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AF - 46036$' , Village of Fridley, l��inn. BUaLDING PElf11'IIT o, N. i'.�� 3 Office of 1NSPEGTOR OF B�JII.DINGS �� a Owner �'�, . �� L � � Architect�;, ' _ Frid2ey, Minn•, � , 19'+� � Builder�' - � OCATION OF BZJII.,I�ING R No. ��� Street ����� °�+ ���t of Lot Lot � Blo � Additfpn or ButaDivision �� ���. DE�C�IPTI01'd OF BUxLDIlVG �'ront��Depth '� � Height� Stories Manner of Construction ��� ,�, To be uaed a.s � To be f, omplete '� `"� � Eetimated Cost,}�+� '�� � g� I .�a 3'��: .i� f� .,�. i�T y �i� - �- - °�"" � ...�. .� .,. e� `ar;.�. �_a.. s�:�,� _ �II�+s s.....� M .k9&� ra..�,..._ � _ � 1� ..� � �,� . � a� Permit ie heraby granted to��'�,�_-���„- ��"�*7 '�'�°°�..�'�$ tp ���'�� � the buflding �� � described 'in the above statement. Thi� permft ia granted upon the espress conditio�n that the p on to whom it ia granied, and his ag'ents, employees aad worlmnen, in all ihe work done in, arouad and upon �id building, or any part thereof, shall conform in all respecta to the ordi- nances oP Fridley, Minn., regarding the conetruction, alteration, maintenaace, repair and moving of f�uildings a�ithin the city limite, and thia permit may be revoked-at an� tfine upon. violation of any oE the provieions o4 said ordina.ncea. - N � � 'g� spector of Buildings. AGR � � ,N'S AND S�VORN STATEMENT In consideration of the issue and delivery to �.e by the Inspector of �uiidings of Fradley of the above permit, I hereby agree to do the proposed evork in accordan.ce witla the description above set forth and according to the provisions of the orciinaraces of Fradley, an being first dul� sworn, I hereby atate and say that the facts stated by an� c�n�ed ' ove permit axe true as therein ata,ted. ,� ,�� ` � ,l� Subscribed and sworn to before me at Fridley, �- � � day o�� .D. 1� . ,..�.� .� ,`1�,. � +� � �. , � : � s > . � r � � � N 1 i v � 1 � r � � y � � � � � � ee �� � �a�� m� Q p �� W n� d O � ,,oy C R �a� 0° �'. � 'o au „ � � � � � � � �� � �� �� �� � : . �� � : i ; N � � �°'�° � � 8 � 8 y 8 M M fA � W 0 ` ,� r � � o � � a � � � � � � � � � � � � � � � o � � � � � �w n � � � f � � � � ^ � � � � � � x � b 0 r ae � < � ti I w S 0o w � '� r.s M C � � � � M � � �. 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Limit '� � � Limit Selting n �O� Fan Setting � � � P Pilot Type Pilot Make Vent Size SG� KIND OF LINER� Draft Hood �� FilTers P/Size �� Chimney Loeation C:himney Construetion �� Pilot Model Smoke Bomb Wiring � Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting 1 st � Prossure � o� Percent CO �'`� Date Tssted —�� 2 + Input CFH 1 Percent 02 � Company Testing Staek Temp. Percent CO ���-� Name of Tsster Form 235 .� In �� 1• � � r• o . ,� . � r ry ;' � n w � s•►- r- s � a � + `• r N r 1� ► ► L w C G r � • i� � B ( � �. � �. � _ � r. • w � � c ► s = � � � � C• q r - -• � �. � - � � C ► n ^ �. � .. � � � = .� � C v C - e ^ . � � _ � f. L A r "' • ^ • = � D A G 4 r L �• r ^ o Y � L C� x L w G e^e : I� �+ r «. � � � � � ^ C. L • ' w w • !�' n � l ~ �. ► M T q � w 1 (f O w •. �T� Y� r R � r r �-' G r � n V1 w •� � Q `� r P e .. ► q G (ti n (� � O � �- �t' �' T .T` w lr ►� y� H -_ . � �� �� A L v' � .� r. 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W � • n•'r C� fT n � � � ^ � u� �G r� �� i; ' �Il . � c. � .- �. i .. p o r. ., s.. • (i • � " 'r .�. n i+ p " r' = o F� f"' Y �- 0 . u O t� F'� u .� .. .. n N F� ' m �. ar :� � � � � � m � t� � �- . c t. r r ti � � y. t� r. ;� r (D Y ' '• Y ►• f, � � �� N 1� �} •7 1• I� 7 M �' ?� n u �• �� � � . `� N 11 � M � /� � M �• �,� 1� R 1 • r� t 1 I� h �' ' i • 1. � (• h . � . • ,� • h . �' .� l.. '�' � /� � �� Ii �� 4 n ;• � . � A R f� I� M � O �" (• r � � A r � � {� �r ' �' � o � • � � u � � � � .� � A . �4• • '� � � � � v � o � � �. � r a x L I } �`'� I 1 1 � _ . r ' Building c��3 � MECHANICAL Permitrlo.: � 607- � Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY ���` 2 DATE I' ,�' �� YOURE-MAILADDRESS SI1'E ADDRESS �� `� l`� C� r e 5� �� 1 V�e `� l� THIS APPLICANT IS: O OWNER �ICONTRACTOR PROPERTY NpME:�� ��,r c� �� �,�Q.It �N� aDDx�ss: �3\� �� � 1\ er e s� A rL crrx �'r ��(-�� STATE �INLIP � s y3 Pxor�: °-i lo ''s S—1 t� 04 �-1 ( CONTRACTOR co�A�v�r N,v�: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN Ti INREN YOUR STATE STATE LICENSE # EXP DATE LIC�NSE WITH �D�S: g3�0 EVERGREEN BLVD STE �rrx "C0011i"°RAPIDS sTa,�MN zrP55433 APPLICATION pHONE 763 — 757 -- 6202 F� 763--�757--6701 PERMIT TYPE �INGLE FAMII,Y ❑ TWO FAMII.Y � TOWNHOUSE TYPE OF WORK• � NEW �REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �T v�� �` ��Z�p r��� � �I-�t r Cp��I �� i o�ne�' PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, wh�chever 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 Wi�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVi� �j� , It� Equipmeirt Installed MFG; L4�LY'r' � ti-° � MODEL: a i-I IRC� (� ?� o'Z y SIZF/BTU a� "i'oYls MFG: MODII.: SIZFJBTU MFG: MODEL: , SIZEBTU C $25.00 _FIItII'LACE (GAS) $I5.00 GAS RANGE/OVEN $10.00 AIIt TO AIR EXCHANGEER $15 _FIItEPLACE (WOOD) $35.00 NEW GAS GRIL,L $10.00 BOII.ER $35.00 _F[JKNACE $35.00 _GAS UNTT H1R $10.00 _CHINIl�TEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCI' WORK $10.00 GAS PIPING $10.00 VENTII,ATOR $15.00 '�r /�l r� f t .q � r x � ti�- �y ",p� },� (�'� `,y� .. ry� t �'��� . lr�^��� , ;7. ��N�,S1 �� . ��; �a�� .�� �`: � � H � ��'� �'� � ;�t. , r��ik et��flF �riiA?3.�c �� '., i �" '.�Vil\ 1t:7'%r , �`{?..�} r . �'�.:,. ��.�'.��. Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surchazge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @$25.00 � x$25.00 =$ ot `S,� Number of fixtures @ $35.00 x $35.00 = $ State Surchazge = $ .50 Tota1= $ o`Z S � SO 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 percnit 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 work which requires review and approval of plans. SIGNATURE OF APPLICANT �. � ° � x� ROGER HOFFHEIN DATE � ' � � �U� � ���,��L�'�'�'�`�� �Fp.�`�tA� w ��?��IiTSr�RE �.�'��1��3 � `�b�;'Q�;:�L .�:��- ATi;; ��G�,A���� �,.� zE 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 PERNIIT RESIDENTIAL PERMIT APPLICATION HVAC � 0 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 REQUIItED 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. ACZ,`A 1V�TarivaTD — -- - - - NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building Inspections 763-572-3604 DATE ` � '° °� ° � $� src-E aDDxESS t 31 `� THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR � MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY ICr�c YOUR E-MAIL ADDRESS • N'► ❑ owr� �coNrRa,crox � Permit No.: Received By � D����CT 07 200� ADDRESS: /��� Il �� � r re c� �' _ f� � CITY � t2 ��1 STATE�ZIP � S� 3� PHONE: �1 b�`$� �,• l? d-I �-} I Co�axY SUBMIT A COPY OF CONTACT PERSON: �' ��'�3 i���� YOUR STATE ST'ATE LICENSE �1 EXP DATE LICENSE WITH ADDRESS: �ai � � q"� 0� � h ��'JF^ 1eJ � CTT'Y F2 � c� I� STATE M� ZIPe�S � L- APPLICATION � PHONE �b� `DS�I �l q �j FAX PERMIT TYPE TYrE oF woxx: �1 SINGLE FAMILY ❑ TWO FAIvIILY ❑ TOWNHOUSE o rT�w �ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �,���� � � �� ° �d °'l �d'�`' Z� s� �'� PER MS 16B.665 the permit fee is a minimum of 515.00 or 5% of the 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 WF�RE LABOR EXCEIDS $500, FEES ARE BASID ON $10.00 PIIt FIX7'URE, EXCEPT WHERE NOTED. Fl3CTURES: (II�iDICATE TOTAL NUMBER OF EACH BELOVi� Equipment Installed . MFG: `��� �o-� MODEL:�1Aclas�atil � l( SIZFJBTCJ MFG: MODEL: SIZFlBTU MFG: MODfl,: SIZE/BTU A/C 525.00 'ZFIREPLACE (GAS) $15.00 . _GAS RANGFJOVEN 510.00 AIR TO AIIt EXCHANGEER S15 FIREPLACE (WOOD) $35.00 NEW OAS GRII,L $10.00 BOILER $35.00 FUItNACE $35.00 GAS UN1T iiTR $10.00 CI�Q�iEY LINER $10.00 _GAS DRYER $10.00 POnL HEATER $35.00 DUCT WORK $10.Q0 _GAS PIPING $]0.00 VEN'TII.ATOR $15.00 Swcharge TOTAL DUE _ $ Number of fixt�ues @ $10.00 x $10.00 = $ .50 Number of fixtures @$15.00 J x$15.00 =$ FS• o v $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ SO Tota1= $ �S. � � THIS 1S AN APPLICATION FOR A PERM�T 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 czse of all work which requires review and approval of plans. SIGNATURE OF APPLICAN7' C�-�-� o ��.—� _PRINT NAME ��'+�' l b ��►4 L3 DATE I �" �`° ,� / / - �p f��vU City of Fridley �� L Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FA.Y: 763-502-4977