PRE 2010 DOCSiA
a
City of Fridley, Minn.
BURDING PERMT N? 6883
f
e . �,i . :2 __ 'Builder
Address
LO T N OILDING
NO. Street _ Part of t
Lot__ Block Y.._. Addition or Sub -Division
corner Lot _ Inside L _ _1.ot - Setback ®
6--�_ _ ieyard
Sewer Elevation __ — Foundation Elevation
DESCRIPTION
OF BUILDING
T U
`� Front Depth Height Sq. Ft. Cu.
Depth Height .Z Z T Sq. Ft. Cu. Ft.
Type of Construction _ _ Esto be Completed
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description above set f and in plica with- ih provisions of
ordinances of the city of Fridley. 6)IV
In consideration of the payment of a fee of permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or anypart thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construct%n, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. — _ f—
Building Inspector
NOTICE:
This pennb does not corer the construction, hulaUdion for whfim phunbiug, one boding, sewer or wdter. Be an to we
the Building Inspector for wparde permits for thew Items.
4
r
APPLICATION FOR BUILDING PEPMET
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME UILDER
ADDRESS ® /J/Ai Cy `'j` -Aly f o ADDRESS
LOCATION OF BUILDING
No. 4 L / Street ,C 0& 15- P'P_ X -C ®l✓ Part of Lot
Lot�O Block Addition or Subdivision 514.6 jd/p /
Corner Lot Inside Lot Setback 9-5-/ Side Yard /2 a2 a
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
5 ,, Front D-E.ih % ' Height
Sq. Ft. Cu. Ft. ®L�
Front Depth Height
Sq. Ft. Cu. Ft. --
Type of Construction EL&Vs' by e e,6 Estimated Cost / �0
To be Completed_ q(_% J}
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of�Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
C 02 2 lq t�
,(Schedule of Fee Costs can be found on the Reverse Side). �)
. ,
ell
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-1
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
Number Fixtures ......................
x
$1.50
Future Fixture Opening ................
x
1.20
New Fixture Old Opening ..............
x
1.00
Catch Basin ............................
x
3.25
Water Heater (Up to 200,000 BTU) ......
x
2.00
New Ground Run Old Bldg. ............
x
3.25
12
Z
i°Cii
w
Z
•
F
N
WATER HTR.
GAS
ELEC.
+�
3
cc�
CU�'
G
(�9 ¢S
� O
Base
1st
v
2nd
3rd
4th
• Future Connection Openings
Connected with
e New Fixture, Old Openings
I
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
Number Fixtures ......................
x
$1.50
Future Fixture Opening ................
x
1.20
New Fixture Old Opening ..............
x
1.00
Catch Basin ............................
x
3.25
Water Heater (Up to 200,000 BTU) ......
x
2.00
New Ground Run Old Bldg. ............
x
3.25
TOTAL
$�fa
$
GAS FITTING FEES: NO. RATE
1st 3 Fixtures .......................... x $1.50
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
X .50
x 2.00
TOTAL
$
$
Description ..................................... $
TOTAL FEE
City of Fridley:
101
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this appliM-7,414
true and correct.
Mi
Fridley, nn 19_
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No 62GfG
f,3 Permit No. U
Signed
By ism
Business Phone No
ROUGH
FINAL
a2 2M
j I0
Application for Power Plants and. Heating. Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs, Phone SII. 4-7470
GRAVITY WARM AIR: RATE TOTAL,
Furnace Shell & Duct Work .......................... 8.00 6'0
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
.each add. 60,000 BTU .... . .................. 2.00 $ _
Replacement of Furnace ............................. .§.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam.......
8.00 $
Furnace Shell & Line—to 640 sq. ft. IDR Hot Water ...
8.00 $
Each add. 200 sq. ft. IDR Steam ......................
2.50 $
Each add. 320 sq. ft. IDR Hot Water ..................
2.50 $
OIL BURNER --to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....... . ............... 5.00 $
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ..
_ ........ x 2.00
$ .
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
��
ALTERATIONS & REPAIRS
TOTAL FFE
$ o •
ROUGH
FINAL
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application true and correct.
Fridley, Minn_ 19 19 4
Owner - ezel=
Kind of Building /•.�--�-�-�
Used as
To be completed aboutel
Estimated Cost, $o
ld New. ding Permit No. a Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANT TS --.Steam, Hot Water, ar�Aii No
Trade Name supee( Size No �iiiD z� /� Z,
Capacity fl �n Sq. Ft. E.D.R BTU H.P.
Total Connected Load y 9 Kind of Fuel
BURNER — Trade Name . Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Sign
gy N H E XTI R 0 EM WM,
!`QURTh AVE SO. 0 U. 3.5267.
.W,R�M42 2M1 7-59 Busines � *•*•
a
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work ..........................
8.00 $
Replacement of Furnace .............................
5.00 $
Repairs & Alterations—up to $500.00 ..................
5.00 $
Repairs & Alterations each add. $500.00 ...............
2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 80,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM at HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam .... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $
Each add. 200 sq. ft. EDR Steam .................. 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x $1.50 $ Z' 67P
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $ 6
ROUGH
FINAL
Dept. of Bldg's.. Phone SU 4-744700
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application a true and correct.
Fridley, Minn_ :0 , 19
Owner (-
Kind of Building
t
Used as
To be completed about
Estimated Cost, $
ld New. B 'lding Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Stearn, Hot Water,arm Air �No
Trade Name Size No / 0-0
Capacity @� Sq. Ft. E.D.R BTU H.P.
Total Connected Load D / y 9T Kind of Fuel
BURNER —Trade NamP Size No
Capacity Sq. Ft. E.D.ft BTU H.P.
(REMARKS -OVER)
Sionpri 6-Y
By /�
.W42 2MBusiness Phone NoJ'
��7-
HEAT LOSS CAL TIONS DEPARTMENT OF INSPECTIONS MINNEAPOLIS, MINN.'
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
Windows Doors Reference Out. Wall JInt.Wall Ceiling I Roof Floor Kind How Applied
Yes—No Yes—No 19_
.,&I. XA..,.'� Room I Lenlzth , �• Width �I=leight Jim II 1.>7� FI.I � Room I Length /(® Width -r Height
Windows a oors—Crackage and Area
Width Height No. oY Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
nip � to
7
Coef. Btu
Infiltration
D Q
Glass
Btu
Exp. wall a 6
/ 3
Net exp. wall
p
Int. wall
Glass
Ceiling
Exp. wall
Floor
/
.Total Btu. 3-9
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
004A.I ;:?,v--ARoom I Length ,-i Width Height P
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane tights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
nip � to
Coef. Btu
Infiltration
JCoef.1
Coef.
Btu
Infiltration
/ 3
i i
�{®
,I ' ; 2
Glass
Ceiling
Exp. wall
Floor
Exp. wall
Net exp. wall
frig
—
--,
Net exp. wall
A®
/ b
Int. wall
Floor
Floor
V90
Ceiling ..
f Z)
Floor
Total Btu. ,2 ;:t
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
.,*A.1 A 4 Room ILength Width � z Heilzht -9b-
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane tights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of panne lights of crack sq. ft.
nip � to
Coef. Btu
Infiltration
JCoef.1
Btu
Infiltration
Exp. wall
9'a
i i
Glass
Int. wall
Glass
Ceiling
Exp. wall
Floor
Exp. wall
Net exp. wall
frig
—
--,
Int. wall
A®
Ceiling
Int. wall
Floor
Floor
V90
1l
f Z)
Total Btu.
Reauired so. ft. E.D.R. or sa. ins. W.A. leader area
Windows anA Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane tights of crack sq. ft.
2
f
Coef. Btu
Infiltration
Coef. Btu
Glass /
Btu
Exp. wall
1(e
Net exp. wall ♦?-
/� ♦ ;�
Int. wall
Glass
Ceiling
fC'a
Floor
Total Btu. 1
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
^a j% Room I Lenath"7; ' Width c Heights
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane Ilghts of crack eq. ft.
Width Height No. of I Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
f
Coef. Btu
Coef.
Btu
Infiltration
1(e
Glass
4z 6
elo
Glass
Exp. wall
fC'a
Eo
Exp. wall
frig
—
Int. wall
Net exp. wall
A®
eplod
Int. wall
Floor
Ceiling
Floor
Total Btu. 1 7 &d'd
Required sq. ft. D.R. or sq. ins. W.A. Leader area
4J1 Room I Length . 7/ Width 7 Height -7'
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane Ilghts of crack eq. ft.
9? 4- r
f
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
®
C® :r e -ii
Int. wall
Ceiling
Floor
Total Btu. I --s'17vsli-
Required sq. ft. E.D.R. or sq. ins. WA. Leader area ,
Permit Fee $ ............................ r
e
APPLICATION FOR MECHANICAL WARM AIR HEATING PERMIT
No. P ------------------------
Dateof issuance ................ .------------------------------------- 1196 ...... Location....----•---...-----•--••--•-••-------...----......................................
.Minneapolis, .Minn ................................................. 196......
Inspector of Buildings
The undersigned hereby makes application for a permit for the installation, alteration or repair of
a heating, air conditioning or ventilating system, device or equipment, as herein specified, agreeing to do
all such, work in strict accordance with the City Ordinances and rulings of the Department of Inspections
and the speci facations set forth in this application as approved and filed in the Department of Inspections.
Owner----------------------------------------------------------------------------------------- 4ddress of Owner ................................ _...............................
Kind of Buildin---------•---..How occupied---- --------------------------•-----•--------------------------•-------•-•-
Work to be started --------------------------------------------------- 196 ...... Work to be completed ........................................ , 196 ------
EstimatedCost $ ----------- ................................................... Old — Xeu, Building PermitXo.............................................
DESCRIPTION OF WORK
Note: Insert the word install, add, alter, or repair, according to which is to be done. Under "Remarks," itemize removals, if any, and
alterations to equipment.
................................................Mechanical Warm Air Heating Plants—Furnaces ........................... .......................................
Make--------------------------------------------------------------------------- •---------------------------------- Size -•-----•------------...--•---•--•-•-----------•---------------------------
Connectedload -------------------------------------------------------------------------------------------- Capacity ---------------------•---------------------------------------•--
Air Conditioning System: Summer — Winter — XZ rear; ....................................... . ...............................................
Make........................................................ --................................. --Capaeitzy................... _.................. Cfm•----•-•---------------------•---
.-----------------------------------------------------------------------------------------------------................................................................. ------
Ventilating System: Make ------------------------------------------------------------------ Capacity -------------------------------- Cfm.
Remarks
.1pproved----------------- __................................................ 196 ------
..................
Inspector.
1 D-20 4.411W3
Signed----------------------------------------------------------------------------------------
By.......................................................................................
.d ddress--------------------------------------------------------------------------
Telephone--------------------------------------------------- -----------------
Date:
City of Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
August 27, 1971
Kenneth L. Nelson same
Owner: Builder
Address 7 Longfellow Address same
LOCATION OF BUILDING
No 447 Street Longfellow Part of Lot
Lot 10-11 Block 7 Addition or Sub -Division Spring Brook Park
Corner Loi Inside Lot X Setback Sideyard
Sewer Elevation Foundation Elevation —
DESCRIPTION OF BUILDING
To be Used as:
Garage 28' 26' 10' 728 7280
Front Depth Height Sq. Ft. _. Cu. Ft.
Front Depth Height Sq. Ft _ Cu. Ft
Type of Construction f ramp- Est, Cost .$1500 To be Completed 1 year
Stipulation: Provide a hard surface drive.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
Oe proposed work in accordance with the description above set ,fo and in compliance with provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of 3 , permit is hereby granted to Kenneth L.
Nelson to construct the buil
the express condition that the ding or addition as described above. This permit is granted upon
person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of
Vridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
an city limits and this permit may be revoked at any time upon violation of any of the provisions of sand
ording Inspector
CL•ARF.AT!'_E BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
e
V1.
-r
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME • `- BUILDER:
ADDRESS:44V ADDRESS: It
NO:.STREET:
LOT: Z,2 -- fI BLOCK • 2 ADDITION:
CORNER LOT: INSIDE LOT: k" 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 Used As:
r
Front: Depth: Height: /®
Square Feet: AW Cubic Feet: 'e"? __? 91-6)
Fronts Depth; Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: $ /®®
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
(See Reverse Side For Additional Information.)
C.X. C. g401UPA and v4SS®CtateS, Aic. LAND SURVEYORS
10130 HIGHWAY 65 NORTHEAST - MINNEAPOLIS, MINNESOTA 55433 Telephone
784-5480
Certificate of Survey: KE N N r= -r H NELSON_
ITI
60
ds� 1
q
A W
1 U
1 I Z
li
� Q
J
i Q.
SCALE.
4
� LO 3a�z-iso-10
qDENOTES 1Pow
22$1 i
LONGFELL.OW ST.
LEGAL DESCRIPTION:
Lots 10 and 11, Block 7, Spring
Brook Park, Anoka_C6unty, Minnesota:
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN.
CROACHMENTS, IF ANY, FROM OR ON SAID LAND.
AS SURVEYED BY ME THIS..... 23rd.... DAY OF .............. AU2USt.................. A.D. 191.1
N. C. HOIUM AND ASSO ATEINC. - LAND SURVEYORS
.................................................................................
1a
-04-47
®
26.0
lO
�
® O
d. m
6.�
0
m
0`
60
ds� 1
q
A W
1 U
1 I Z
li
� Q
J
i Q.
SCALE.
4
� LO 3a�z-iso-10
qDENOTES 1Pow
22$1 i
LONGFELL.OW ST.
LEGAL DESCRIPTION:
Lots 10 and 11, Block 7, Spring
Brook Park, Anoka_C6unty, Minnesota:
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN.
CROACHMENTS, IF ANY, FROM OR ON SAID LAND.
AS SURVEYED BY ME THIS..... 23rd.... DAY OF .............. AU2USt.................. A.D. 191.1
N. C. HOIUM AND ASSO ATEINC. - LAND SURVEYORS
.................................................................................
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace'Shell & Duct Work
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
MECIUMNICAL WARM AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYST2,1:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTU
OIL BURNER- to 3 gal. per hour
each add. 3 gal. per hour
GAS BURNER- from 100,000 BTU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
RATE
$12.00
7.00
7.00
4.00
TOTAL
$
S
S
S
$12.00
$
4.00
$
7.00
$. ,
7.00
$
4.00
$
$12.00
$
4.00
$
7.00
$
6.00
$
$10.00
19.00
$10.00
GAS FITTINTG FEES:
1st 3 Fixtures x $ 3.00 $
Additional Fixtures x $ 1.00 S
Gas Range to 199,000 BTU x $10.00 $
AIR CONDITIONING �) S
FAN HEATING SYSTEMSS
See Fee Schedule
VENTILATING SYSTEMS S
ALTERATIONS $ REPAIRS_ S
State Surcharge $ .50
TOTAL FEE $, sy
ROUGH INSP.
Date r�
FL�IAL INSP. L/
Date
APPROVAL FOR PERU= i
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
AIL
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department cf Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. /® , 19�
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT / �� 4c Ze
0�
ESTIMATED COST 3 0
( OLD - NEW BUILDING PERMIT NO. PERMIT N0.
DESCRIPTION OF FURNACE/BURNER
HEATING or POW/(vF t PLANTS, Steam. Hot Wate , Warm Ai/r' No.
Trade Name / i� -�✓1 Cwt Size No. Com' « 13 O e AIA4,6
Capacity Sq. Ft. EDR AOdd" BTU HP
Total Connected Load , r 7 0 Kind of Fuel Qat
BURNER - Trade Name
Size No.
REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP
($10.00) d
Company 29A�
Signed By 4f
/
Tel. No.�.��(�'�
MINDIUM FEE FOR ANY HEATING PERMIT IS $7.50
v • , , v , 1 Irl Lr 1. 4 1
97 b 416051 APPLICATION FOR PWMEING ANO GAS FITTING PEV11T
&A
u
k
a,
Plater
A 1q. OI C
m N n
1.
4 v m ti
rl
p;
.i
1'/
Or
FULUre FlAture Opening
lied ter
U
N C C C.t;
$
New Fixture, Old Opening
U
$2,00
Catch Basin
x
$5.00
' 0 1 LI N H p n
11 b • b N 0 G
S r1 V7 11 U.
b U q
N
'' N
N
100,000 BIL to 199,000 BTU
U
U rr a � x 4 w �
an n
w u ct a 3
$
watdr Softener
x
$7.00
$
New Gtuund Ran Old BuildiN
x
$5.00
$
Elccuic Hater ►,eater
x
$5.00
$
SAS FIIJING FEES;
1st ] fixtures
x
$3.00
$
X-MItlonal Flxtures
x
Gsa Hengn to 199,000 BTU
x
$1.0.00
r up
_
First 5100.00
$5.00
$
tact, aJJ. $100.00 or IraGtlOn
h
$2.00
$
State Surcharge
R) - I'utute Cunncctlon Opening
I CG1111ectcd
with Sewer
�) o New Fixture, Old Opening
$ 8.00
Water
PARTIAL Rill E SCHEDULE
'LUMBING FIXTURE RATES; NO.
RATE
TOTAL
Watt) er Fixtures
x
53,00
$
FULUre FlAture Opening
x
$2,00
$
New Fixture, Old Opening
x
$2,00
Catch Basin
x
$5.00
$
WAtai IlaaCer - to 99,000 BTU
x
$5,00
$
100,000 BIL to 199,000 BTU
x
$10.00
$
watdr Softener
x
$7.00
$
New Gtuund Ran Old BuildiN
x
$5.00
$
Elccuic Hater ►,eater
x
$5.00
$
SAS FIIJING FEES;
1st ] fixtures
x
$3.00
$
X-MItlonal Flxtures
x
Gsa Hengn to 199,000 BTU
x
$1.0.00
$
LEP,kII(S 4 ALTERATIONS
First 5100.00
$5.00
$
tact, aJJ. $100.00 or IraGtlOn
$2.00
$
State Surcharge
$ 50
TOTAL Vrl!
$ 8.00
Job Address h47 NF Longfellow
Department of BuLldings
City of Fridley
Tel, 115)1-3150
The undersigned hcroby'makea application for a permit for the work herein,
specified agreeing to do all work in strict accordance with, thi: City Codes
and rulings of tho Department of Buildings, and herety declare, that all
the facLu and rcpruoontntions statod in this application aro thio and corroct
Fridley, 1•1n. 10-29-79
OWNER HOTTA
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ALOUT 11-5-79
! ESTIMATED COST 40.00
OLD - NEW BUILDING PEAU -11T HO, FEfUtIT NO.
Company
Signed By �^ �0
Tel, No.
ROUGH ILISP,
Da to
FINAL TtISP,
pate
APPRUVAL FOn PE1011'P s
MIt1IMUM 1'E£ FUit 1.11Y I'LUI:BING MAJ13T Is 67,50 pLUS $,50 STI.TE SUROLAliCE
A.r
ILEI11SP£CTI011 FCC
SUBJECT
P
City of Fridley
2 5 7 9 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
1.COMMUNITY
RECEIPT NO.
DEVELOPMENT DIV.
r 1 V PROTECTIVE INSPECTION SEC.
tI �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
OF
APPROVED BY
612-571-3450
910-F15
2/11/98
F;GE
/
JOB ADDRESS 447 Longfellow Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
10,11
7
Spring Brook Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Anita Hoffa 447 Longfellow Street NE
786-8397
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Panelcraft of MN 3118 Snelling Ave S, Mpls., NN 55406
721-6628 2179
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling, Soffit & Fascia
9 CHANGEOFUSEFROM TO
STIPULATIONS
Install building wrap and call for inspection
of same.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
MOT.
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
$3.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7,000
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
1 $140.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN VALIDATED THIS IS YOUR PERMIT
j,PPR�OPER
!/I/ a
BLOt INSP
2 -1/ 4J
GATE
SIGNATURE OF OWNER oF OWNER BUILDER) IDATEI
NLW
ADDN CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
I-Alecllve 1/1//4
2S �6(Ci
Legal Description: 1
Owner Name & Address: _!��L\� 1_Of- Tel. //
Contractor: p_ MN LICENSE //
Address: 2 `)_SPE%t �� I 1 \Q )X \ Tel. /I
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sy. Ft.
GARAGE AREA: Length Width Height Sq. Ft.-
DECK
t.DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot O Inside Lot O Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $
Approx. Completion Date: e 906)(0
(Cost on Back)
. Driveway Curb Cut Width Needed:
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT:
Ft. + G Ft = Ft x $ _ $
Tel. //
CITY USEOI"LLY
$ 1,�A %S
Fee Schedule on Reverse Side
. ® D
.001 of Permit Valuation (1/10th %)
-�—a
$.50/$1,000 Valuation
$
$800 per SAC Unit
$ :S-, 00
$5.00 (State Licensed Residential Contractors)
$
Alt. "A" or Alt. "B" Above
$
$450.00 Conservation Plan Review
$
Fee Determined by Engineering
Agreement Necessary I I Not. Necessary I I
CITY OF FRIDLEY PERMIT NO, '� 2004-00567 '
6431 UNIVERSITY AVENUE NE
-
FRIDLEY, MN 55432 DATE ISSUED:
04/22/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 447 LONGFELLOW ST NE
PIN : 033024310063
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 400.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
INSTALL A GAS WATER HEATER
# ELEC WATER HEATERS 0
# NEW FIXTURES (EXIST OPENINGS)
0
# GAS WATER HEATERS 1
# GAS DRYERS
0
# GAS RANGES 0
# OF NEW FIXTURES
0
# WATER TRMT APPLIANCES 0
APPLICANT
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
0.00
0.00
NORBLOM PLUMBING CO
2905 GARFIELD AVE S
PLBG FIXTURES (EXIST OPENINGS)
0.00
NIINNEAPOLIS, MN 55408-2173
WATER TREATMENT APPLIANCE
0.00
(612) 8274033
WATER HEATER - ELEC
0.00
WATER HEATER - GAS
35.00
GAS RANGE FEE
GAS DRYER FEE
STATE SURCHARGE, PLBG FLAT
0.00
0.00
0.50
OWNER
HOFFA ANITA M
447 LONGFELLOW ST NE
TOTAL
35.50
FRIDLEY, MN 55432
PAID WITH CHECK # 28149
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume give authority to
violate or cancel the provisions of others to or local law
regulating constructio the perf ance f construction.
Applicant Date
Bldg D
PARATE PERMITeAQI&D FOR WORK OTHER THAN DESCRIBED ABOVE.
;ITY OF FRIDLEY INSPECTION DIV.
4:i1 University Ave NE
'ridtey, MN 55432
763) 572-3604, FAX (763) 571-1287
Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBEK OF FIXTURES TO BE INSTALLED
ON EACH FLOOR
Urinal
"I't�:..... we
...............
::<:::>z:>:::: Wash
`; «
.��.�...�-:.:.�::
.................. Tray
t :..:;::>::::>::
:£[::::.:.
.�t�iil>� --
..............:::..::
Floor:>:<:
Drain n
Auto.>::>:::::<<:
• -:.::-.<..:-• Washer
`.�':•':'::::::.:_:
(.;:.:::<;:;
Gas
Range
:iItSG::::;::
Water Heater
--------------------
:� • •::.-:: •.:.�..
;s��....
�;;'•`"::>
fir::;:.:::.:,
Gas Elec
Basement
Floor 1
toor 2
F0
Floor 3
Floor 4
'LUMBING FIXTURE RATES:
dew Fixtures
)Id Opening, New Fixture
3eer Dispenser
31ow Off Basin
NO. RATE TOTAL JOB ADDRESS_ 6&^--VX0- • a.S O W AAAr
'atch Basin
lain Water Leader
Sump/Receiving Tank
Nater Treating Appliance
Nater Heater -Electric
Nater Heater - Gas** 1
Sas Range**
Sas Dryer**
3ack Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
kLL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
3S. do
$ 6b
0S. sb
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
HOFFA, ANITA
447 LONGFELLOW STREET NE 0-05-'20 �
FRIDLEY, MN 55432
OWNER (763) 786-8397
BUILDING USED AS K e,Si O) e ,1C -e
ESTIMATED COST �� oto PERMIT NO.
'PV
PLUMBING COMPANY NO C \0 ` aWk U, / IOT
SIGNED BY TEL N0. (4,I2)S27-q033
Approved By Rough -In Date Final Date
— 91n4
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST
OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existina furnace, 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 plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length,. number of elbows and termination. Yes O No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No ( )
When Installina a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( )
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( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input Fan Assisted or Nat
Appliance #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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date
Building
$
BUILDING
Permit No-d(®11-0 ILI 10
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Surcharge
CITY OF FRIDLEY
Date RES F P 2 8 200
763-502-4977 FAX
$ SDU
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
EFFECTIVE 1-1-09
Curb Cut Escrow
DATE - a -3- ®
YOUR E-MAIL ADDRESS ,/L /L ®E'
Erosion Control
SITE ADDRESS
o 4 % cal S? A14
Park Fee
THIS APPLICANT IS:
�O R ❑CONTRACTOR
Sewer Main Charge
PROPERTY OWNER/
NAME: C0 z W ,-c o o S
Total Due
TENANT
-ic /
ADDRESS: /,S ,o / g %, �g .e CcJm e, CITY Fr, , ad a.
-STATE/V//It ZIP S'S 13
PHONE:_ tr' ,/�
CONTRACTOR
NAME: Q e-
/i/ c—
SUBMIT A COPY
YOUR STATE LICENSE
® �
STATE LICENSE # 0 _- Ci V EXP DATE
� 3
� `3 � °� v /O°
AND CERTIFICATE OF
ADDRESS: 3 Me Au ,y /(,,, 4 4- ke 91 k'W 5-J1CITY AhyoA, it ,- STATF/'t/ 4 ZIP-5-S30,-
INSURANCE
PHONE-"/ - 35'2-e'64-1 FAX 76-5- Z47-S-030
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
WBASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR 90 REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
❑ HOUSE ONLY
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW
CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS []Yes ISNo LOCATION OF WINDOWS
/
OR FOR NEW OPENINGS-DESCRIBE SIZE OF L� Dar ' ss W i �� d a tic"
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ °� i+' OCCUPANCY TYPE
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$ S
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ SDU
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ ,
Make checks payable to: City of Fridley Attach Stipulations
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 1 understand this is not a
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME /(a 4► p „ r IG .P to FS DATE G ' 2 3 - o i
I
Building PLUMBING Permit No.: ;& 7-0170
Inspections RESIDENTIAL APPLICATION Received ®B
763-572-3604 CITY OF FRIDLEY DAM
763-502-4977 FAX q EFFECTIVE 2-19-09
DATE / Z YOUR E-MAIL ADDRESS
SITE ADDRESS %-1, &-t, 577
THIS APPLICANT IS: ❑ OWNECONTRACTOR
PROPERTY NAME:
OWNER/ ADDRESS: AC� �P ��w CITY �y'G� �
TENANT 1i STATE►1 ZIPS
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE, BOND AND
CERTIFICATE OF
INSURANCE
PHONE:
NAMC: _�' C C ') ] _5L< W/_
STATE LICENSE # 5—,e 4 , f A9/'Z-L EXP DATE
STATE BOND # EXP DATE 1 �- -3
ADDRESS: l .�cn< /ter (ft l CITY_%y� /3:'5,Bc' STATE ZIP
PHONE �I �� =j� e' v FAX
PERMIT TYPE 106NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: I ❑ NEW ❑ REPLACEMENT
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$)5.50.
BATH SINK/LAV
_FLOOR DRAINS
SHOWER
WATER PIPING
—BATHTUB
_ GAS PIPING (NEED CITY LIC)
SWIMMING POOL
_
WATER SOFTNER ($ IU
_ CLOTHES WASHER
_ KITCHEN SINK
WATER CLOSET
_
BACKFLOW PREV. $1
_ DISHWASHER
_ LAUNDRY TRAY
_WATER HEATER ($35)
_
FOR IRRIGATION
_ WATER METER
OTHER
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and 1 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 an application for a permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in theca f all work which requires review and approval of plans.
' GA 9
SIGNATURE OF APPLICANT 2�—zy'�- _- SP RINT NAME_ (�I "� �' -� G� ✓ �� V� DA E [ t' —� p
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
MECHANICAL
Permit NO.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
763-502-4977 FAX
EFFECTIVE 1-1-2010
DATE1 c�/ lT O Off, -MAIL DRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER TRACTOR
PROPERTY
NAME: S
ADDRESS: ITY °—�'� STATE ZIP '5 -
jTENANT
OWNER/
TENANT
PHONE:
CONTRACTOR
COMPANY NAME: 4* do(,
CONTACT PERSON:
SUBNUT A COPY OF
YOUR STATE
LICENSE WITH
STATE LICENeS�'E, # EXP DATE ® ,A
L`t� i�� tL� V J-- STATE �^. ZIP 5�
ADDRESS: j CITY A
APPLICATION
PHONE FAX _76 :�?> -q- �
PERMIT TYPE
09IN LE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
0 NEW ❑ REPLACEMENT WALTFRATION/REMODEL
DETAILED DESCRIPTION OF WORK I �,1� ��- `z �YL°—f
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: SIZEBTU
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
$25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
_A/C
TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00
_AIR _FIREPLACE
$35.00 $35.00 _GAS UNIT HTR $10.00
_BOILER _FURNACE
LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00
_CHIMNEY
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
1 � `'�• �.t 'G � xr ski- � ' � a� � - ��� > 85 t�.�k � z f,�.'�-;� �...
RY
'�^ �SY' .. *✓�A. N
<
..
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 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 allwhich requ' s r view pproval of plans.
k�l�
SIGNATURE OF APPLICANT P�4 NAME L oj DATE
Ll 6
APPROVAL INSPECTORS SIGNATUREDATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
4. Heat loss & cooling load per room
a. MN Rule 1322, Sec. N 1104.4.13
5. Ventilation
a. Per MN Rule Chapter 1322. Sec. 1104
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.