P - 48373Building MECHANICAL Permit No.: G
Inspections RESIDENTIAL APPLICATION Received By:
�63-s�2-3604 CITY OF FRIDLEY Date�'�1: �" C� t� ,� �
763-502-4977 FAX EFFECTIVE I-1-2011
DATE �2-� ��' �I YOUR E-MAIL ADDRESS t.! .er Z�CXjM -��
SITEADDRESS �Z.f �j�L'O L't�t.= �L ,�CY
THIS APPLICANT IS: ❑ OWNER �CONTRACTOR
PROPERTY NAME:
OWNER/ ADDRESS: C[TY STATE ZIP
TENANT
PHONE:
CONTRACTOR COMPANY NAME: /Z u e � �'
SUBMIT A COPY OF CONTACT PERSON: 4 �� �` '
YOUR STATE STATE LICENSE #� EXP DATE �L —�� 2�
LICENSE WiTH ADDRESS���/ l� y� � CITY Z��w.��,.s._ STATEM IP�
APPLICATION pHONE C��Z' .3G�7',� `{�O Fax %�oj� �.�-�- ��'7
PERMIT TYPE SINGLE FAMILY � TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW ❑ REPLACEMENT �ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK Q� (/X v/ on �(/
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE IYOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: MODEL: SIZE/BTU
MFG: MODEL: S1ZE/BTU
MFG: MODEL: SIZE/B7U
A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00
_�HIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
_DUCT WORK $]0.00 GAS PIPING $10.00 VENTILATOR $15.00
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THIS IS AN APPLICAT[ON 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 wilt be in
conformance with e ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only n lication for a pe ' nd work is not to start without a permit; that the work will be in accordance with the
approved plan in the ca e of al c which r ires v� w and approval o
SIGNATURE OF APPLICAN RINT NAME �`..., � TE � Z;,�—, �
APPROVALINSPECTORSSIGNATURE DATE
n�,�.: < , ... ��,
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City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
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Directions - In order to c%termine the makeup air, Table 5013.1 must be filled out (see below). For most new insta!latrons, column A �
will be appropriate, however, if atmospher+cally vented appliances or solid fuel appliances are installed, use the appropriate column. ��i
For existing dwellings, see iMC 501.3.3. Please note, if the makeup air quantity is negative, no additional makeup air will be re-
quired for ventilation, if the vatue is positive refer to Table 501.3.2 and size the opening. Transfer the cfm, size of opening and type ���
S Pt?sC+�
(round, rectangular, flex or rigid) to the last line of section D. The make-up air supply must be instotled� MC� 1�3t �'3. D����
-�- � wt��l � 1 �ZFc,� C�. t� �v� ►�►'� «
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Table 501.3.1
PROCEQURE TO DETERMINE MAKEUP AIR QUANITY FOR EXHAUST EQUIPMENT IN DWELLINGS
(Additionai combustion air will be required for combustion appliances, see KAIR method for calculationsj
One or multiple power One or multiple fan- One atmospherically vent Multiple atmospherical-
vent or direct vent ap- assisted appliances and gas or oil appliance or ly vented gas or oit
pliances or no combus- power vent or direct vent one solid fuel appliante appliances or solid fuel
tion appliances appliances appliances
Cotumn C Column D
1.
a) pressure factor
b) conditioned floor area (s� (inciuding
unfinished trasements}
Estimated House Infiltration (cfm): [la
x lb]
2. Exhaust Capacity
a) continuous exhaust-only ventilation
system (cfm); (not applicabie to ba-
lanced ventilation systems such as
b) clothes dryer (cfm)
c) 80% of largest exhaust rating {cfm);
Kitchen hood typically
(not applicabie if recirculating system
or if powered makeup air is electrically
interlocked and match to exhaust)
d) 80% of next largest exhaust reting
{cfm); bath fan typically
(not applicable if recirculating system
or if powered makeup air is electricaily
interiocked and matched to exhaust)
Tota� Exhaust Capacity (cfm};
[2a + 2b +2c + 2d]
3. Makeup Air Quantity (cfm)
a) total exhaust capacity (from above)
b) estimated house infiltration (from
Makeup Air Quantity (cfm);
[3a — 3b]
(if value is negative, no makeup air is
4. For makeup Air Opening Sizing, refer
to Table 501.4.2
Column A
0.15
�3G�
��
N���
135
(v(jp � .£st� =
� D�
Not
Applicable
(�J� �1���
�
�) �
3� S�
C7`-� �
�" �i�551��
Column B
y �•
135
0.06
135
0.03
135
A. Use this column if there are other than fan-assisted or atmospherically vented gas or ofl appliance or if there are no combustion appliances. (Power vent
and direct ve�t appliances may be used.)
g. Use this column if there is one fan-assisted appliance per venting system. (Appilances other than atmospherically �ented appliances may a�so be in-
cluded.)
C. Use this column if there is one atmospherically vented {other than fan-assisted) gas or oil appliance per venting system or one solid fuel app iance.
D. Use this column if there are multiple atmospherically vented gas or oil appliances using a common vent or if there are atmosphericaliy vented gas �r oil
.�.. ,;..; , ;
appliances and solid fuel appliances. �, � �` ' ''�, "' � "
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Page 3 of 6
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