AF - 46193BUILDING PERMIT
Viliage of Fradley, Minn. N° 215 9
Date ��OC��� ..........................
Owner �. �. v�s!�• • .GrCC:-: c.,�.rx-�D>L�r. . .
Address ����...ri.�'".d.A"-�stt-t'�'...G'c.t-^f.°..
Builder .��'.,.7'".'�."S? . . . ....... .. . ... . .. .. ... ..
Address.........................................
LOCATION OF BUILDING
No. .y�.•�Dy�(,� ..... Sh�eet . yt��-.�,-yz�«�:tkriirY.y...(L-X.sF?.. Part of L.ot
.......................
Lot ........�p...... Block . �........... Addition or Sub-Divieion . .�, ,.y�j; �,�„Qri��.........
Corner Lot ............ Inside Lot ..-......... 5etback ............ Sideyard ..........................
DESCRIPTION OF BUILD[NG
To he Used as:
. r
,,� �iv:��Cfl:C�s�'..... Front ; �-
- r ��; .f, : . Depth . .:..-�'. . . He�g] t � � >� ! � . . . Sq. Ft. . . . . . . . . Cu. Ft. . . . . . . . .
.................... Front ........ Depth ........ Heigirt ......... Sq. FY. ........ Cu. Ft. ........
� It'J y�—
1�pe of Construction �� .r f,;.,.,. .. Est. Cost . �'�.'%��, , ,r.-. , , , , , To be Com leted .. �{. �'7-
- i( ��- P : . r. . � �.
� In consideration of the issuance to me of a permit to construct the building descrihed above, I agree to do
the pmposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
...................................................
In considaration of the payment of a fee of $. . �y,/ .�tppemvt is hereby granted to � . . . .. . . .. .. .. . . .... .. . . .
• • • • . . .. . . .... . .. .. . . .. . to cronstruct the building ot ad dition as deseribed above. This permit is granted upon
the express Mndition that the person to whom it is granted and his agents, employees and worlmien, in all work
�done in, arouad and upon said building, or any part thereof, shall confo*m��.in all respects to the ordinances of
Fridley, Minnesots regarding ]ocation, conshvction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon. violatiyfl'�qf any of the pmvisions of said
Ordinances. _� ,r �f ( ( _
t.y Building Inspector
NOTICE: .. �
This permit does not cover the consiruction, installation or aiteration�for wirfng, piumhing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits ior these items.
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sue�ec* � �� PERMI .
City of Fridley � 13048
�� "TT"ET°`°`T"�,�'"S gUILDING PERMIT
� �_ . �. . � RECEIPT NO.
.
COMMUN�7V DEYELOPMENT DIV. - .' "�� �+I
V ��..��' . / ��i
� r�� � � � PROTECTIV6:iNSPECTION SEQ � �
(..-_� ��'�1•� CITY MA4L �`FRIDIE`/ SS4$2 NUMBER REV. DATE PAGE OF APPFOVEO BY
�' 612be0-3�50 � 910-P15 � �
)OB AODRfSS�
582
1 IEGAL �OTNQ � BLOCK � TflACTORAD0ITION � SEEATTACHED
. �ESCR. 6 3. P� R SMEET
2 PROPERTYOWNER . MAILA�DRESS ZIP PNONE
� � CAHI. METOXEN 5829 FIACKMANN �
3 CONTRACTOP� � MAIL AD�RESS ZIP ' PHONE LICENSE NO.
�1
4 ARCHITECTOHDESIGNEF MAILADDHESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
� 6 USE OF BUILDING
7 CLASS OF WOqK �
� ❑ NEW . }� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 �. DESCRIBE WORK �
� CONSTRUCT DECK 16 x 16
� 9 CHANGEOFUSEFROM TO
STIPULATIONS �
SEPARATE PERMITS APE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, ryPE OF CONS�. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING. � �
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING - � SQ.FT. CU.FT.
-AUTHORRED iS NOT COMMENCED WITMIN 60 DAYS, OR ff.CONSTRUCTION
� OR WORK IS SUSPENDED OR ABANDONED FOR A PERtQD OF 120 DAYS AT �
�ANY T169EAFTER WOflK IS COMMENCED. . . NO. DWLG. UNITS - OPFSTREET PARKING
! NEREBY CERTIFV THAT I NAVE REA� AND EXAMINED THIS APPLICATION S7ALL5 GARAGES
piJ�KNOWTHESAMETOBETRUEANOCORRECT.ALLPROVIS10N50FLAWS yp�UATION SURTAX
AND OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER 6PECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � �3SO.00 . SO
DOES NOT PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL THE pERMITPEE SACCHAPGE
PROVISIONS OF ANY OT11ER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OFi THE PERFOFMANCE OF CONSTRUCTION. �S.00
PLANCHECKFEE TOTALFEE �
$IGN�TUREOiCONTPAGTORORNUTHORIZEOAGENT ID�TEI SS.SO
WHEN PROPERLY VALIOATED THIS IS YOUR PERMIT
�
6.z� 7a ;,�.�-� Jur� za, ie�s
SiGNniUREOf ��.p� . NE BWLOERi �p�Tfl e�oG.iNSP D<iE
+e a-
nrrLicn�rzo:�� r�o;; rz�:szDL:�Ti�:�., .�L�rLa:11�1ov, .
OR AllllITI0�1. BUILDIV`G PrRhtIT
CITY OP FRIllLEY, AIL\;:ESOT��
ot� �,�r's nTn:��: �d� � ��-�/mX261 BUILD�r�: �� H � /J�Je �osr�eh
n�nt��,ss: SF/2�f �.v����s��i nnnF.�ss: .S'�r.,.e
td0:. STREET: f�`�G'�3,-�u.Yi, ��<.
' LOT: � ISLOCI:: 3 e'1DDliIG�:_ /�c'i,�v, c�-V f�las-roL�
CORPiE3 LOT: Iiv'SID; LQT: SET�yC--'____j�y% °'-li�'r;=.7:
9p�licant attach �o this fo� i`c_'� Certificates of St�rve•r of Lot an3.propose'
building location dracan on these Certiiica_es. �
DESCRIPTIOV OF BUILDI\G
To Be Used As: �.7eC�
Fxont: Depth: Height:
Square Feet: /6J�/� Cubic.reet
� Front; Depth: Height:
Snuare Feet; Cubic Feet:
, �
Type of Constructioa: ���0� Estimated Cost: $ 3.s0
To Be Compieted:
The ur.dc.-si�ned hereby m�kes apolicatinn for � permit for the work l�zrein
specified, aoreein5 to do <^.11 caorl: in st:ict accordance c�itn the Ci_� of
Fridlcy O�dinances and =clin.ys af the Departr:�.ent of Suilcinos, and i�creby
declares that a11 the facts and represenCaL'ion� stated in this anplicatioa
' Are true and correcl-.
DATE:
SIGNATUP�:
(See Reverse Sidc For AddiCional Infonnation.)
p�,�.,y...� �:� �
� ��_ �-� . . �
_�_ .��-v _ . _�� _
e
suuccr P �
City of Fridley 3 8 9 6
ATTNETOiOFTMETWINS gUiLDING PERMIT
� ` RECEIPT NO.
� �V_���� COMMUNITY OEVELOPMENT D�V. �D^�
� � PROTECTIVE 4NSPECTION SEC. y
1
� ` /'�'1 � LITY XALL FRIDLE� SS�SI NuMlEP �EV O�iE ��GE Oi �MRpvED �v
�""� � �'� 763-571-3450 9�o-Pi5 9/18/03 / /
lOB �OORESS 5829 Hackmann Avenue NE
1 IEGAL �OT NO. BLOCK TRACT OA ADDITION SEE ATiALHEO
DESCR. () 3 Parkview Manor SHEET
t PROPERTYOWNER MAILAODRES$ 2�P PMONE
7 CONTqACTOR MAILADORE55 21P PNONE IICENSENO
B& B Remodeling 6760 Madison St NE, Fridle ffi�I 55432 571-0248 9042
� ARCNITECiORDE5IGNER MAILAODRESS ZIi PMONE IICEN5EN0
5 ENGINEER MAILADDRESS 21v PHONE LICENSENO
6 USEOFBUILDING
Residential
7 CLASSOFWOFN
❑ NEW ❑ ADDI710N ❑ AITERATION §7 REPAIR p MOVE ❑ REMOVE
8 OESCHIBE WOFK
Reroof House (19 Sq) Tear-off
9 CNANGEOFUSEFROM TO
STIPUTATIONS
Underlayment must comply with the State Buildiag Code.
TVPEOiCON57. OLCUPANCYGROUP OCCUPANCYLOAD
SE�ARA7E PERMITS AFE AEOUINED FON ELECTRICAL, PLUMBING. MEATING.
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NUII AND VOID IF WORK OR CONSipUCTION ZONING SO. FT CU FT.
nUTMORIZED IS NOT COMMENCED WITNIN 80 DAYS. OR IF CONSTHUCTION
OA WORN IS SUSPENOED OR ABANDONEO FOR 4 PER100 OF IX) DAYS AT
ANY TIME AFTEA WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTREET VIRNING
I MEREBY CERTIFY THA7 I H�VE REAO �NO E%AMINEO TMI$ I,PPLICATION 1 STALlS GAA11GE5
RNO KNOW TME 5�1ME TO BE TRUE ANDCORNECT. A�� PqOVISION50F LAWS yA�UAiION SURTA%
AN� ORDINANCES GOYERNING THIS TVPE OF WORK WIL� BE COMP�IED @
WITM WHE7MER SPEC�FIED MEAEIN OA NOT. TME GRANTING OF 11 CERMIT WZ�ZOO �L.LO
DOES NO PRESUME TO GIVE THORITV T� V�OI►�E OR CANCEL TMk pEPMITGEE SACCMIIRGE@
GROV N OF 4NY pTHER ATE ON L l REGULATING CON� Q83.ZS Fire SC y�2.�LO
STR CTIp OR TME PERF ANCE : T ION W
PLAN CMECKFEE T07ALFEE
L ens C $5.00 $91.55
YG�+�*U �CON'A�QOAOA�u*wOAi2E0�GEMi �O�1E� y� E pROPEAIY V4LIDATED TM151$ VpUR pQ MIT
��t � l� �,1
_ � «.�
$�GN�IUFEO�OWNfMi�fOWNfABUI�DEA� �D��E� B �M50 ��L�f
. y
NEW
ADDN
ALTER
�� CITY OF FRIDLEY Effedive 1/1/2003
�� 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description: ,
Owner Name & Qddre,
Contractor.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
f �C � /��,,�/(/
��.�7�% �
•�r'
.
Tel. #
MN LICENSE # / n �f�" L
Tel. # ✓ ��'U� �✓
Attach to this application, a Certificate of Sunrey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
—�— Width HgUGround S . Ft.
- //i°7��% /�/' S� �//%/1-� �i�
Construction Type: Estimated Cost: $ ���0
/�i2 -Dl�
Driveway Curb Cut Width Needed: �Ft. + 6 Ft =_Ft x S =$
DATE: ���-�� APPLICANT: 1/�2� ��� _Tel.#�4'3J?� vZ`��
Call (763) 572-3604 for Pertnit Fees if mailing in application. Fax to 7635T1-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Cur� Cut Escrow
Erosion Control
$ .as
$ .lD
$
$ .00
$
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conserva6on Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary [
TO7AL $ , S S�
• : •.
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENLTE NE
FRIDLEY, MN 55432
SYL-36U4 r r�:
: 5829 HACKMANN AVE NE
: 243024230007
: PARKVIEW MANOR
: LOT 6 BLOCK 3
: BUILDING
: RESIDENTTAL
: DECK
�fi-i�ar
PERMTT O.: 2004-01432
DATE ISSUED: 08/27l2004
VALUATION : $ 3,274.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTII,ITY LOCATIONS. CONSTRUCT A 16' X 16' DECK.
APPLICANT
GARDNER GREGORY J
5829 HACKMANN AVE NE
FRIDLEY, MN 55432
C���:7
GARDNER GREGORY J
5829 HACKMANN AVE NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and ]mow the same to be true and correct. All
provisions of laws and ordinances goveming this type of worl
will be complied with whether specified herein or not. The
ganting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating:C,QnshvFtioppr the performance of conskuctjon.
Sldg
BUILDING PERNIIT FEE
PLAN CHECK FEE
FIRE SURCFIARGE
STATESURCHARGE,VALUE
TOTAL
SEPARATE PERMITS RE(2UIRED FOR Wh3RK OTHER THAN DESCRIBED ABOVE.
4725
6321
3.27
1.64
16537
NEW [1
ADDN j]
ALTER � j 1 �
�� l
Construction Address: s
Legal Description:
Owner Name 8� Pu
Contractor.
CITY OF FRIDLEY �� � 4�
l�`f��6431UniversityAveNE,Fridley,M 55432
� SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
CG Effective 4/1/2004
(763)572-3604 Bldglnsp
(763) 571-1287 Fa�
�/�\��rQ�
Tel. # %6a- �"7i- b eai
MN LICENSE #
Address: Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width - Height Sq. Ft.
Length /6 , Width /6 � HgUGround �� Sq. Ft o25�
QTHER:
i .-c � �r�,1 ?
Construction Type: �%� iC�u �c-u �"�- Estimated Cost: S 7• °� ��
Driveway Curb Cut Width Needed: _Fk + 6 Ft =_Ft x S =
pATE: 8/% � APPLICANT: (.�Re4oRy T C-�iPdNPiP Tel. # 763 -S7/'�8��
Call (763) 5723604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ 7�
$ 3:a
$
$ f , (Q',�
$�
$
$
$
$ _
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th°fo)
$.50/$1,000 Valuation
$1350 per 5AC Unit
$5.00 (State Licensed
Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.�0 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ) Not Necessary [ ]
TOTAL . $ u�i� STIPULATIONS:
Desi n #• 85097 �R g/n/2oo4
9 • .- .
k*' Take this sheet to the Building Materials desk to purchase your materials.' '"
You have selected a 16� X 16' deck 2' off the gryund. Below is a section of the railing style and
Pressure treafe�" rF` m ng`Ma�erial � options you have selected For your deck.
I;�r���n�y� �inn�inn
5/4 xig d D�_�_eck�oards' � ! r
u n u 9 � rl ��
36" � 6e�X �' �'
2" x 2" x 36" Cedar Beaded Spindles ,, , i;
I
II It II "'� ,i /�j ...L .J� I I I ! II
2" x 4" C dar HandrRail (ing Posts �� Qu-v � I_
Concrete and a Post foofings C� (_, ,i �
Premium Gold Square Drive Screws �--- -- - �
6alvanized-F�aming Fasteners
�2" x.8" Joists j _,
�2'_z 8" Beams> � �'
40 PSF Deck live load
Illustra
(See above
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Stair Widths : 48"
For Building Material's use only : 1921920240105011406070002000150200000001
Today's cost for materials estimated in fhis desi�n with o�tions: $1633.04
"Base priee may inelude: 4U PSF deck live Iwd, hoti:aihl deckiny, h6 preswre he�Eed bmrds, pressure hated fnming m�erial, ao sbirs,
36' 2c4 railing, pressure trerted nilinp posts, and g�lvanized box n�ils. *( gpSE Priee): $1063. S�
Joist la�out for Your Deck
The cale is 1/4° : 1'
Design#:85097
B A A A A A A A A
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Msrk_ _ _ _ _langth . __. eseription ---_ _ _ _ _ Usqge _ - -
p 1;'9" 2z8 6reen Treated Joist
{l 15'9" ?x8 6tean Treatad ledger
B 15'10-1/2" 2z8 6reen Treated Rim joist
� 16' 2x8 6reen Treited Rim joist
Joists to be on 16" centers.
Joists to be huna from the ledoer wiih ioist hanqers.
Joists fo be toe-naited io beams with 2-t/2" (Sd) galvani:ed nails.
Rim joists fa be face-nailed to joists & ledgws with 3-1/2' (16d) galwni:ed n�ils.
Blocking and bridging is not slwwn, 6ut mey be required by your locel cude.
Illustr�tion may depict optio�s not inclu�ed.
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esign#:85097
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the oashierto purchose.
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INSPECTION REPORT
CITY OF FRIDLEY MINNESOTA
(763) 572•3604
ADDRESS o,
OWNER
BUILDER
�
If no corrections are listed above, approval is hereby given to proceeds. You will be in
violation of the ordinance if you do not call for the proper inspections and make
co�rections as called for.
Building
Inspections
763-572-3604
763-502-4977 FAX
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
Permit No.: ` l0 IU
Received By:
Date �il'e�tt. � � � � �
DATE ��� � /�� Y�OUR�CMAILADDRESS Y'C't�']JU�GN�Q�li���?�.-1MA�a �_
STI'EADDRESS �$2�I YRl! iifYKR/\ i'�"� �C�
THt9 APFL[CANC IS:
PROPERTY OWNER/
TENA111T
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
TYPE
DESCRIBE
ROOFRVG
N[JMBER OF SQUARES _
CA1eAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
smwc
❑ vmyi
❑ a��n�
❑ Other
❑OWNER �7EICOT37RACCOR
FYi A��u STA'1'6��ih ZIP S�i3Z
PHONE: �Ifo3^�—I i ^ SSZ I
PHONE 2475 Maplewood Dr. FA7F �OS I—�I,ZS'�'IOW'S
STATEUCENS�P��W���MN 55109 e'-�11C� �nnrE Ci�-3I'c9U17-
(�6INGLE FAIvIlLY/NEW CONSTRUCTION
❑ 1W0 FAMILY/NEW CON57RUCI70N
❑ BASEMENT FINISH ❑ ROOF
O DECK ❑ SIDING
❑ N8W HOME CONS7RUCI'fON
❑ MAINTENANCFJREPAIR
WINDOWS
IN EXISIING OPE�IINGS �i es �No
OR FOR NEW OPENQJGS-DESCRIBE SIZE OF
OPENING CHANGES & ,.
ALJOB
Plan Review
Fire Surcharge
Surcharge
Licen.se Surcharge
SAC Charge
C�irb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
❑ ADDITION
❑ REMODELING
❑ HOUSE ONLY
❑ HOUSE & GARAGE
O ATTACHED GARAGE
❑ DETACHED GARAGE
osorrrc
❑ r��
❑ Facia
`'�AT{ON OF W DO S
�eutir o �` �,y`.,,,..
❑ DRAQJ T7LE
❑ OTHER
BASEb1EN'I' REMODELING SUBMI7:
l. ExiAi�FloorPlan
2. Proposed floor plan
3. List of slrucbrtal members [o be used
FOR NEW CONS7RUC770N INCLUDQVG DECKS,
1. Sice Plan/S�uvey slawing the existmg strucUUes
� ProP� ProJ�.
2_ Two sets of constn�ction plans
3- Energy Calculazions
✓ALUATION, INCLUDING TllE WST OF LABOR AND
(USING THE 1997 UBC FEE S('HF.DULE)
See Back Page for Fee Schedule
65% of Building Pertnit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum 5.50
$5.00 (State Licensed Residential Conuactors)
51825 per SAC Unit (Plans to MWCC for determi�iation)
ft+6ft= ftxS21=S
5450 Conservation Plan Review
Fee Detcmmi�ed by Engineering
Agreement neccssary ( ) Non Necessazy ( )
chxks oavable to:
77iIS IS AN APPLICAT[ON FOR A PERMI'I-NOT VALm ON'IiI. PROCESSED
1 hereby appty for a building permit and t acknowledge iha[ Me infmmalion above is comple[c and aaauate; ths[ tl�e work will be in confo�mance with ihe ordinances and codes
of the City of Fridley and wilh ttc Minnesota Conskuc[ion Codes; tFiat I understar�d this is rot a pumi[ bu[ only an application for a permi[ and wodc is rwt ro slart without a
pelmit on si[e; that the wak will be in �//c/e w�rth �the �ap/p ed plan in e case of all wak which requires review a?nd ap�proval /of plm�s. /
SIGNATURE OF APPLICANT��� Z✓ PRINTNAME��p� V /lZGGV/c H DATE �%� �d
/ V
APPROVED BY
FOR
DATE
�r
Building
Inspections
763-572-3604
763-502-4977 FAX
S]TEADDRESS .
THIS APPLICANT IS:
PROPERTY
OWNERI
TENANT
MECHANICAL
RESIDENTIAL APPLICATION
e��3tBS CITY OF FRIDLEY
� FFFFfTIVF 7_19-09
--�� -`� —�' �- YOUR E-Mqil
f+GLIGYYLa-ny� Tk
❑OWNER �EICONTRACTOR
Pemut No.
Received By:
re�z�P�,3al
CONTRACTOR - -coMenNVNnnne: CENTERP T-ENER6Y— — ---
coNrncrreRSON: JOANN ZINK N ""'
SUBMIT A COPY OF BOMD 22013346 -�
YOUR STATE STATE LICENSE N EXP DATE
LICENSE WITH Apo�ss:9320 EVERGREEN BLVD NW SUITE B cirvC00N RAPIDS STATE MN Z�P55433
APPLICATION pyO7dE 763-757-6202 Fivc 763-757-6701
PERMIT TYPE
TYPE OF WORK:
DET
�SINGLE FAMILY ❑ TWO FAMILY
❑NEW �REPLACEMENT
OF WORK
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
FEES ARE BASED ON 510.00 PER F[XTURE CCEPT ERE NOTED. FIXTURES: (1NDICATE'COTAL NUMBER OF BELAW)
Equipmentlnstalled MFG: �jyys�1 � MODEL: �/�_Q�YI�"� SIZ TUI OOC�'�
. MFG: �\1Sid MODEL: l.l PVYi�� SIZFIBN ��✓I
,Lac szs.00
_AIR TO AIR EXCHANGEER S 15
dEY LINER S 10.00
woxx sio.00
MPG: MODEL:
. FIREPLACE(GAS)SI5.00
FIREPLACE(WOOII)535.00
TFURNACE 535.00
GAS DRYER E 10.00
GAS PIPING SI0.00
SIZE/BN
GAS RANGFIOVEN 510.00
_NE W GAS GRILL S 10.00
GAS UNIT HTR 510.00
POOL HEATER 535.00
VENTILATOR SI5.00
THIS IS AN APPLICATION FOR A PERMIT-NOT VAL1D UNTIL PROCESSED
I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work will 6e in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Conshuction 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 view and approval of plans.
SIGNATUREOFAPPLICAN���' �' ��S�PRINTNAME ROGER HOFFHEIN DATE 7/O�-O f/�
c►�y or Frsaiey
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
REOUIRED 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
REOUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction TMC 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 Mechanica{ Code Guidelines software may be used for
combustion and make-up air calculations.