AF - 35741�
Village of Frielley, Mi�.
�
BiTILDIIY� PE811iTT
N� .__ 6 4 6 O�ce of IN�PEGTO$ OF BUII.DINGF$
�,�
Oavner ''j,��, !d; ��,dad+n�c,';+'���� -
r�
Architect Fridley, Minn. 19�
Buiider�
f LOCATION OF BUILDING
NO,. l�r�.w��1 � Btteet ..�'�L��' ��� � Part of Lo+
Lotw Bloek Addition or Sub-Diviafon
DESCRIPTION OF BUILDING
� r �
Eront Depth �c� Height� 3tories_�_ Manner of Constructio���'�r �
To be used aa `""�!�+ To be completed � sj� °� �' ��'uf"� Estimated Cost �� ��
� ,
Permit i$ hereby gra,atsd to `��� ���' s¢�ii�:» tA ;�•�+� ��.���
the butlding ��-+9 described in tlse above atatement. This persnit is granted
upon the express coaditioa t�at Lhe peraoa ta whom it is granted, and Bis agents. employees and worknnen, in all
the work done in, around and upon said building, or any part thereof, shall conform in ait respects to the ordi-
nanees of Fri8ley, Minn., r,egarding the canstrnction, alteration, maintenance, repair and moving oP buildinga
withtn the city iimits, and this permit may be revoked at any Lfine upon violation ot any of the groviaioas of aaid
ordinancea.
�d
t��'�'� �`����"� • inapector of BuildiAgs.
AGREIIIZENT AND SWORN STATEMENT
In eonsideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the prnposed work in accordance with the deacription
above set forth and according to the provisions of the ordinancea of Fridley, and, being first duiy
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true aa therein atated.
—�- , ` _
Subseribed and sworn to before me at Fridley, Minnesota, this, � �
cia,y af ...._____l1.D. 19. �`�`
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City of Fr�dley, Min.n.
BUILDING PERMIT
N° '7005
Date: _..�� [_. `."" '�`._.. . __.._.._....._._......._._.,._.
._. _._ ._ .
!
Owner: ��.`._�.��l� . . Builder _.._. _... . . . :._......__..._ ............._......._..._.._._.__..__
Address_._...__..__._..._..._...._._.__._.._,._._.._._....._..__..___._.___.._..... Address _.___.._._.._..._..___.__.__..... . ._..._.....___...___.._.__.____._.._
� �c��i'�
CAT� � B ILDING
No. _����.7... Street _._�o�����ZSI._. �a�:�.,�._._ ..t ,�.�...y......_._. Part o! Lot ....._.._..._._._.. _._ _.__.. .. �_.,....
Lot _._.�.�.__ Block _.._..._._�..._.._...___.._._. Addition or Su ivision .. . .. ..... �_ . .. _
�� s
Corner Lot .___.._._..._......_ Inside Lot ....._..._......_..._.._..._..... �ttb'Sc .......___�.�.._..'�.... Sideyard .:---._.. �_0.__..__.:...___..._.._......�_
Sewer IIevatian _._.___._.._.._._.______.__._._._.._.__._.._______....._ Founda on Elevation ..__.._...._._._..___._..._._:.._..._.__._.__..._...
DESCRIPTION OF BUILDING
T :
/ �y // �`�
if < <
"_ �_..._._..._ Front -I!-•�� Depth _..�ld__. Height ..,/._Q.._.. Sq. F� �C�� Cu. FL �.5�.�. �
�._.....__w__._.........___.__ t_.____.,___ Depth _..._._._ Height ��.._....__ Sq. Ft. _.._..__..._.. Cu. F't. _._.....__._
Type of Construction ._.. _.__._ Es� Cos��fe.�.c.� `�� To be Completed _.:_...._.____.:_.._.._.__.._._
In cansideration of the issuance to me of a permit to construct the buiiding des ' above, agree to do
th� propoaed work in accordance with the description above set forth �� co li 'th all pro�visfons of
o�dinances of the city of Fridley.
�
In co�sideration of the payment of a fee of $...�"�._f�..._.._.., permit is hereby gra.nted to_�_.._.� _....
. to constxuct the builcling 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
dane 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, maintexiaace, repair and moving of buildings
within the city limits and this permit may be revoked at anyt� upon vio]a�on of any of the provisions of said
ordinancea / 1 /VI / 1
Building Inspecto�
NOTICE:
ihis p�rmit dwt ne� eowr Nu eonsfroeNoe. Msta11N1on fer rwi�ino. Plumbin�. yas h��, aw�r er wN+u 8� wn to tN
th� suiWiao Intp�se for a�p�rah pamits for ftwa INms.
, �
�t�! �' ��€�t �i�.'�a Qf:d � � � �.. C�dtBar�, Y��rii���, R����iai! �t
. Ai� ������ ���s c� D:ri� -
PARTlAL RATE SC�f �pULE n.pt. �s g�a�. �. sev-�sso .
ca��vrr�r w�nx .�: �u►,r� Toiu. �� f �� 3 �Gl�c�.. �0 �
�r s::�tt a� vu�t w�c . tio.00 s.�
' Cicy ad Friatry:
Repiacrment ot Ftirnare 6.00 �
't'he undersigned hereby makes application for a permit for the �vor# Des'eft
RC�dI't Sr AtteraE.ons--up to tSOb.04 . .. � �.�.�6 00 S � � �. specuied. agrering to do aU a•ork in strict accordance with the Ch�. Ordfn,ancer ��
Rcpairs & A3.eratlons rach add. f500.00 . 3 W � and n�iing of the Depar tm�nt of Buildings, and hereby declazes that aIi tAe fads
and reNresentatiuns statrti in this application are true and corrtct.
i�'tCIi. t8'�IAM J►IIt : � � : `7'
Fl�ldley, 'nn- 1�/�
E�1:rnace SheI3 & DuR Woris to 170,000 BTV .E10 00 �
tmth sdd. 60.000 B'PiT .: .. (1„vner
. 3. W ;
RepIacemrat of Ftiznaer 6.00 1-�=-= Kind ot Building
Re�in � A'terations--vp ta f500.00 6.00 :
Iiepain & Atterations each add. t500.00' �Jsed as ,
3.0o i
To ►�e rnmpleted about . S� � Q-- %�°
BTEAM o: HOT WATER aYS'f�l[ �
i1lrr.acr Shel1 Sc Lines—to 400 �Q. Lt F.DR Steem �10.�J S £stima?eY3 Cos�, S ll7) � .
�:rnace SheIl 1k Line---10 S40 sq. ft. EDR Fiot Water 24 00 S. New. Building Petmit No. __ P�rmit No. �
Each add 40�J RQ. ft. EnR S?esm 3IN1 =
---- —
Each add. 320 sq. ft EDR Hot Water 3.00 t�_�,_,_, _
DE�CAIPTIOA OF iR0lt�
OIL DIIRh'iP.—to 3 g�i. per hour 6.00 s.��„
HEAT`ING a�'WEA I'' NTS--S am, Hot Wa � Wum No
over 3 ga1. per hour-See Fee Schedule .
S� 'i�ade Name � �- fl� �O� ��'%
c� aa�r+�x C�o ro �s.aoo sTU� a.00 :� ,
ovrr I99.UU08'PL) 8N FM 3eh�dul• Capacity_._. _ Sq, i't. E.D.R HCi'[)�Q�'�%f;,/`'�^'7J �.�r
GAS iZTTINC FEF.�: lf0 R/►TE T07AL
Sst 3 iixtures x= 200 S •� Total Connected Losd����� ICfnd af Fuet
Atiditlonal 27ztures x 9d S__ - . BURNER —'hade Narnp g� �
Gas Range ta 299.00a :f 6.0� s
State Surcharge .50 capadey sQ. Ft �.n R sTV $1►
� co�rrioxixa f,.�
F�e �� a�rs�c s« F» s��,.a�.
v��an�c s�rs�x �
�c.�,TZO�$ k�� zo�ru. ras s�.�� g .
, _ . �i .
��vax : ��, � 33
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� UQ/IAKf�OYER�
SuBJECT •
c�cy of Fridley 217 6 2
' , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T RECEIPT .
�
� �• COMMUNITY DEVELOPMENT DIV.
v PFOTECTIVE INSPECTION SEC. ���
, � -.._-
r � ;
( � r'��1 � CITV HALL FRIDLE� 55432 NUMBER � REV. DATE PAGE OF APFROVED BV
�""� � ��� 612-571-3450 910-F15 3/18/93 / /
J08 ADDRESS 6433 Able Street NE
1 LEGAL ��T NO. BIOCK TRACT OR ADDITION SEE ATTACHED
�esca. 25 2 Moore Lake Highlands sHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PHONE
Merlin Gunderson 6433 Able Street NE 571-6782
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
'Itvin City Storm Sash Ihc 10825 Greenbrier Rd, Mtka MN 55345 546-8160 3090
a ARCHITECT OR DESIGNER MAI� ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WOFlK
Install sashes & trim
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTfiICAL, PLUMBING, HEATING,
VENTILATING OF AIR CONDITIONING.
THIS PERMIT BECOMES NUIL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OFi IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOF A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERT�FY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORfiECT. ALL PFOVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2 /�-�-2 $�-.O6
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEHMITFEE SACCHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE DF CONSTRUCTION. rjC�. QO Fire SC 2. 1�.
PLAN CHECKfEE TOTA�FEE
S�GNATUF7EOFCON'RACTOAORAUTHORIZEDAGENT IDATEI WHE PROP LY V LID D THIS IS YOUR PERMIT
� ~ !�r/����
SiGNATURE OF OWNER�iF OWNER BUILDER� iDATE� BIDG WS� ��4TE
�.,.. �
.:.:,>. , .�.;. . . �. ,:;:: � �.",�,i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . f�
............ .. . .. .. ... � ;�. � �
�W � � Effective 3/1/92
ADDN [ ) CITY OF FRIDLEY
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
. Bailding Permit Application
Constiuction Address: �p ��� �p , .11 11Z._� �
, /
I,egal Description: �� i �� ' L . .� " c' � /� �- C � ���� L-� ��S
Owner Name & Address: � Tel. ��� - ��
Contractor Tw�N CITY $TORM 3ASH, INC. LICENSE ��D a d
Address: MiNNETONKA� MN 55345 Tel. �
Attach to this application, a Ce�tificate of Survey of the
lot, with the proposed consh ucti� drawn on it to scale.
DSSCRIPTI4N OF IMPRQVEMENT
LIVING AREA: L�►gth �Vidt6 Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DBCK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: �uJ ,�'c�va qL- 1_2c�-�I
Corne,r L� [] Insid� Lot [] Fk Yd S�ck Side Yard S�backs
Type of Constivction: �� � Fstimatsd Cost: � �, ��°?
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Neaded: Ft. �+ 6 Ft = Ft x� = S
. �i
DATE: � � � - �� APPI,ICANT: - - - Tel. # ,� ��o d%DD
Permit Fee $_��_4�
Fire Surcharge $
State Surcharge $ f . O
SAC Charge $
License Surcharge $� p �
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL $ -I
STIPULATIONS:
�,_
Fee Schedule oa Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
5700 per SAC Unit
55.00. (State Licensed Residential Contractors�
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Ne�xssar�' j J Not Neces.saty ()
sue.,eiT RMIT NO.
c�cy of Fridley 29774
AT THE TOP OF TME TWIWS g � � � D � N G P E R M I T
f
; � R PT NO.
� •
COMMUNITY OEVELOPMENT DIV. ��(�
� ��: ----- � f)
r � � PROTECTIVE INSPECTION SEC.
1 .
� � �"'� � CITY NALL FRIDLE� SS�32 NUMQEN pEV O�TE v�GE OF �PPROvED Br
�----�•' �'' 612-571-3450 sio-F�5 6/25/99 / /
�oe nooaess 6433 Able Street
t IEGAI �07 NO. BIOCK TfiACT OR AODITION SEE ATTACHED
oescR. 25 2 Moore Lake Hi hl ands SHEET
2 PROPERTY OWNER MAIL AODRE$$ ZIP PMONE
Merlin Gunderson
3 CONTAAC70R MAIL ADDRESS Y�F PMONE UCENSE NO
R chard Hastin s 6331 Rz�x R' -
� ARCHITECT OR OESIGNER MAIL AODRESS 21P PMONE LICENSE NO.
5 ENGINEER MAIL AODFiE$S , 21P PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WOFK
❑ NEW O AD�ITION O ALTERATION � REPAIR O MOVE D REMOVE
8 DESCRIBE WORK
r hu
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment mus't comply with the State Building Code.
TYP@ OF CONSL OCCUPANCV GRQUP OCCUPANCY lOAO
SEPARA7E PERMITS ARE REOUIREO fOii ELECTRICAI. PLUMBING, MEATING.
VENTI�ATING OR Alii �ONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT CU fT
AUTHORIZED tS NOT COMMENCEO V�IITMIW 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR A9ANOONEO FQR A PER100 OF 120 OAYS AT
ANV TIME Af7ER WORK IS COMMENCED. NO OWI,G. UNITS OffSTfiEET PARKING
1 HEREBV CERTIFV THAT 1 MAVE REAO AND �XAMINEO TM15 APPLICATION S1A��S GARAGES
AND KNOW THE SAME TO BE TRUE ANO COpRECT. ALL PROVISIONS OF IAWS VALUATION SURTAx
ANO OqDINANCES GOVERNING TMIS TVPE OF WORK WILL BQ COMP�IED
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OP A PERMIT ZO9H 1.O�J
DOES NOT PRE$UME T� GIVE AUTMORITV TO VIOLATE OA CANCEL THE pEqMlT FEE SAC CMARGE
PROVISIONS OF ANY OTHER 57ATE OFi LOCAI LAW REGULA7ING GON•
STRUCTION OR TME PERFORMANCE OF CONSTFUCTION H3. L�J F1 1�@ SC 2. ZO
P�.AN CHECK fEE TOTAL FEE
, '�- ��' G ZS f S 4p
S�GNATUAE 0� CON"AACTOQ Op �U OAiZEO �GENt �O�iE� WHEN PROPER ALIOATED TNIS IS YOUR PEFMIT
S�GNSTU�7E O� OWNEp��f OWNEpBU�lOEAi � '� �� ATE� � g (� ��' � � ��ii� �
� _
NEW [ l
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� ���
BUILDING PERMIT APPLICATION � �
Construction Address: �� 3 3 �4, (.�� F' S��
Legal Description:
Owner Name & Address: /� ��. �� �l �' u nr �� �-S o�e/ Tel. #
Contractor: �� c�, f�,�� s'�� 5�i nt 6 S MN LICENSE #�a S( �
Address: 6,3 3 � �� � �e� � �-� '���2.. Tel. # S�� ��1�6 �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LNING AREA: I.ength
DESCRIPTION OF IMPROVEMENT
Width Height � Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: Z � S
��.s� �- 5 �rZ �
Construction Type: '��f� � � �� �- �Z � � n o � Estimated Cost: $ , °�
Driveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �' 2-S �"C APPLICANT: A �I���-�.,,� Tel. # S ? � � �7 �6-6'
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 3, �
$ , D
$ ��
$
$ S,�
$
$
$
$
$ ��
�CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Deterniined by Engineering
Agreement Necessary [ ] Not Necessary [ )
.. ..
BiTII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing pernuts for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair 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:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and inciuding $2,OQ0
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $5�,000
$500,001 to $1,000,000 �`$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,002 and up
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minunum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the locadon af the foundation once it has it has been constr�acted will
be required before proceeding with the framing.
Building �' MECHANICAL PermitNo.: G�G -(�3la�F
... __ .
Inspections C.`� �+ SIDENTIAL APPLICATION Re�ei�ed By: "`
763-572-3604 CITY OF FRIDLEY ����'C �� q�nn�
DATE � �`, S` U% YOURsE-MAIL A�D\DRESS
SITEADDRESS 1nU33 �`� ST 1VE
THIS APPLICANT IS: ❑ OWNER �3CONTRACTOR
PROPERTY NAME: f � O
OWNER/ q�D�$S: V 3 b.� S N� CITY r � c� -e�. STATE M NZIP SS�
TENANT pHONE: � V�' S� �' `o� � i-
CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY
SUBMIT A COPY OF
CONTACT PERSON: JOANN � INREN
YOUR STATE STATE LICENSE # EXP AATE
LICENSE WITH ,�Dx�ss: 9320 EVERGREEN BLVD STE H1Ty ��COON��RAPIDS STATEMN ZIPSrJ�i3�
APPLICATION pHONE 763 —?5T ° 6202 FAX 763--757�-6701
PERMIT TYPE �GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW �PLACEMENT ❑ ALTERATIONfREMODEL
DETAILED DESCRIPTION OF WORK �r•s � '�L-c `c�.� c. �.�,r �l Pt
PER MS 168.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, 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.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON S 10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOV� ;�
EquipmentInstalled MFG: '���� MODEL: �i�2(� `�� SIZFJBTU lt0 b00
MFG; � MODEL: � a� SIZEJBTU � 1�(9CE
MFG: MODEL: SIZElBTU
A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEJOVEN S 10.00
_AIR TO AIR EXCHANGEER S15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL S10.00
BOIGER 535.00 FURNACE $35.00 GAS UNIT HTR S 10.00
CHIMNEY LINfiR S 10.00 GAS DRYER S I0.00 - ---- POOb HEATER $35.OQ - -
DUCT WORK SI0.00 GAS PIPING $IU.OQ VENTILATOR SI5.00
�ermit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge � .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @$25.00 1 x$25.00 =$ c� S.C�
Number of fixtures @ $35.00 � x $35.U0 = $ 3S ,CA
State Surcharge = $ .50
Total = $ (e0. sa
THIS IS AN APPLICATTON 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 APPLICANT eJ4 �• � rr,a� ROGER HOFFHE IN DA� � � �� V-%
City of Fridley
Building Inspections`Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS Ca'EXISTING HOME ❑ MAI�E-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Prapane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Cl�apter 8 with MN Amendments .
REOUII2ED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 ar 7672
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6. Duct Design Per IMC 1346.0603.2
a. ACCA Manuat D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.