P - 48268Building MECHANICAL
� Inspections RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTrvEi-�-zoii
DATE �� �!�7 � ��� YOUR E-MAIL ADDRESS
SITE ADDRESS �7 a� d L� ��i7 GL/'� /� r� �
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
❑ OWNER �ONTRACTOR
� ��i"�-- /
�
� iii� �
Permit No.: �
Received By.
�'����
CONTRACTOR COMPANY NAME: /�f ,D �S'!�n /r'���r O/,.7,��� /t-� G�_v-
SUBMIT A COPY OF CONTACT PERSON: G��/7 iy i-� L�SC�� ��� -�J��
YOUR STATE STATE LICENSE # EXP /DATE
LICENSE WITH ,q�DRESS: ���JD!>` D��-rL h J�f�/� CITX�iC�L�,,,;,,3�3�7T�f�i�'��!
APPLICATION I pHONE��/� ����jFAX �c�- �v� �__d�o
PERMIT TYPE ��GLE FAMILY ❑ TWO FAMILY
TYPE OF WORK: � NEW �REPLACEMENT
/
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
0
FEES ARE BASED ON $10.00 PER FIXT[TRE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELp�
PROVIDE HEAT LOSS CALC'S PER MANU J 2006 AS HANDBOOK. / ,�/
Equipment Installed MFG: L? �) MODEL�[7 1� D%�'��,�LEBTU �/� �d �
MFG: MODEL: SIZE/BTU
MFG: _ MODEL: SIZEBN
A/C $25.00 ' ` _FIREPLACE (GAS) $I5.00 _GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANG�ER $15 F PLACE (WOOD) $35.00 NEW GAS GRII,L $10.00
BOI[,ER $35.00 7' [JRNACE $35.00 GAS L1NTT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the C' of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit d ork is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work whi equ' es re iew and approval of plans.
SIGNATURE OF APPLIC �' � �' �'J , � ` ' " � � " "' ��"` _ �%%�_ �
APPIiOVAL INSPECTOR5 SIGNATURE
DA
City of Fridley
ilding Inspections Department
1 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
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� DATE:
JOB NAME: JO� ADDRESS:
Heatiri TD = 90 F+70 F indoor -20 F outside Coolin TD = 20 F+75 indoor +95 F outside
� HEAT LOSS HEAT GAIN
SQ FT COEFF BTUH SQ FT COEFF BTUH
Single 116
_ -- - - --- -- - ----
Double _���-- 82
--- -- -
Low E 40
-__ -- - --- _ ___. _ _. ------_ - -------
Other
r . . # — --- - 4,000
12"
_. _---- __-
9,�
6"
____.._,_.
3"
3"
1-1/2"
0"
1"
�
0
�
7
10
6
3.5
C�DO
N
NE & NW
E&W
SE & SW
S
�,od. 12�� �
9„
6"
�i�o � 3" ---
3"
1-1/2"
23/19 33/24
43/34 65/54
58/49 90/74
48/39 78/64
33/24 48/39
300
1 .
2
3
4
3
4
# � 600
_
�
Blw_grade_ __��� 1.5 ��c.�
Slab-grade Iin.Ft. 30/Lin. Ft. ,•• - �` -������ 2500
SUBTOTAL 3GJ c.� ��, SUBTOTAL
INFILTRATION: Infiltration CFM =*Factor'(see'below) x cubic feet of house tlivided by 6
_ __ .
factor . x L x W x H / 60 = Infiltration CFM
NOTE: Additional heating infiltration load should be calculated only if house is loosley constructed
Infiltration Infilt. CF Coeff BTUH Infiltration Infilt. CFM Coeff BTUH
* 99 Sensible 22
Latent 24
Attic or crawl s ace 10% Attic or crawl space 10%
i� �'�'"�` , �" �
�%�K % 4w q ?'' . "�,
�S_ a a,y„��.�Z�,s.?�,� ..�s+�¢ ::. ;�`. . ,..�: � En�.
80% Furnace divide by .75
_ _-- ------- -----------
90% Furnace divide b r�.85____
95% Furnace divide by .90 3 v�0�
FURNACE MODEL # Lf,�(Jc"i� -
*Infiltration Factors: :- Heating , Cooling ,;
---._...-------�--.—..-------- _- - --
Loose house 0.50 0.30
Medium-Average XX (.30) 0.20
Tight house XX (.25) 0.15
R COND. MODEL #
NOTE: Drawing or sketch including location of Condensing unit on back of this form! :
7/16/2009