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AF - 36385Building PLUMBING PermitNo.:•.�.-:;v � ` • Inspections RESIDENTIAL APPLICATION Received By: � Ul 763-572-3604 CITY OF FRIDLEY ��°�::� 17 '� 763-502-4977 FAX EFFECTIVE 7-1-2010 DATE �% � SITE ADDRESS THIS APPLICANT iS: PROPERTY OWNER/ TENANT YOUR E-MAIL ADDRESS VZ � �_ O OWNER �]CONTRACTOR NAME: ��C��1 G� � � � C, C%� "\ annRFCC �`f :i I I �.�.k?� �t `�'�; :� 1 h l�� l�l'll�'I i �L' ( c?'-'''1��:5��, �� ' CITY r �r � 1�ltl `��=f .� � TATE� ZIP CONTRACTOR NAME: I� ��10 I'� � L� � � 1 G. , n�r� � � Cti. L� �, -- SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ,qDDRESS: jl,� � I`(„ . r' (M �L 1 k S�' I7 ; CITY Z. I�E°'l- STAT�'� � ZIP �� Z INSURANCE PHONE � �; '� � � ' I �C> FqJt PERMIT TYPE TYPE OF WORK: ,E3SINGLE FAMILY ❑ NEW DETAILED DESCRIPTION OF WORK ❑ TWO FAMILY ❑ TOWNHOUSE /�� REPLACEMENT �'U � �•' �C � � �-� FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (RJDICATE TOTAI. NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV FLOOR DRAINS SHOWER WATER P[PING _ BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35) _CLOTHES WASHER KITCHEN S[NK �ATER CLOSET BACKFLOW PREV. ($IS} _ DISHWASHER _ LAUNDRY TRAY '� WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Nurriber,of fixtures @� $10.00` �x $7 0.00 = $ �� Number.of f xtures @�,I5.00 x$1 �.00 —$' � � <;- I�Tumber'of fixtures r�i, $3�.00 '= x $35.OQ — $ . ` ' � State Surcharge $ . �.0t} (MINIMUM �40.O4� Total — $ TI{IS IS AN ,�Yi'LICATION FOR A PERMI�I-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will e in a ordance with the approved plan in th c'se of�all v,/brk,_ iT�c� cequires review and approval f,pla s. �, SIGNATURE OF APPLICANT � � �� \ �' v �'� � ��'�' PRINT NAME }�� \ � � � � i � Z4--� DATE � � APPROVAL INSPECTORS SIGNA URE � City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 PermitNo.:',,_;•= �'`—! Building MECHANICAL - ' Inspections RESIDENTIAL APPLICATION Received By: �, IY# T'T�r- 763-572-3604 CITY OF FRIDLEY Date �' � 763-502-4977 FAX EFFECTIVE7-1-2010 �C��. `� �� J `l ' —7 DATE � � ` � YOURE-MAILADDRESS ��-"'��`�'1�Y��'��%�`''«��'�"'�r�— SITE ADDRESS %� c� � I �x "��"� �� `�' I�� I=- _ THIS APPUCANT IS: ❑ OWNER 6'JCONTRACTOR PROPERTY NAME: '�CJ�' (��'1G+�. C1.�L�C��'1 OWNER/ ADDRESS: �� c� 1 L,��F:^r �y� i 1�/ CITY � f�L �� STATE �Y1�� ZIP �) �J ,'i jL TENANT pxONE: �� `� � iC' �: 4- �}� jl CONTRACTOR COMPANY NAME: �' 1�G`��) I� I► 1G� �✓� 4 �'1L� � ��- SUBMIT A COPY OF CONTACT PERSON: ��' +� �.' % �t' t�:.-k YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: ��J �� '1'1�-`�'� Sf I�lI_ CITY I'�� I�. ' STATE��ZIP ��Z APPLICATION pHONE �(, 3% Z,�1 % l I C� FAX PERMIT TYPE � SINGLE FA1vtILV ❑ TWO FAMILY ❑ TO�'NHOUSE TYPE OF WORK: � NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ��-' `�� -- FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT V1'HERE NOTED. FIXTLiRES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK. Equipment Installed MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 _�REPLACE (WOOD) $35.00 _NEW GAS GRILL $10 00 BOILER $35.00 URNACE �35.00 GAS UNIT HTR $10.00 CHIMNEY LINER � 10.00 GAS DRYER $10 00 POOL HEATER i35_00 DUCT VdORK g10 00 GAS PIPWG �10_O0 VENTILATOR 51 � 00 � Number bf f xiures cr $10:00 x$ i 0.0� _$ Number offixtures � $15A0 x $15.00 = $ � � � � Number of fixtures @$2j.00 x$2�.00 —$ � Number of fixtures , L $3 �.00 ` � $35.00 $ � " ' State Surcharge = $ 5.00 ' <:�' (MINi?l9UM FEE �40.00) 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 ll work whi h re uires review and approval of plans._ SIGNATURE OF APPLICANT �� ,C� � �� L; � PRINT NAME � l C i � � W � � �`k DATE �� %l � � (� APPROVAL INSPECTORS SIGNATIIRE DATE PLEASE N(3TE: SEI'ARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHAI�iICAL WORI� City of N'ridley 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 � EXISTING HOME ❑ MAKE-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 Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. SOl 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N 1104.4. ] 3 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.