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AF - 468314 � _T _ ;.��+ � �1 � City of Fridley, Mirm.. .,., BUILDING PERMIT No s�o2 �� ��/�� Date: _L.:._ '� � Owaer: ' Buflder Adar�as � . ,[�� LOCATION BUILDING No. .��� ��--.`�- Stceet _�,�' ...�_ ..��. P f t ��- Bl� =--d Addition or Sub-Divfsian -�� s ��� �- Inside Lot �� Setback __�:� z Sideyard -- d�� � �� II�'8�� — ...... Foundation IIevation DESCRIPTION OF BUILDING T Used • � Front _��� Depth � Height ,�.�� Sq. FL ,�Cl��Cu. FtvS���� � -- Fro t.�� Depth H'eight ��C �� Sq. Ft ��� Cu. Ft �,��� Type of etion��$��� Est Cost _�""R o�e Completed In consideratYon of the isauance to me of a permit to construct the building d�scril� ab�ve, I agree to do the ProPosed work in accordance with the descntpt3on above set forth and in comp ce wIth all proviafons of �dinanc�s oP the dty of Fxidley, f Ia consfderation of the Pa3►mex►t of a fee of $���° ,�t fs herebY graated to to conatruct the building or addition as described above. Thiaperm� t fs granted upon the express condition that the person to whom it ia greated and his agente, employees anc� worl�en, in all work 8one iq around and ugon safd building, or anY part thereo� shall cunforin in all respects to the ordinanc� of FridleY, Minnesota �g lacat3on, consstructi�on, alteration, maintenance, r+epair and mov]ng of bufldings ordin�an�c�es. dtY ]imYts� an�this Permit m�y be revoked at aqy time upon violation of any of the P�vlsiona of said n Nonc� 'IWS Wemh doaa aw eorsr ths censtru�toe, Ies�alldioe fo� wirieg, piumbie8, ea 6aHng, rswu or wa�sr. B� suro to iss ����d�n8 les�er for aparal� pamhs for fhea Uemt. °%�� s � �� ,,�.5 I �� - � _ � r � � � ' 1 � Land Plonnin9 L�rdSurve�y�i� . So;�s Testiny Cfvi/ b Mun'rcipnl En9ineeriny 6�8TS-Ni9hnvr� �c5 uF. Mi�meo�/is 2/, EN G I NEE R I N G� I N C. 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I ��. 5 ' noo. a owuHS � w urc►� � 6ASINS , /lUlO � '� WAS�t�A � GhS .y � :< c�t � a�HCC m « c�s Op[NINGS v e z e N y i � � � y � � b . aaY � :i � �a� ° � � � � � ���a � m � � N O A � � •• F�-� N ���� � � � w o A H � � Lti 1:1 : � � � L+ � n- � �MO � � y �K`� o b �• a m � CP'�V � �� � m $ °i � o � � p, n � 1 �' ry '� Cp » ry CL h � A d � � � � � A � . �.�7� ap ~ Y�p � u ry M ���� r�•Qo �aK m "�� � � Z � �• � � �, N O � °�� � � 4� � � � � A � C I � � w � � 1 � . �� � � � 'n ` � �o � � � � � v�'i I O i9) f.-J' .., � � � a � � �r �. � � r 0 °� i (� � � � O w � � �' t� H � o � � . � O � ' C� fi �i cD I ci' � �,.,� � City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# t�- �� Residential Applic�ation City of Fridley See Back Side For Required Information Date 11 1� 0 5 Site Address: -��o Zrotn'�or �s�- �1 �, The applicant is: (cirlce one) Owner ontracto Property Owner: C, � ; Address: S,o,�rn�c.� City: State: Zip: Phone: �1�03 — S�S-9 S� 4� Cell: Fax: Contractor Information Company Name: River City Sheet nAetel, Ina Contact Person: --- 82�Q MSi11_ t .� �.hs�s ��nn Address: FrldleV, MN 55432. C�� �---� �1 3i�5'4-�8 �p' �a� � �5 A8 Phone: ell� Fax: Email: MN Bond# & Exp Date Type of Work (circle one): New Re I c AlteratioNRemodel Detailed Description of work: �$�o,.QR� ��,. �a c� m� n� �.►� rac.e. Equipment Installed: MFG: '��w,..� Model:l�pKonFt�me�Size/BTU: '7S doo MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 A/C $25.00 Fireplace (wood) $35.00 Gas Unit HTR $10.00 Air to Air exchanger $15.00 �C Fumace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 Chimney Liner $10.00 _Gas Piping $10:00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ 35�- da (Total from above-Minimum fee $35.00) Surcharge � 0.50 Total Due $ 3 S. S v Make check payable to City of Fridley � n�s �s an appucaiion ror a perm�t- not vaua unin processea I hereby apply for a mechanical permit and I acknowledge that the informa�on above is complete and accurata; that the work will be in conformance with the ordinances and codas 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 case of all work which requires review and approval of plans. Signature of Applicant: � Date: �� ll Q S 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 APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES .o 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendmen.ts b. Natural Gas or Propane!lFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendm ents 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with N1N Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new constru.ction IMC 1346.0312 5. V entilation a. Per MN Energy Code 7670 or 7672 — 6. Dact ]�e�g� Per �I� 1�.0603.2 --- - --- __ _ a. ACCA Manua1 D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations e Building Inspections 763-572-3604 763-502-4977, 0 From: City of Fridley To: 6124362300 Page: 4/6 Date: 5/5l2009 2:57:35 PM MECHANICAL Permit No.:� RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY D���'�� tHr•�.cTiv�2-�9-09 llAT�, O�/ (SJ�'� / �—� S1T�. AllUR�;S5 �� (� � --�a— THIS APPUC:ANT IS: ❑ O PROPERTY NAM�.: OWNER/ TE1�IANT AUllR�:SS:_ PHONE: CONTRACTOR SUBMIT A COAY OF YOUR STATE LICENSE W[TH APPLICATION P�RMI'1' TYPE TYPE OF WORK: R E-MAIL A COMPANY NA$M ': CONTACT P�,kSC�N: � �/� �p)C�T �A��TREE7' —g�v�re STAT� LIC�,NS�, t� (��NNEAPOLIS, MN 55408-Z9OQXP DAT�, ADUR�;SS: 6�2-824-2656 C�Ty STAT�. 'L1P PHONE FAMILY ❑ TVa'O FAMILY ❑ N�W ��PLACtM�NT DETAILED DESCRIPTION OF WORK r•�;�;s A�t�; sAS�u ov $io.00 rr;H rixruK�;, �quipment lnstalled MNG: �C $25.00 AIRTO Allt EXCHANG�,E12 $IS BO1L�.R $35.00 _CHIMNEY L1NER$IO.QO _DUCT WORK $10.00 MNG: NAX ❑ TOWNHOUS�: ❑ AL7'�12AT10N/R�MOU�L r-ixruK�,s: �ljoy�A-�o�ra►L vuns�:K �� TUH � ow MOD�L: �— {Q MOD�L: MNG: MOD�.L: NIREPLACE (GAS} $ J5.00 FIREPLACE (WOOD) $35.00 NURNACE $35.00 GAS DRY�,R $10.00 GAS PIPING �10.00 Sl"G�/BTU SI'L�,/BTU GAS RANG6/OVEN $]0.00 NEW GAS GR1LL $10.00 _GAS UN1T HTR $]0.00 POOL HtAT�R $35.00 VENTILAT012 $15.OQ TH1S 1S AN AAPLICATION NOR A PEIiMIT-NOT VALIU UNT1L PROCESSED � I hcrcby apply for a building permit and I acknowlcdgc that thc information abovc is complctc and accuratc; that thc work will bc in conformancc with thc ordinanccs and codcs o City of Fridlcy and with thc Minncsota Construction Cod�; that I undcrstand thiti is not a permit but only app ' i for a it a d work is not to start without a permit; that thc work will bc in accor cc with thc approvcd plan in th c of which ui s rcvicw and appraval of pl SIGNATUR� OH APPL AN -' "" �-' I I�1NT NAMt T� � LJr .,:..:..:u.::.y.::._._ .:.:.:..:...:::, _. ,,._, .. . — / City of Fridley �uilding Inspections Department b431 University Avenue NE, Fridley, MN 55432 ?b3-S72-3bQ4 FAX: 763-SQ2-4977