9l 57 Iq.. W. .
�OA line Of Vnt NW'/4 0f
IiSG+.lb �1 4tfS.7to 9S,Sa3
tat' Dodald Le Anderson and Ione Me Anderson, his �"'I�f'�' , f97►d�• a I
�owinp Oescribed property situate in the State � ,1.e►+el,.�es PC PO 1
N,:That part of the IIW-1/4 of the NE-1/4 of. Sec- 5�� �_ +f�.f�s �-%% 9G�•f Lrp9.S ;�'
?� Minnesota described ds follows: Commencing .7-' -
f.
the ItG-.1/It a +li ,t.tnce of 797.36 feet North
Land PYa 687.1-hG +ts AtE.
�/'� Muu�ao�ralrs3?,
5rtl�9 ENGINEERING, INC.
Cm1 &Mwcipal etA.6tlb&
-- Enyineers Sur vecyors , —
cestifica to of sumveir sa:
157 NORT H
r L,
E f v
3q3
l
DRAINAGE AND UTILITY EASEMENT
LOT 10 SLOCK 'J' DON'S v r" ADDITION
ANOKA C(,VN'T
/ha►s&�/ ca'fi fll chis a a trw and 0r+2cf npn?SWi&tW7 #'o .SWWy 40/k lfty es jr& 4&W a(scniW /an S d
!ate g('atl ,xrkls tl�reary, aad d/ rsiE�i oirrov�imanfs , i�'anrf,i ar «sold /and. As st�rrr ed nr flts... _/
AlidLST kvda. y
SUBURBAN EM61NEURVO, INC.
,SCALE
v K— r .:5
4tolt %)najd L. Anderson and lone M. Anderson. his
-111:4ino described property situate in the State
f the NL�_J/t4 of -Sec-
T.Iiit p.,rt of the NW -1!4 0
follows: commencing
Mirinerota deticribed cm
of 287.36 feet North
U)
ICIO
w
Bill
La ki
V)
CC
Iln
�1.
--
,
- _4
IL
y
5o
n 76,%j
j.
h, tj*rl. 75"
Call
bV 51, Ir)
W,
14 S#.Jon a
Sw !4.j. Nw,/4
OU. 0
of
i IL
A
A
4tolt %)najd L. Anderson and lone M. Anderson. his
-111:4ino described property situate in the State
f the NL�_J/t4 of -Sec-
T.Iiit p.,rt of the NW -1!4 0
follows: commencing
Mirinerota deticribed cm
of 287.36 feet North
Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... $10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam ...................... 3.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $
OIL BURNER—to 3 gal. per hour ........................ 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) ............. I ......... 5.00 $�
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x$ 2.00 $
Additional Fixtures ................. x .75 $
Gas Range to 199,000 ........... x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL .:3 - 3 -7Jr
See Fee Schedule
$
TOTAL FEE $
Dept. of Bldgs. Phone 560-3480
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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.
0
i
Fridley, Minn / 1
Owner %.- 1 Z7. %zoeleQ.
Kind of Buildings
Used as i> �'��j /
To be completed about " eey f
Estimated Cost, $ I Zd4
Old—X0. Building Permit No. Permit No.%S
DESCRIPTION OF WORK
HEATING or P015TR PLANTS; -Steam, Hot Water, =aarmAirNo
Trade Name's Size No-
7z)��
Capacity y Sq. F�tJE.D.R ✓ BTU H.P.
Total Connected Load ��, ��
Kind of Fue
BURNER — Trade Name ��° `�' Size No- Oe , ej-
Capacity d 4Zl Sq. Ft. E D.R BTU H.P.
(REMARKS—OVER)
RAY N. WELTER HEATING CO
Signed 4637 CHICAGO AVE.
MINNEAPOLIS 7. MiNNE80TA
By
ae Business Phone No-
A+ai�A,r�h=.�, 2� ..j.� �.......,A.n. �..,�.% (R�;Q.. r:�---• .•. wo't �.A" '�!'a,r,. n.:!'+.R� Grp, .. kp.,•� .q.•ye..'i�.�
D^1.� �. r9os s+i: r'aJi D�a,'i ��i�i4y..r Y s a.�W 4ri•r��l 58ti e.ua t��� �+d'w ciG��' �t�m ..roYtu l►�9 W9 Vi1:r Jwiv�4r'Fr�t.L� � .
PARTIAL RATE SCHEDULE Dept. of Bldgs. > WD -VM
GRA YITT WARM Alli:
7%=ace Shelf & Durt Work
RepIacerntnt of Furnace
Rrpavr & AlteraCors--up to $500.00
Reraars do A:tvratiors each add. 3500.00
111MCIL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU
eoch add. 60.000 BTU
Replacement of Furnace
Repairs & Atterations -up to $500.00
Repairs is Alteratims each add. 3300.00
19 1111 TOTAL
;10.00 ;
6.00 ;
600 S
3 Ott ;
i� •oo
3.181
$
6.00
3
6.00
S
3.00
;
STEAM or HOT WATER SYSTE2d
Furnace Shell & Lires_ to 400 sq. ft F.DR Steam ;10.70 $
Furnace Shell At Line ---to 640 sq: ft. EDR Not Wa,er 1000 $,
Each add 200 sq. ft EDR Steam 3 W ;
Each add. 320 sq. ft EDR Hot Vater 3.00 $_r_�_
OIL SUFNER-to 3 gal_ per hour 6.00 S
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 199,000 BTU) 400 ; 10.00
over 199.000 9Ti1 See Fee Schedule
GATS FITTING I -E-3: WO RATE TOTAL
13t 3 Fixtures _ - x!; j00 3 3 •DO
Additional Fixtures x .75 --
Gas Ra:ige to I-99.= _ z$ 6.W $
ATR CONDMONING= State Surcharge .50
FAIT MA -1150 STSTEX Sw Fee Be-vdZI&
VEXITUIATING STSTEM tx
ALTERATrONS a ll ZPA M r0TAL F= 'S '56
-►t
L 1-3433 7
_�EO g_,O• Y2 • "t tt-
City of .Fridley:
The undersigned hereby makes application for a permit for the work ilereit
specified agreeing to do all work in strict accordance with the City Ordin4me:
and ruling of the Depal tment of Buildings, and hereby declares that all the fact:
and reprrrsPntatiuns stated in this application are true and correct.
Fridley. Minn )0 is
, f?wtter _ �p�inrn�s e mJ -
-a
Kind of Building Aa4,2=j
Used at �1a be BD o2 a_ CAd&.t"
To be completed about
Estimated Cost; S =E-40 /�
Old -New. Building Permit No. ______ _ Permit No. /% /o
B-2-PICRiPTiON OF ti o tz
HEATING or POWER X ANIS-,Steam, Hot Water, Warm Air --No I
Trade Name �r--L� _ Size
Capacity la.�,QD1L -_Sq. n ED.R BTU /A5. Dnp NJ?B.T. el .
Total Connected Load.__ Sled of ftet maiZ
BURNER - Trade Kaisize No 6:uP-
CapacityA6,a(J !3 &/J Sq. FI. EDR � B''i4II D
tsosu►inrzd_Crta)
AppRcatla� for Pager Plants aed Heating Coding, VeetilatteR Rehigeraflon and
Air Con010dw Systems and Devices
PARTIAL RATE SCHEDULE
GRA4!TY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ................ .. $10.00 $
Replacement of Furnace .... 600 $
Repairs & Alterations—up to $500.00 6,00 $
Repairs & Alterations each add. $500.00 3.00 $—__
MECIL WARM Alit
Furnace Shell & Duct Work to 120,000 BTU ...... . $10.00 $___
each add 60,000 BTU .................... .. 3.00 i
Replacement of Furnace .. .... &00
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 .... &00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $.
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_
Each add. 200 sq. ft. EDR Steam
3.00 $--- -- Each add. 320 sq. ft. EDR Hot Water 3.00 $
OIL BURNER—to 3 gal. per hour 6,00 $ —
over 3 gal. per hour --.See Fee Schedule
GAS BURNER (up to 198,000 BTU) 600 $
over 199,000 BTU See Foo Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x$ Zoo $
Additional Fixtures x .75 $
Gas Range to 199,000 x$ 600 $
AIR CO1fDITiONI1/G
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL -/,fl - %S
See Fee Schedule
$
TOTAL FEE 0`S-0
(SURCHARGE
Dept. of MdoL Phone 960-34110
Lecesm /3 K3 7 a `- /V E-1
City of Fridley:
The undersigned hereby makes application for a permit for the work :hereir
specified, agreeing to do all work in strict accordance with the City Ordinancft
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
s , ®
Fridley, Minn_ .,,15
Owner / 6Ce W
Kind of Building
Used as
To be completed about
Estimated Cost,t--
01 ew. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS --,Stream, Hot Water, Warm Air—No
Trade NameSize No,
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fbet
BURNER — Trade Name Size No
capaci Sq. Ft E.D 19:- BTU
iSP.
(REMARKS -OVER)
Signed =�✓�� " " �.u.lr �'
By_ � _ G2- //.•
Bum Phwe >ae % ®`K-1/ 6 SZ__
SUBJECT
PER
City of Fridley
. 14428
AT THE TOP OF THE TWINS
PERMIT
r
BUILDING
RECEIPT NO.
`L -_---_ COMMUNITY DEVELOPMENT DIV.
INSPECTION
I
r PROTECTIVE SEC.
1 �
i CITY FRIDLEY 55432
NUMBER
REV,
DATE
PAGE OF
8Y
_HALL
612-580-3450
910-F15
10/19/77
JOB ADDRESS 1343 - 75th. Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
3
Don's 5th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gil Holstad 3= 1343 - 75th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Berggren Construction 8 Crocus Lane, St. Paul, Mn.
55110 484-0715
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 C. ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 18.81 x 22.8' Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide City with copy of truss design before capping. Fire stop
kitchen soffits if area included in remodeling.
WARIGN117
Before digging call local ►zri;i�i�:
REQUIRED FOR WIRING
TELEPHONE - CLcCiEi� � iriS Vi=i:•:.
SEPERATE PERMITS
PLUMBING AND SIGNS.
REQUIRED �� ��
HEATING,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES TYPE OF WORK WILL BE
ING
$10,795
$5.40
WITH WHETHER SPECIE EDN ER INIOR NOT. THE GRANTING OF AO PERMIMPLIED T
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-
$20.32
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$5.0
$30.80
SIG^ 1, lVhE OF CONTF&CtbRORAUT RIZE AGENT 1 ATE1
W p bPER Y VALIDATED THIS IS YOUR PERMITS
BLDG SP
/6—,-%'/
DATE
SIGNATURE OF OWNER OF OWNER BUILDERI (DATE)
CITY OF 'FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: �BUILDER:
Address: _ / 3 �� //�/-� Address:
Tel. No. elf�(D;7/6
No.. /3930
LOT: /®
CORNER LOT:
Street:
BLOCK: ADDITION:
INSIDE IAT: 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: ,Ll,_ ►�-g�„ ;� c� �, ,� �_ �-py,
X491 - Front:J Depth: �a Height: L�--�--
's
Square Feet: % 2 is Feet: J�Q
Front: Depth: Height:
Square Feet: Cubic Feet:
Type' o€ Construction: 1_;)16Q %1/2'�eJ�Estimated Cost: $
To Be Completed:
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
specif• d, agreeing to do all work in strict accordance with the City of
Fridl,,eY Ordinances and rulings of the Department of Buildings, and hereby
decla,tes that all the facts and representations stated in this application
are true and correct. See reverse side for additionalinformation.
DATE: GU /7 - 7 SIGNATURE: P
Stipulations:
tv
/Jjj S I A
7
O�
08 .
ftko_c
,3,
I=
s� -j_V_777A- -
A ;E«er—L,
6', �fl
3�
� 6-11 So
ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLI,CATION
PLANNING AND INSPECTION DEPARTMENT
for
CITY OF FRIDLEY, MINNESOTA
MR
CO
s
This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE
AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING
OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION
DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA
in the plans; submit product specifications, if needed to support the "R" and "U"
factors used; and to assure construction is per approved plans.
JOB LOCATION: r�
OWNER/CONTRACTOR: 1
ADDRESS:U043 7s �.� PHONE:
A. Determine the Total Exposed Wall Area as follows:
1. Total wall window area
2.. Total door area
3. Total sliding glass door area
4. Total fireplace wall area
5. Total wall framing area(average.10%)
6. Total net wall area above floor(average 90%)
7. Total rim joist area
Subtotal: Total exposed•wall area above floor
8. Total foundation window area
9. Total net foundation area above grade
Subtotal: Total exposed foundation area
Lf/
GRAND TOTAL EXPOSED WALL AREA y
B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 =d•� 7
C. Determine the Total Exposed Roof/Ceiling Area as follows:
10. Total skylight area —
11. Total roof/ceiling framing area (10%) 9mf�
12. Total net insulated roof/ceiling area
GRAND TOTAL EXPOSED ROOF/CEILING AREA
D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = q,)3
Item.I I
Item II
i
.1P
r. Determine the "U"
value of each segment (1-9)
and multiply by the area as
follows:
+
Item
II
1.
��
x
"u"
{
, J =
a �Ik
2 •
X
foull
3.
3 3
x
fluff
.4.
_
%
foul#
5.
X
foul#
6.
7.
x
ffUff
8.
—
x
fluff_
-
9.
hF 3
f
x
fluff
, L47
ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III qyf
F. Determine the ffUff value of each segment (10-12) and multiply by the area as
follows:
10. X ffUff
11. x ffUff
12. 3 x oluff
e1r
0
ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS
= e�
ITEM IV G ►,�
G. If Item III is the same as, or less than Item I, you have met the intent
of State Building Code 6006 (c) 2.
H. If Item IV is the same as, or less than Item II, you have met the intent
of State Building Code 6006 (c) 1.
I.
Add
Item
I
+
Item
II
J.
Add
Item
III
/ +
Item
IV
K. If the sum of Items III and IV are less than.Items I and II, you have met the
intent of the Code for total envelope system.
The undersigned, as applicant for a building permit, hereby affirms the above
information has been prepared and submitted by himself or under his direction,
hereby acknowledges the information to be correct and accurate;'and hereby
presents the information with required plans in support of the building permit
application.
By:
DATE:
. A
Land planning smiffilpff, 6eyS ffloway No. 63 lu.1.
Land Surveying r1 • • ( Minneapolis,
Sells testing /il �jlpC"F' ! p n�. Minn. $5432
Civil Engineering telephone yll4-6O6fi
Municipal Engineering Engineers & Surveyors Area Cade 612
Mortgage Loan Survey for CJC! roar tion
'r /�� F/ t -e
Orci6x ie � Utli l Y Usernen f
157
72
E.
d3"
I� Scale -1i=640 eft
��T 10 2LOCV 3
DONT S 5t�- AOMITION
4o6 Cotml+y
Tills is a true and correct represeptation of a surrey of the boundaries of the land above described and of the
location of all buildings, it any, thereon, and all visible encroachments, if any, from or on said land. this surrey is
made only in connection with a mortgage loan now being placed on the property and no liability is assumed
♦Rcept to the holder of such mortgage or any other interest acquired by the reason of sash: mortgage. 1t h
anderstoad and mann" s hove been g�cod for the purpose of establishing lot firms or bovndory
corners. fluted IMs /6 IF of %mr-1 C A. w 1V r`. Is
3000toyRGAN iNGINIORING, INC.
i. 3 33 ieginss� liltry 6►,s