AF - 36458City of Fridley
Application for P�umbing and Csc�s Pitting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK ,�
Number, Kind and Locatioa of Fixtures Location �.� (✓? �'���,,, Q
y � � � �n w w Z � � WATER HTR.
� F� z x� '� Y x} iz �Q�z �z ox � c� z
�<0J ��� � Z�S� � p = Jo4 <'� �� <a 7Z 7a i N GAS ELEC.
� 3(j � N 3 H Q LL N LL � V m< 3 c� < t� �� O
►S 1 I 3 j
lst 2, 2+
2nd
3rd
4th
• Future ConasCYion OPeniags
* New Fixture, Old Opesiiags
City of Fridley:
v;
�
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the faci
and representations stated in this application are true and correct.
Fridley, Minn._��/ � � /� 6 , 19_
Owner
Kind of
seWe! � Used as -�/ �-�Y"1'L.sZ
Cesspool � �� �
To be completed about �`�i–��-�--`� k ( �. �� C'� _
PARTIAL RATE SCHEDULE Estimated Cost, �;f�o ��
PL.UMBING FI%TURE RATES: NO. RATE TOTAi. / Old 1\Tew. Building Permit No.
Number Fixtures ...... ..
�/ /�C '�5�� ,
� x$1.50 $ � Z. u G / Sia'ne f
Future Fixture Opening . . . . . . . . . . . . . . . . � x 1.20 $— 2' ' i��
New Fixture Old Opening . . . . . . . . . . . . . x 1.00 $
Catch Basin . . . x 3.25 $
Water Heater (Up to 200,000 BTi� ...... x 2.00 $ Z� G�
New Ground ftun Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures .......................... x$1.50 $ , y
Additional Fixtures . . .. . ......... .. . .. . x .50 $
Gas Range to 200,000 BTCi . ......... .... x 2.00 �
ROUGH
FINAL
i/
REPAIRS 8c ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ G �, «
, ��yu
$y G C� %
Business Phune
Permit N
�
`�G'-'.f� - • �. ..�p
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,�r: � �5
f��" �; -,,.� �
. .. . . . .:
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Application for Power PIaM�s and Heerting. Cooling, Ventiiation. Refrigerotion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 � �
Replacement of Furnace ............................. 5.00 #
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,Q00 BTU . . . . . . . . . . . .
each add. 60,000 BTU .......................
Replacement o! F�rnace .............................
Re`Pairs & Alterations—up to $500.00 . .. . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . .
8.00 $ �
2.00 �
5.00 $
5.00 $
2.50 $
STEAM os HOT WATER 83Ca!'EM
•
I' Furnace Shell & Lines—to 400 sq. it. EDR Steam ...... 8.00 $
y Fumace Shell & Line--to 640 sq. ft. EDR Hot Water ... 8.00 $
' Each add. 200 sq. !t. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . : . . . . . . . 2.5Q $
OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ v
GAS FITTING FEES: NO RATE TO�'AL
lst 3 k�xtures .... ................. x $1.50 $ �
Additional Fixtures . . . . . . . . . . . . . . . . . x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.OQ $
AIR CONDITIONING � �
FAN HEATING SYSTEM 3ee Fee Schedule
VENTILATIPIG $YSTEM �
; ALTERATION$ & REPAIRS TOTAL FEE ��' S v
ROUGH
FINAL
Depi. of Bldgs. Phoae SU 4-7470
L` �
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City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and conect.
� �idle�, 1Vlinn. � 1 7 �66 ` , 19 _
Owner
Kind of
Used as
To be completed about� �7' I T l�
� o�
Estimated Cost, $ ��� J ' ��
@�t ew. uilding ermit •. Permit No.�� ��
DESCRIPTION OF �
HEATING o , Warm Air—No.�
Trade Name ��� Size No���v-���
Capacity Sq. Ft. E.D.R<L ��-�-d BT[J H.P.
Total Connected Load �0� �, 9 7�«GV Kind oi F�e
BURNER — Trade Name l�(-�-�/ Size No.
Capacity Sq. Ft. E.D.R��` •�� g,p,
� _ f5 0� _
(REMARKS-OVER)
�.� sM
Signe � � ` �' `
sy �
Business Phone o.
w
� � . . • '
� �2 5 r..' `. • "� . •+ � �
D•s6
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MIIVN.
Weatherstrips A.S.H.V.E, Construction No. Insulation
Guide
Windows ( Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Yes—No Yes—No 19_
FL�.! Room � Length Width '�`` Height �.l FI.��`+`,j �: Room Length J+�/ Width Height
Windows and Doors—Crackage and Area ' Windows and Doors—Crackage and Area
�Yidth Height No. of Lineal ft. Area Wldth Height No. of Llneal ft. Area
No. o[ pane ot pane lighta o[ crack � aq. ft. No. ot pane o[ pane 116hta ot crack eq. tt.
f / f :1 � ': '7 '� � � / r i � �, C !� ""3 "� �' '� /_
Coef. Btu
Infiltration
Glass Z ( �`� <
Exp. wall �
Net exp. wall �
� Int. wall
Ceiling
Floor - C" 6
Total Btu. G
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.��;r' j �� Room ( Length / Width �1 Height '
Windows and Doors—Crackage and Area
Wtdth Height No. of Lineal ft. � Area
No. of pane ot pane Ilghte o[ crack eq. tt.
1 �i/a �r� Z. 2 `S 2 �
Coef.l Btu
In6ltration '%
Giasa
Ezp. wall }C � L��
Net exp. wall 5
Int. wall
Cei�ing
Floar � �„ ( Cg (�,,
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Ft. �►' � Room � Length Width ,
Windows and Doors—Crackage and Area
- Wfdth Helght No. ot Llneal tt. Area
No. of pane o[ pane Ilghts o[ crack aq. ft.
In6ltration (
Glaas
.
Exp. wal! . 't'� YC �
Net exp. wall �
Int. wall
Ceiling � ��`
N loor
Total Btu. ,
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
Infiltration
Glasa
Exp. wall �
Net eap. wall
Int. wall
Ceiling %y��
Floor
Total Btu.
Btu
��i
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �
lT.1�.1 ---- Room ( Length � � Width l�j/ Height
Windows and Doors—Crackage and Area �Q
Wldth Ae No. ot Lineal Lt. Area /�
No. o[ Dane of pane lighte ot crack aQ. tt. ,,,,,.►
4l� �/ � � ,� 'it � 9z-
� � � G R,, �t t `�'.�--
z
t��
�
In&Itration
Glass
Exp. wall
Net exp. �
lnt. wall
� Ge+ II Floor �,/++�'''' ,!�':
Total Btu.
/
Required aq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.� Room I Length Width
Windows and Doora—Crackage and Area
"R'tdth Height No. ot Llneal ft. Area
� No. ot pane ot pane Ilghta of crack ea. tt.
Btu (
� Inhltration
�j' � �j Glass
Exp. wall
��� Net exp. wall
� Int. wall
_,',2�' Ceiling
Floor
j � �/ Total Btu.
Required sq. ft: E.D.R. or sq. ins. WA. Leader area
�
B
Btu
R .
o-s6 Z ` 5 . x .., ��� c�SS C' � f � C t�SS ( . ... . N E ( /%% , C8S S � � .. � �
HEAT LOSS CALCULATIONS ��/ �� EPARTMENT OF BiJILDINGS ��i ��� MINNEAPOLIS. MINN.
Weatherstrips A.S.H.V.E, Construction Na Insulation
Guide
Windows I Doors Reference Out. Wall Int. Wall C,eiling Roof FIOOT Kind How Applied
Yes—No Yes—No 19_
Fl•� „� � vr Room � Length �'� Width / 3 Height F7.� /�t/ Room Length �(,,,�, Width Height
Windows and Doors—Crackage and Area Z'1 Windows and Doors--Crackage and Area
�Vidth Helght No. ot Lineat tt. Area � 3 �Width Height No. ot Llneal ft. Area
No. of pane of pane liBh[a o[ crack aq. ft. """" No. ot pane of pane llghte ot crack eq. tt. �
4 d 2. J`"�% Z� Q C� 7�, �' Z�s
�.
�s�
Coef. Btu Coef. Btu
Infittration 7 2 � Infiltration Z� � '� �' .
Glass � � Q Ci Glass "��b l C� C7
Exp. wall Q�' Z,,Q Exp. wall �t,' '.
Net exp. wall 'l� / l'b Net exp. wall �� _ ��.
Int. wail
Ceiling 'Z "� � 3
Floor
Total Btu. / �
Required sq. ft. E.D.R. or sq. ins. W.A. l..eader atrea
�' j'dP Room ( Length Width Height
Windows and Doors—Crackage and Area
Width � Helght No. of Lineal ft. Area
No. of pana ot pane� Ilghts � of crack eq. tt.
� '7 0 !r- • � �
Coef. Btu
Infiltration ` � `
Glasa �
Exp. wall
Net exp. wall
Int. wail
Ceiling °�; „ '
Ftoor
Total $tu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Length Width l Q Height 'j
Windows and Doors—Cracicage and Area
Wfdth Height No. ot Lineal ft. Area
No. ot Dane ot Dane Ifghte ot ccack eq. it. -.
/ � � � � �"�.. Z.-� � 1
_ �
Infiltration Z
Glaas 'Z
Exp. wall � � �
Net exp. wall
Int. wall
�eiling
Floor Z I f �
Total Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
;
Int. wall
Ce�ling
Floo�
Total $tu.
./�
u
�
uired sq. ft. E.D.R. or sq. ins. W.A. L.eader area
FI.I ��iynii C Y�m I I-ength \ � Width
Windows and Doors---Crackage and Area
� Wldth Hel6ht No. oL Llneal (t. Area
No. of Dane ot pane liBhts ot crack aQ. ty
In6ltration ^
Glass
Exp. wall k
Net exp. wall
Int. wall
Floo�Ce�ling
�---
I U �'`
7�otal Btu.
Height
—���C
���
�-_
���
-�_
vm
�
red sq. ft. E.D.R. or aq. ins. W.A. Leader area
' Fl.� ��q �'ry/ Room I Length � Width
Windows and Doors—Crackage and Area
Width Helght No. of Lineal ft. Area
No. of pane ot pane � Iighta ot crack sa. tt.
Btu
� '� � Infiltration
'^Li � Glass
Exp. wall
�$" Net exp. wall
Int. wall
Ceiling � � (
�; Floor
�. Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
, _ ' �
Btu
i
City of Fridley, Minn.
BUILDING PERMIT
OCTOBER 24, 1966
Date: _.._..._.._..___._._._..___...._.._.___�
�o
„�,�y��
9U66
Owner: RON FINLEY . Builder _.._.. RODNEY__BI�,LMANs.__�NCORPQ��1?..___
Address ...---.------ ............._.___.__.__.. . Address _._...3000 _.'---36TH.._AVENUE-N-z---E.t.__.._....__....._
. . -----�--.._...__.........._.-�--�-----
MINNEAPOLIS, MINNESOTA 55421
LOCATION OF BUILDING
No. •----1604 ----------- Street .....----•-BERNE . ROAD-•-�'--E'---_._._-------�----�-------�-•-•--_..... Part of Lot -----------•--•------_..._....__..._..---.._...__.._
9 1 Addition or Sub-Division _...._.._._INNSBRIICK, 5TH ADDITION
Lot ....._......._...._......._....__ Block __.._...._---._....---_.
CornerLot ----_------------•--.._.... Inside Lot ------......X......-.--•-.--------. Setback ..-----•-------•.--.--•-----.---...---- Sideyard __.....__....___.. _...___._...__
Sewer Elevation
Foundation Elevation
To be Used as:
DWELLING & Front _ _
GARAGE........_..._........_.._.._ Front .._.__
Type of Construction _..._....._FRAME
DESCRIPTION OF BUILDING
DePth _..__.._----.__ Height .._--
Depth _...__...----------. Height ._.._
-.---.. Est. Cost .....-.-----$35.,_000
Sq. F� _._..._._...._.. Cu. FL
Sq. Ft. ._..__...._.__.. G�x. F�
To be Completed _..._.__........_.._._
� 2z x 3o X Zo = is,2oo
37.6 x 40 x 20 = 30,000
22 x 20 x 20 = 8,800
���� 52,000 cu, ft.
VAR?ANCE APPROVED BY COUNCIL OCTOBER 3, 1966
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
th� proposed work in accordance with the description above set forth and in compliance with all pravisions of
ordinancea of the city of Fridley.
� �. �i';�� �
In consideral3on of the payment of a fee of $.._5 2. 00 ���t is hereby granted to___ RODNEY
BILLMAN, WINC . to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city ]imits and this permit may be revoked a t a�y time upon violation of aay of the provisions of said
ordinances.
CLARENCE BELISLE B�� �
NOTICE:
� '�his psrmit doa not eowr th� eon�ruetion, inshllafion fo� wieing, plumbine, oas 6�afing, »w�r or waMr. M wn 10 sN
fha Buildieg Intp�eFo� for s�pa�aN p�nnits for fh�a iHms.
, - � +�
APgLICATION FOR BUILI�ING PERMIT
CITY OF FRIDLEY, MINNESOTA `
-� • ,rC f�-� :�l
OWNER' S NAME .��Z /1� BUILDER �c-� �!�-�c— -f`�
J !/ `
ADDRESS ADDRESS .��,r� r ��_�� ,C�L'`� � � �
LOCATION OF BUILDING
N0, ��`� STREET -2�I�1„�� �f PART OF LOT
LOT BLOCK / ADDITION OR SUBDIVISION ���!✓ [�2�z-c�IG <� .�'�. ��'��
. ��-Fi �i'�-'7.�.��c�/ . .
GORNER LOT INSIDE LOT Y� SETBACK / STDE-YARD
SEW�R ELEVATION FC)UNDATION ELEVATIQN
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location dxawn on these Certificates.
e ..' �' ,Y �..��,:� ,j. �, � c' '�
DESCRIPTION OF $UiLDIftG ; �; � . � �� � � � �. � ,� -" " �''
SaF' .� ---,E i z- 41
To be used as: z �` ' ''"� °�� �� �� � � � � � h.
t2. � ' ��..�...
� �'' . �� • ` � c� <� a
c��C�t�P� � ��' � . -z< . Front - �1� Depth _� 7-��: Height �l�"tC
� ( �
Sq. Ft. � �-�1/ Cu. Ft.
Front Depth Height
Sq. Ft: Cu. Ft.
Type of Construction..�/������� Estimated Co��� �`��'`�%
,
To be completed_� ����I f-" � �� J�
The undersigned hereby makea application for a permit for the work herein
specified, agreeing to do a1X work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. %f
��-C��t--a.�t-G �
,�_��z�.� � .� � J
� ' t
DATE �%p— 1- e_— ��� SIGNATURE �---�— ?--� L—�--
(Schedule of Fee Costs can be found� the Reverse Side).
�
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• � � , . , ' _
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• a—_a
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:BUILDING Pk�RMIT FEE SCHEDUL$
SECTION �2': The Inapector o� Buildings shall., before isauing any permit for
the erection of any bui,lding or atrucCUre, or for any addition to any existing
buiLd�iiig o���tru�ture, or for any alterations or repairs tv any existing
building,o�r.:structure, upon �pplicatioa thexefpre, require the pay�ier►t by the
, applicant for such permit of fees to the�amount herein below set forth and in
the manner herein proyided toMwit:,
2.Z, For any such permit.for:the erection ;of any fire-proof building,
other than a garage, warehouse, factory or grain elevator, or for the erection
of any fire-proof addition, for similar occupancy, to any exi,sting building,
shall be at the rate of $1.40 for each one thousand cubic feeC, or fraction
thereof, in such cubical couten�.a.: .
2.2 For any such permit for the er,ection,of any fire -proof garage, ,
warehouse, factory or grain elevator, or for the erection of any fire�proof
addition, for similar occupancy, to any existing building shall be at the
rate of $1.25 for each one thousand cubic feet, classified as'"fireproof"
by Section 502 of the-Minneapolis BuiXding C.ode...'
HOIISES .. .
2.3. For any such permit for the erection of any non-fireproof .
_ .. . .... . . _ .
building, other than a garage, warehouse, factory or grain elevator, or
any non-fireproof addition, for similar occupancy, to any existin� buiXding �
permit $1.00 for each one thousand cubic fee�, :�_� . ..
GARAGES , ,
2.4. For any such permit for the erection of aay non-fireproof garage,
warehouse, factory or grain elevaCor, or for the erection of any non-fire-proof
addition, for similar occupancy, to any existittg buildiag or for each such
building or addition - ninety cents ($0.90) for each one thous.and cubic feeC
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the purpose of computing fees for building permits, the cubical contents
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point six (6) inchea below the floor line of the
basement or celZar to the average h�ight of the upper surface or to the average
height of the roof surface of the maim gable of a pitched roof..
2.5. For repairs or alterations to an existing atructure, the fee shall
be at the rate of $3.OQ per each Rive Hundred Dollars ($500.0�} or fxaction.
thereof in the cost of all proposed work. ..
2.6. In no case shall the fee charged for any permit as set forth in
Section 2 be Tess than $4,00. `
'
STORM REPAIR DANIAGE FEES: .
, Residential; Estimated Cost of �rork up to �5r,.�.�q .. �g,�p
' Estimaied Cost of wor�. otie� "`�����;,,�,�J -$'i C�,�O
Co�nerciai; Estf_ma.tP o�t of wr�rlc�up to' N`_=i�z?_ t'�J -$?.G na �
' • Est:i�r�ate�st of work ouer $:�C'u.�0 - $�� •
yw- �
CtTY OF FRIDLEY iNSPECTiON DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBtNG AND GAS FITT6NG PERMIT
Effective On May 10, 1999
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas"
Gas Range"'
NO. RATE
�
Gas Dryer'"' _
Back Flow Preventer Required ()Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10_00
$10.00
Type $15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPA4RS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
TOTAL JOB ADDRESS ST 1 N� � 5 �����- d���
��
$ ZO. 50
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance wiih the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in ihis apptication are true and correct.
/4/3�
ENGELHART, SHERILI_ < Lf�
1604 BERNE ROAD N.E.
FRIDLEY, MN 55421
Owner _ (763) 571-6236
Building Used As ��/CYP�✓J�SZ..
Estimated Cost � �Q� � PERMIT NO. �� � �( �'� �
� �,�0 �bt��'1 f�L-c���13/�J�
PLUM8ING COMPANY
SIGNED BY L N0. �12 lJ�7� ��33
Approved By Rough-ln Date Final Date �-•�
a � : ■::
"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES_
Building MECHANICAL pe�t No��'�, --� z��
Inspections RESIDENTIAL APPLICATI�N Received By: ,-
763-572-3�04 CIT�►' OF FRIDLEY Date Re�'d: —� -��'
DATE 1 1 1
SITE ADDRESS _
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
E-MAIL ADDRESS
❑ OWNER
� L�'.�Je�_�J1[_�'[�uL�
/ i
.��• -• `- v- ��
• � �- —
COMPANY NAME:_
CONTACT PERSO�
STATE LICENSE #_
ADDRESS:
PPiO?�IE
�'SINGLE FAMILY
410 WEST -
$ �, MN 55408
2-�24 �—
FAX _
❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: I � �t'�' '�PLACEMENT
DETAILED DESCRIPTION OF WORK
❑ ALTERATION/REMODEL
STA'
STATE ZIP,
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5°/a of t6e total cost up to $500.00, whichever is greater, for the
improvement, installation 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.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $SOQ FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOVI� � SIZEBTU �� ��
Fquipment Installed MFG: �� MODE : � 1� SIZEJB,I,U
�G: MODEL:
�C,. MODEL: SIZEBTU
A/C $25.00 FIREPLACE (GRS) $.15.00 GAS RANGFJOVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRII.L 510.00
_BOILER $35.�0 �URNACE 535.00 _GAS IJNIT HTR 510.00
CHIMNEY LINER $10.00 AS DRYER SI0.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTII-ATOR 515.00
�.���a� —
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 of fixtures @ $35.00 � x $35.00 = $�
State Surcharge = $ .50
Tota1= $�
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 City of Fridley and with the Minnesota-Construction Codes; that I unders�and this is
not a permit but only an application for a pe ' work isiiot to start without a pernut; that the work will be in accordance with the
approved plan in the case a�l hic r ir, s r view and approval of y�an� �
/ 1 �- _ %�I�
SIGNATURE OF
L ' �i��'j. . , '
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED T4 PROCESS PERMiT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDI�IONS EXISTl�IG HOME ❑ MAKF-UP AlR
REQUIRED FOR NEW/EXISTINC H01�1(�S . ,
, � . . •��`
1. Combustion Au- (See note belo�wj
a. Oil ar solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropanelIFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a.. IlvIC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances ]FGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED 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 76'10 or 7672
6. Duct Design Per IMC 1346.0603.2 �
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines saftware may be used for
combustion and make up air calculations