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AF - 35305a City of Fridlep, Mirm.. 6431 Univeraity Ave. N. E., Miinneapolis, Minn. 55432 BUILDING PERMIT ��; Novembe��, 1�,72 lo.�S� � ��.�?96 pWnex; --�• J. Messick B�� South owr tzea� t�r ,AddTeSiq --��nFi Cavn1 ih-i TP „��F, Addre9s �.Sl Silver Lake R�ad Roo�., 5� New Bri hton Mi LOCATIOiV OF BUILDING i1To - h�.� Street �-n Mnrp 1M-it:o �i.F'. Part of Lot � ��I SioCk � $ Addition or Sub-DivisioII Haathc�r iH 11 �a Adr77.1'��T* Corner Lot inside Loi _- X Setback ___.3.�.. Sideyard _ 1 5�,�. ��iFIIevatYcsn _ 918 94 �q{17�i�tid�']�'�0'�1��1� 9 -9L4 Minitrn�m _Ldve op �f Foot�n� DESCRIPTION OF BUIL�IN9G To be Used as; ikae] 1 in� �ont �_ Depth ___�_�.�.. Heighi _..��.�....._ Sq. F� �..��_ Cu. F't. ..3.Qy.$�-�.4 GRrage Front r.2.0_� Depth � Hei�ht ..�„p! _ Scl. Ft. --••�yp•� Cu. Ft -�� Type of Consiructian �T�n.a FxamP Est. Cost ,.,427�.LL To be Completed � MA��iLi� Stipulations: Provide a varifying survey before eapping. Provide a hard surface driveway. Provide_a verifyin� survev on 6253 Ben More Drive before a rough in inapection will be made on this address. WATER LOCATION: 10' West of Sewer Service SL�WER, I,OCATION: 60' West of Ma,nhole (WIE 918.70) In consideration of the issuance to me of a permit to const �be proposed work ia accordance with the description above set O�hances of the dty of Fridley. � � �� above, I agree to do nth a11 provisYons of In conssideration of the payment of a fee of $ 58.00 ,. p�t is hereby granted to�t..h_ TOwne Realty to construct the building or addition as described above. This permit is granted upo�, the express condition that the person to whom it 3s granted and his agents, employees and workmen, in ali work done in, around and upon said building, or any part ttiereo% shall conPorm in all respects •to the ordinances pf l�`ridley, Minnesota. regarding location, construction, alteraiion, maintena.nce, repair and moving of buil�g� �� dty limits and this permit may be revoked at any time upon violation of any of the provisions of Sa�d � �8 �P�toP CI,ARENCE BELISLE NOi10Es . �'i�i s permh does not eover t6e eonstruetion, installaHoa foe wering, plumbing, gas heafing, sewer or water. Be an 4o sae t6s Building Inspaeta� fo� sepa�aTe parmits for these items, _ _` � < �� � ; � �� : �y , � , ^�`; ,� � � �.: , x' `'�'•`+"€ w� �,� �. .�. ` �: �� ` — _ � ' �`- � ._ - . � � ° ;� t �` F x � _ . � � ��',�� � �'� �; � R ` . , �� a. {� ;;� Y � � ���` "' � . 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Cn�+i� �'�G8 ��� a f 19 �i �ie .,.. �. �, . „ � �.. j Ir ' ' �-? (�� �� �r+o�6� t -'' (;� De�� ; ,.� ; , � ,�. H@i.�ht ; �qus��t �'get; "'a" ��� � -� Cubic Reet t ` �� � �° � �Y"° 0� 6l0�194�+aAt`.��.�+�� e � I� .� \ s ��� ai8�� 'iRd VOB� � $ � � � . , s � v �� � �WS� �iA �i ��+��:+�dj � ,��" 1��� / 7� �-- _��, �,:' �� ;� � o�+���d hereby aa�e� a���c��iv� �or, $ pe�t fafi th� wa�ick h�reir� �g�#,f�,� ag�ee� -� da al�, �T� �n ett�at acco�dance wi.tt�. the C�ty �� F�dA�' Qz�d�c�� �d t�l�a� aPf �e+ De#�art�aen� Qf Bu�$d�n��a, �} �e�eeby +��� � al1 �h� ��cts a�d ��reser�tai�;ions ed �, ta,li� ap�►I�,�atia�t � � a�$ cvrrec�, . �- � ��.Ta,1 r ��l�1VATq�E : .�/ . �� 1t�v�� B� ��oS Add�R�� I o�atiau�� �,� "`� � � _ ,� ��' � i� ``:,�. � � `: � "u/ �_ �- � ' , �� � �r�' �`''? S,� @� �f °,� 1,'� � � E �� t�`�� g 4` � �' Q` � � ° ���' 1 j 5,- �f � .�---� �.; ,-�_._ � t ��, � t-� ,� �^ �' �' � + e ,. f F 6_ �, ,�' d � _ � � : � � .�, ,� - � ,� L a � `' ` �' � - �� . -�y �� � �3 h;� YBU���TN� P�RMZT F�� �GH�nu�E � ������ �, �'he I�s�ecto� pf �u�ldin�� s�al�, be�axe �asuiag permi�� for the ������on o� arty bu�lding a� struc�ure, ox far any addition to any �is���� ����d�� ox stxuCture, or f4� any alteratio� ox �epairs to any ex���i�g �&a�����,� o� stx+uc�uxe, upo� �pP���ation th�xef��ey xequ�re �he paym��� by �hs ���li��t fp� su�h F@x�,t p� �ees t:o the a�ount herein below set �a��h �d �� ��.�; uaa��ar h�+x�:�.� g��vided � �c��wik s ti�Qltl"i �U�LIITNG �ODEt �►pe �.a 2& 4�$2.�:5 �ar each aAae tY►ous�nd cubic �e�C„ +A�' ��ac�ipn th�7c�eo�, in ��tc� cubical co�,tents. �.'ype 3& 5� -$�..8�5 fo� I�C�1 O'1'�81 i�A1�$SAa ,�1�.:�.0 �@��e • ��D�T�UI�IA� I�F1�AT'�ON FQ� �� puxg�8a af �a�pt�t��.t�� �ees for building pereaits, the cubical conteats of �ty building or addition, is datermi�.ed by mui�$plyin� the �ound area �Ay��. �tmt a� poit�� s�x ��� in�ies below �he flo�r �ine o� the basemet�t ��� �+��la�' i�o �he average �ieights of the upper surface or to the avera�� •! ��� �� t�s �o�� �.��ace o� the maia� �ab�e p� � pi�chec� xoo�. ���L3's o� ai������.ot�� � aa� existin� s���eF �a� f�e shal�, be �� ��.� �'�,�� fl� $�s�U �g' ��,r� g�ve h�dxed dollax� ($300q0E3) � f���i�a. �hex'�o£ �,� �h� ca�s� a� a�.� �a�o�rsec� wo��c� ��a c� sh$�1 i�3�� �+e� d fo� a� pe�it as se� �v�a � S����.az� 2 bs :L� -�au �5.6�A. 0 V�.�����i'TiQ�i 0� �t,��TN�lA'£IC3N �� ��.ts �4� �c�st.?�u���o� wi��, be i��ued a �iniu�m a� �4 %�urs ��o� t�a � o.� �►pplicat#.on,, �a ��.�c� �ox pra�e� rev�.ew o� �e �p7ropa��d ��ACuB#�x+� �ud �� �e �s��u��ion �siXe. 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L ����1 : . ■���C ' ` ■:■,■�, " • �.■�1 ---r-- � � ❑ A ���� n � ►�'� ~ � � b ° a o. �n m ff � �� � � ,I m N WATER �lTS uaiw►�c � �� 51N16 WIy�'/l FOUNT. S►nrR4 DRAINS GTCM �5�� �o c� � � � c�s OFENINGS � • a • � > T a � � n " A � ��c� .°. ��� � � ,.o� w � om��' � ���� b� � oq 5��� �''�.� 00 b � �� � „ �� �� mmc ���o �ti �t � m �! CL � � 8��� � '� � .°� ���� � � � � � � y� "i 3 � :°• �C � N � �� A d � �x �S �i p � M � � � � � � � � � � A• d= � m � �� $. ID ' � x � . � � a (��'� � �� � City of Fridley AT THE TOP OF THE TWINS i � � � � `L ______ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. � ; i i•---� ��"" �•� CITY HALL FRIDLE� 55432 i 612-571-3450 SUBJECT BU ILDING PERMIT NUMBER REV. DATE PAGE OF 910-F15 5/18/88 � � JOB ADDRESS 6257 Ben More Drive N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. L� 2 Heather Hi.11s 2 PROPERTYOWNER MAILADDRESS ZIp Messick 6257 Ben More Drive N.E. 3 CONTRACTOR MAIL ADDRESS 21p D& D Home �p.proveaent I'nc. 7401 Central Avenue N. E. 4 ARCHITECTORDESIGNER MAILADDRESS ZIP 5 ENGINEER 6 USE OF BUILDING Residential 7 CLASS OF WORK MAIL ADDRESS P�+ 'VITN �0 19478 REC . ,�� �/ APPROVED BV SEE ATTACHED SHEET PHONE UCENSE NO. 784-7543 PHONE LICENSE NO. PHONE LICENSE NO. ❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (22. Squares ) 9 CHANGEOFUSEFROM TO STIPULATIONS R�f can be 2nd layer but not 3rd. Install ridged galvanized valleys. Urt all new roofs or tea�-offs and replacement roofs� State Code requires that 2 layers of 15 Ib. fett, mo��ed together, be installed io a poinf 24 inche� uR from ext��iQr wa�l �ine, or the use oi other aRpra�e� uR�e�i�yment membrane. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPI VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTAUCTION OR WOpK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1�1QO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $27� OQ RUCTION OR THE PERFORMANCE OF CONSTRUCTION. ����,�,r PLAN CHECK FEE � %� SIGNATURE OF CONTRAC R OR AUTHOR12ED AGENT �DATEI �a�uor.i ooneee� v v. 11F OWNER BUILDERi iDATEi . GROUP OCCUPANCYLOAD CU. FT. OFFSTREET PARKING GARAGES SU RTAX $. 55 SACCHARGE TOTALFEE $27.55 pED THIS IS YOUR PERMIT 1�%v [ ] 1�1DDN [ ] ALTER '[� City of Fridley R-1 Ai�ID R-2 �,;�ding Permit Application EEfective 5/L88 Construction Address:—� � � � ����1 ���°� �� - Legal Description- Owner Naaae & Address:_ �%°� � 5 i C� Tel. �`��l/� G��� Cbritr act or : � `�" � i� �t �e � un $� a��e �c � ,� �- �n e ,- Tel. # � � —7.���� , Adc]ress : �� � � � r�� °$ � � �-�� r �d� Attach to this appl ication, a Certif icate af Sl�rvey of the lat, with the proposoed construction drawn on it to scale. LIESCRIPPION OF IM�'ROVII�Tr T.TVTI�Y; ARFA; j�,an� Wl�l He1Cjtlt --- - ---- .�. �. (�RAGE ARF,A: Length Width Height St�. Ft. DECtc ARF�: Length width �t/Groima sq. Ft. S�+S:. �rner Lot [ 7 Inside Lot � Ft. Yd Setback Side Yard Se cks Type of construction: P�5���31 �e -�� � Estimatecl Cost :$`�� Q F�- Approx. Completion Date: � Alt. A Alt. B Proposed Driveway Width If New Opena.ng Is Desired: $ $ Width + 6' See Back Page nr�E : � =/ � - � � ��zc�,rrr: � �'rl o lso � Petmi.t rlee State Surcharge SAC (harge Driveway Escraw Park Fee Sewer Main Qzarge TOTAL STIPIJLATIOIJS: S �� �)� S � �: $ $ S S $ a`�• ,S: ,�.° (3TY OSE OHI�Y T�. � �� 7�"5�.� F�ee Schedule on Reverse Side $.50/51,000 Valuation $550 per SAC Unit Al� '�," or A1t. "B" Above F�e Determired by Ehgineering Agreenerit Neaessary [] Nat Neaessary [ l � 1=_+���� � �+��� 4 :r� �«:���.1 'IRze Chief Building Official 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 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 Y�elaw set forth and in the maruier herein prwic]ed to-wit: �'t'AL VALUE $1 to $500 5501 to �2, 000 S2, 001 to $25, p00 525,001 to $50,000 550,001 to $1Q0,000 5100,001 to 5500,000 FFES S15 (Minim�n Fee is S15 glus surcharge) � $15 for first $500 plus S2 for e�ch �dditional $100 or f raction thereof, to and including 52,000 S45 for first 52,000 plus $9 for each additional 51,000 or fraction thereof, to and including $25,000 5252 for first 525,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including �50,000 5414.50 for first 550,000 plus $4.50 for each ack7itio�al S1, 000 or fraction thereof, to and including $100,000 $ 639. 50 for f irst $100, 000 plus S3. 50 for each additional $1, 000 or fraction thereof, to and including 5500,000 $500,001 to �1,000,000 $2039.50 for the first $500,000 plus `$3 for each additional $1,000 or fraction thereof, to and including 51,000,000 51,000,001 a�c] up Alternate "A": RemWal feet times 513.50. $3539.50 for the first. $1,000,000 pl�s $2 for each additional $1,000 or fraction �t�ereof•: • ' ; �,�� r� (Concrete Curb Streets 'Ch�].y) �.s..'.Y.;;. �:;"�.` .�` d . and replavement o�' curb and gutter ��cinly, -` Dr�veway width plus 6 Alternate "B": Re�nwal and replaoement o�f curb and gutter and install a 3 foot wide approach with 6 inch depth - Drivesaay width plus 6 feet times $15.75. ��� � � • � • ' �►� J��� : Y �J�I Permits for construction will be issued a minimum of 24 hours f rom the time of application to allow for proper review of the proposed structure and of the wnstruction site. A Certificate of S�rvey of the lat, shawing the location of the foundation once it has been aonstructed will be required before proceeding with the fra�ning. .. a �. - City of Fridley AT THE TOP OF THE TWINS g � � L D I N� P E R M I T ;, � � i j V ��'..�' COMMUNITY OEVELOPMENT OIV. r � � PR07ECTIVE INSPECTION SEC. l.-_-� ��"" �'� CITY HALL FRIOLE� SS432 NUMBEN pEv t 612-571-34b0 9�0-F15 10B ADDRESS 6257 Ben More Drive NE t IEGAI �OT NO. BLOCK TRACT OR ADDITION OATE I PAGE OF 3/7/O1 � � �i 66i RECEIPT NO. APPRpVED SEE ATTACMED DES,CR. l} 2 Heather Hills SNEET 2 PROPERTY OWNER MAIL ADDRESS 21P PFIONE Sue Messick 6257 Ben More Dr.ive NE 763-571-6737 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 763-502-4777 4 ARCHITECT OR OESIGNER MAIL ADORESS ZIP PMONE LICENSE NO 5 ENGINEER 8 USE OF BUILDING Residential 7 CLASS OF WORK 20130983 MAII ADORESS 21P PMONE LICENSE NO ❑ NEW � ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WOHK Replace 10 full frame windows and 1 bay window within existing openings 9 CHAN(iE OF USE FpOM TO STIPULATIONS Provide smoke detectors in ali sleeping rooms nnd on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. SEPARA7E PERMITS ARE REOUIRED FOR ELECTRICA�, PLUMBING. HEATING, TYPE OF CONST. VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK Ofl CONSTRUCTION ZONING AUTMORIZEO IS NOT COMMENCED V�(ITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOO OF /20 DAYS AT ANY TIME AFTEfi WORK IS COMMENCED. NO DWLG. UNI7S I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINED TFIIS APPLICA710N I ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION AND ORDINANCES GOVERNING THIS TYPE OF WOFiK WILL BE COMPLIED WITH WHETHER SPECIFIED HEpEIN OR NOT. THE GRANTING OF A PERMIT �I.G,676 DOES NOT PHESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEI THE pERMIT FEE PROVISIONS OF ANY OTHER STA7E OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �Z79 . ZS PLAN CHECKfEE Lice C S�GNATUAEOFCONiRACTOpOAAUTNOAi2E0AGENT 1DAfEi . .• r nn. � ibATE� � B G �aSO : SQ. STA�LS � NCYGROUP �OCCUPANCVLOAD CU OFFSTREET PARKING GARAGES SURTAX ' $8.34 SAC CMARGE Fire SC $16.68 T07 L FEE $309.27 ��-,� � � �- ' , �ective 5/10/99 ` �. ; .� �:�: ;i ;r�. �. ;�, ..; ;�y,�; .; �, ,., : r r:i � � `� : : .► f. �onstruction Address: %a1 S� %-ex��c�ncat-Q.�c �w1 . . . Legai Description: � _ Owner Name & Address: �cc,� YYe-e�5 i 1�. '1`� Tel. #�'lc3 • S�L •�3�° Contractor:; � REN�WAL BY A�IQERSE� 1�'IV I:.IC�TSE # 350m73RD AVE. �E Address: FRIDLEY, MN 55432 Tel. # �(03 f��02m4777 F Survey of the � LICENSE #201.30983 ---�, ,r-= — -.- - -- - � on it to scale. �: - ;� :.: ,.., ;, , ,. .. t , ;,;�� • �onstruction Type: D�.S.��IflP�T t?lF �����'� _ � ' I-eength �Vi�ltb. Height Sq. Ft. I.ength Width �ieight Sq. �t. Length � Y�li� � �Igt/Ground Sq. Ft. .�.s�.��►t��'!'�:�ir1L"i�i��l'\�i�..t�Z:��s7/�j ► •' �J _ J • � a / � �� . �. . , , ," ` I3riveway Curb Cut i�l'idth Needed: Ft. + 6�t = Ft x$ _$ � �.: , � , � � : . .. : � . . ; ; -. > � .• . . . � - - � %J���_ t. '�+_. �_i ..i.a... .i.�_.. . . � _ � r Permit Fee Fire Surclia.ige State Surcharge SAC Charge I.icanse �rcharge l�riveway Escrow Erosion ControI Park Fee Sewer Mai.n Charge � �� i �� $ iio [�$ $ � ��-. $ � �� $ $ $ $ �8.8 8 �.1� �1lY.t� �ee Schedule on iteverse Side .001 of Permit Valuatian (1/lOth%) $.SQ/$1,000 Valuation $1050 per St�C Unit $5.00 (State Lic�ns,�d Residential Coutractors) Alt. "A" OT Alt. "B" AbOVe $450.� Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not IVecessary [ ] T���. � 9 a� , `��1!/D�"' „�i�-z.olC� �!��-��-' �%w`�� . S�u��o�vs.`, 9 / // /� �'�i��/�/s✓ �- ��r 3 /V • ! . / .�--- / .,l �� �% C/C. y ♦ C. L �Z �GL �Z- � l?�Z t��'•�.���lcl-.�-.f _ ;:` � .1 1� f ,- "' :�1' ' .t � ::1i�i The Chief Building Official shall,loefore issiaing permits for the erection �f any building or st�ucture, or for azry addition to any e�isti�g building or stn�cture, or for any alteration o� -�pair to any existing builciing or structure, upon application therefore, require thc.payment by the applieant�:for.�sucir permit:of ��s to the amourn, herein below set forth and in the manner herein provided-�o-wit: . '� _. _ k � TOTAI. VALUE $1 to $500 $SO1 to $2,OOU $2,001 tQ $25,�d $25,�1 to $SO,Q00 $50,�1 to $100,000 $100,001 to�$5�,(�30 $500,001 to $1,Q00,000 $1,OQ0,001 and up --__..... - FEES _ $23.50. $23.5:0_far first $SOO pI"us: $3.a5 for each additional $100 or fiaction thereof, to and�;inrclnding::$2,� - ... . $69,2� for first $2r(�O plus. $.14,0�3_f4� each additionai $1,�0 or fraction thereof, to and including $25,0� $391.25 for first $25,(M?0 plus $10.10 for each additional $1,000 or fraction thereof,. to and: includin� $50,�0 -� $b43.75 for first .$50,000 plus` $7.00 for each additional $1,000 or fraction thereaf, to -and �inciuding $100,000 �$993.75 for first $i�,000 plus $5.b0 foir each addition�l $1,�Q or fraetion �ier�o�,� t� and i�cluding $5(3�,�0 , - �3,233.75 for the first $500,000 plus $4.75 for each additional $1,Q00 or fractian thereof, to and including $1,000,000 °` $5,608.75 foz the first $1,OQO,Q00 plus $3.15 for each additianal $1,000 or fraction thereof � I)���IAY I)EP�SSION ��Oi�V (Co�rete Curb Streets Only) . Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Aiternate "�": Remova� and replacement of eurb and gittter and:in�Cali a 3 foot:�w�dee.: .: �- approach wi#h 6 inch depth - I)riveway width plus 6 feet times $23.25. CA�O1�T O�+' i+'{)UNI)A�'ION Permits for constructi.on will be issued a minimum of 24 hours "from the time of applica.tion to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey af the lot, showing the Iocation of the foundation once it has � it has i�n ���� vvi11 be required before:proceeding with the framing. _ � �� _ Building MECHANICAL Perrnit lvo.: C�0 �`�'Q Inspections RESIDENTIAL APPLICATION Rec� ��8� 763-572-3604 Date�ec d: CITY OF FRIDLEY DATE .�=a � °� � YOUR E-MAIL ADDRESS � � /vl � ��G ��C�..` � !� �5/V . C� SI� fwD�SS 1� a � �_ � e � � � �' � � �. THIS APPLICANT IS: ❑ OWNER �ONTRACTOR PROPERTY Nq�: � OWNER/ pDDRESS: � � � � �'� �S CTI'Y � STA �IP��,�� TENANT PHONE:' CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: � YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH pDDRESS: l���_ F�Tr� 5� < CITY�C,A ,.�, �c� � STATE�Z[P�a�� APPLICATION gHONE�������� FAX � �° �� LI -° T� PERMTT TYPE �Gt.E FAMILY ❑ TWO FAMILY Q TOWNHOU5E TYPE OF WORK• 0 NEW �EPLACEMENT ❑ ALTERATIONJREMODEL DETAILED DESCRIPTION OF WORK ..� PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installarion 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.05 = FOR PRUJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. F[XTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� Equipmentlnstalled MFG:�_i�'�����, MODEL��.�p�C�� SIZE/BTU�}_� MFG: � MODEL: SIZEBTU MFG: MODEL: SIZFJBTU A/C $25.(l0 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 _BOILER $35.00 �FURNACE $35.00 GAS UNIT HTR $10.Q0 CHIMNEY LMER $10.00 GAS DRYER $]0.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPMG $10.00 VENTILATOR $15.00 � � �� ��p ��:; � � : �'�� � ; � �'�.�v _ Permit 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 x $25.00 = $ � Number offixtures @ $35.00 x $35.00 = $ State Surchazge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNT(L 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 'dley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicati n r a ermit and k is not to start without a permit; that the work will be in accordance with the approved plan in the case of all 'ch e u' eview and approval of plans. SIGNATURE OF APPLICAN7' PRINT NAME �� �� ���° `�� DATE �� � �'� / z,° r �� „� � � �..,, �= c:'�,. ` . � ,�.. . ° - � . � .: ., :: . . .. ;�� :, � • f i1v nf Frir�lav 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 0 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 3. Venting a. Gas appliances IFGC Cha.pter 5 with MN Amendments b. Fuel other than gas IMC Cha.pter 8 with MN Amendments REOUIRED 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 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for cQmbustion and make-up air calculations.