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AF - 41817City of Fridley, Minn. . _� BUILDING PERMIT N� s o s Date: �'� --�f -�-�� ,� #� a Owaer: � Builder � .. _. �S Address Address -�'� ' LOCA�'ION O B y_ ING No. '`� �Siaeet Part o t a+ ,,� Lot '����� Block Addii3on or Sub-Divis�ton Coraer Lot _ Inaide Lot � 3etback ��— Sideyard _ti�� ��..'__._..__ Sewer Eleval3on Fo�mdation IIevation DESCRIPTION OP BUILDING To Use�l Front � Depth �s! Height � Sq. Ft. _���� Cu. Ft�_'L+��t'_..�`+�+'' Froa�t,�; Depth �i�ht Y._.. Sq. F't. Cu. Ft. T�►pe of Constructioa -� ���._-��,._ Est. Cos" t..�. � To be Completed Tn consideratlon of the issuance to me of a permit to conatruct the building described above, I agree to do the proposed work 3n accardance with the description above set forth and in compliance with all provSsions oP ordinanc�s of the dty of Fridley. �� �.,�7 � In consideration of the payment of a fee of $.�.� "'""'`�, permit is hereby granted to to construct the buildiag or addition as described above. Thispe rmit is granted u�n �he express condition that the person to whom it is granted and his agents� employeea snd workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding la:al3on, construction, alteration, maintenance� repair and moving oP buildings ��th�e dty limits aad this permit may be revoked at any tune upon� h�,any of the proviadona of eaid Inapector NOflC� Thh permlt doas eot eover t6s eonstruetioe, instaqa8on foe wirine, plvmbtner e� h��e. �►e* or wafer. Be sure to as 1he BuildU�g Inspeete� for aeparate pemdts fo� fh�e hanu. ,�,.a . - . s�i 4 - _ . �� �, � . �-. - �. �.'�DUSTRIAL �� �f ��I U� SURVEYS IN: GOMMERCIAL ANOKA, CI� �OTS ..AIYD asSOCIAT�s IIVC. �N EP�N, TOPO�RAPHICAL � LAKESHORE • ' � " ° '$HERBURNE PLATTINO L A N D S U R V E Y O R S COUNTtES •:, SHOPPIN(i CENTER — W�gT MAIN STREET ANOKA, MINNESOTA • , • HARRISON 1-6340 . *���r,. �c�:;��r:�r � � � [:r`'°�-i''.�'`' . . � FAI � �JT. . : ✓� . ! _ oi� -_ � � � � ��� ', ; � � : � �� �; � �� . . . V m 1. . � � . I " �' � ;' v , � -- �o m- � �- , , � . � � � I , , � I � � N O. �b + , �' V- � I � � i � � DENOTES �� � � � � � _ � I RO NS �1 ' `� � J . 1 - ,,i1 � �►�4' ' '� �5 . �+ ' i . --' � ;;:� � � . ;� - �- . -- 50 -- -- � �. . d M at . � , , ;: � _ �' : x ' , ,. .. � , � �E , .. . . . .. � f ,. L�t� }�� �snc? .L;j, :il ��� u , ' . .�:. , �}. � A�"VE�VT �W Ii�I�t:�"�; '` - r .,, ' r w" � � � .� • �. - ._ ',� � r x . _. _ � � . : ;,� r�' s �y`Y � y t . *, } . :r . ., . 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'sa ���``�� .�. �:> ``� � I � . - ,"`_ � _ - - '� - - - _ - � � � s -� <,_ ' . - I �f` �• ����� thiDUSTRtAI. itlitVgY81N• i COMM6RCIAL AhOKA, a CI TY IATS � �� �� �� � TOPOdRAPHICAL � NENNEPlN, i If/►NTt, L/lKE8F1011E. SNE�l11WE I PLATTINa L�►!�D SURVEYORS `�""`�" ' iN0'PING CENtER — WEiT MAIN iTRtET � ANOI(A, MINN�ipTA < . HARR1� �-6340 D�r, Schv�t�r " �M� � � �,P� ' �7-b5 �!F3MQt' ST• � . ,� _ I ' - �� -.. � I , - h � / s ,% ' _, �� _-I �, . a . - � - d1- � _ _ _ _ _�«_ _�.�o. -°- - _ _, _� :.: _ _ � � 1'' � ' .. I . � � . . .. Y � -' �.. � - ,' 1O � ` I ` I ♦ . •R-_"4'�. L . ' � : M ' I ' I 1 � i / � � O � � ,"�= � — (� I il. � � I �� II �D EN 01''E:5 ��1 � � � � (� ln � �', i RONS — —� = � -, � �'li � �_ � � � � � �� . ,, �, t�l t�,� �;f �, '�'J . .� � . � � � t _ -- -- s5O -- -- . . �- ��-�.. � � ...:� .: �.�..;�. - - � _ � , I Lc�ta l�.� anc: ,'.;, :�? ��k .; , `I RI'JiR`JS :W H;.I:;:: T�> , , ��, AnokR C�,�rK�� Mfnr�c:s^`� '°I _ _ . � : , . �. ' I _ 1 NERitir CCRTIRV TMAT TH{i li A TRUE AND CORRECT REPRE8ENTATION Of A d1JRYEY �f' TM$ �(i,�iFliMRt�i @F - TME AdOVE 08iCRf0ED LAND� AND THt LOCATION OF ALL BUILDING&. THEREON�J4�!ID�.L fi�liE�ir� �NLRO/IC�FFM�FY�. I -; tF ANY, FROIN O!{ ON iA1D LAND. - _ M.P-.�-. Y.-. �x-- �`.I AS SURVEVaD eY M£ THIi �r�.. DAY OF ��� _,_.: __ - � .--1R.#i`-ii°� ` '��`�"� �" :;: - . ` ��` _., �_ _-: N. C. HOIDM A1�Ii A -lliC. " �_� �. � � 4}--��.�;=�:_ - -- �,�� , � �.� _ _ � _� .y� ,� � ��-.�- _ >,:,_ � ,�� � j ; .� ='�.� � . ... _ .:..:... ................ ... � .,- = . , . ��` � ,� <�, _ ,� 4 � � � �: _ _ . 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FLOOR oaniNs CATCH BASINS nu�ro H//�$Hf�{ �� APPL GAS RANGE GAS OPENINGS � • 2 � � � � A m � m � ��� � o. c+. � �� � ���� � po,�a � � �y � � � oc�o�'�. � � O � ��°� �' a � � ei� ��y �. � �, � � � �� �: � � � � n ��' �w p � m o � � o p � lD F' H � � � � ro � ���¢' n n � � � � � � M 'Yw �� � � � � O M � � � � � M � � �� p �' M �A � � a� �x ix �°n d � M � � va � m � . 'O 3 �i � � � • � � � f� ' � d a �- b � � � M 00 `� �. 'd �d' � � � �. A 0 ����' 3 � � r r+ 0 � N tn a � r� y � � y x � � y � °� � � � o ���� ���� � `-'� ' � � O � t' � � � �P �. � N :: � y �'¢�. � � w x ���� ���� o � � k � � � o �C? ' O �! • o . � : : i i i Z ���o � � oa�� ���� . � ��� �r � � x � � � � �D z 0 0 � � � � p � m � � � m � � � � �� b � a r��e �'1 L.` � � ?b � W 00 x 9�d � a 0 P O 0 0 � � �, 0 0 � � � � a � O r t� � °e � �o � W �� � � M � � � � � �: �. � • �: � � c� • � 0 0 .� � � M 0 � � � � �s z 0 P z � o ; � � � �' � ro °x M � � � �r ,a�'. a W� 00 �� � � x� �. � � M ' �- �� -b. � � � �� � � � � �i � � � h • �' � � a�x �'�� �� �' r�o �c� � �� b�� ��� �,�� � � �� � a � � � � p � i � � m � f0 0 � � . � � 'a $ � w � : '� p �. � : � ' � �' ' � � ° . � S� p � : • O � `�' 0 � . : � d � : : : : � � � ' : : : : ' : : : : : : N��� ��oo 0000 � .� .� ����� 000�o .��� � � 0 0 O � p y � z � o � o � � 8 � � � � � � � � � � on $' � N' � 0 � ` � I9 : � 1 � m I � H ` ►� m I 4� � � � s b ro b � � � � � � R°R°�� � �y �. � � ����° � � � ,��, � � � €'r � � ° � �, � : ¢�.. � . . �•°: : O $ . . Op . . O : : : ����� �000 0000 �� 0 � p � � �' a.a� �� � O b �� � ���� � O �'�y"��' � ��o� �D�O� �' �3 � 5���a � ��� � � ���'� �' �� a�` i w 0 c�o o p ���� �! a p� �4 W � R7 � ia � �a. � ���� Q� ���►°�'i �A ���� � ��� � o � � � � �� � w���°o I �' � b � � rD- � � m N _ T C m 1 � o � S � M a � �\ a � � � � � � 0 n` 1 � � oC, � � � � • � � s� �� �� �' � �_ ��� , ��� �`� � � �� � �` �'. � � � � � 0. � �' �� � �.is � 8 1�� � ��°�,��� HEAT LOSS CALCULATIONS DEPARTMENT OF BIIILDINGS MINNEAPOLIS, NIINN. Weatherstrips A.S.H.V.E, Construction No. Iasulation Guide Windows Doors Reference Out.'WaU Int. Wall Ceiling Roof Floor Kind How Applied Yes—No ( Yes—No 19_ Fl.� , ° Room�Length :/ Width ��' Height � Fl.� � Room Length Widthlr�=GHeight Windows and Doors—Crackage and Area Windows and Doors—Crackage an Area �Vldth Helght No. ot Ltneal f. Area Wldth Hefght No. ot Lineal tt. Area No. ot pane o[ pane lighte of crack eq. ft. No. of pane o[ pane tlghte � ot crack eq. tt. 1 sv /' � > LO �6,� � � �, �j-- � �� �� � �� s� � .� g . > � �' � �i,�' / � %6 9� � � � ° Coef. Btu Coef. Btu Infiltration � �'� � � � Infiltration � � �-�`� , �� � Glass � �� �,� �,� � Glass �=r .<<� �.� Eap. wall 7/� Esp. wall �. � Net exp. wall '� �O , `'� � � �•- ; � ; ^ �� C=��? � Net esp. waD , Int. wall Int. wall Ceiling �+f? ���"� Ceiling ���'-' �;:� r" ��� Floor �' �✓ � , ;� �� ;,� ,� .�-�' - � ,�' ,� a� < Floor , Total Btu. �; ��� `�''� Total Btu. �-/;�, r�,� Required sq. ft. E.D.R. or sq. ias. W.A. Leader area Required sq. k. E.D.R. or sq. ihs. W.A. Leader area F1.� T , Room � Length :/�Width �/•0 �� Height � �,I a Room � Length �" %� Width �' �, Height � Windows and Doors—Crackage and Area Windows and Doors—Gackage and Area Wldth HetghL No. oL Lineal tt. Area Width Hefght No. of Llneal ft. Area No. ot Dane ot pane Ilghte ot crack ea. ft. No. ot pan oL pene IlBhte o! crack eq. tt. �� � h '�' � �� �1� � � �..- .. �� (� /' ° e `•-�l�' - �? % � ��+ Coef. Btu In6ltration _��-t�� -"-� ,;' ;�� Glaas f :%; �, �_ � ; � �_� Exp. wall �; �'� Net esp. wall � '� '� � �'� `�`-.`1 Int. wall Ceiling "�- ,a ^ �=���'r� Floor ^ � ��' %' ,'� � =� Total Btu. r-"`�' .�� � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. .- Room ( Length � Width ;�' °� Height ��' Windows and Doora—Crackage and Area Wldth Helg6t No. oL L1nea1 Lt. Area No. ot pane ot pane Ifghte ot crack eq. ft. � . � �� � �;-� -� lnhltration � �� �� Glaas f"�/' � Exp. wall �� � Net exp. wall ��F /' i' _� Int. wall Ceiling ��i ��� � �w l�loor �--� -�' �" Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area In6ltration Glass Eap. wall Net esp. wall Int. wall Ceiling Flaor 'I'otal Btu. , �= �'�A ,� � ��.� % � _, �� �, �� �a � F-� ,,,,�vy' �.,.� p�,_;; `�"r� >.�,�' i "' �g, �x° f ° �? "�' �� ", �'' r; r_� " �. rr�- '. , {a, � (� ft. E.D.R. or sq. ins. W.A. Leader area Windowa and Doora—Crackage and Area W1dth Hefght No. 01 Lineal Lt. Area No. of pe.ne ot pane IlBhte of crack ea. tt. ,/ � � � ��� .� �,�`' - _ � P, -,��- � - y Btu ;�". r � Infiltration �,�-��',� Giass Eap. wall �;,;�� -. - �� Net esp. wall Int. wall %�;� ,�� Ceiling a,�� Floor 1'otal Btu. � �. � <—. Coef. Btu �� �� �� � � /�-� IRequired sq. ft. E.D.R or sq. ins. WA. Leader area � � 1 � City of Fridley, Minn. � n BUILDING PERMIT N� 6 4 93 aate: �'� �' � p 5-- �, � � o�: �� �,c ij� B�a� Adc]reas Address � � t LOCATION BUILDING No. y��� Street ���y�-�„��-L�'.,p Part t �� � Lot � Block Addition or Sub-Di an _ ��C�� .� Coraer Lot -" � Inside Lot � �tback Sideyard .�� � Sewer IIevation _— — Foundation IIevation DESCRIPTION OP BUILDING T ea: Ftnnt �L�.. Depth � Height �:-L! Sq. Ft c;�� Cu. Ft.��� Depth _...__.�r fTeight � Sq. Ft. Cw Ft. Z�+pe oP Construction ._ � F.st. CostDV/��� _ To be Completed In considerat[on oP the fssuance to me of a permft to construct the building described above, I agree to do � P�Posed work in accordance with the description above set forth and ffi compliance with all groviaions oP or�linances of the dty of FrYdley. � � n �� _ ,¢ii e.s'� Ia consfderation of the payment of a fee oP $� ., permit is hereby granted to to conatruct the builaing or addition as descxibed above. Th�ta permit ia granted upon the expresa condil3on that the person to whom it 3s granted and his agents, employees an�� workmen, 3n all work done in, around and upon said building, or anypa� thereof, shall �nform fn all reapects to the ordinance� of Fridley� Minnesota regarding locat3on, conatruct�Ton, altera.tion, maintenance, repair and moving of buildiugs o��� dt3► �mi1's and thia permit may be revoked at aqy � upon violati�of eny of the provisions of said Building Inspector NOflC� 7W psnet� d� no� eewr the eomfruetioe, tmtatl�im Por wWe9. P��+�9. 6� 6�8, �u' er wa�er. B� ams /o as 11n Bnilding les�e�sr for pp�rd� p�rm6s /or fh�a k�aa. C 3 � APPLICATIQN FOR BUILDING PLRMIT CI�Y OF FRIDLEY, MINNESOTA �i� � � s � � � O � � �� � ,�P �� �BUILDER �npwss_ _S" � � ��-, � � �`� �, r �nn�ss LOGATION OF $TJ'tLDING No. ��� Street ��'j� /,�%, Part of Lo� • T�ot �'� �S�Block � Additioa or Subdivist � Corn.er Lot �Inside Lot SeCback Si -Yard 3EWL� ELEVATION FOUNDATI�DN ELEVATION Applicant attac& Co thia form Two Certificates of Survey of Lot and pxoposed build- ing locat�.on drawa oa these Certificates. DESCRI�ION OF BUILDING To be use as ; ��� / ���� � � Front / Depth � � Height � a Sq. Ft\�l� � Cu. Ft. �_ � � � FrOIIt Depth Ae3ghC° q. Ft. Cu. Ft. Type of Construct3on EstimaCed Coet To be Completed �he u�dexsigned hexeby makes �pplication for a permit for the work herein specified, agreeing to do all wo�k ia strict accordance wieh the City of Fridley Ordiaancea and r�slings of the Depaxtr�Pnt of �uildings, and hereby declares thet all ehe facte and represeaatations at�ted 3a this appl3cation are Crue and correct. _ � DATE '� �� �r � SIGNATURE �� „�� (�chedule of Fee Costs can be fouad on the Reverse Side). r •. r+ / \ s s x a 1 1 0 e BOII.DING PEIiNQT FEE 5CHEDULE Sect�on 2. The Inspector of Buildiaga shall, before ieauin� anq permit for �he erection of any building or structure, or for any addition to anq exist- ing building or atrueture, or for any alCerations or repaire Co any eaiaring buiZding or s�ructure, upon application therefor, require the gaymea� by �he applicant for such permit of feea te the amount herein below set fosth and ia the manaer herein provided to-wft; 2.1. For any such permit for the erectioa o,f any fire-proof building, ot�e: than a garage� warehouse, factory or grain elevator, or for the erectfan of any fire-proof addition, for similar occupacicy, to any existing building shall be at the rate of $�..40 for each.one thousand cubic feet, or fraction �.hereof, in such cubical conte�rt�. 2.2, For any such permit for �he erectioa of any fire-pro�f garage, warehoa�sea factory or grain elevator, or for the erectioa of any iire-proaf edditiQn, �or sim3l�.r occupaacy, to any existing buildiag shall be at the r�te of $1.25 for ench one thousand cubic feet, classified as "fireproof" bq Sectioa 502 of the Minne�poi.is Building Cade. ' ' �OUSES � 2.3. For any auch permit for the erection of any non-fireproof buildiag other than a garage, warehouae, factory or grain elevator, or any noa-fireproof addition, for similar occupancp, to any exieting building - permit $1.00 for each oae thous�.n,d cubic feet. GA�A�ES 2.��. For aay such permit for the erection of anq non-fireproa� gasa�e, w�rehouae,�f$ctory or gra3n elevetor, or for the erection of anq non-firepr�f additi�, �or s3milar occupancy, to any existing building or for each such � vu3ld3ng or add3.tion - ninety ceata ($0.90) for each oae �housand cubic feet or fraction Chereof, in the cubical contents thereof with a minimum of �4.04. For the purpose of campue�Lug fees for building perm3ts, the cubical contents of any bui�.ding or additfoa to a uniform height throughout by multiplyinS the gsound area covered fram a poiat six (6) inches below the flaor lin� of the b�.semeat or cellar to the average he3g�it of the upper�surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an exiatiag structure, the fee shall be at the rate of $3.00 per each Five Sundred Dollars ($5 00.00) or frsction thereof in the cosC of all proposed work. 2.6. In no cas� ahail the fAp.charg�d ��r g��s �rmi� as set forth in SeCtioa 2 be lesa than $4.00. /"� �. �.,� r",, .. . � _ -: - � H a� y r ,d O � o �0 V z � y Hy � t� . fp h � n ►� �d m C� W W b W P�. In � b1 7 7; 'r; ('I '; hJ :; f] rt H N a rt ry L a a Ai y � � a' N r• �n � �o � n ��pr� w rr � �f � w y � n H Or N �' ^� W ►{ � +�'-� � w � w '� a ° o ° � a � � M v� ��f �� 7 � A. n o° K w n� r�c � O M� � W tD U IG � N t� �t o ° '"3 r �t a°, 'n '�° � � m ry n �i � � � � ► f p M � 3 I Q �p y °o � o� � a w o� a� n ~ � � ►�t u� F' `�° � w n czi� 07 tw,, �o °o � � � � � oo w o . � w� � � � N t!� O O 1 � � tn v► t� tn 0 � O � � tb'� � � y�� H H N t/l V N O N � N N O Hy H . M I I I I I I � I I I I x x x x x x x ee x x x x �v► O I-� W �n iA tA . F+ t/l N N Vi N V� �n � 1 O U� Ui N N W 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 N �N N � � ty 0 � � H 'V � .'~� G� �r1 H C txn -v tyrl --�� � � r a � . m N c� x d •° rn � tc1 iA �N tq N iA t// fq N fA H 0 C� ta-. 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N Q. � � � � �'� O � Z � ...� � �� �n < � N � zZ m � -D m n � O Z D < T � � r mn a � �o o� Z T Z � v D O � � nm z� � v_� � Z Z y Z D �z �v cn = � � � Z vn ` rn O " m z � � � C m � � � , � z � �,` 1 m � � � 0 �� � Zi � m � � cn -�EQ :t�8 j�II�[S O� JI�II.Ld�H . tag Id �.�Y2I�.I.'Ii� E : sxsetuag ( ) orI ( ) ��C ��ZI jaIEAA .IO� F9PIAO.Id II� .IIL' IIOi�SI1QID0� SEj-� •g () ol�I ()�� .ia�eaq ia��nn ao3 PaPtnoid uaaq iaui� � s�H •� . S�f1,Lg 'Id.LO.L . �...Q.�� �-��a�o IIV � �o S�nis $u��l�o� �H 9 ( ) o1v ( ) �x �.�u� �,�wo� S�fl ' I�o� puE � _ azis io� sluaiva.nnbai apo� �ua.un�iE s�a�jy __ •� � — . _�� ( ) o� ( ) sa� pa�ioddn's�ain�as sI •� : `� ()� oN () Sa�C vnginn pa�poJ s��afqo u�►a.�a3 ou s�H . '£ � � � ;.....,.� () ol�i ()�A uo��oua�ap i�`'n.i uio.g aaa3 sI 'Z �� ( ) ol�i ( ) ��i pauT�uExa � .re� uaay sEH ' I . � :x��s io �Cau�uiu� �u�sixa a� �E� sa�ua»�ay pau��s�apan ay� ��OI.Ld�I�I2I�A �1 N.L QNd �� WIH��! «-� �� `�, SUBJECT City of Fridley / 7 � � � � - AT THE TOP OF THE TWINS gU I L D I N G P E R M I r � � � � � ; y �_��� COMMUNITY DEVEIOPMENT OIV r � � PROTECTIVE INSPECTION SEC. "1 � Q� 1 . � p°� Cd ' � �'��1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED BY �----� � ,•� 612-571-3450 910-F15 7/27/95 � � JOB ADDRESS 548 Fairmont Street NE 1 LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �F�F,45 J Riverview Heights SHEET 2 PROPERTY OWNER MAIL AODRESS ZIP PHONE Debra Langer 548 Fairmont Street NE 783-0645 3 CONTRACTOR MAIL ADORESS Z�P PHONE LICENSE NO Panelcraft of MN 3118 Snelling, Minneapolis, MN 55406 721-6628 2179 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDfiESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK � NEW �] ADDITION ❑ ALTERATION ❑ REPAIFi O MOVE ❑ REMOVE 8 DESCRIBE WOFiK Construct an 18' x 12'3" Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. . ������V� Before digging call for aA utility locatians �54•0002 R�QI��.R�D 8Y .LAUIi SEPARATE PERMITS ARE REQUIRED FOR ELECTHICAL, PLUMBINCa, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 5 402 L.7O DOES NO PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVIS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRU 10 OR THE PERFORMA �CE OF CO STiiUCTION 8],.0� Fire .5�.' .5.1F� � � �� PLAN CHECK FEE TOTAL FEE �' License SC 5.00 4.10 SIGNATURE ON7RACTOAOAAU7HORIZEDAGENT IDATEI �HEN PNOP � LV VALIDATED THIS IS VOUR PERM�T � � � Z�i �� S�GNATURE OF OWNEA ��F OWNEA BU�LDER� IDATE� 8 G� SP DaTE NEW [ ] ADDN � ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Applicadon ' � FJ � ,: _ _ �J _ ����o Construction Address: � � � !A-1 � M n �� � -S� � i �- Lega1 Description: Owner Name & Address: � �3� ����� > 6 � �, �� � Tel. # '`� � � - � Co-� � Contractor: ��, � 1 c�� ,� r;�n ,� MN LICENSE # Address: 3 U.P� 4�.� �-� ,� � . Tel. # °y Z/ - C� (O z� Attach to this application, a Certificate of Survey of the lot, with the proposed constructian drawa on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT , Length � � Width . `Z �3 Height � � Length Width Height Length Width Hgt/Ground � ,����y, � sq. Ft. ' <�° . Sq. Ft. Sq. Ft. Comer Lot [] Inside Lot �j Ft. Yd Setback �J � Side Yard Setbacks iv � Type of Construcdon: c,�}}�a� 3 � � �.,� � . J ��d �= $ � � =� ` � Approx. Completion Date: ��� �� c�,� �', y��, ai� (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: /3 � I APPLICANT: �� � � Tel. # 7z I - � [� z- °� CITY USE O Permit Fee Fire Surcharge s�� s�n�ge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: , - $ �10, � $ �. �/'cJ $ � 7� $ $ `i'. � $ $ $ $ $ .r� Fee Schedule on Reverse Side .(�1 of Permit Valuation (1/lOth%) $.soi$i,�o v��a� $850 per SAC Unit $S.(� (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary j] Not Necessary [] �cuu.uirvc: !'I:KM1"1' ri3E SC(iEDULr_ �'I�c: (;lii;:t i3uildin�; U�ticial �hall, (x:fqre issuing permits for the erec[ion of any huiiding or stnicture, ur ti�r any a�iclitic�n tu any cxisting buildin1; c�r s[ructurc, or for any altcration or rc��air to any cxisiin}; (�uiliiing <�r- s�rucwre, u�n aPpiication therefore, require the payment by d�e al�Plicant for such j�ermit c�(� t�c:s t<� the: amc�unt hercin t�eibw set 1<�cih and in th� manaer hereia Prcividui to-�vi(: "CO"I'AL VALUt? � i to $500 �501 to �2,000 $Z,001 to �25,000 $25;001 to �50,000 - $50,001 to �100,000 $100,001 to $500,0�0 $500,001 t,o $1,000,000� - $1,000,001 and up r-r_��.s $15 (Minimum Fcc is $15 plus surcharge) $15 for fust $S00 pius $2 for each additional $100 or fraction ffiereof, to and including $2,000 $45 for first $2,000 plus $9 for each additioaal $1;000 or fraction thereof, to and includiag $25,000 ' $252 �for first $25,000 ples $6_SO far each additional $1;000 or fraction thereof, t,o. and inclading $50,000 '- $414_50 for Cust $50,000 plus $4S0 for each additional $1,000 or fraction tha'eof, to .and including $100,000 $63950 for €irst -$100,000 plus� $3_SU for each additional- $1,000 or fraction thereo� to and inciuding -$500,000 $2039.50 for ti� 5rst $500,000 pMs $3 for each additianal $1,OOD or fraction thereof, to and including $1,000,000 $3539_50 for the fust $1,pU0,00p pius $2 for each additional . $1,Q00 or fractioa t�ereof - DRIVEWAY DEPRESS[ON ESCROW (Concrete C�ub Streets Only) Alternate "A": Removal and replacem�t of cu� and gut�er only - Driveway width plus 6 feet times � 13 _S0. Alternate °Q": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times � 15_75. VCRIFICA"f(ON OF FOUNDAT[0[Y ('ermits for consu�uction will be issued a minimum of 24 hours from the t�me of application to allow for proper review of the propc�sed stnacture and of the co�straction site_ A CertiGc;ite of Survey of die lot, showing the IocaUon vf the fou�ciation once it hac it has t�een constructeci will be re;yuirexl i�efc�re proctxding with lfie framing_ . , �� Cl :' --1 �� c_ �� � � -99 I 1-9 V r- � 8� -- a O z_ z r� � � � �r �� r ��-'' --� u � � Cl ._bD �-t cn tl __d� �:. s- 4� cn Q� �. ;�ll i�E I � � �� �� �.>- :) (� = �i = � c- O 1�i �_� �ri rF� `r (�> ,Ti _�: -{ B� c°; l.�D -� io� •• �p, �c°� r¢o i^, I9B " ��9 � z �� 6� < ,�(I �b -(4 Sa : e : { c Z--9 6_- �— I..I. V �II --t ]=>-. 1:tls=Z��� eil�D t - f _� _7_ -� , (� �B � I_:B9 7 �� gL I B Q.�., �.. 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AUDRN,y'y --- � .. ` FI30T1E.�_ . ,� �� S �' N�: E'6Z` Gv Y STA'i'Fs L,iCEt�E fl,�4 7 D_. ����s�:_ 22'Z__�{ � �}iANF A� \ (� Z��C/ ..A9/A � B�15LMGIJ'f FIN15H 0 I}FC:K TYPE OF WARiC: � ❑ � • " CE DESCRIBE WORK HEINCi DClNF: 51PL OF 1MPROVEMF.NT ' �.A90I'� 0 31UIN{a ���' _.... . S7ATE ZO? ... ._. _E�2 � c� .. ....ie�— ._._.. DAT& .? / ,� j O _ C17'Y � ,��. §'PATE ��r� - S - Og« S���h;�� ,� . ...._ ,vn�moa�.� la IJIiAIN 1'[I� C� L�iIiI� !- �" vd i� IIlAll Lll2 LJ ci � I A1LIM6k�k UF SQUAtt�S . DU9E & QARAG� PItUPUSEn SI�� [] A7`!'AC•1�D aAltAdE �RUPC).9Ef� HB?(iHT: �CNP,17tARAGE `'' • "'�' OSuFlit 0 q,luntim�m O Trim � �� -- ., 0 Fe�oia iN�R t30PLTNA+IC;S OY�s CINo L�OCATION C}F WtTJL?OW'S OR P{N1 NEW trP�ttNCiS.DP.5CRt3E SIZ� c9� 4PEIuA10 CiIANTQES de .�.'. .— 't`YA� OP'iV3NDOW i'a 8E IN(9TAl,LE��D PJUM[iIIt OF WINDnWS EE9 ARE R,d,��;� �� VAI.UATIUlV, lNCLUDING Ti�IF. Cpi51' ( 3 I� J (�JJS11vG � 97 .'.0 FEE 5CHEDUL. �r sr..rnnvwe n.ti•er.�.i m - - - - ---- rsrrm�C r � sn eviaw � ' `'� Fire Stt�harge � . � �'� 9tncharge � �,i�� a.icenae Surch�,rge E� � �°+`L� SAC Cb�rgm Curb CuC F�c�'ow Ero$ion Caum+ol Park Fe� 5ew�r Main �harAe_ _ e • ir R.4S�MEhi'J' ��pDiLIPIC7 S11BA�''T• � . �'.�cistir� Floor rl�n, 3 Pm�aeti llcb�r ptnn 3. Lfst oP�tnatturel me�nbeca �u bc w�ed P(1R NF:W C.Ui�tSTRUGTIQN INCLt1DiNd 17ECN:9� ADD1TlAV� ��1'tGH�CUqnarr• 1. Sltt PlaalSiarvey shitwinp tha axiating Atracwrze and ptnA� P�4i�wt. 2. Two s�xs of oon�cttuc�ims pl�s 3. Enmroy Ceic�latisir�s �AAOR AI,TD P�YA' � -_ see B�ck Pa�e for F� Sehedule -- 65°l0 of Buildin� Pennit Fee $ .001 nint�s tho tptal jnb valuati�n � .p005 x Permit Valuation Mir.imum $.SO - � -- --.e�—��' $5.00 {9tate L1c�:lCti Rt�idCrltit�l Gotlk'actoTS) � $155(� par SAC Clnit (plens to MWCC Fnr detprminatir,n) $ ft'�' 6 tt a FY x S21 =$____^e _`. $ $45Q Camse�rvat�ion Plan Review Fee I3eterrnln�i by Englneerir,g �— Ap.�emant npc,,�ry ( j Nen Nec�ssaay {� - - — °° , . � � r , � • �a� enecks a blr to: Cf of Fridl AttaeZ �tt e�lattoa�a TH1S tS LT,@�,ATtAN F. a PFRp1IT-\IOT VtV,ln iJl`''!1L PROI"•GS3ED i 1�eroby appdy for a buiidin � ��t�mit and a+�knCtiwledga thc� nnEiarmatian above ts completa antt eccura�e; lh�t th� wprk wi�t b:, in confrn���nce with eho ordinanco� and, s of �2ie Ciry o 'dlcy snd wifli the Minnesotn Cansmactton Cocf�a; �l�at i emder��tar,d this is no� a pormit but only an �ppltuntian for ft � wnrrk is to �a�t Hrithaul e pomtit• hnt chs �a�or will be In accardance ith Ch appr�vvd pl�n in 1he c� of all work whlcla view and p of plan5. 51C)NA'fl)fl8 OF t1PFLIC�Vd'1'_,,,,.. PRIIaT NAMB � i/f�✓ ISATB � Q� 9 �- � ��*. c ;a �'''�. �� � `._h � � ' � �'; ,A� �4:�, �_� � :'� �._ `. . . , ,. .:..� v , � : , � , ; �....9 _ t:-;' , •'�7 • a' � �o-i' ��.,_ + � o t ��ti��� ...� o� `e,�y;l�� ��9'_'.A Y' ..,� ��' r� � .�.. ` � . ' ,�� � � �;+ � ._ e �ye a8 ,i . �:� �. � , r.� ,� t e.. �"►t.0 : .�."t �s -.q' .::{ �s� • �1 � L� " , a, o?, � 4} . y� � i �� �J � � � "� � � �n�-� e i.b t�' 4�_�.! 0 ` " � �'� •�� �'•n;,-�� � ' • � °'L''•� `.., ' a.y, �. -, "`� � �- � ' �..9 s`, .d 'ti f.. -+a .� �p �v» a b � �. � i "� , , �e �.., � 4 . , e: �A. �5 /.'7iY`- i o` _ • o Q� t,1.'D`'i ,�'J .� �' T t� • . � � . � � R. �`}y l,,. �i� �, -•�i ti° r �'�"' � �C�i •y ab �� _ s . 'i t y .����,�� s�'�. . ��'9�, .� a i .. :� :ti[� �'�j � . , — �► • . 'l s��.," Building ��� Inspections C� 763-572-3604 763-502-4977 FAX MECHAlvICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 2-19-09 DATE i � �? �� I � YOUR E-MAIL ADDRESS SITE ADDRESS .� �•( g �C� i r �'Yt �✓1 S� 1 v� THIS APPLICANT IS: PROPERTY OWNER/ TENANT ❑ OWNER '1 l0 3 - �1CONTRACTOR Permit No.:'� C Received Byz i. �- . `i �1 � SSy3�. CONTRACTOR coMPANYNAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANPI ZINKEN YOUR STATE STATE LICENSE # BOND 22013346 EXP DATE � � LTCENSE WITH �D�ss:9320 EVERGREEN BLVD NW SllITE B ct�rC00N RAPIDS sTATE MN ZIP55433 APPLICATION pHONE 763-757-6202 FAx 763-757-6701 PERMIT TYPE �INGLE FAMILY � TWO FAMILY TYPE OF WORK: � NEW �[,REPLACEMENT DETAILED DrSC� TION OF WORK C[�v�d�'�icne�'' ❑ TOWNHOUSE ❑ ALTERATION/REMODEL FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EA BELOW) Equipment Installed MFG: e Gi,r r i er MODEL: � 1Yl U (Q O SIZF�(�� QOO MFG: r � �-°r MODEL: e�'�P�� oi.� SIZEBTU �'�►'1 MFG: MODEL: 1 A/C $25.00 FIREPLACE (GAS) $15.00 AIR TO AIR EXCHANGEER $ I S FIREPLACE (WOOD) $35.00 _BOILER $35.00 �FURNACE $35.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 ,_„DUCT WORK $10.00 _GAS PIPING $10.00 S1ZE/BTU _GAS RANGE/OVEN$10.00 NEW GAS GRILL $10.00 GAS UNIT HTR $10.00 _POOL HEATER $35.00 _VENTILATOR $15.00 THIS 1S 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 all work w�h r�4uire eview and approval of plans. .� SIGNATURE OF APPLICA.T�'�1�' �' ,�� �"'°p�T NAME ROGER HOFFHEIN � � a� � c d DATE City of Fridley Building Inspect�ons 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 PERNIIT APPLICATION HVAC . ❑ 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. l�iatural Gas or �ro�ef�FGe �hapter � witYi A�IN Amendmerrts 2: Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments : 1 11: 1 1��I�.i�[�] ilx.y 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. ACC�ua� _H _-- - - --- NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. $ui�di�g BUILDING Permit rio.: ,�� bzb `3 Inspections RESIDENTIAL APPLICATION Received By: - 763-572-3604 CITY OF FRIDLEY vate��: M � � 763-502-4977 FAX � �c�-�v� 1-1-zoio DATE YOUR E-MAIL ADDRESS � SITE ADDRESS 0. � � THIS APPLICANT IS: �OWNER �CONTRACTOR PROPERTY OWNER/ N�: TENANT ADDRESS: � A.l�� � CITY STA�ZIP���� rxo�: 7 Le 3—? $ 3— D�a-��' CONTRACTOR N�: SUBMTI' A COPY OF YOUR STATE LICENSE STATE LICENSE # E}CP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE pHONE FAX PROPERTY TYPE �SINGLE FAMILY/NEW CONSTRUCTION SiZE � q ❑ TWO FAMILY/NEW CONSTRUCTION STORIES s/ � PERNIIT TYPE ❑�DrrION ❑ GARAGE/SHID Wnvnows �r�5 K-� x t� o �ASEMENT FII�TISH O ROOF ❑ DRAIN TII,E 'fD t2�u"F' I� °� atcMr�� , ❑ DECK ❑ SIDING ❑ OTHEIi � � � ,� �� (> ❑ SWIIVIMING POOL TYPE OF WORK: � NEW HOME COAISTRUC170N ❑ ADDTI'ION ❑ MAINTENANCF/REPAIIi MODELING DESCRIBE WORK BIING DONE: 'L g X W% SIZE OF IMPROVII�i'f LENGTH X �� X Bd�H HIIGHT �j�� S FI' �� ROOFING ❑ HOUSE ONLY BASII�IENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE 8c GARAGE 1. Existing Floor Plan GARAGES 0 ATTACHID GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structmal membeis to be usad PROPOSED HIIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vuryl OSoffit ADDITIONS & PORCf�S SUBMIT• ❑ Aluminum � Trim 1. Site Plan/Swvey showing the existing structures and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plazis WINDOWS 3. Energy Calculations IN EXISTING OPININGS ❑Yes ONo LOCAIION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANiJFACTURE STIC�t ON V�V�W. / OPENING CHANGES & �t.J�1,�4l�OINh- � W ��aw �}j�n � TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS , p e,�q,�p Ai.T. FF.F.0 ARF. RACF.1) ()N VAi iTA'IT(1N_ iNfT.TTiIiN!`_ Tt�F. !`(1CT (1Ti 7.A7ini� ANn iur�m�ui�r e. �awP TOTAL JOB VALUATION Permit Fee Plan Review Fire Swcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Chazge Total Due $ $ $ $ $ $ $ THE 1997 U.B.0 FEE SCHEDULE) OCCUP, TYPE ,�,$ See Back Page for F� Schedule �$ 65% of Building Permit Fee . tJ� .001 times the tobl job valuation ,�'� .0005 x Permit Valuation�Minimum $.50 $5.00 (State Licensed Residential Conhactors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) ��_ Make checks pavabte to: Citv of Fridlev Attac THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTII., PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; thax the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand ttus is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of 1 work ich requires review and approval of plans. SIGNATURE OF APPLICANT I\ PRIIVT NAME � j^t� ,(�,y� a ei DA'I'g S� �`�O . E PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK . . . Y �� �"� � 3 � Q� �. „ ., �.'��� � a .� ;��� �' �� �J -'� 1� � ` � • � °L. ��. J � � ,� �� � -� _s� � � 2 � � � � � � ��� �� � �, .� �� � -� v �p � ����� � � � � � � � �� � � � v �� '( v � � � � � � � �� � — V � � � � � ` V �.,� � � — �r � �� ; � J �.� � n I � v � � � �'° Q.; '� � �,. _ e .. -� :� � �� � � �=� � � �.,_ � �` � ��-2� "-� _ �V � � ��� � W `�.' � � �� �� � f � �� w�� tN av � ° o��j° i8.� �� � 1 1 � � � � � � .m.. (7� � � o . �' �° � �' �° � � s—$ s � �,-� � � =d —� .� � " � � .� s-c. J � � l� � � i� e fl. '� V• , `� i � � � � I �� �" � �• � � � ,� � __ � � � � ��� � (� � , � �' � - - ' - �.... - i- �,__�- a..-_,_ � � � � � i � � c� Q � a�� � Yv l�A Y� � � � �� ^ `�_ � CJ�'�' � . �� � � ; ; . ..t/ \� ,p�� � � `o �� v �� � �� � � � � � �� � ,�s � li �� �3 ".r-'i' • �� � � � ..-�; �-Y� �. ` = v� a w t� il "�,� � .W , \ v9 � � �� °r� '�'a, � � � �� 0 � � �� '� -a � L � � � � � ��/1 0 °l5 � � ---#� O � � �� � �� �� � '� : . � . �� � , � �� w� , �� Z � � � � ��� �� � � r � Vv . . � 2 � � a , � �� � � � L ��� � '� � � �. � � � �� �� � � �� � d v - �r � T� � � � � � � � . a 1 s�� � � � v � ` � � � � � 1� �I �! � �}' � � � �� �. � ��� �VJ �� ;___.. V n �� i . O 1 � �V C:� � �1 � .� � � � � 1 � s H � F; . � �...� �� � � � � � � � � � � �. '�!� � BUILDING PERMIT APPLICANT: PROPERTY OWNER I, - u , understand that the State of Minnesota. requires tha.t a11 residential buil ' g contractors, rernodelers and roofers obtain a sta.te license unless they qualify for a specific exemption from the licensing requirements. This license requirement applies to owners of residential real estate who build or improve such property for purposes of speculation or resa.le. By signing this document, I attest to the fact that I am improving this house for my own use and am not building or improving this house for the purpose of reselling it. I hereby claim to be exempt from the sta.te licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that e house for which am applying for this permit, located at _,� �'( �_,'Y-,,,,��.� S�; � G, �%j�f ,j,�`%Z is the only residential structure I have built or improved in the past 24 months. I also� acknowledge tha.t because I do not have a state license, I forfeit a.ny mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. §514.01. Furthermore, I a.cknowledge that I may be hiring independent contractors ta perForm certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota.. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minn. Stax. §326B.082, subd. 16 and can also result in a fine of up to $10,000. I further state that I understand that the filing of a false statement with The Citv of Fridlev may also result in criminal prosecution and/or civil penalties to applicable city ordinances and/or state statutes. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to The Citv of Fridlev for compliance will all applicable building codes and city ordinances wit the wo k being preformed on this property. Signature of Pr erty Owner JY � �D ' Date For questions or information on contractor licensing, or to check the licensing status and enforcement history of a pa.rticulaz contractor, call the Minnesota Depariment of Labor and Industry, Construction Codes and Licensing Division, at (651) 284-5069. The web site is: httu:/1www.dli.mn.gov/Ccld as� Building Inspections 763-572-3604 763-502-4977 FAX SITE ADDRESS = THIS APPLICANT IS: MECHA1vICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 2-19-09 O` O YOUR E-MAIL ADDRESS ��i rrnc�n'�' J�'�- iVrG � OWNER KICONTRACTOR PROPERTY NAME: ���ro� �r. r O�� �wnxESS: SL\8 �• � S TENANT t r'vrlon PHONE: `1 �e�✓' ' 1��J ' �(o �i 5 Pernut No.: Received By: � , r:,,�� :� ATE�ZIP �5u3� CONTRACTOR coMPANYNAME: CEPJTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: �OANN ZINKEM YOUR STATE STATE LICENSE # BOND 22013346 g}tp DATE - � LICENSEWITH ,�Dx�ss:9320 EVERGREEN BLVD NW SUITE B crr�rC00N RAPIDS sTaTEM�N zir55433 APPLICATION pHONE ]6�-757-6202 FAx 763-757-6701 PERNIIT TYPE I��GLE FAMILY � TWO FAMILY TYPE OF WORK: I � �W � �PLACEMENT DETAILED DESCRIPTION OF WORK �11 e w c r k ❑ TOWNHOUSE �AL.TERATI ON/REMODEL FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU � MFG: MODEL: SIZFJBTU MFG: MODEL: SIZE/BTU A/C $25.00 . FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $IS FIREPLACE (WOOD) $35.00 IVEW GAS GRILL $10.00 _BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 �rAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $]0.00 _VENTILATOR $15.00 THIS 1S AN APPLICATION FOR A PERMIT-NOT VAI,ID 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 all work whi h r uire review and approval of plans. .� SIGNATUREOFAPPLICA.T� �' �` � o ' PRINTNAME ROGER HOFFHEIN DATE S I�( I C� , City of Fridley 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 ❑ 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 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 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 combustion and make-up air calculations. �uilding Inspections 763-572-3604 763-502-4977 �AX DATE "�'� � SITE ADDRESS � THIS APPLICANT IS: PROY'�+ RTY O�YNER/ TENEiNT I��, � Y '� � i�' `�, .: ,.; ; ; S��EI�T'���b� AP�Y��CA'�'��I�T b� Y� �I'�'Y �F F�DI.E`�I EFFECTIVE 1-1-2010 YOUR E-MAIL ADDRESS ❑ OWNER $�ONTRACTOR ADDRESS: ,YriQ/ `J CTTY PHONE: 1��'� �� Petmit No.: D���:�'c � ', �. s. � �°�` STA CO1VTItACTOIt NAME: �I t� SUBMIT A COPY OF STATE LICENSE # ,i� �� �TO-PM EXP DATE �` V YOUR STATE 651 _g65-1 LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: o CITY STATE ZIP INSURANCE pHONE ' FAX PEItNIIT TYPE �Y'YPE O�' WO1tYC: I ❑ NEW FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE DETAILED DESCRIPTION OF WORK �PLACEMENT FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINKILAV FLOOR DRAINS SHOWER _ WATER PIPING gp'I'g'I'�g GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) CLO'CHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY �WATER HEATER ($35) FOR IRRIGATION — WATER METER _ OTHER THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNT[L PROCESSED 3 I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved plan in the case of wor c uires review and approval of plans. SIGNATURE OF APPLICANT � .� PRINT NAME �G/Y���. ��G �DATE �'1 a I� �fl�y o� �r����y �uilding �nspectgons Deg��r��aent 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 ' FAX: 763-502-4977 �Cr�� l.4