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FL�R o��� CATpi BASINS Auro �I/I�SHER G0.S nav� RANGE GAS OPENINGS � • 2 • � � � A � � n �, � � � � ��� ��� ���� � � H O N P � � � O � � ��°� �' a � `� � �'° ° � � m b � � b � � � � � � m p � m o � p' o p ty. fD � M F �. � W N � � � � a�`° a��� , � `� � '°, :���� ��� ��o , � �' � � m n M + m C• � 0 � � G �' d �C� w W � a0 Rx & �°n p � M � M D� � m � � � � �; �i � � � - � � � � ., T' d a °_- ro � � r � �. m � �. O � � � a �A � V O i~1 �1 City of Fridley, Minn. BUILDING PERMIT ��� ��� NA 7zs� �: _ � - � - .-� J� �. � , • ,..-¢�awr � -, �;��. ,.� / X . 4% �� : s . �^.����_� /L_.,_;� No. �/��, LOCATI F I ING � st�t Part of Lot Lot _ Block Addition or Sub-Divleio$ � � Corner Lot — 7naide Lot _..,�� Setback ���t�..--._ Sideyard Sewer IIevat4on � _ Foundation IIevation Type of DESCRIPTION OF BUILDING Fraat �� Depth Height �� �1. � �� Fro DEpth IT� t 89. Ft Cu. Ft �, �_�� �/ ��TO be Completed in consideration oP the issuance to me of a permit to constnict the bwllding descrit�d above I agr+ee to do the P�P� work in acc�rdance with the description above set f and complia=ce with proviaio of ordinances of the dty oE Frldley. � � _ f l ,..�.�'vf...j In consideratton of the payment of a fee of $� , permit fa hereby granted to to construct the buflding or addition as d�cribed above. This germit is granted uPon the expre� con�iition that thepe�on to whom it ia granted and his agents, emPloyees and worl�en, fn all work done fn, around and upon said building, or anypart thereof, shall c�nform in all resPecta to the orclfnancea of Fri�IIey, Mi�oaesota regarciing location, conatruct3on, alteration, maiatenance, repeir and moviug of bufldings wittiin the dty limits and this permit may be revoked at any time uponj� lai3o of aay of the P��� of said ordinancea /1 �/ /� Bu9lding Inepector ^ NOTIC� 7hb ptemM does not cowi t6s com�ruetlee, Iestallattoe /er rrieiee, phimbtee, ea hades, awu et waba B� atrs to aM tha Bnilding le�e ior a�p�raf� p�rmils fer thas k�ns. �, d � , ._:� . , . - .. � ., � . OWNER'S NAME >I AIIDRESS �� � ��'�'� APPLICATION FOR BUILDING PE�.A�T Ct�.'Y OF FRIDLEY, MINNESOTA ADDRESS 'LdC�ATION OF BUZLDING / No� �`� o Street � part of Lot Lot Block A+d�i.tion' or 5ubdivisfon� Corner Lot Inside Lot l�,Setbac�C ' S3de Yard . SEWLR ELEVATION �OU1�DA�.'ION ELEVATION Applicant attach to thi.§ form�Two C�rtificatee of Survey of Lot and proposed bLi1d-. ing locatioY► drawn oa these Certif�cates. DE�CttLPT'�CON OF $tiILD�PTG To be used as; � Ce� �7 Front O` � ��?�=h � � Height /�1 Sq. Ft . �'"��` c�-1� Cu . Ft . �� e�- �� Front Depth Height Sq. Ft. Cu. Ft. Type of Construct�on Estimated Cost __ _ To be Completed _ The undersigned hereby.makes application for a peranit for the work herein apecified, agreeing to do all work in strict accordaaca with the City of Fridley Ordinances and rulings of the Department of Buildings, and herebq declares that a11 the facts �nd repreaentationa stated in this applicatian are true and correct. DATE l/��� ��� � g �,{Schedule of Fee Gosts caa be found on Che Reverse Side). �a.- � P., dt i � _ � -� -- � � a BUII�DING PT::Rt+::T � SC:�EDULE Section 2. The Inspector of Buildin�s shall, before isaui�g aaq pe�nit for the erectioa of any building or etructt�re, or for any addition to aay e�iot- ing building or strucCure, or for any alterations or repeir� to any existd.ng bu�tlding or structure, upon agplication therefor, require the p�y�ent tay the applicant for such p�rmit of fees to the amount herein:below set fortlz ar.d ia the manner her_eia•provided.to-wit: 2.1. For any such permit for �he erecti.on o,f any f�.�e-proof buildin.g, o9:tier than a garagei warehouse, factory or gtatn elevatar� or�for the erectio�a of aaq fire-psoof addition. for similar occupancy, to any euisting building shall be at the rate of $1.4Q for each oae thousand cubic feet, or fract��+a thereof, in such cubical caatenta. � �- 2.2. For °any sueh perm�.t #or the erectioa of any fire-�S�oof �arage, warehause,.. factory or grain elevator� or for the grecCioa of aay ffre-proot edditiou, for simila� occupancy,--Eo any existing buildiag sha11 be�`at the rate of $T.25 for each one thou$and cubic feet, classified as °1firegroof" bq Section SC2 of the Mi.aneapolis Building Code. - flOUSES 2.3. Fo'r any suc5 permit for tbe erection of any noa-fireproof buildir..� o4:res than a garage, warohouse, factorq or graia elevator, or aaq noa-firegrcc�f. addition, for similar occupanay, to eay eacietiag building - permit $�,�0 �or each one thousand cubic feet. C_ S 2= For any such permit for the erer_r �n� �; a;:;� �.��o��LQ�;���� gasa�;e, warehouse, factory or graia elevator, ��� �} �• �,��i1 ,r-F.:,r�er� a;� 2uy non�t�r. �ro�of additioa, .€or�-s.imil,ar occupancy, to r=�°y ��:::��r��lr.�, i�:�:.�4��; or for each aLCh ., _ �build�ng or- additi`on - aiaety cP*a�:;, �'���;;,��.?; ;�^.� �;,,;.;a oe�e thoc�saad cubi� feet or fracCion thereof, in the cu���G � r;•�,.� ::.r. �. rt1e�P�s• with a minimum of $4.0�.- For the purpoae of comput�tag fees f�,r '_l�' �,�ing permi�s, the cubical conteats -- of any building or addition to a unifcx�a ��e�' �iit tliro�ghout by mu1t3p1y�ng the . ground area covered fram a point ais (6) iac��s be?.:Jw the floor�line oi.i:he. basement or cellar to the average height of t��� cag:Y•er gurface or to the averege heighC of the roof surface of the main �ab1e of a pitched roof. 2= I�or repa3rs or alteratioas to ea exis�ing structure, the fee shall be at the rate of $3.00 per each F3ve Huadred Dallara ($500.00) o� fr�action thereof in the cost of all proposed work. 2•6. In no case sha11 the �fee. charged ,.for:.any perm,{t .a� eet forfh �in .Section 2 be lesa.thaa $/+�pp� � . „e . � � -- �: ,�_ _ ._„ •> _ ^ __ _ - � - : - � . �iL�rr 2�, 't'9�1 � - _ �:::; . � _ _ �x I� . 8obe�lt ��► ��: �. "" _ !'�1d1 ����� a � _ . ; 4Y• . J .; �I��.. - _- _ _ ,: i�ts ��� �� �►. ��e±d,� ' � _ , �'e .�' _ _ . . �. � .. ,, � . _. � .�: _ .- � _ M�. H. g. 8�mt�'�._ �--. . - . . _- � _ . ; �, - �_ _. , � . C�� �'�.� �d b�,� � �� �� ��i �. _- . � � � ..� � `� ��,►. ��� � �� .��! ' �`��- ' � � , � -��� _ _ ; .. ,_ ._ _ �,� o���. �.; �: . . - _ .- � �d �"u �p�#_-st� �� s� �ldl.�-�.? '�����,��:�!� � * - ., s�r�r �cw�.' ��t���n� • " _ - _ - �, � ; _ , � �� . . � ��'°� �ia►� �r.'�==o��#�� af � �3�� �� ��° ' � � �ti�or� . � _ � .: ��:- .. . _ . _.- . � _ . _ ._s , � _ - . , _ ` `�.�` �i�� � � _ r--� ` ' _ Y`�I��� - . _ . �; :� C�f�b .LL - , `_ i - _t ,< . _ . '�:. - ;. _ . . :�_ � . . ._ . _. _ ,�..� _ - . _ . h .. . � _ . y �-�,,. .� ..� - ,_ - , .s L : sue�ecT PERM IT City of Fridley 13688 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T , r S � R IPT N � `L _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. �1��%�, 1 . � r� L� , � r"�1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""� � ,�� 612-560-3450 910-F15 8/9/76 � � JOB ADDRESS 420 Hugo Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7-g p, Ri.nerview Heights SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Tony Emnnerich 2579 South Coon Creek Drive, Anoka 757-1480 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. $ama 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO. 6 USE OF BUILDING RL'S1C1P.I1'tldl. 7 CLASS OF WORK 0 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 8' x 8' Porch 9 CHANGE OF USE FROM TO STIPULATIONS ���ERATE PERMITS REQ���� ��� �(��.�.�, HEATINC► RIU�iB�NQ ANO SIGHS� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICA�, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TAi00C1 Fl"3�C.' THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING Sa. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ], ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $]„�OQO y4`.5O WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- y�%�SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � PLAN CHECK FEE TOTAL FEE �.\ $`8. �� � SIG� REOFCONTRACTOR f;AU ORIZEDAGEN7 IDATEI�e, WHEN P PERLY VALIDATED THIS IS YOUR PERMIT s- � - O v I c�,v� � -� - ��o ' ,. �SIGN T REOFOWNERQF ERBUI D R IDATEI BLDG INSP DATE CITY OF F�RIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT .� �- OWNER' S NAME :� Q,LfG� L� �t �I�c2 fC /y BUILD�R : S/�2-�: _ ADDRESS : d S7� S�a�� ����✓ CrP-� ADDRESS : sh��t �r . .��� v � �4.v'.� f� �- N0 : . �2 � S TREET • ,I��'� � � LOT: %— � BLOCK: ,� ADDITION: /�,4i,o Y�.er���cl ��/'Q1�i�c' CORNER LOT: INSIDE LOT:�_SETBACK: SIDEYARD; Applicant attach to this form Two Certificates of SurveY of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be,ilsed As: �C"�=�� . � e e Frontt � Depth: � Height: S Square Feet :�� Cub ic Feet : �r � Z� Front�: Depth: � Height: Square Feet; Cubic Feet: Type of Construction: �i�,��[� Estimated Cost: $ l o�`�` �� To Be Completed: ��� / /9 ��' The undersigned hereby makes applicatinn for a permit for the work herein specified, agreeing to do all work in stxict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated ir� this application are true and correct. � DATE : '`�% SIGNAT[TRE • ' • (See Reverse Side For Additional Informatian.) /��`� - � 7'�0 � � �� � �� � � �. �. �� . � � � t. 13UILllING 1'I.iRMI7' I;L'1: SClil:l)ULli SECTION 2. The Inspector of I3uildings shall, bPfore issuing permits for the erection of any building or struc�ure, or for any addition to any exisCing buildi:ng or structure, or for any alteration or repairs to any existing buil:ding or structure, upon application ttierefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit; NEW CONSTRUC�IOI�: S.i.ng],a Family Homes and Garages: $�},00/1000 cubic feet PLAN CHECK: 25 percent of building permit fee. ADDITIO�IAL INFORI�IATI�ON For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered �rom a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average..- height of the roof surface of the ma.in gable of a pitched roof. For repairs or alterations to an existing struczuxe, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. I�n no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50. � V�RIFICATION OF FOUNDATION , NOTE: Permits for eonstruction will be issued a minimum of 24 hours from the time of application, to a11ow for proper revieca of the proposed structure and of the constxuction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the iraming. CERTIPIC�1'E OF OCCUPANCY Application fox a Certificate of Occupancy shall be ma.d� ten (10) days priox to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. • ,� y� _ � ` �ao T'iNG.. ) ��q�, „�� � � I�SP�.Ana.o!� � a���� _,- __ 1 "_.� _. . �j' . . . � __ -__ __1 __ ---- — - � _ - � , __.__ ___� �_____� � _ _.y� . � ,�` � . �r� .: � � � � �� D��'nn�''r� �8-l�Ji 2 L � , -- �:flF�� °�"�•_ --- _ - A, , __._ _ ,I � � i .` i , i� ;>�, �.. � : ;�,� , � - -- � . � - � - � � �. � � . � �.�� �,, �. �U� : sJ � - -- c � rr'i�'��" - -------- -- ------ ----------------- --- --- -- - ----_-, � -- - — - - i � �[ _. -_.,e� T - --�r=- - .� _ �o •�.=� �:��: � . i _ ��_-� _ � - �.. ._ .,.,,; - _ � - - - , cto5�7+ � __-- -- °.3y'- � i � � i -- --� - � - G' a ,,7 ,.J - - L 6 Ll� - -- -- L — �� � ��lz o� � �-" � - -- --- - - - - -- -- - _ _ - - - - — - ----- __ ---- ---- - - - — -- � ---- ------`��� �Ci� �.o_ Ao(cl _ � �,V �' � =� �' r'��� --- -------��- ��� ��--- - � . ---------- ' � - ;�X 'rJ' �/cc�1 Jo. 5 � -- - � �._ vG G . - - _ - -----��U=v. ��/v( tL� � e� r C y , __'�_ _ _ _ __--- � / -�----------��_ L�'Y s�.h �'����z _ - - ��-_!��o ------------�- �-- - - - --- ------- -- -- --- _-.__ �`- _: __vZ x � Stvds %b ��- -----'�6 0_�-------- - – � - -- � �- -- -- — . _- - -- --- --� S��3Z �t3� 1`t2r �� � . � --- - --- � � � ----- -- - -- ! --- -�----=,-=-�=� _ _----- -`----- - � ' y 5 �- P- - --- -- - _ _/ �� -_ _--- ' —_- --� 2a' GZr/,N' '�o� �_ �' C,_ , '� % - ,— `" � X � 1i�,o fr�,Z 5 __- - - - ��`° � ------- -- .--- -_ _ � ��dG _- - , - -�_-- -- - �=1 - ,`` - y ��oc� ��� � � 0 3�/� � �� --- �— - - � . , ��.�.z.�r�: _ �'".^ Ce �,��� ���, F_X �-e1� ��d s� o� ,J� � l I%� < �� � - ,, g 91 , -- -- lZ �L � yC' c� g � �. �,.� ��r ro �jr�aGe s I , �`_- � " / �� .-- 3!� gi} 1T /N s t/L � Ti a� / N "• . . �A-�Ls ` r ���A-1 L �__.-___:=-� � P � � 6 . • ,� . �+�a �u �. �i�- ,�a��" .� r�, �iA. . - , I H , � � I �� i � O M � � ', , y N�i yy N' t� � M �i �' G � 0 �F,o, Gy'1 'O m �f :�j �n S• r tn M " = � n, " "1 `/.• G W►�• W N /-� rt+' N Pr P i:� [. 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(� cri +�t a o W n m � '+ " j r� o r . . ? o r h O p n I� n ►.' 7 .s , " 0 r► e � � rt r o e G _ s n n � r r r+ v n n �p � �* K J� a -� O -i � � m m D 70 � �m � o � -o � � ° m �. < � _' � (D D � 0 o m � 0 A � � N c p t� m m o w o � ? m D c � � a � - D � � Z � n � �° � D � r � m a � O Z � c» �s -,. in � o -r � m vi ��`� c w m p c�u Q m ��c m m m�� � f� � -a .n o �o � � -. v �- � O .� m ,� °i = _ --� � O . -a g �D cQ � � co � � � � -a � c * m �'. ?'. wy m �'. � � � � � � m m � � m �F � � 7 z � N N tQ (n m � � � cQ n. � Z � w m � m � � '� t/l - > TI � * � � . � � � � .n ° � c � m m a � m � I � I I� 4 I I I I I I I I r� �, �,�,�,�s�,��,fn�,�,cfl Ut O O O v O v;J �1 ;�I (7� A V 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � � � � � C Z a � c � z � c m` o W x 3 � � � m � � � u� m p �, m � o � � v� O D � � _ .� � � 0 � � s ► � 0 � ., m TI 7 � v � � -� m r Z O �(1 �h 0 \ � N 3 m. � a n 0 N � W � 0 0 m � � -i Z O � °� � �J - � c ,Q � � c N m a D � O � � m � � � � � \ � � � V � r c � m z � � X � c � m � m � z O � � m � O � L Q � D O 0 � m � � Building Inspections 763-572-3604 DATE �OV STTE ADDRFSS _ THIS APPLICAId'f IS: From: Ciry of Fridiey To: 6517760456 G �- Page: ?J3 Date: 11/13/200710:59:45 AM �UILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY E-MA1L ADDRESS '.�� ❑ OWNER �ONTRACTOR Permit No.� ' .� `��C Received By: Date Rec'd: 1 � �_ � � PROPERTY OWNER/ I NpME: GG�.��tf�to► TENANT �DxESS: �I'�-� �� 5� f�� ci�t �r�-►�Z�'Y sTA CONTRACTOR SUBMIT A COPY OF YOUR STATE LICEN5E WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: PHONE: NAME: �'�� �5+� vrar9vv.� 6g STATE LICENSE # 2'd � Z� FJ �/ EXP DATE � � J ADDRESS: ��' � CieiaA/T]�i'� %a �- CITY l�7TGEL��D4 STATE ZIP � I/9� PHONE ❑ SINGLE FAIvIILY/NE ❑ TWO FAMILY/NEW ❑ ADDTfION ❑ gASEMENT FINISH ❑ DECK I DESCRIBE WORK BE]NG DONE: � SIZE OF IIvIPROVEMENT ROOFING � �C � NUIVIBER OF SQUARES �l GARAGES PROPOSID SIZE: PROPOSID HEIGHT: SIDING ❑ Virryl ❑ Alumim�m ❑ Other FAX •„� i�y ■ �� • � � ■ n � ■ • i�� ■ � rru ��• ■ � ��YY�� � ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ A'�fACI�D GARAGE ❑ DEf ACF�D GARAGE HEIGHT Ft gpSEMEiNT REMODELING SUBMIT: 1. Exisdng Floor Plan 2. Proposed floor plan 3. List of shuch�ial members to be used c FORNEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS & PORCE�S SUBMTf : ❑ Trim 1. Site Plan/Survey showing the existing struchires c ❑ Fascia and proposed projed. 2. liao sets of coasW ction plans C lculadons �D�� 3. Energy a IN EXISTING OPENINGS QYes �To LOCATION OF WINDOWS ORFORNEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES 8c TYPE OF WINDOW TO BE INSTALLED NUMBER OF WIl�IDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATE1tIALS: �Iv � �d-� (, (USING THE 1997 U.B.0 FEE SCHEDULE) � TnTaT, JoB VALUATION $ 7� � o o �CCUPANCY TYPE Permit Fea Plan Raview Fira Surcharge Surcharga Licensa Stuchazge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Mam Charge Total Due $ �%o �� $ $ �,�Z— � � , 'S $ � $ Sea Back Page for Fee Schedule 65% of Building Permit Fea .001 times the total job valuation .0005 x Permit Valua.tion Minimum $.50 $5.00 (State Licensed Residential Contra.ctors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21 =$ $450 Conservation Plan Raview Fea Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to• City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a build'mg permit and I acknovaladge that tha information above is complete and accurate; that the work will ba in conformance with the ordinances and codes of the City of Fridley and with the Mivnesota Consiruction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a pemut; that the work will ba in accordance with the approvad plan in the case of all work w h requires re iew and approval of plans. SIGNATURE OF APPLICANT ��/t..- PRINf NAME �r`1 �y �t l�+t vrru>'-ej DATE �� /�� �� City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 } � 64�1 University Ave NE Fridley MN 55432 Mechanical Permit���`U�R67 Residential Application Dati The Ciiy of Fridley See Back Side For Required Information o$ Site Address: ` � is: Property Owner: Address: 'L0 City:� Phone: 763- Z fce one) Owner TZWL`• CG��D /r>v �(u�o St State - e/ so S Cell: Contractor Information Company Name:� Contact Person:_�e _D �pe of Work (circle one): Detailed Description of work: Equipment Installed: MFG:�, MFG: MFG: Please check all that apply: A/C $25.00 ,_Air to Air exchanger $15.00 Boiler $35.00 _Chimney Liner $10.00 Duct Work $10.00 S3- tr�ta�r Zip: F cva�D,��,�' N� State: /�'l� Zip: .SSYz� Cell: Fax: 76.3 - S36 -OZZ(o MN Bond# 8� Exp Date New n/D AlteratioNRemodel s� a�� Model: Size/BTU: Model: Size/BTU: Fireplace (gas) $15.00 New Gas Grill $10.00 Fireplace (wood) $35.00 Gas Unit HTR $10.00 ,�C Fumace $35.00 _Pool Heater $35.00 � Gas Dryer $10.00 Ventilator $15.00 Gas Piping $10.00 �L Gas Ranae/Oven $10.00 `����J��� Permit Fee $ �D �° �,]�nriinimum fee $15 or 5% of cost of improvement Surcharge � P�, 0.50 whichever is greater + surcharge Total Due $ 4f�� �� Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanlcal permit and I acknowledge that tha informatlon above is complete and accurate; that the work will be in conformance witfi the ordinances and codes of the City of Fridley and with the Minnesota Construttion Codes; that I understand this is not a permlt but only an application for a permit and work is not to start without a perml� that the work will be in accordance wlth the approved plan in casa of all work whlch requires review and approval of plans. Signature of Applicant: i�,P�'Y sl� �� Date: � Z� O 8' Approval Inspector Signature: Date: � Please Note: Separate permits are required for Building, Plumbing, and Electrical work - � Revised 6/14/2005 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT � ' RESIDENTIAL PERMIT APPLlCATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOF� NEW/EXISTIWG HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Cha�ter 7 with MI'd Amendments b. Naivral Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with N!N Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 wifh MN Amendments REQUfRED FOR NEW HOMES 4. Heat loss & cooling load. per room a. Required on new construction 1MC 1346.0312 5. Ventilation a. Per MN En.ergy Code 7670 or 7672 6. Duct Design Per 1MC 1345.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations . _ � Date: 06/25/2008 Revision Date: 06/25/2008 Site Information Address 1: 420 Hugo St Address 2: City: Fridley County: Anoka A�plication Information Business Name: Marsh Heating and Air Conditioning Contact Person: Kelly Marsh Office Ph: 763-536-0667 Fax: 763-536-0226 Address 1: 6248 Lakeland Ave no Existing Construction: Pre 1994. Project #: Lot: Block: Subdivision: MN Contractor License #: Cell Ph: City: Brooklyn Park State: MN Zip Code: 55428 Minimum Mechanical Code Requirements Met Will you be replacing or adding a water heater, furnace, or boiler? Will you be installing a decorative solid-fuel appliance? Will you be installing an exhaust fan 300 CFM or greater? You have met the minimum requirements for make-up air and combustion air as required by the international mechanical code, as adopted by the state of Minnesota with amendments. Applicant Name (print): C� � f� � A-�sN Code Official (print): NO NO NO Signature/Date: i�`� Co ���� 8 Signature/Date: � 2004 CenterPoint Energy Minnegasco. 2004 Mechanical Code Guidelines. Page 1