P - 48352Building
Inspections
763-572-3604
763-502-4977 FAX
DATE "b�U � �
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY NAME:
OWNER/ ADDRE;
TENANT
PHONE:
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
MECHANICAL Pe��t N°.' '�'
RESIDENTIAL APPLICATION Received By:
CITY OF FRIDLEY D��'��� �
EFFECTIVE 1-1-2012
YOU - AIL ADDRESS �� r `'�
�
❑ OWNER �ONTRACTOR
E' S
i: a-IY1 � CITY STATE ZIP
�a�A�
COMPANY NAME:
CONTACT PERSON: Q �7 '�'�i��O�F�R%��
STATE LICENSE # O3 7d tS�'I .� EXP DATE '_��CD ��onn
, o��r-�:
ADDRESS: CITY �,�_75fl_dnnn STATE ZIP
PHONE FAX �'�-�� D! 3� _
�INGLE FAMILY ❑ TWO FAMILY
❑ NEW �iEPLACEMENT
DETAILED DESCRII'TION OF WORK
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
�
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FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL 2 06 ASHRAE HANDBOOK �^ �
Equipment Installed MFG: MODEL: �:5�'I�-�d�0 c��ElBTU Q�
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
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 YFURNACE $35.00 GAS UNIT 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
0
Number of fixtures @ $35:00 � x $35.t}� = $ �� �
State Surcharge = $ 5.0�
(MINIMUM �'EE $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 applica 'on for a it an wo is not to start without a permit; that the work will be in accordance with the
approved plan in the cas ork which r i w and approval of pl n. � /�
SIGNATURE OF APPLIC ���� O� PRiNT NAM��I' ///� �/IP �([n cx7Vl.EIiE�9F',/ ��Q/I�
TURE
DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
//
0
Page 1 Residential Heat Loss and Heat Gain Calculation 1/30/2012
In accordance with ACCA Manual J
Report Prepared By:
For:
Riccar Heating & Air Conditioning
Job name is missing
6588 cloverleaf
fridley, mn
Design Conditions: Minneapolis/St. Paul
Indoor: Outdoor:
Summer temperature: 75 Summer temperature: 95
Winter temperature: 70 Winter temperature: -12
Relative humidity: 50 Summer grains of moisture: 98
Daily temperature range:Medium
Building Component Sensible Latent Total Total
Gain Gain Heat Gain Heat Loss
(BTUH) (BTUH) (BTUH) (BTUH)
Whole House 37,323 920 38,243 52,473
Main Floor 37,323 920 38,243 52,473
All Rooms 37,323 920 38,243 36,237
Basement 0 0 0 16,236
Whole House
37,323 920 38,243 52,473
HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101
Load calculations are estimates only, actual loads may vary due to weather and construction differences.