AF - 47978sue�ecr PE .
City of Fridley 20084
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
' ' RE
� � •
� • COMMUNITY DEVELOPMENT DIV.
� �L � PROTECTIVE INSPECTION SEC. � 1,`_ °1 0�
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.--_� �/"',,j CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
� 612-571-3450 910-Ft5 8/25/89 / /
JOB ADDRESS 1660 Kristin COU];t LQ.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. S 1 Heather Oa.ks SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Brian Jacenko
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Bxickner Builders 6240 Highway #65 N.E., Fridley, NIlV 55432 574-9871
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
�
8 DESCRIBE WORK
Construct a 38� x 28� �elling and a 32' x 3Q' Garage and a 12' x 12' Porch
9 CHAN(iE pF USE FROM TO
STIPULATIONS
See nota,tians on plan, �x'ovide a haxd surface driveway. Provide sod in
the �ront and �.i.de yards, �xavide Ci.ty witT�.. copy of verifying survey before
capping. Paid �ark Fee of $1,5QQ,OQ� Paid S�torm Sewer of $800e00
MINIMUL� FOOTING ELEVATION o� LOWER LEVEL; 961.60
SEwER LOCATION: 27` �rom Hydxant; 23r from Manhole
WATER LOCATION: 10` West of Sewer
�
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATIN(3, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCV �OAD
VENTILATING OR AIR CONDITIOfJING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ]. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED 142 45.0 $71.23
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $ I
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THF pERMiT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TH ANCE OF CONSTRUCTION $%9OROO $575.00
PLAN CHECK FEE TOTAL FEE
� p� $1,436.23 + PF & SS
SIGNAT OFCON T RORAUTHOR12EDAGENT iDn7 WHEN PqOPERLY V IDATED THIS IS YOUR PERMIT
s �
SiGNATURE OF OWNERIIP OWNER BUILDERi IDATEI BLDG �NSP ���
�AT
�+1
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�LTII2 � �
�1 AI�ID 1�2
Building Pezmit Applicatiaa�
Effective 5/1/88
O�nstr�ction Address: /� � d . ��/Z/ .S T� N �� 1� �'L �'
Iegal �escripti�: �� �' S� � L �' / /���Q �',� � �. � o� ,� �
Owner Name & Addres.s: _ �,� A.aQ;✓ � � � �� %q� �el. �
oaritractor: _ /� s,� A � '�
l�+�s: G z !1 ���. � ,
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Te1. � � � �� � � r�''�
Attacii to thi.s applicatia�n, a Oertificate of S�uvey of the
la�t, with the prq�ased caa�stnict3aa�► drawn on it to scale.
�C�I�T � II�'l�H�TI'
L1VII�G ARF�,: Ie�th Width Heic�t Sq. F't.
� AREA: Ie.ngtti _ Width Height Sq. Ft.
DDCR ARE�i: Iez�gth Width Hgt/Gro�uryd Sq. Ft.
O�:
Cbrner L�t [] Inside Iat [�j Ft. Yd Setback ��. Side Yard Setbacics /� �- �
Zj+pe of Construc.�tion: � G� � �,,,,�(A7• '�,�C�7:!! � Estimated Dost: $ A P
Approx. Caa�tpletian Date: /S - / .S� ' ,� �_ Z1���
Pro�osed Driveway Width If New Openir�y I Desired: Ft. $ $
W' + 6' See Back Page
DATE: � �' / ' � � APPLICANr: � • # -�� �° g��
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S'I'IPULATIC�IS:
,, ,� y �. , �,�L,
CSPY UB� �Y
Fee Sd�edule an Reve�.,e Side
$.50/$1,000 Valuat3an
$575 per SAC Unit
Alt. nA" or Alt. ^B° Ai�ove
Fee Detenmined bY E�gineerirxJ
� �Y � � �t �Y � �
a
P,
:' 1 � � � ' :F'. � " :a = = 4 . I :n � �
The �ief Building Official st�all, before is�ing permits for the erection of any
buildirg or stn�cture, os for any additiaai tc any existir�g building or stn�cture, or
for any alteration or i+epair to any exist3nq buildinq or �, upoaz applicatio�►
therefore, require the payment bli the applicant for suc� peYmit of fees to the amo�u�t
herein belvw set forth and in the manner herein pzwided to-wit:
ZO►I'AL VAIIJE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
� a.�
$1.5 (Minimun Fee is $15 plus s�n�ci�arge)
$15 for fizst $500 plus $2 for each additional $100 or
fraCticrl thereof, to ar�ci iTicludir�g $2, 000
$45 for first $2,Q00 plus $9 for each additional $1,000
or frackiaaz thereof, to ar�d including $25, 000
$252 for fizst $25,000 plus $6.50 for each additional $1,000
cr frdCtiCei thel�eof, to and inCludiTlg $50, 000
$414.50 for first $50,000 plus $4.50 for eadi additional
$1, 000 or fraCt.ica� tt�f, to arxi including $100, 000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or frackion thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or frackion thereof, to and including $1,000,000
$1,000,001 ar�d up $3539.50 for the fisst $1,000,000 plus $2 for each additional
$1,000 or fraction ther+eof
�tIV�IY �Pli�BIQiT E6G'[�OW
(doncrete Qi� S'treets Only)
Alternate ��A�� ; Relooval arid replaoe�ent of c� ar�d
gutter only - Driveway width plus
6 feet times $13.50.
Alternate ��g�� ; l�ooval ani re�lao�ment of curb arri gutter arid install a 3 foat wide
approach with 6 inh �i - Driveway width plus 6 feet t9mes $15.75.
����� �� V: N •.� •)' ��.Il.i�'_ Y •:.
Piermits for' c�t�uct,ioci will be issv,ed a �nini,�.m, of 24 ha�5 fY� ti'ze t3me of
application to allvw for pzape.r review of the prvpos�d � and of the
o�c�tion site.
A oertificate of S�uvey of the lot, st�owing tl�e locatian of the fwndatioa� �oe it has
it has been oo�nstructed will be requirad before prooeeding with the fzamirig,
I � � o s , ��, .
RONALD F. MEYER �
T.AND SURYEYOR
L4ND SURVEYING SUBDIVI910N DE31GN
TELEPNONE 771-4586
I�
9B5 JESSIE ST. ST. PAUL, MINN. 55101
I hereby certify that this survey was prepared by me and that I am a duly
Registered Land Surveyor under the laws of the State of Minnesota.
- . Reg. No. �J051 Date: , � /%��
,� f%�,�e Lo c, /o - 7- 89
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Lot 5� Block 1, I�ATHER OAKS� Anoka Countye Minnesota.
Contains 14�272 sq. ft..
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LAND SURVEYOR
LANO $URVEVINO sveorv�e�oa DteroN
T[llPNONe 771-4d6d
O9D J!lSIL� 3T. ST. PAUL, MINN. d010I
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[ hereby certify that lhis survey was prepared by me ond that I om a duly
Registered Land Surveyor unde� the laws of the State of Minnesota.
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-' • J Reg. No. 9051 Date : �
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Lot 5� Bloek 1, HEATHER OAKS, Moka County� Minnssota.
Contains 14,272 aq. ft..
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9 � architectural consuttants inc.�
' S008 b� ST. S. E. OSSEO� MN. db368 _PN� ial2)-4L4-977� .. _. �
Plon *� I �► - o°� ,— Dote � -�- ,o� .
b�wner
Contractorf � � � ���-�- �'—n�� � . �
Site Address:
IjTOTAL EXPOS.E� 1NALL "AREA . Z,�� sq. ft x�U�� '��
2) TOTAL EXPOSED ROOF�CEILINQ AREA � �� � �'sq. ft. x�U�� ��� "� �� b .
WAL� AREA CALCULATIONS� - ;
—�c� �'
?OTAL WINDOW AREA ' � � � sq.ft.x�U���=_I! � � �
GLAZED
_70TAL DO�R AREA
?OTAL GLASS DOOR AREA
_ _ GLAZED
TOTAL fIREPLACE WALL AREA
TOTAL WALL FRAMiN� AREA
NET 1NSULATED WALL AREA __
TOTAL RIM JOIST AREA
TOTAL� FOUNDATION AREA (EXPOSED)
. ,
s6 sq.ft.x�U�� ' �07 ���
� d d sq.ft x�U�� ��F'L= • d
� sq.ft.x�U��� �° — ��
L—Q°� 'SQ,ff,X'V",� _ �o►
i0
o'�`2 � sq.ft.x'U" , 04 = %'� � g
Z�1� °
sq.ft. x�U�� �_ ° •
— �� sq.ft.z�U��_�= � �,�
TOTAL FOUNDATION WINDOW AREA sq.ft.x�U�� _�—
_ 3) TOTAL �- Y �
�:
__ 1f ifem 3 ls the some os,oi less than Ifem l, you hove met �he Intent of
2 MCAR 1.16008 A on d O. �
it00F/CElLINO CALCULATIONS�. '
� �OTAL SKYLIGHT AREA —� �q.ttz�U�� � = "`�
JOTAL ROOF,�ILING FRAMING ,AREA � �� �q.�x'�"��� _ �, o
NE7 INSULATED ROOF CEILING AREA '�� � sq.ttx�U°� �Z�� •�
_ _._ _. _ -- _ _ , ___ . .. ._ _ ---- . . �4) TOTAL : ���
�-.Jf ltem 4 Is the same as,� less than �tem 2, you fiove met 1he intent of ..._ ._ ... �
2 MCAR l.16006 A and O. �• '
ALTERNATE �UILDINO ENVELOPE .DESION . ' � � �
_� To utilize the totcl envelope system method, the sum af /tems I and 2 shall _p_ �
: be �reater than the sum of Items 3 and 4. . _.' : _ _ . • � :
� . , . �) t2) _
� � - - --3) +4) _ _
� 1 hereby cerNfy thct the bulldln� here qlescrt6ed meets or exceed the Sfote o innesota
Enerpy Conservatlon Act.
/�r...,sa�
?� CONSTRUCTION
�G � ..�.. I ��}�-. 2��-�•
FRAMING SECTION
� interlor afr f11m 0.68
2 i'' s�+�,e� .�s
3 52 Jnches of soft wood �,��
4 L�I 3c e5r�i�}¢�+E Z, 01e
� �io�� , dl
--�
S exterior a1r fllm 0.17
. � TOTAL R � � � °
U = I/R � °�
SECTIOAI (INSULATED�
� nterTor air film 0.6
2 "s.a.i-.��-+� �4S
g S� � ��.+ �..�. I°I, �
4�I sL Er.t� t�-� I�E Z, 0 6
r, S� w �•+c� . $1
g exterior aIr film 0.17
. TOTA L R Z� � �
U = 1/R �
)IST SECT�ON
� interior air fllm 0.68
2�z q f���+ b-em. I`i � o
3 �'d � s�t�...�v ( � oml
.4 P� �� ����i+-E Z,�.�
5 '��,� � ��y � 8 l
� exterto► air film 0.17
_ TOTAL R � � �
U = I/R o 0
ATION SECTION
� interlor air film 0.66
2 ����T� �,��. �.o
3 ����.� �r� � Z$
a exterior air film
5 0.17
_ _ TOTAL R �I �?
U = !/R '��
e
��
_c
0
VENTED
CONSTRUCTION • � _
__CEILING .SECTION (INSULATED) .
( � �interlor air fllm 0.61
— � 2 'c-��e �� � � 5�
. � 3 o���i � � .,��.,� 44
(4 exterior olr film (still . 0.61
TOTAL R 45.� S
.. . U = �1/R�
_ . •-
_CEILiNG FRAMING SECTION � .
� � �nte�ior alr ftlfi 0.61
- _�2 '�'P, S1•ti•.�a.a�rc. .Sto
-- ( 3 - �.;�a•,�.� (...��u �
(q interior air film • 0.61 �
(5 �Jzinches of �oft wood . 4.55 •
' - TOTAL R `�� � �
. U = I /R � �ZtO
CEILING SECTION � INSULATED)
_ � � interio► air tilm 0.61
_ (2
i3
(q exterior air film (still) 0.61
TOTAL R --
� . U = I/R
�EILiNG FRAMING SECTION _
_ ( �,interior air film 0.61
_ (2
__(3
(4 interlor air film 0.61
�g ioches of soff wood
.TOTAL R
� ; .0 = I/R
�XPOSED 6EAM CEILING SECTION
(_� interlor a1r tifm fl•61
�2
{3 . - -
t4
{5 exterior uir film �•17
T�TAL R _
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CHIM��EY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (,)
2. Is free fram rust or deterioration Yes ()
3. Has no foreign objects lodged within Yes ()
4. Is securely supported Yes ( j
5. Meets all current Code requirements for size and
total BTU connected
6. Has Total heating BTU's of
Al1 other BTU's
TOTAL
Rema rk s
No ( )
No ( )
No ( )
No ( )
Yes ( ) No ( )
Com pa ny
Signed By
Da te
�
_
C�TYOF
FRIDLEY
FRIDLEI' ML'NICIPAL CE?�TER • c��l UNIVERSITI' AVE. N.E. FRIDLEI'. MN 55�3? • 161?1 571-3�350 • F.4� ic�l �� �71-I ��+7
November 15, 1989
Brickner Builders
6240 Highway #65 N.E., #208
Fridley, MN 55432
Re: Final Inspection at 1660 Kristin Court N.E., Fridley
Dear Sirs:
A final inspection was conducted on November 15, 1989 of the above
address and there were no corrections/violations noted at this
time. The structure is approved for occupancy.
If you have any questions on this matter, please feel free to
contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
_ '� IA.N O. JACENKO � ,f%�� �
166 RAISTIN COURT N.E. '«o �
FRIDLEY, MN 55A32
(612) 571-0788
July 27, 1992
Brickner Buildera
624Q Hwy 65
Suite 208
Fridley, MN 55432
Dear Brickner Builders,
The purpoae af this letter is to inform you that we are continuing to experience
a problem with the plumbing in our house. Thie ie the same problem that wae
brought to the attention of Mr. Rick Brickner long ago by my wife, Nancy.
When thie was brought to Rick's attention there was a 3 foot water line mark
running acroas the eheetrock aeam in the family room ceiling. Water ie coming
down from the master bathroom. Rick's assesement of the problem wae that
poesibly when Nancy mops the bathroom floor, water seeps through the floor vent
and onto fhe ceiling downetafrs. Rick indtcated ti�a� he would have someone come
out and look at it, but to date no one has.
Since the time that thia problem was firat brought to Rick's attention,
additional damage has occurred to the family room ceiling. There are additonal
water mark linea that run across joists and sheetrock seama in the ceiling. As
a result of this, water has been leaking through the ceiling and onto the
carpeted floor beneath. Several circular water marke appear in the ceiling when
the water is leaking. The moat notable one is 8 inches in diameter and has
water dripping through a hole in the middle of it and onto the carpeting below.
The othere are approximately 2 inchea in diameter and getting larger and more
numerous.
Z have been testing possible problems myself since it appeared that Rick was not
going to have someone look at it, and Mrs. Brickner safd they would no longer
stand behind their work, becauae we are well beyond their one year warranty, even
though the items that were brought to Rick's attention, were well within this
time period.
However, I cannot determine the aource of the problem and it appears to be a
major defect in the plumbing of the shower in the master bathroom. The problem
is not being caused by mopping the floor as Rick firet asaeased. The problem
arises whenever the master bathroom ehower is used and probably began with the
first ehower and continued to the problem it is now, causing damage to the family
room ceiling.
I have done the following to try and determine the source of the problem:
l.
2.
3.
4.
Tighten and silicone caulk around the shower fixtures. This did not
stop it.
Run a hose down the drain to determine if it wae in the trap or
pipes. There was no water coming through after this.
Put a seal around the drain with a silicone caulk. This did not
stop the problem.
Run a hose from the aink to shower floor after using silicone caulk.
5. Remove the handle plate to look at and test the connection.
Unfortunately, Thompson plumbing in their infinite plumbing wiadom
cut a hole just large enough so that it goea around the handle. One
cannot see in there let alone work in there if there wae a problem.
6. I had Mr. Clyde Wyler, Fridley Building Inepector, look at the
problem for his opinion.
.-
My best guess ie that the leak is either in the drain because it hasn't been
properly sealed, or it is the pipes to the ahower head and/or handle because the
water marks did not appear when I ran a hoae from the sink to the shower floor
after caulking the top of the drain.
This is only one of the many plumbing problema we have had with Thompson
Plumbing. We have also experienced the following aince we moved in:
1. Hot and cold water lines mixed up in the bathroome.
2. Drain plug in the master bathroom ahower not removed. The ehower
base filled with water.
3. Whirlpool faucet which drips and stiill continues to drip.
4. Sewer cap not replaced in the basement sewer line which wae
apreading gas throughout the basement and nearly caused my wife to
pass out while ahe was unpacking boxes. After feeling dizzy and
eick to her atomach, she called poison control and was advised to
leave the house immediately. They aleo recommended staying out
until the problem was found and corrected, due to the poseibility of
an explosion. When I informed Mr. Tom Brickner of thie he thought
it was humorous. I wonder how funny he would have thought it, had
it been his family.
5. Inatallation of the wrong fixturea in the whirlpool bath.
6. A crack in one of the faucet handlea in the maeter bathroom which
appeare to be from over tightening the fixture. This problem wae
brought to Mr. Rick Brickner's attention, but never fixed. We have
taken care of this on our own.
7. Plurobing for the water softener that was never done. We were
reimbursed and had it done on our own.
8. While looking for the poasible leak we noticed that a one foot
section of the ceiling joist had been cut out to put in the
whirlpool tub. This cannot be within the building code of Fridley.
My understanding is that it is not within code, and never should
have been done. How could the Fridley building inepector approve
this? We hope that problema don't occur in the future due to the
weight put on the weakened ceiling by the tub, cement, and water in
the tub.
9. There was only a 2" hole cut in the shower for the handle. Because
of this, you cannot look or work in this area to determine if there
lies the problem much lese try to correct it. If the plate is
sealed properly, why make the hole eo small? Water would leak
through at any dimenaion of the hole.
When we were having some of the above problems fixed, Rick indicated that
Thompaon Plumbing had used a plumbers apprentice to do the plumbing work on this
house. The plumbing reflecte the work of an amateur and not a profesaional that
one would expect when building a$200,000+ houae. It appears that Thompeon low
balled a bid and tried to make up for it by cutting their own cost.
This current problem (and mese) is the reault of gross professional negligence
and/or incompetence on the part of your plumber. It probably began with the
first ehower taken and has gradually built to the major problem it has become.
Rick wae made aware of thie when the first water mark appeared. Rather than
trying to determine the source of the problem he suggested it might be from
mopping the floor in the master bathroom.
We want this problem to be corrected permanently ae well ae the family room
ceiling repaired. We have been advised to give you the opportunity to correct
the problem on your own. Therefore we will give you two weeks from the date of
thia letter to permanently repair the leak and also repair the water damaged
aheetrock and ceiling in the family room, or to make a bona fide attempt to etart
the necessary repaire. If you refuse, we will hire eomeone to correct the
problem and make repairs, and seek reimbursement through legal means.
yIt is too bad that we have had to reaort to these means to get some work
performed that should have been done to begin with. Tom Brickner once told me
to come to him firat with any problems concerning the house and to please not go
outside of him. We did that when we first brought thie to the attention of Rick.
He apparently chose not to have someone look at the ceiling and now the problem
has gotten out of hand. We are extremely disappointed in Brickner Builders
quality and the backing of their work. One would not expect to experience
problems like this in a$200,000 home. I would aesume that if you experienced
the same problem in your home, you would not accept this quality and would have
the plumbing company out immediately. It is your subcontractor, Thompeon
Plumbing, who should be held accountable for their negligence and incompetence.
S ce ely,
��
�
ian . Jacenko
cc: Th�mpson Piumbing
Mr. Clyde Wyler, Fridley Building Inspector
Mr. Gary Ford, Fridley Plumbing Inspector
Mr. Paul Zisla, Attorney .
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THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPUCATION WILL BE RETURNED
rnti�ti�nti ��ctirr ��cn�T r►nn�ni�r_TnR nNn cnnnAt �cT10N AIR VFRIFICATInN
When � �n acin� n eYietin�, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plasti�JPVC and meets all current codes and manufacturer
specifications 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 manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The pY�n� �emt���tien a�r is sized and installed to meet the current codes
and manufacturers specifications.
Whe11 f�qul�Bd t0 inc�all a new cemh�c_6en air�it will be sized and installed
to meet the current codes and manufacturer's specifications.
W�'�8n installine a new ver�tin0 sy,��, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
speciflcations. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
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.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes( jNo( ),
�.� ,� .- .�. .����.� -� .�. -� ..�- . . .���. .�
Appliancs #1 Type BTU Input Fan Assisted or Nat
Appfiance #2 Type BTU Input Fan Assisted or Nat
Appliance #�3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type
Vent Height 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
r � r•► �- ..-
HEATING CO:
Signed By: Date :
Building
Inspections
7. 63-572-3604
DATE�w "/
SITE ADDRESS _
TFiIS APPLICAIJT IS:
PROPERTY
OWNER/
TENANT
i.
MECHANICAL
R�SIDENTIAL APPLICATIC�N
CITY OF FRIDLEY
YOUR E-MAII. ADDRESS
❑ OWNER �ONTRACTOR
!/1/1 rY_o _��t01Z
..
Permit No.: ��' ' e
Received By:
Date Rec'd: I I_ o
ATE�IVLIP
CONTRACTOR �p�,y�.1y N,�tv�: -
corrrACr PsxsoN: ���r �#y ��Pnace 8� �are I
gUBIVIIT A COPY OF �6P1 S�. p'�U1f� 3�
YOUR STATE STATE LICENSE � ijfJl��/, MR� 5'rJ4:'�lTY STATE ZIP
LICENSE WIT'H ADDRESS:
APPLICATION PHONE (763� 754-2199AX
PERNIIT TYPE
TYPE OF WORK:
�rINGLE FAMILY ❑ TWO FAMILY
❑ �W �1.REPLACEN�NT
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
❑ pLTERATION/REMODEL
r,
PER MS 16B.665 the permitr� �ement of amresid ntial fixture� xc uding the�fixtures� $iThissho ld reflect o y the c�o�t oflabor )
improvement, uistallalxon o p
Labor cost under $300 = $15.00.
FOR PROJECTS WI�KKE IABOR EXCEEDS $500, FEFS ARE BASID ON $10.00 PER FIX7VRE, EXCEPT WHERE NOTED. FlXZ'iJRES: (AiDICATE TOTAL
MJMBER OF EACH BELOV� MFG: i I� MODEL.�D IIO �' � z D SIZE/BTU DIi O
Equipment Installed . MODA.: 5���
MFG: SIZFJBTU
�G. MODII,:
FIREPLACE (GAS) $I5.00 . _GAS RANGFJOVEAI 510.00
A/C $25.00 '—�p�CE (WOOD) $35.00 NEW GAS GRILL $10.00
_AIR TO AIR EXCHANGEER $15 F�A� $35 00 G,yg UN1T H'TR $10.00
BOII.ER $35.00 � PQOL HEATER $35.OD
—CHIMNEY LINER $10.00 GAS DRYER $10.00 y�p,,pTOR $15.00
—
GAS PIPING $]0 00 --,
DULT ORK $10 00 --. .. . . `
W . ,�...,....�..�� �-,�.rsei;�s�?'"�:.-tc+r.aatiit'`�1C�L."�'iw�'d . . �?'_..�."'���
Labor cost between $300 to $500 = cost of labor x.OS =
_ ��,,.,.;,.�. „..�».4-,,..�..r..�� .
e :•. � � ; . ' �_ � � . . . . . . a :.n:.:.. ..- .
_ . . ....._. .. _. . , ,.;.
' � � Number of fixtures @ $10.00 x 1 . —
Permit Fee . $ .�.t�2•� Number of fixtures (� $15.00 x $15.00 = $
Surcharge $
TOTAL DLJE $ . V Number of fixtures @$Z5.00 x$25.00 =$
Number of fixtures @ $35.00 � x $35.00 = $ . G�1D
State Surcharge = $ .50
Total = $,�
THIS IS AN APPLICATION FOR A PERM�T-NOT VALID UNTIL PROCESSID
I hereby apply for a building permit and I aclaiowledge that the infomnation 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-Constsuction Codes; that I understand this is
not a permit but only an ap �cation for a permit and work is not to start without a pernut; that the work will be in accordance with the
approved plan in the case f work whi h requires review and appro>>al of plans. /�
/'(� B/Yllil%/ _PR1NT NAME�� �Y) S H� '� DATE�V `� _
SIGNATURE OF APPLIC �, —
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
...
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RES[DENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDtTIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
�
REQUIRED FOR NEW/EXIST(NG HOMES
1. Combustion Air (See note below) .
� Oil or solid fuel lMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendmen.ts �
2. Make-up Air (See note below)
a. TMC Chapter 5 with MN Amendments �
3. Ven.ting
a. Gas a�pliances ]FGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooli.ng load per room
a. Required on new construction IMC 1346.0312
5. Ventilation . �
a. 76�Q �r 7672
6. Duct Design Per IMC 134b:0603.2
a. ACCA Manual D
NOTE: Cenierpoint Energ3T Meehanical Code Guidelines sofiware may be used for
comb.ustion and make up air calculations
�LUMBlNG
�ESIDENTIAL APPLICATION
City of Fridley
� . ua. ui
e� �� � ,� �
NOTE: (F PROP�RT1l iS I�T OWNER/OCCUPIED- A UCENSED CONTiiACTOR MUST OBTAIN THE PERMFT.
DATE' Guv �
SRE ADDRESS I [Q�
7HE APPLICANT IS: {CIRCLiE ON�
NAAAE _
PRt}P6RT1f OWN�R! ADDRESS
TENA{yT
C11Y �
PHOt�fE Ji
YOUR E-hhi11N1, ADDRESS
OWNER
NAA/E LICENSE #
' CO1dTRAC'fOR ADDRBSS -
G1YY • . .' A LP
PHON� � ' FAX�
63) 75�-�199 ��� r���� ��A �n��
peRa�r �e
TYPB OE WORK � ❑ NE1N
FAMtLY
Ji�. R6PLACEA�ENT
RE�S AR� BASm ON 510.� PER FDCTURE, EXCEPT WMERE NOTED
FDCRIRES; (INDICATE TOTAL NIUMIBER QF ERCH)
BATH Sp�1KMV FtOOR DRAMiS SMOWER WATER RIPING
BAT1iTUB �AS PIPING (Nesa t7tY (n�rse) svYGVIN�NG POOL WATER SCF.iEAFER (s95�
CLOTHEB WASIIER KtTCOiEN SINK WATEfL C►LC6ET BAf�(FLOYV PREV. ($7�
DBHWASHER LAUNDRY TRAY �WATTaR fiiR (536� FOR IIiRIGA710N
. WATER M6i6R OT1iER
Permit �'ee $ .� —�U
Ptan Review S
S�rcharge $ . .SO
MINfAAUM: $18.00 or S% af cost of the �mproveme�tt-whichever is
greater on work less than $30Q
TOTAL DUE S 3"�� - S O Make ch�cks payable to: City of Fridley
THI� (S AN qppLlCqTlON POR A PERd�IT— NOT VALID 1lNTIL PROCESSED
1 hetebY epp1Y ior a ptumb}ng permit and i adcnowledge that tt�e in6ormat�n above ts oomplete a�M aecurate; that the w�lc wi9 tse In confonnanea wdh
ths ardinanoa and wdes of the (;1b of Fridley and wiTh the N6rtnesote Comsirtidion CodeS� U18t I under�nd fhis is rrot a permit btd or►!y en
appliLetan for a permit and wa�k is �ot to start without a pe.rcNk thal the work wiU b9 in acxordanee witt� the aPP►aved plan in the cage of aU worlc which
req�ures reMew arttl aRWoral
RW
NAME OF APPUCANT `I S OATE /I �I `�! �� y
i ` or AriM��
SIGNATURE OF APPUCANT
TOTRL P.01
Building PLUMBING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY �
DATE YOUR E-M/.�IL ADDRESS
SITE ADDRESS � �9 � (9 « i � ��`%
THIS APPLICANT IS: ❑ OWNER `F�i`ONTRACTOR
PROPERTY NAME: L�- / L
OWNER/ ppDRESS: � ' l i CITY !� �I STAT�ZI�'a
TENANT pHONE-i�� ��� �j,�_
CONTRACTOR NqM : �.
SUBMIT A COPY OF STATE LICENSE H EXP DATE ` � �
YOUR STATE ADDRESS'�—I CITY 1, � STAI��ZIP �� lp
LICENSE WITH pHONE � FAX� L�J �� � �
--APPI.I�ATID�I--- --- - - -- - -- - - - - —
PERMIT TYPE �GLE FAMILY ❑ TWO FAMILY O TOWNHOUSE
TYPE OF WORK: � NEW �REPLACEMENT
DETAILED DESCRIPTION OF WORK � i.` I�
PER MS 16B.665 the-permit fee is a minimum oi$15.00 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 $300 =$I5.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEbS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOV�
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPMG frv�n c��rrrcErvsF) SWIMMING POOL � WATER SOFTNER ($35)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
DISHWASHER _ LAUNDRY TRAY WATER NEATER ($35) FOR IRRIGATION
WATER METER OTHER
p��'� . . .�'R�1� :� _:�~�i7�'>��t�$Sb0 r� } � h a�<� . r . �. x� t. � { ��' �. �.,; � = j �EI�IT���:�C1��P. R�JE?��'S'OV�R'�500!'
Permit Fee $ . �� Number of fixtures @ $10:Q0 x $10.00 = $
Surchar e .50 Number of fixtures @$15.OQ r. $I5.00 =$
TOTAL DUE $��. Number of fixtures @$35.00 x$35.00 =$
State Surcharge = $ .50
Total = $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNT1L PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; tl�at 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 case of � rk which requires review and approval of lans.
SIGNATURE OF APPLICAN A- ' /�-- PRINT NAh� InY1 �,I! L�.1'�ATE � v l
" '� "� . .. . .:. ���I�i T "#�E ��E ': . . �7:�1't'7It.��;1� .tN�f;;E�,E+�'i".1tYC .. �N17:� ' , � ' �i4li�,'t�?'K�1tK' �.r .:,
�<g.��. �• ,:i���x :.� ' . �'` _ .. . '
, ,, , . ,
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977