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AF - 46432, land Plonning • �€l��i��B���'�� • . 6675 Highway No.65 N.E. � • �� Minneopolis� land Survcying ���.���.,�p��d���.�� ��dC• Minn. ssosz Soils Testing ��� Civil Engineering Telephone 784-6066 Area Code 612 , Municipal Enginecring Exlgineers 8L ..�7L1T'VG�g70iS 1\ t�, `1 V � �� V1 � �� � � 10/l0����,�� I..�a,a2 5urve� fo� ��i'�N�'C4-� �1�O�RG— � � � Sau�l �i►�e o,�'l��s 1£ 2, hla;l /, S�v.��>>r.�� T�-r. .� � _ � -- �5g, �g -- --�. '_�b -------- .24---------: ----- � . � , . .,;..i / � : . \ o; � � N; } ' J � G � � � Z � "T 5 <3 � Q i✓�� . s.\ i . \ p . .. �� 2 `, Z , . v � �: �.t � � r � , 3 �� �' % Q � 1 �� � , - z % . � `� % o; � : � � ; �: ' � � t : !.. � ` -�-- 3 S. 3 ' ii. .iiiiii:, , a 5. L� �'k.o.m.e. � �'~- : , 5• �� =� I � � � � �� ---__ � .� .�.— � � I U I --� I �- . I � I cz— � -� i � � I 11` _� � � I � � Q O � � � � � � �� � � Y` �`�� �/ ; ✓ ; — l�Q• �0 — � �- 1� � ! ,� --�. h �, / . u �'� I►�� a,�all�l wr;i-11. A�ml P�o ea} �7ou�i, �.�, �he . . �� � �� ��� � G. 5�u� iz ��n� o� Ic� l 4 2 —Ifii�PORTANT—� \` ! � _i 4.l�OTIFY THE FRIDLEY ENGR � Before digging call local utilities � '' DIVISIO�V REGARDING CURB' TELEPHONE - ELECTRIC - GAS Etc. �` BEMOVAL AND REPLACEME�L�'r � REQUIRED BY LAW � � � DR!v_Ew,aY ,OP_Ef�l_��� f �� � .��' 30� That part of Lois 3 and 4, Block 1; Swanson Terrace, lying nor�herly of a line whiEh is parallel with and 80 feet south of the southerly line of 'Lots 1 and 2, Block 1, Swanson Terrace, according to the plat on file and of record in the office of the Registrar of Titles; Anoka County, t�innesota; together with all that vacated part of Hugo S�treet ]ying easterly of the southerly extension of the west line of Lot 1 and the most westerly line of Lot 3, Block 1, Swanson Terrace, and which lies northerly of a line parallel with and 80 feet south of the southerly line of Lots 1 and 2 of said 81ock 1. . � This is o true and correct represenration of a survey of the boundories of the land obove described and o(the location of oll buildings� .if any� 9hereon� and all visible enc�oochmenti� if any� irom or on said la�d. This survey is mode only in connection with o mortgage loon now, 6eing placed on the property and no liability is assumed excepf fo the holder of such mortgage or ony other intereat acquired by the reason of such mortgage. It is understood and ogree �T� m�numen h ve been Iaced,For the purpose of establishing lot linas or boundory ' co�ners. Dated fhis � da of �� A. D. 19� ' SUBURBAN EPlGIiV�EERIPIG, ItdC. . � Enginee s , Sur�e�ors ���SF b � . � �..1..-rr � -z.L. _ �� o . Y - ' 4�� l �/ 1 �7 � � P 6 • ' �� � r �,� VC� �� , �o �X/ �T�� G- �'� %� � � /i�l � �� ��U s � G�%, o � �- ��� ���� 1i.�� � �i � ��' �- �� �� � �� �� �e5 T �D �'P�1� j� �i�t, P .. � .A i O . � � � ' . '. '0. ' } � ' � r . IA � ' • �i .►� � � f� 'l. '�1 �: Z � s N � : � � „ � � '� A ir G (ti w � 8 °= :i E r � 'd t� .h i1 y;� n '' 'T ►4 �o � � • � y '„� � O � � � f �f x � y n w � %� � `1 hl d '` /0 N � . 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Su�c1 E'.. E!. w�►+ � tl ` ,� r4wn ` M � � o:iac. � � /OU�1T. � 311Mi4S. � M /lCio• �' O � o�u�..s 7 ' UTCH � � � . lASU�S 0 A:J70 � � � wALKR O� O • . G� � � � !�'Pt" � . � G� � �, �.,��t � ctis v . O�'t HurGS . v p . z o . �� � > . � � ' �� � �. - � A � . . . �N. "• � � ,'•'. � , � � � �f . � O � � .a � � ' •�' Z ' O � a' W• c o. o��. � " p► '• t' n 7y r'' n f�' H, =i . N • o �C. �. � � °' � i � � �- . r � o • � \ 1 � � � � � � � � �. i ,�\ A � ' . :. � . �l � �. • � .� � . ' • , � � � . � • ,� \ • • • . . ' • � . . . i ' p n ti F' h � �, ' a y � � Oq Q� . �d G � � � I 'tl . � u. x S1 �• � �,� A a n. � � ���� � v „ h .. •, � a � �� c � �°�ro � ... � > � � � ' � y �. � a� a n N �. � Q. � � . � . : � a n, �' �I U � �t o. � :3 r � '� C � � � r '� .r �e n � � . � Lr w o ,��,. y � 7: x� r� � V .•. q m Y) �yN v e�i t.hj :1. n l'•. u ^ y. � °' � o �� �L � .: � ! O . ro �; �1 . C. f° :� Y �Y � � t� ��� �.; ._� » a�'� � �� r� �9 p � n � r� � 1 . � � � O . r it ir n � i ; r � ��'a a t� 1 . i . � � "Cf �� � � � .. � . -v .�.. � �� .� � �, � -� � �, � � � � � � . � '^ .� - � 00 � 41 = �+ � � � . Y o :� o � • � . �� . � e.. i. � � � � • , �� �_— `_�� R. SUBJECT City of Fridley , AT THE TOP OP THE TWINS g � I L D I N G P E R M I T r � � � • COMMUNITY DEVELOPMENT DIV. � �y-------� r � � PROTECTIVE INSPECTION SEC. 1 = � � �""1 � CITY HALL FRIDLEY ! 55432 NUMBER �.---� • •'� s�a-5so-3a5o ' 910-F15 10B ADDRESS 180 HUGO STREIET N. E. 1 LEGAL LOT NOjj.tS � BLOCK � TRACT OR ADDITION DESCR. 3& 4 1 SWAN50N 2 PROPERTY OWNER MAIL ADDRESS REV CLARENCE A. SP�RRE, 2644 - 14TEi 3 CONTRACTOR MAILAD¢RESS SAME 4 ARCHITECT OR DESIGNER MAIL ADI�RESS 5 ENGINEER MAIL ADDRESS B USE OF BUILDING RESIDENCE 7 CLASS OF WORK � B1X NEW ❑ A�DITION 8 DESCRIBE WORK 9 CHANGE OF USE FROM STIPULATIONS DATE PAGE OF f2_l o�_7S � � P r. 13134 RECEIPT NO. %C�-�`�g APPROVED BY SEE ATTACHED SHEET ZIP PHONE SOUTH, MINNEAPOLIS ZIP PHONE LICENSE NO. ZIp PHONE LICENSE NO. ZIP PHONE LICENSE NO. ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 0 TO '� WARHING PROVIDE HARD SURFACEDdRI�EWAY Betp� digging t�ll I�{ t�tiliti�s SOD FRONT & SIDE YARDS {. *^'�' !"��j' <<� �� � �CC 1 : �J.: � ... I},� • .. SEE FIREPLACE AND WINDOW SPECIFICATIONS NEED SECOND SET OF PLANS REQU����' �% �. � SEWER: 8" VCP 20' W. of W. Property Line No Existing Wye �� (��'F�����'; �� : �1-f��� ���R IIIIPRIN�G, WA TER: 6' CIP 30' W. oi West � � Property Line. ��� ����,� �� ��� Must be Tapped. TYPE OF CONST SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTIIATING OR AIR CONDITIONING. FRAME THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS� OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UN I HEREBY CERTIFY THAT I HAVE READ AND EXAMII4ED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AL� PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WOFiK WILL BE COMPUED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GftANTING OF A PERMIT 3 2 ], 5( DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � $ 4 7. 9 S SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT � (DATEI � ¢ �� �i° - ..5.� �-+�-. cinninTi �oC nc ntAna[o i1C 11WNFR RI111 f1FR1 � IDATEI - .�. WHEN so STALLS ICY GROUP OCCUPANCY LOAD 1,056 cu.FT21,120 OFFSTREET PARKING IGARAGES SAC CHARGE $325.00 TOTALFEE $389.02 �TED T IS IS YOUR PERMIT AUG. 19, 197 DATE . � `r, _ e .: ' • '. . •APPLICATION FOR R�SI'DE.vTIA�, ALTL'RATION, OR AllllITION. BUILDING P�R1�4IT CITY OF FRIDLEY, h1INNESOTA O�,1NER'S NAME:��%�1^�y71' - /�`o ��DY►Y��? BUILUER: ��J?% _ -- h AnnxESS : � ���r � ADDR�S S : ��% �� —/ y' � �(�'P. �l . - %��-��3, . 110 : . � S�REET : .� 01 P'a � • ��'�s �^�' • � LOT: �`�`��" BLOCK: 1' ADDITI01�?: �iv��.Sc��v CORNER I.OT : - INS IDE LOT :��,_SETBACK: SID�YAr.D : Applicant a�tac�. �o this for� Tc�o Certificates �f Survey-of Lot and.pxoposed building l.ocation .:rawn on these Certificates. � HESCRIPTION OF BUILDING . . . � Ta Be Used As : . . � ' P P ,1 ��� Froni : L%�-f Depth : � '� � Height : � �� �� �G� r�,: ` . � i : • : ������.�: Square Feet :��Cubic . Feet : Z � m ' �„f� Cr�2�� Front :�� Depth : „�` � Height :�' J� s� y-� . • . � Square �eet; � �'� Cubic Feet : . �i�� cD Type of �Construction: ��-�.,+�i r� Estimated Cost: To Be Campleted: ���V n �a /� i � . . � 3 �'s� e • The undersigned hereby makes app-1�?c�c�� :�+� fox a permit for the work herein specified, agreeing to do all worlc in stxict accordance with ttie CitS* of Fxidley Ordinances and rulings of the Department oi Buildings, and her�by declares that all the facts and representations stated in this application 8xe true and correct. - , , .� . DATE i�" � r�i `? SIGNATtTRE - Ga'�vt.� ' d'`�`t-�-- •.(See 1{everse S3de Fox Addi�ional Infoxination�. )� �a. 4�•q�. . � 1b . 0'1 • � �, . 31.�r O-r� 3��0-� . y �aoy►�'� �� sE�. �., . S, U�� u� �c�o �' �k S, orL. 4� �. F',a. � WINC�e, � i��� , �. _ ti ��� � S � � �� a'� . 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Aa � . : d � �O Q' o . _ k 22.Lo . � 23 BG��oo x y. s �:�` y�,,00 ^ _. x t . �_ .. � ��, � � .t� �� �o � - �1 �4 g n, % �� L c� � � �,p �} go o G�, � , . '��': ou Z �' �I'� � v , - w - �. _ � y � � 0 _- IMaM OMIq 7Qii0b6 6875 Hi�iiar !b. 85 N. E. �� I �Minneapoltd� NMnawh 55�32 .�_J SOUth Dltlt�}" 69a6S1Y� Ciuil Bs�Munidpd EnQinceru�g � Soi! Teatmp � Land 3wueyin8 � l.and PLann+n8 1101 CIiH qoad Bumsvllls, Minrwaota �387 Certificate of � Survey for hEN�ET�{ C. 3PORR� I(` Sou�h line o�� 1 o�s i� 2 � BI�Gk �,�r���t�r� �vr��a�v_ - � 159.99 �, � � � j � --ti-l. .. I � ��p�� � � - . , �� _ � , _ � . ',+ � � �� . � � � , � C a'.� '� � � � �, C'°T°`t 4= � � � � � I � � � � � w �. , � -� w :.�cal� o ��ne�, � �0���� � �� ���94 � �, � C ,� 7 7 � (��} ��� � � ,�i .� ` � � � a �r, -- --- - . � �, r,,�i�� �,�t .� � ���� �� . . � V,/ �` . ,�� h.� ""'�'�.� �— ,-`__ � �. � d ? i �D.OU '`�— __,,,__ . _, /� ��� � � . � --- -_ _ --- � �� ,�..�r�.;a�l ���'� �r�N� ��:� �;��- ��,�° �' j�-r� ��J6�h �i►��, �' Lcr�s $ �� 4 . Zhat part of Lots 3 and 4, Block 1, Swanson Terrace, lying northerly o� a line which is para1121 with and ' 80 €eet sou�h of the southerly ]ine of Lots 1 and 2, Block 1, Swanson Terrace, according to the plat on file and of record in the office of the Registrar of Titles, Anoka County, Minnesota; toge�her with all that vacated part of Hugo Street lying easterly of the southerly extension of the west line of Lot 1 and �he most westerly line of Lot 3, Block 1. Swanson Terrace, and which lies no�therly of a line parallel . with a,nd 80 feet souih of the southerly line of i,ots l and 2 of said Block 1. - ! hsr�brcortifJr thof fhia is a fwf and correct.,�ep►essefallon of a wrvey oi fh• boundmf�s of the abev� d�scrlb�d laad� aerd of the locafton of all buildingi �hereon� o�d nil visibls eneroacl+m�nis� if onr� froa+ er en told lond. As survsred bp me �his ZS'Kday o1�L,Y .� A.D. �9� � - SUdURdAN ENGINEERING, INC. � (1�i3dt�5 �i'UCi ��lLO�`!'�I'11��3i . Eagin��rs Su�varors _ 3�er� , � . �- '�-� �-,�..-.�._..::. oia _ . � , 0 � � � �_ C� ��Y OF FRIDLEY �• _ 465 .�pplication for Installation of water and 8ewer Service T'his form to be completed before a tap is made to any eaasting water or sewer line. s Lot .�-�-`---�------ Block .---,-�------------- Ay�dition -- -- --- - � - - - -- Address ��.C�t� Plumber ----(.l1.. -�--ll.G...����.� _._fCl�� ____C,,���� (this porbton of form to be completed by n requesting ta.p) CHA.RGES TO BE PAID BEFORE TAP IS MADE — WHERE ASSESSN�NT HAS NOT BEE1V T•�n AGAIl`aST PROPERTY Sewer Connection fee �Street patch _._ Water Conaection fee Meter deposit Materials used •Street patch � � Where applicable The above applies for all regular residential size - , � , ., .. � : ;�. 3 ,2 �f� O IF LATER.AL ASSFSSMEIVTS HAVE BEIIV T•'N'•«•n AGAIlVST THE PROPERTY, '�`�`•R-F WILL BE NO CHARGES OTFmZ THAN CONNEG°1'ION PER,MITS AND ME�.'ER. DEPOSIT The City will furnish materials for water service snd the plumber will bill the City for sewer, not to exceed $3.00 a f�t or a maximum of $60.00. ASSF.SSMENTS TO BE 7'•�n Water Lateral Credit for material Total assessment Sewer Lateral Credit for material i �� �_._-------------- �-------------.___._..._-- 60.00 Total aQa�,.+ent $ _ - �% Clerk's signa.ture --- - -����11.t..z.�--�--����-���) I hereby authorize the above ta.p 1st copy—Public Works Director of PubHc Works � � � � � :i r; � � L% . � � �� ry . � .�v`' .� � � �) • •� � � � r � � � . y�� ` � Yr� � q � F: ►7 �, � Fi � �i 6� p Si P p N :a .,� C� «` � �D �cj� s� ��� � . � � � w � "� m *n � � � � N � � ' ,�,��� ., r e: �,, i rl c: M � Q � J J ✓ My � A � � (Ci .,p, V g r-�' '� Gi it! � �„� �� �� � • � W W ►� . $� � E 0 � I �'� H A � � � � � � � tt � O . � � . ���� �, �, .� � � S. � :l1 � � . � Q1 r �� � � . • � � . • O t� � � � o �d ` f � h r W o w " �' � � �� � ? ~ o � C � � � � � A "�.1r E �. � $- � � � V ,I [a�� � � � A , R �� � � '� � � � . q �� � n � �. n U ri � � ° � r4 Y '� � � � e W i � ti O' P' � O �� � c � � � n h � � � � � � ►a► b� � �;3 � � � O � 0 � . � �� � � � � m a� � n ti P. 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Cn! � ` � � � Li A fj C- n41 � � �A� � ^'r�a i1.� � ~ a � � � � � � . ci A, � � ' t.. p a��'r. C� ���� � �-�� � u ... � ��� � � � ��o �. � � ��� �� � � � 0 �� 4 !3 Z ' �. �-0 f" -�-1 � � � fT0 ' � Iti �a r �. � � . � � � a.,:.� , `y �,i _ ,�-� Custom� Name City Dealer Name Straet City � /�o - ,��'G�-d �� HEAT LOSS CALCULATION �° TEMP. DIFF. +'� . Type Caiistruction � '� r �'�^'�' - W indo�' �' � � Storm Sash Walls �� �� ��� Ins. Ceiling �°��' °°^ � y ns. Floor �"� t�C' P? �� �"� �"3 . Fl.�l;� Room�Length �� Width � Height FI.I �.�� �� Room�Length Width Hei ht Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area Width Height No. of Llneal ft, Aree Width Height No. of Llneal ft, Araa � No. of pane ot pane Lights of crock , sq. tt. N�• of pane of ane Li hta ot ersck aq. tt. ' � a �c� s �e� .�a � .�_ ��.� �� �= I nf i Itration `" � �E� � � Ex�s. wall � f Net exp. wall 6 � Int. wall Ceiling s F loor s Total Btu. FI.� � t� Room � Length Width Windows and Doors-Crackage and Area No Width Heigrit No. of Urreat ft. A►ea _ . of pane ot pane . Lighn of crock fc, ft. Infiltration �, j G lass 7 EXp. wan �� 6Z3 Net exp. wall , g Int. wall �eiling F loor _ Total Btu. Pr FI.� �=-�` Room � Length ��' Width --.,- — — - • Windows and Doors-Crackage and Area N� W�drh Hr.ignt Nu of Lineal ft. Area � nt �yny nf n�nr. Liqhts of crack sq. ft. � � � -� m°°__ _ °' _ � �___ � f Infiltration � G lass � - --- � Exp. wall ---�-��------- � el Net exp. wall � � Int. wall CeiJirg ^ S� Floor __� ._ �� Totaf Btu. '�� �� �� -� 0� �� e Coef. Btu � a° ;� �/2� tS .� /� � � � �' �` / � �u �- I nf i Itrat ion G lass Exp. wall Net exp. wa Int. wall Ceiling Floor �v � � � Bt� !� �� O�Q _� 3/S v S`6 ? .3/S Total Btu. � FI.� Room � Length �' Width .� H Windows and Doors-Crackage and Area No. W�Oth Height No. of Llneal ft. Area of pane of pana L hu of crack sq. h. � �� .�6 � 9 � y � I nf i Ftration G lass Exp: wall ' Net exp. wall Int. wall Ceiling F loor �r, � ° .._ � �".. .5 Total Btu. �(� Height FI.��;��, � Room�Length ��7 Width Windows and Doors-Crackage and Area No W�dth Height No. ot Lineal 1t. Area of pane of pane Lights of crack sq.ft. a' i �" .� � ,� --�-- — Coef. Btu --- - --- -- �.� � ,� Infiltration --- -----___ --- j „� � Gfass - -- -- --- -- - ' ...,.. Exp. wall._ '_�' � /�j Net exp. wall �'a � - -- ---- `� Int. wall %(jca� Ceilin�-- Tota! Btu_ Btu .�. ta� �..� ��v Coef. Btu � �� �� -�...�.� %�/ � �� = 9 S.� !� � �� _ � , d .� ,.�� . � HEAT LOSS CALCULATION ° TEMP. DIFF. '. � � Cusiomer Name Type Construction �nY Windows Siorm Sash Dealer Name Walls Ins. S�� Ceiling I�s. City F loor FI.� �p Room � Length Width Height Wir�ows and Doors—Crackage and Area No, W'dth Height No. of Lineal ft, Area o} pana of pane �i hts of crack sq.ft. •�� �� C! Coef. Btu Infiltration � �" t�� G�� a% ! 3 SU Exp. wall �, � Net exp. wall � /S 6 Int. wall ---! Ceiling � / ,� '7 Fioo� �/ 3 7/ ,S' Total Btu. D � FI.� D� Room � Length Width , Hei ht Windows and Doors—Crackage and Area No. W�dth Heignt No. of Lirreal ft. Area of parro of pane Li Ata of creck aq.ft. � / � � Coef. Btu I, Infiltration j � �c� . G lass � �' 9 O � Exp. wall +..•� Net exp. wall � L/,/ Ini. wall Ceiling Floor TOLaI BLU FI.) Room � � a �-79 � i y� � �� �v� � Width W�r�ows and Doors—Crackage and Area N � W�>1th He�qht No, ot Lineal ft. . �� nanw nt pene Liqhts of c►aek sq. ft. -�----- - - -- ��q.?� ; � , Coef. Btu Glass _ - Exp. wail - _ Nlet exP- wall - _ �. 1nt. wall Ceilirg - F� Toia! �t�. FI.� Room � Length Width Hei ht Windows and Doors—Gackage and Area No. W�dth Height No. of Lineel ft. Area ot pane of pene Li hb of crsck sq. ft. --- --- Rv Coef. Btu Infiltration G lass Exp. wall Net exp. wall Int. wall Ceiling F loor Total Btu. - FI.� Room � Length Width Hei ht Windows and Doors—Crackage and Area No Width Height No. of Lirreal h, Area of pane of pane Li hu of crack aq. ft. Coef. Btu I nf i Itration G lass Exp. wall Net exp. wall Int. wall Ceiling Floor , Total Btu. FI.� Room � Length Width Height Windows and Doors—Crackage and Area No Width Height No. ot Lineal ft. A�ea 01 pane of pane L�ghts of crack tq. ft. Coef. Btu I nf i Itrat ion G lass Exp. wall Net exp. wall -- Int. wall -- Ceilir� F loor Total Btu. ��.. � �� � � ��= �� f r * ��."�:.�, � � ;.� �� � ,; � . � • � 1 � � � r' � L: � , �� � • i. x ' `� � "� � � a � `' a , • .. , � p -- � � � W �]', ': L �'c�: ?� G �,q G) • � .y q $ � �;'�; � • c, �y� • o � � � � M + ' � � � a 0 'wt�''. 7 '�'7 n t.t , -i .'. C. i;u �� .. w� � tA ;� Y: 'a c:. 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Yes () No () The venting system is plastiGPVC and meets all current codes and manufacturer speciflcations including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the cuRent cades and manufacturer's spec�cations. When required to instrall a new combustion air, it will be sized and installed to meet the current code� and mfinufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) VVher� i��allitua a� ventin� sv�em, th� undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. No ( ) Yes ( ) No ( ) Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Appliance #2 Type BTU Input Appliance #3 Type BTU Input Total Appliances Tdal Btu Input Common Vent Type Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter,�in Type Appliance #3 Vent Connector Height ft Length ft Diameter . ::in Type ALTERATIONS:1Describe) HEATING CO: Signed By: Date : Building Inspections 763-572-3604 DATE � SIT'E ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WTI'H APPLICATION PERNIIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATI4N CIT�.' OF FRIDLEY YOUR ❑ � NAME: � ADDRESS: PHONE: CoMPANY CONTACT: 410 Permit No.�`C°v� z"� " Received By: ! Date Rec'd: �� `� � ?. STATELICENSE# � - MINN�$��, I�N 55408 2- 24- STA1'E ZIP ADDRESS: PHONE '�SINGLE FAMII.Y ❑ TWO FAMILY ❑ NEW �EPLACEMENT DETAILED DESCRIPTION OF WORK FAX ❑ TOWNHOUSE ❑ ALTERATION/REMODEL PER MS 16B.665 the permit fee is a mi�imum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the unprovement, installa#ion or replacement of a residential fixture, excluding the fixtures. ('Ihis should reflect only the cflst of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 ° cost of labor x.05 = FOR PROJECTS WHERE I.ABOR EXCEEDS $5 , FEES ARE BASED ON $10.00 PER FDCP[JRE, EXCEPT NOTED. FDCf[]RESc (IIdDICATE TOTAL rrutv�Ex oF Eac� an.ov,� � 1� srz��ru �� O� x Equipment Installed . MFG: __ �`�� MODEL: �� 7 MFG: MODEL: SIZFJBTU MFG: MODEL: SIZFJBTU AJC $25.00 FIREPLACE (G14S) $15.00 GAS RANGE/OYEN $10.00 AIIt TO AIR EXCHANGEER $15 FIREPLACE (9J�D) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 �FURNACE $35.00 GAS UNIT HTR $10.� CHWWEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.W DUCT WORK $10.00 GAS PIPING $10.�0 VENTII..ATOR 515.00 ., ,�. � �. ..... _.. _ _. Pernut 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$25.40 =$ Number of fixtures @ $35.00 � x $35.00 = $� State Surcharge = $ 50 Tota1= $�� TI�S IS AN APPLICATION FOR A PERNIIT NOT VALID UNTIL PROCESSID I hereby apply for a building permit and I aclmowledge 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 � understand this is not a permit but only an ap lication for d work is not to start without a permit; that the work will he in accordance with the approved plan um the of w'c r' s review and approval of 31QNATLJFLE OF APPLI �� a ATE City of Fridley Building Inspections Department 6431 �Tniversity Avenue NE, Fridley,. MN 55432 . 763-572 3604 FAX: 763-502-4977 REQUIRED tNFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICAT(ON HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED F�R NEW/EXIS1fING HQM�S .:;. _ : .. , . :,:� . �'a-t�i' . 1. Combustion Air (See note belo�vv-j� �'� . a. Oil ar solid fuel IMC Chapter 7 with MN Amend.ments b. Natural Gas or PropanellFGC Chapter 3 with MN Amendments 2. Make-up A.ir (See note below) a. IIvIC Chapter 5 with MN Amendments 3. Ven.ting a. Gas appliances IFGC Chapter S with MN Amendments b. Fuel oth.er 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: P�r Ml� F�e�gy Code 7670 or 7672 6. Duct Design Per lMC 1346.0603.2 � -� a. ACCA Manua1 D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combusiion and make up air calcula.tions