AF - 34976��y of F�a�ey, �.
BUILDING PERMIT N� s� �
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AddrBSa - Adarese
-. � LO ION UI �`���� ��
:
No. � , � Street ° � Part Lot
Lot' .=�_ Block �. , � Additfon or Sub-Divls! .,
� 4
Coraer Lot � Inslde Lot �"'"`� Setback Sideynr�i r�'�
� __ ,t ,
3ewer Elevatlan Foimdation IIevati�
,
DESCRIPTION OF BUILDING
To vsed �r °�,� � �,�ra
Fi+oat .���' ��pth ;��l�eight- =` "� 9q• F't. Cu. F��
F �.
, it � DePth -.:��efSht. ���, Sq. Fk' , t�t. Ft �
- ` � ����'!".r `
Type �! C truction , , , , - F�t. �t . �-�= To be Compieted
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In consideratioa of the fssu�ancae to me of a perrnit to const�.uct the building descrYbed above I agiee to do
the proposed work in accor�iance wlth the descrlption above set Porth �lnd in c�mplianee with aSl provisi+�na of
or8iaaaces of the dLy of Fridley.
'.r�
Ia cams4deratia�t of the payment of a fee of ,�+�''� permit is hereby granted to
° e
to canstruct the buildin� or �8dditton es dacribed above. Thispermi t ia grauted upon
the exAress conditlan that theperso to whom it is �anted and hfs agents, employees an� worlm�en, in all work.
doue fn, around and upon said builndin� or any�p� thereo� shall coffiorm in all rpspects to the or8inances oP
FridleY� Minnesota location, aa�nslls�uctCon, alteration, anaintenanoe, repair and moving of buildi�s
� dty ]imfts and�a permit may be revoked at ar�rtime upo� violat�lon of any of tbe pr�viaions oP sa�d
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NOTICEs
1W p��i dws � es�a da cemteod�e, � �er vrLie�,-�, �a �, aw' or wal�► B� an to a�
Nn Boild�g 1�' hr pPnati p�ls �or fMn B�e�.
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. . � : APPLICATION I�OR `BUILDING PERMIT
�CifiY OF FRI1�Lh"7i� MTI�IQE80TA
OWNER ° S NAN� BUILAER �a� � _ , `�1�a�1�--
. �
�,DDRESS � t . , • . , , � : ADDR�SS f0 1 d� a/ 3� et,�a ; - � .
LOCATIOAT OF SUILDING
ATo. �� (� �treet �� �G�i Part of Lat
Lot � .�Block % Addit�.on or Subdfvision J�'� �,�''c.�-Q ��:
Coraer Lot Inaid� Lot X Setback Side Yard
SEWER ELEVATIOAI FOZJNDATION ffi.EVATION
Applicant attach-to this•fozm Two`Cex�ificates of Survey of Lot and,proposec� build-
in� locgtion �rawn on these.Cert�.ficates. . . �
DESCRII�IOPT OF .BUILDING
To be used as;
i .� • .
�� • F�vnt ��` 7 Depth �3 4� / o geight f
Sq. Ft, f C� e Cu .$t .
--�`P-�'� �e e p'roat .�� � Depth a a' Ae3�ht
� Sq. Ft . Cu . Ft .
Type of Construction �i�,,,,�. . Estimated Goat
To be Completed
The undersigned hereby makes applicatioa for a permit for the work herein specified,
agreeing to do all work in strict accordance c�ith the Citq.of Ftidley Ordinances aud
rulings of the Department of�Build�ngs,�and hereby declases.that all the fac•ts and
xepre�entations stated in this applicatioa are true:and correct.
DATE Zi L°�u • 1 � , / �7 6 � _ R tGNATURE ���f '� °�-i�.�i..�
(sch�dule of Fee Costa can be found on Che Reverse Side).
. . �
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F. l
a
BUILD7NG PERMIT FEE SCHBDULE
Section 2_ The Ins�ector of Bui],dings sha�le before isaui�g any pea�i,t fax
�hF erection of any bciiidintig or structure, or for aay addition �o aay ex3st_
ir� buildi�g or structure,.or for any alterations or repairs to anq exis��n��
building or s�ract�re, upan agplicatioa therefor, require the a
apglicant for such permit of feea to the amount hgreia below set�foxthba�..�3��
in the manner herein provided to-wit;
2�1. For aay such.pes�mit for the erecti6n�of any fire-proof building, other
th��a� a garage� warehouse, factqxy►, Qr �r8i� e�ey8tar� or for,the erection of
.,, any �ire-proa€ addtti�, . for s3nailar occupaucY, to any _esieting buildizt�g
_. shall be at the rate of �1.40 for each oae thousand cubic feet, or frac�ian
��!ereof, ia such cubical content��
2.2. For any such permit for �he erectioa of any fire-proof_garage, warehou�e9
i�.e�ory or graia elevator, or for the erectiom of any fire-gro4f acllditi�,
�or simiiax occupaacp, to any existin� buildi
for each one t�ousand cubic feet, clasaified as Bfirepxo�ft byeSectiou�502�of
the M�traaeapolis Building Code.
`' Ft3�1$$S . .
2� For any auch permit for the erection of auy non-fire
than a garage, warehouse, facto Proof�bui1dixtg other
additioa, for similar occupancy,�to anra�istinatbuildin�p n��fixeproof
each one thousand cybic feet. y � �` pe�t $1.00 far
�''-ARACES
2_•�� For aay such permit for the erection of aay nou-fir
warehouae, factory or grain elevator, or for the erection o rany nouafi.�eprc,of
additiaa' gor .s�};ar:��up�cy� to anq euisting bui].diag or for each such
b�ild3ng or add3.tion - ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof, ia the cubical cvntents thereof with a minimum of $4.QU.
For the purpuse of compu�ia,� fees for bt�ildi
o.f �ny build3ng or additfon to a uniform heightpthr�ot8hout bc��lti 1 inQnthe
g�ouad area.covered fram a point six (6) iaches belo�the fioor line of �he
basement or ceilar to the average height of the upper eurface ar to the
ave�age heighC of the roof �urface of the'anaia gable of a pitched roof.
2,�5. For repairs or alteraCions to au exiati
at the rate o£ $3.00 �8 atructure, the fee shall be
per each Five Huadred Dollass ($500.00) or fractioa
thereof 3n the cost of a11 propoaed work.
a_.b.,. Iu no case aha;l the fee , cbargQd �or aay pe,�i� � set forth ia
Sectian 2 be le�s ,tha� $y.;,pp� ° �
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HEAT LOSS CALCULATIONS � � �, = ; BURMAN COMPA�
_ _ _ _ _. _ _.
AS.Ei:Y.E,
, : i�,�athe;strips . - G�e , -- Conetrncdbn No. �' � , InsWation
, ,. :
t�/indows �, rs Reference ' OuL �ap In�. Wesli Ee�ing Roof Floor ; . I�d . Hav�► i4pplied
No o :_19_ _--r 4 _ -,_ _ _. __
T _ . �,
Fl.� _ Room � �� _ �� �� ' ��t _ : /� Fl.( i�`hf Room' Lengdi ,,��i�ith' I Ieight
`_ . Winciaws a�l I?oors—�rackage and Area __ � �Y'rndo�vs and. Quors--�rackage and ATrea ,�� �
n A
'9Vtdth 8e18ht - - Na, ot = -�aneai ta - - �rea %, * � : , � ' wiaeh seisns . ava o: rrneatxc. nrea . � � � �
Na ot nan¢ of pane lisl��e of cracg eq. tG ' � " No. oY pane ot pane 1lgLte oY craok eq: fQ
; _ _ � � .. �' - � �" _ _' � . _ ' . ..� . _. _ . .•... . � � ., .. ; -� . -, . %� : ._.�+r . . ; ,�/ ..w.r�+�'�,'� �.
�- /'r: :�'� � �: _ _ ,_ � .. - �� �'
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_ • '_ - C� . �. ta : . . -' ' , Coef. �Bta -
Yn6ltration - � _ . - � _ �- -- , � - '' , Infiltiatioa _ _ _. � _ _ . _
_ _ ''r�'� � ��
�lass ' _ _ _ _ _ ,�: �- t� Gla�s : _ : , , �'� �,�., .�
F�tP: w�4 _ _ _ _ _. _ , _ � _: . . _ . __ _: _ _ _
: �•. � . � '
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In� wal�
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Total Bte�: - -- - - / !/ � � @!
_ _ . > ' _ __ , To�l $Eu. ' � ' �
_ �+�
tiequired sq: ft. �.D.R. or sq. ins. W:A. Leader area - . ' .
- _ __
- Required sq. #t. .R. or sq. ias. W.A.. L�ader area
j��ii-"i!_i`� _ Room Lsngth' _..'Rl'idth_ l',! Height _.
dth � � Fl�I� ,�`�' •-� Room j 1Jength ,t" : ' Widch . _�`f Heigh�
�- Vif'iadows and Doors-Cratkage aad A�ea _ Windorvs and L�oTS—Crachag� and Atea :� °,=.` '
' Width "HetBbt Na oY Ltneal ft Area --�L% ��;�`j �► Width 8eigh! Na o! Llneal tQ : Area, , �� �� ,;
IVw —: - at Ba.ne -of Pene , il8his of �%� R� Na oP t�ne of 1�"e ltBhtm' ot araak" sp.'Pt, — .,
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_ ._ .
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. ; - _
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wa � '
_
e� _ .- _ +�' Net'eap. wa11 : . . /. �: �'�
Int� �all ' .: _. _ _ _ : ' jeG vvell _
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_ _ . �Yoos
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TO� �h1. - - — - _ _ _ _ _
= - - - 4 ?otal Btu. +D
" Requued saj: #t. E:D.iL. or s'q. ms.�"W:A:=r.ea�er arta _= � � ��_- � ; ` - , . Reqmlr�e�d sq:�t.-�1� oi'sq.�.A.`�eacler area �` � � -- -
_ __ _ _ - .. __
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''W`indows _ and Doois—Crac� ansl Aiea .-- .-` - Windows aad Daars--�rack�ge and Area �.•=��-
Idth �Iei�tit 1Yo. ot .Lineal fQ Area ���� } idth Height Na of L1aea1 tL Area �
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; - - �,, , � `�...:_.
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�� '
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� �, ._ , r
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HEAT LOSS CALCULATIOIVS
dV_ __. _ _ _ _ .
eatlierstrips Gui� Conartinction No.
�i/indows Daora Reference. ' Ov� Watl Ini. W�11 Cei`!mg Roaf
!1
�No " ' Y�io 19 ,
�f
� _ � � �
- - � .,
Floor �—
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: Insnlation - -�'
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- _ _ ,
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�•� _ ;_ -'_ __ -
_ �� � _. _ .
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_.
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. . , Total Btu. ' � : � - ._ _ ..r
�equired sq.. �t. E:D.1Z. o_r sq. ins. W:A.. Leader aze� -_ Required �. #G E.D.R. or 'sq. ms. W.A. Lr.ader atea '.
_ _ -
' �'� � ` - _- __' F7.{ . Room « _ . Width` _ _ ; . . Heighx ;
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__ � _.. , �..',., :g.
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� �� �J Windows aad Doors-�Crackage an► n. , a�:
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araok s4. tt. .�
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_'____ _ _ _ _ _. _ •
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_ _ _ ____.
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- - �� d+� �.' � ` � � � _ _ _ _ _ _ , _ _
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.
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� - -� -- - Esp wall
, ,
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� �11 - - _ _ _ . - - '; ; iat. wall - - .
Floo. ��' ����. Ftoor .- '
Btu.
- - - - Ceil:
" _ _ . � � _ �` : �oeal Btw::
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I.R., or 'sq. ins. W.A. Leader area
.'
�,• CITY OF FRIDLEY
6431 UNIVERSITY AVENLTE NE
FRIDLEY, MN 55432
57Z-36U4 l+'AX: (7631571-1Z87
PERNIIT NO.: 2004-02169
DATE ISSUED: 11/24/2004
ADDRESS : 6660 ANOKA ST NE
PIN : 133024140118
LEGAL DESC : RICE CREEK SCHOOL ADD
: LOT 4 BLOCK 1
PERNIIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTTAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE
# NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS
# GAS DRYERS 0 # GAS RANGES
# OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC)
# WATER TRMT APPLIANCES 1
I:\���I[N\►Y1
NORBLOM PLUMBING CO
2905 GARFIELD AVE S
MINNEAPOLIS, MN 55408-2173
(612) 827-4033
� ;� �
YOUNGDAHL RONALD A 8c GAIL A
6660 ANOKA ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and conect. All
provisions of laws and ordinances governing this type of worl�
will be complied with whether specified herein or no� The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Bldg
PLBG PERMIT NIINIMUM FEE
PLBG FIXTURES (NEW OPENIlJGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 29543
SEPARATE PERNIITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
0
0
0
400
0.00
0.00
0.00
35.00
0.00
0.00
0.00
0.00
0.00
0.50
35.50
6 •
. CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
57Z-36U4 FAX:
: 6660 ANOKA ST NE
: 133024140118
: RICE CREEK SCHOOL ADD
: LOT 4 BLOCK 1
e
PROPERTY TYPE .
CONSTRUCTION TYPE .
PLUMBING
RESIDENTTAL
ADDITION/ALTERATION
571-1287
PERMIT NO.: 2004-02170
DATE ISSUED: 11/24/2004
VALUATION : $ 0.00
NOTE: COARBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE
# NEW FIXTURES (EXIST OPENINGS)
# GAS DRYERS
# OF NEW FIXTURES
# WATER TRMT APPLIANCES
APPLICANT
� NORBLOM PLUMBING CO
2905 GARFIELD AVE S
MINNEAPOLIS, MN 55408-2173
Ii (612) 827-4033
OWNER
YOUNGDAHL RONALD A& GAIL A
6660 ANOKA ST NE
FRIDLEY, MN 55432
0 # GAS WATER HEATERS
0 # GAS RANGES
0 VALUE (FOR NIINIMUM CALC)
0
AGREEMENT AND SWORN 5TATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and lmow the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date ,
PLBG PERNIIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENIlVGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 29543
SEPARATE PERNIITS REQUIRED FOR WORK U"1'ti�x "1�HAN 1���l;Kiti�i�.v3t7v�.
0
1
0
400
0.00
0.00
0.00
0.00
0.00
35.00
0.00
0.00
0.00
0.50
35.50
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FILL IN COMPLETELY.FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
NVhen raalacin� an existins� fumace, the undersigned hereby verifies that the
ventmg has been examined and is free from rust, deterioration, obstructions,
and is s�urely supported and firestop�d where required. Yes () No ()
The venting system is plasticJPVC and m�ts all current codes and manufacturer
specrfications including sizing, length, number of,elbows and termination. Yes () No ()
The undersigned aiso 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 Fumace Verrting Tables for fan
assisted and natural draft applianc�s.
The e�ci�ino-combus#i�n �ir is sized and ins#alled=to meet the current codes
and manufacturer's specifications. � �
�.
When required to Install a new combustion air. it will be sized and installed
to m�t the current codes and manufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installinsa a new ventin� svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
speciflcations. This. does include AGA-GAMA Cat�ory I Csntral Fumace
Venting Tables for fan assist� and natural draft appliances. Yes ()
Is the cammon vent and vent connectors sized and installed correctly after
an appliance has �en removed from the common vent and vented
separately as per current codes.
No ( )
Yes ( ') No ( )
Aaaliance Tvae and Siae/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Applianc� #2 Type BTU Input Fan Assisted or Nat
Applianc� #3 Type BTU Input Fan Assisted or Nat _
Total Applianc�s Tdal Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Conne�tor Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter 4 in Type
Appliance #3 Vent Conne�tor Height ft Length ft Diameter in Type
ALTERATIONS: (Doscrilmrl
HEATIIdG CO: �
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FILL IN COMPLETELY.FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When nealacin� an exis�ns� furnace, the undersigned hereby verifies that the
venting has l�en 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 m�ts all current codes and manufacturer
speciflcations 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 currsnt codes and manufacturer's specifications. This does
include AGA-GAMA Cat�ory I Central Fumace Venting Tables for fan
assisted and natural draft appliances. _
The exiatins� eonrtbust6on air is sized and in�talled�to m�t the current c.o�les
and manufacturer's s�catfons. �
When required to install a new combustion air it wnll be sized and installed
to m�t the cUrrent codes and manufacturers speciflcations.
Yes ( ) No ( )
Yes ( ) Nc ( )
Yes ( ) No ( )
..
When installins� a new ventin�a svst�m, the undersigned hereby verifies that
� is a listed assembly and meets the currerrt codes and manufacturer's
spec�cations. This. does include AGA-GAMA Category I Centrai Fumace
Venting Tables for fan assisted and natural draft appiiances. Yes () No ()
Is the common vent and vent connectors sized and installed correctly after
an appliance has l�en removed from the common vent and vented
separately as per current codes. Yes () No ()
Aaaltance Tme and Sfze/Common Vent and Vent Connector Information
Appliance #1 Ty� 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 Tdal Btu Input _
Common Vent Type Vent Height _ Diameter inches
Appliance #1 Vent Conne�tor 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
ALTERATION3: (Describel
HEATIIdG CO: �
Signed By: Date :
,�
Building
In.spections
763-572-3604
DA'I'E ► d
SI1"E ADDRESS ,_
THIS APPLICANC IS:
PROPERTY
OwN�R/
TENANT
CONTRACTOR
SUgAqIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICA'ITON
PERMIT TYPE
TYPE OF WORK:
�
f-
MECHANICAL
RESIDENTIAL APPLICATIC)N
CITY UF FRIDLEY
YOUR E�JIAIL ADDRESS
❑ OWNER �NTRACfOR
� ' • // /'/ �.
� � - -. : `�r
`'a . ��� � i� I I
� ,�, _ :� R
�,arE,�ur
COA+�ANY NAt�+�: , earth & Ft�re T� .
C0IJTAGT PER50N• , ��� �,�,. �'
STATE LiCF.l�SE � V�
DATE
• STATE ZIP,
.....�wwsov� FAX
PHONE
�SiNGLE FAA�ID..Y D TWO FAMILY 0 TOWAhIOUSE
� �,, ❑ y��,� ❑ ,v..rExnnowxn�onn.
DETAII.ED DESCRIPTTON OF VdORK � S�-u I( �7H t F r�,� 1� c� �.a� �S �•�-� �
PER MS 16B.665 the permnt fee is a minimum of SI5.00 or 5�/. of t6e iotal cost vp to �OO.OQ, wlucheve� is great�r, far the
impr�v�nent, installation or� replacement of a residential fixfiyre, excludin.g the fnctures. ('This should reflect only the cost of labor )
Labor cost �mder $300 =$15.00. Labor cost between $300 to $500 = cest of labor x.OS = -
FOR PROJECTS WI�RE I.4BOR EXCEEDS $500. FEES ARE BASID ON S] 0.00 PER FI3CTURE� EXCEPT WHERE NOTID. FI3CT[]RES: {AIDICATE TOTAL
NUMBER OF EACH Bfl.OR7 .�, I� I o MODEL: �ac �'a S1ZElBTU �
Equipment Instalted , AqFG: W�r^ ^ MODEL: STZEJBTU
�'' SIZE/BTU
MFG: MODEJ.:
A!C $25.� ��� �GAS) $15.� GAS RANGFIOYEN 510.�
AIR TO AIlt E3CCHANGEFR S 15 FiKF.PI.ACE (WOOD) 535.00 NEW GAS GRILL $10.00
BUILER $35.00 • _FURNACE $35.00 _GAS UI�Il1' IiT'R $10.00
' �vWEY LIIVER SI0.00 G/�.S DRI'ER $10.� POOL HEA'fER 535.00
DULT WORK $10.00 .LGAS PIPING $] 0.00 VF�TTD.i4TOR $15.OU
� - �
- • • .a - . . �:� _
Permit Fee $ Number of fixtures @$10.40 x$1 Q.00 =$
Surcharge $ .50 � Number of fixt�res @ $15.00 x $15.00 = $
'I'OTAL DUE $ Number of fixtui'es @ $25.00 x $25.00 = $
Number of fixtures @ $35.� x $35.00 = $
State Surcharge = $ .50
Tota] _ $
THIg 3S pN AFPLICATION Ft3R A PERMIT NOT YALID UNIiL PROCESSFA
I hereby apply for a building �rmit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordin.attces and codes of the City of Fridley and with the A�nnesota �Construction Cotles; that I understand this is
not a permit but only an application for a permit and work is not to stazt without a permit; that the work will be in accordance with the
approved plan in the case.of ail w rk which equires review a.nd appro�►�al of plans.
SIGNATURE OF APPLICANf PRINT NAME /'� L�✓ �/1 1�I.I �� DATE � ' D
City of Fridley .
Building Inspections Deparhment .
b431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
r�
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
« � �. RESIDENT[AL PERMIT APPLlCAT10N HVAC
[] h{EtiN HOMESIADDi�'IONS ❑ EX1STlNG HOME ❑ M�E'UP �R
REQUIRED FOR NEVYtff/EXlSTING HOIVfES .� T��� �;;V,k .
1.
�
�1 �i � eb6��,sa sc
Cambustion Air (S�e note below) �s�$ �"'g91J
' �►w�s� .w �►z�
a. Oil ar solid fuel IMC Cha�ter 7 with MN A�� ��
b. Nafiu al Gas or Propane/1FGC ChaPter 3 with MN Amen.dments •
Aqak�.up Air (See note below)
a. IMC Chap�r 5�with A9N Am.�n.dmea�
3. Ventin.g
� Gas a�plianc�s ]FGC CChapt�r 5 ovifih R�lNN Amendnaents
� b. Fuel ot� tlian gas 1MC Chapter 8 wi�. N!N Amendnaen.ts
REQUtRED FUR NEW HOIUIES
4. Heat loss & coolin� load Per room
� Required on new co�tion IMC 134-6.03 I2
5. Ventilation .
a„ Per MN �n.ergy Coc�e 76'�0 ar 7672
6. �Ct Design Per IMC 1346.0603.2
a. ACCA Maaizal D
NOTE: Cen% oint Energ� Mechanical Code Guidelines software may be used for �
, � .
comb'ustion and make up ai� calculahons .�.
i �
0
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