P - 40689�
� Building MECHt�NICAL
°Inspections RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTIVE 1-1-2011
DATE ( - G
S]TE ADDRESS _
THIS APPLICANT I5:
PROPERTY
OWNER/
TENANT
C�Z�]�'.7_��Ci7:7
SUBMIT A COPY OF
YOURSTATE
LICENSE WITH
APPLICATION
❑ OWNER
NAME:�
ADDRESS:
PHONE:
COMPANY NAME:
CONTACT PERSON�
STATE LICENSE #�
ADDRESS:
PHONE
YOUR E-MAIL ADDRESS
PERMIT TYPE �INGLE FAMILY ❑ TWO FAMILY
TYPE OF WORK: �NEW ❑ xEPLACEMENT
DETAILED DESCRIPTION OF WORK
FAX
CITY
.
Permit No.:
Received By: "v r�,
�'�: � � � , , � �-+i
Date
STATE ZIP
TE e�nnv�a t�N 55304
CITY ]63-]�3�"�� ZIP
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
C�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: MODEL: SIZE/BN
MFG: �,,�� MODEL: �I�Z.L i��pG%%'j/T� SIZE/BTU ( p, ��
�G: e e✓y � Mo�EL: ��i'P%Z D�yJ � Z srzEisTU a�072 �.�o
I A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
A1R TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
BOILER $35.00 �FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Number of fixtures @ $10.00 x $10.00 = $ ,
Number of fixtures @ $15.00 _
Number of fixtures @ $25.00 �
Number of fixtures @ $35.00 �
State Surcharge =
(MINIMUM FEE �40.00) Total
x $�t5.00 = $
x $25,00 = $ �%�' �
X $3s.00 = $ 3� . oz>
$ 5.00
-� /��.Q�D
SCANNED
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 permit but only a a plication 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 o rk hich re ' e eview and approval of pl s.
SIGNANRE OF APPLICA � .. G� PRINT NAM��P.�[ P Clt�c! ��C',j�ATE �/ZN � I
APPROVALINSPECTORSSIGNATURE
PLEASE NOTE: SEPARATE ]
DATE —
S ARE RE IRED FOR BUILDING, ELECTRI .
City of Fridley
uilding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
i
Date: 9/20/2011 Revision Date: 9/20/2011
Site lnformation
Address 1: 6301 madison st
�
Address 2;
City: fridley mn County:
Application Information
Business Name:
Contact Person:
Office Ph: Fax: Cell Ph:
Address 1:
City: State: Zip Code:
Existing Construction: Pre 1994.
Project #:
Lot: Block:
Subdivision:
MN Contractor License #:
Combustion Appliance
Water Heater: Natural Draft Input BTUs: 38,000 Independently Vented
Furnace/Boiler: Direct Vent/Sealed Combustion Input BTUs: 60,000 Independently Vented
Make-Up Air
No Make-Up Air Required by Code
Combustion Air
Round Rigid Required: 4 inches or Insulated Flex: 5 inches
.
.� � �e % �. �C�rr e� �
�C e - zo
Applicant Name i . Signature/Date: ' �/
Code Official (print): Signature/Date:
� 2004 CenterPoint Energy Minnegasco. 2004 Mechanical Code Guidelines.
Page 1
Page
Report Prepared By:
For:
Residential Heat Loss and Heat Gain Calculation
In accordance with ACCA Manual J
Riccar Heating 8� Air Conditioning
meuenga resid
6301 madison
fridley, mn
Design Conditions: Minneapolis/St. Paul
Indoor.
Summer temperature:
Winter temperature:
Relative humidity:
9/20/2011
Outdoor:
75 Summer temperature: 94
70 Winter temperature: -17
50 Summer grains of moisture: 98
Daily temperature rangeMedium
Building Component Sensible Latent Total Total
Gain Gain Heat Gain Heat Loss
(BTUH) (BTUH) (BTUH) (BTUH)
Whole House 17,933 2,260 20,193 43,677
First Floor 17,933 2,260 20,193 29,489
All Rooms 17,933 2,260 20,193 29,489
_ _ __ . _
Infiltration 1,003 1,110 2,113 6,890
People 1,500 1,150 2,650 0
Miscellaneous 1,200 _ 0 1,200 0
Floor 0 0 0 0
_ __ _ _ . __ .
W Wall 685 0 685 2,637
Window 2,005 0 2,005 1,342
__ _ _ .
Glassdoor 1,504 0 1,504 954
E Wall 625 0 625 2,407
Window _ __ _ 3,938 .0 3,938 _ 2,637
Door 437 0 437 1,681
_ _
N Wall 323 0 323 1,244
Window 904 0 904 1,917
'♦ w Y
Page 2
Building Component
+
mezzenga resid
Sensible Latent
Gain Gain
(BTUH) (BTUH)
9/20/2011
Total Total
Heat Gain Heat Loss
(BTUH) (BTUH)
S Wall 348 0 348 1,340
Window 752 0 752 959
Ceiling 2,709 0 2,709 5,481
Basement 0 0 0 14,188
All Rooms 0 0 0 14,188
Infiltration 0 0 0 0
Floor 0 0 0 3,758
W Wall BelowGr 0 0 0 3,477
E Wall BelowGr _ __ 0 0 0_ . 3,477
N Wall BelowGr 0 0 0 1,738
S Wall BelowGr . 0 0 0 1,738
Whole House
17,933 2,260 20,193 43,677
HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101
Load calculations are estimates only, actual loads may vary due to weather and construction differences.