P - 35494s Building -
Inspections
763-572-3604
763-502-4977 FAX
DATE �- � O- ��
SITE ADDRESS � Q
THIS APPLICANT IS:
PROPERTY NA
OWNER! Ac
TENANT
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
❑ OWNER �CONTRACTOR
CONTRACTOR I COMPANY
SUBMIT A COPY OF
YOUR STATE
LICENSE W1TH
APPLICATION
Permit No.:
�' - � i`
� i
u. - •- �
n rC.. CITY STATE ZIP
CONTACT PERSON:
�v r n�. i viv titATING & COOLING
STATE LICENSE # —�1ZU - 8Sih AVEIVU�j�i��'H
ADDRESS'. K, MN 55q�Y STATE ZIP
PHONE 3
PERMIT TYPE �ryGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE
TYPE OF WORK' � NEW �pLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK �° �
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANU 2006j �SH�� HANDBOOK. /�,��q �,l
Equipment Installed MFG: �,��LLIaJ��( MODEL��1 �V pO SIZE/BTU � D, ��t_.J
A/C $25.00
_AIR TO AIR EXCHANGEER $ l5
_BOILER $35.00
CHIMNEY LINER $10.00
�DUCT WORK $]0.00
MFG: MODEL:
MFG: MODEL!� - •
FIREPLACE (GAS) $15.00
FIREPLACE (WOOD) $35.00
�FURNACE $35.00
GAS DRYER $]0.00
�GAS P1PING $]0.00
SIZE/BTU
SIZE/BTU
GAS RANGE/OVEN $10.00
_NEW GAS GRILL $10.00
GAS UNIT HTR $1-0.00
POOL HEATER $35.00
�VENTILATOR $15.00
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 all �k wl�c qqui s re ' and approval of pla� �
SIGNATURE OF APPLICANT
NAME
CJ\l�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
TE / �—�V �✓V
MANUAL J: 7th Etl.
1 Name Ot ropm Entire Housb whple houae
2 Length Of A�tpo3ed Wall 120A ft 120.0 tt
" 3 Room dlm+enslons 2b.0 x 35,0 h
4 Celings ' Condit OpBOn 8.0 tt d 5,0 ft heaUcoof
7YPE OF C NTM Aroa Load (Btuh) Area Loatl (Btuh) Area A�e,�
EXPpSURE N0. Hty C1g (H� Mtg Clg (!1� Htg Clg Htg CIg Hig CIQ
5 Grosa a 12C 8.1 2.1 9(i0 ""•' "'• fla0 ••"" ""F• •"' ••« "" �••
.... .,.., .... ».. .... .... ....
ExpOSetl b 14C 6.9 1.3 272 "" 272
walls a�d c 15A 11.3 0.0 890 «•• •••• 660 ,••• •••• •••• •••• •••, •,••
partitions tl 0.0 4.4 fl ,,.. ;*,,, o .«. .... .... ..x.. .... �.«.
e o.0 0.0 0 0••"•
f0.0 0.0 0 .». ..« p .,.. .... ..» .... .... ....
6 WintloNrs antl a 2A 4Q.8 " 200 8550 ••« 200 8550 *""• «•• �` ±
qiass dooss b o.a •^ o o R••• o Q••« •••• «..
HeeGnp C 0,0 " 0 0 ��° 0 D "'�• .«. ....
d 0.0 " 0 0 Q 0 "
e oo •« 4 0.... a o.... .... ....
f �.0 •• 6 0 .... p � «.. .... ....
7 Windowaantl North 31.0 50 "°• �SSb 50 �"' 1550 "'"" •«•
IaSSCppfs NEJNW 0.0 0 "" 0 0 """" 0 ""' ""'
g ss
CO011f19 FJW 89.0. 105 "" 93A5 105 """' 9345 """ ••"
.... .... ..« ....
$put�H 48A . ds •••• 2160 _ 45 •••• 2160 •••• ••••
Haz OA _ p .... 0 _.� ..» p M�., ....
8 Ol�sr Elof�s a 10F 28.8 7.6 42 1210 3i7 42 1210 317
b 0.0 0.0' 0 0 0 0 0 0
c a.o o.o 0 0 0 0 0 0
9 NEt a 12C 8.1 2�1 718 5818 1526 y18 5816 1325
expp�ed b 14C 8.9 1.3 272 1885 �41 272 1685 341
WiNa anC C 15A i 1.3 OA O80 7A50 0 680 7050 0
psttlUOn� d 0.0 0.0 0 0 0 0 0 0
e 0.0 0.0 0 0• 0 0 0 0
f 0.0 0.0 0 0 0 0 0 0
10 Ce�Nnpa 8 18C i,9 3,7 875 8950 3198 875 �6930 a196
b 18C 7.9 9J 0 0 0 0 0 0
e O.o o.o 0 0 0 - o 0 0
d o.o o.a o 0 0 0 4� 0 0
e 0.0 0.0 0 0 0 0 o C
• f 0.0 0.0 0 0 0 0 0 0
11 Floor� a 21A 2.2 0.0 8�5 1E90 0 875 1890 0
{NOte: room b o.o o.0 0 0 0 0 0 0
oetlmeter c o.0 0.0 0 0 o a o 0
is dispi. d, 0.0 0.0 0 o O 0 0 0
I'or slab a 0.0 0.0 O 0 0 0 O 0
11oon�) ! O.0 0.0 0� 0 O 0 0 0
12 IMlttratlon e 36.9 a.4 2a2 8931 627 2az aas� . 827
.... ..» .... .... .». «.. «.. ....
13 SI�Yb-W�e91�I"�I��S=�B�a�8y..+11+12 42851 42861
NYOMWI��OIIIOOY� . �t\� O MV� N�i O 1�M rrN ���� N� „Y�
l.osa transfer �•... � p .... ,... � ..» .... .,.. ,... ....
M�Irfp redlsVlbution '""' p •••• •••• � •••• •••• •••• ••,•
= . .... . o «» y .... .».
�� ouaiaa a o tt�
16 TOt111 b!S R 13�14 "" 42881 '""" "« q2861 •,•• ,••• •••• •••• «»•
is Intgains: Peoplel� s00 a"'"' t2o0 4•"«, �200 »» �"'
Appl. � 1200 1 ""' 1200 �•••• 1200 •••,
t7 Subtot RSH pain�7i,,+,,8:.�12•18 •••• ••,• 21861 •••• «•• 21681 "" .... •«• ••••
l�s�� �anq �wr ���� . Q ��rw �... O. NM w�� ��
LCis ��K . � � w�� �►w 0 .��� �M+ 0 a�aw arn ..�e e�w
�j�NiQ ����Oii ���� w��� . � �w� ���� � �w� �w� �� Nw
�e o„a n o'~- o o�- o .... ....
19 70qII�H ypm=(17+1�'PLF 1.00 "" 21661 1.OG "" 21681 •"" ""
20 Air roquirlid (Gm) •"' 1158 1158 '•» 1758 1158 "" ""
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