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PRE 2010 DOCSnelf (9MM U D1IU_ ti Village of Fridley, Minn. N° 2938 Datef ......... ............. c Owner �. ��, ....... . Address . P . a . ....�............. ....... . Builder.... . zle- Address .../...�!. . . ................ LOuPATION OF BUILDING No. 7�.? . .. Street............ ............. Part of Lot ... ... .... . Lot .... .... Block .... r7% ........ Addition or Sub -Division .................... .... .. .... . C Corner Lot ............ Inside Lot .:/ .... Setback ./...... Sideyard DESCRIPTION OF BUILDING To be Used as: . ...... Front ... Depth . Height Sq. Ft 10X� Cu. Ft........ . l.......Front .� Depth ... Height Sq. Ft.....1... Cu. Ft......... of Construction .............. Est. Cost ...l..� . ® f .. To 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 forth and in compliance with all provisions of ordinances of the village of Fridley. � �(�: lam? :.. ........ 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 any part thereof, shall conform in all respects tq, the ordinances of Fridley, Minnesota regarding location,. construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _ "l �:? NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas sewer or water. Be sure to see the Building Inspector for separate permits for these Items. t J N s CT OT H L m f, S Ily C'.. ... v 1f)- p- � 4T P 01- City of Fridley, Minn. BUILDING PERMIT Date: September 14, 1965 Builder Bye , Tne- 3as-�3 W? 8448 AddresaXan_127 Mississipgi St. N.E. Address 251 Rice Creek Terrace LOCATION OF BUILDING No. 727ff Street 'M'ississip,Fi street N -E. Part of Lot Lot 5 _ Block Addition or Sub-Divisicm . Clover Leaf Addition Corner Lot — Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: nwP l j i ng Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est Cost �,15,000.00 To be Completed Storm Damage In consideration of the issuance to me of a permit t. construct t building described a the proposed work in accordance with the description above set in compliance of ordiaanc es of the city of Fridley. In consideration of the payment of a fee of $_].0..94 , permit is hereby granted to Ben Nolke, Inc. to construct the building or addition as described above. This permit is granted upon the empress condition that the peon 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 Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buil�ng� wig dty limits permit may be revoked at any time upon violation of any of the provisions of said NOTICE This perms► den not cove dm conshmMom, hufalF m for wietag, phm"g, 6n 6sadn& awar or water. Be sore to as da BuMmg hopnter for spm" psndts for duns Berra. City of Fridley, Minn.. N° 8221 BUDDING PERMIT Date: July 19, 1965 Owner: BMNARD �/ Builder SM Address $V$ Bice Creek Terrace Address Fr3dleys Minnesota LOCATION OF BUILDING No. 727 Street it, BeRM 1091MUZZIMEM Part of Lot MISMWIPPI Lot _Block Addition or Sub -Division Corner Lot Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation all To be Used as: Front Front Type of Construction AlP".AN')i4laXC+ DESCRIPTION OF Depth Height Depth Height- ____ Est. Cu. Ft. Cu. Ft. 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 forth and in compliance with ;Jl provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $-2Q.0 - , permit is hereby granted to BERNARD BLOW 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 any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota gg location, constructCon, alteration, maintenance, all and moving of buildings within the city limits pis permit may be revoked at any time upon violation of any of the provisions of said ordinances. A=N G. JENSEN Building Lupector NOTICE Ub perft doss no osrss the coeaf edw, helm for whieg, plimbing, gas haatln& saww or water. Be ars to sso the Building hwpuftr for separate Mrmw for thea buss. _ -%. J APPLICATION FOR BUILDING PERMIT // CITY OF FRIDLEY, MINNESOTA OWNER'S BUILDER ADDRESS . �,IADDRESS LOCATION OF BUILDING N0.STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE YARD SEWER ELEVATION_ FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF ING To be used as:,,,-' �FrontDepth Height 1� P g Sq. Ft. Cu. Ft. Front Depth Height 401 Sq. Ft. Cu. Ft. 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 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. DATE --Z �� �SIGNATTRE �. (Schedule of Fee Costs can be found on the Reverse Side). CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 $ e3� 0 JOB ADDRE Effective On January 1, 2000 BUILDING USED AS RESIDENTIAL ESTIMATED COST �� PERMIT NO DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load FIREPLACE --- Burner Trade Name Size No. BTUHP EDR ``c,5 -7—,, s�,_ 5— —,5u- -e� X'7 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 an rulings of the " " ' ^' onri horahv declares that all the facts and representatic Fireside Hearth & Home 2700 Fairview Ave. N. :orrect. Roseville, MN 55113 651633-1042 License # 20512060 HEATING CC o VER Signed Approw Rough -In Date TEL # Final Date' FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 () 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 installing 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: 1' ... HEATING CO: Signed By: Date : 1 ��/� ��5 • -0 -4 2 �0 � -N5' 134 ALL FF.M ARE BASED ON VALUATION, LXCLUDINC THE COST OF LABOR AND MATERIALS: (USING THE 1997 U&C FEE SCHEDULE) JOB Permit Tree $ BUILDING Plan Review hnnit No.: 1Building Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 763-572-3604DateCITY .0005 x Permit Valuation Minimum $.50 OF FRIDLE"Y"�i _ $ � r..�-�?0 DATE ! O? YOUR E --MAIL AbuRK%p; $1550 per SAL Unit (Plans to MWCC for determination) srrE ADDRESS 14S I sS AP , - ...._ $ THIS APPLICANT IS: OOWNER ONTRACfOR $ PROPERTY OWNER/ NAME:__. ( y t 6 P=�y7 $ TENANT ,r/ yam► ADDREss; { oZ // ! J SS ! 5 S f / ST , r Iv G� C[TY L / STAT -. IF Agreement necessary ( ) Non Necessary ( ) n PIIONE:..... /�— _ CONTRACTOR NAME;_ Window Concepts of MN, Inc. - - SUBMIT A COPY OF STATE LIC 990 Lone Oak Road Suite 114 - - YOUR STATE LICENSE ADDRESS: Eagan, Minnesota 55121 CITY .. STATE_ZIP _. . WITH APPLICATION PHONE INGLE 1 License # 20163493 PROPERTY TYPE o Dart N www.window�Lc�spi �mn.com �S INtx)WS r PERMIT TYPE 17 BASEMENT FINISH ROOF ❑ DRAIN TII.P. 13 DECK 0 SIDING ❑ tYCHNR 0 SW33"INCI KXX TYPE OF WORK: C] NEW13ADDITION D MAINTENANCF/RFPAIR ❑ 1tEMODELING DESCRIBE WORK BEING DONE: r uJl� e;j �SQiyru2 .. Q a-„2� 4A SIZE OF IMPROVEMENT LENGTH WIDTIi HEIGHT Sq. Pt. ROOFING O HOUSE ONLY NUMBER OF SQUAkCS „_ ❑ HOOSE do GARAGE !148=14T REMODM- ING SUNdrry GARAGES Q ATTAC:HLD GARAGE 1. Existing floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Propascd door plan PROPU$ED HEIGHT: 3. List of structural mcmbcrs to be rased 910ING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 VMyI 08K)Mt ADDITI(MS. & POjiF(;Ij S SUBI\�IIT: 17 Aluminum 0 Trim 1. Site PIWSurvey showing ft existing structures C3 Othcr ❑ Fascia and propased project. WI- 2. Two ails of construction plans c% Ohio LOCATION OF WINW nvS 1N EXISTING OPENINGSA-DESCME 3. Energy Calculations OR FOR NEW OPENINGSIZE OF 5020-0 OPENING CHANGES & — _ TYPE OF WINIX)W TO BE INS" M&ED 141.nqv NUMBER Of WINDOWS ALL FF.M ARE BASED ON VALUATION, LXCLUDINC THE COST OF LABOR AND MATERIALS: (USING THE 1997 U&C FEE SCHEDULE) JOB Permit Tree $ --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 _ $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAL Unit (Plans to MWCC for determination) Curb Cut Escrow $ it + 6 i1= ft x $21 _ $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks Davable to: Citv of Fridley Attach Stinuilattons THIS IS AN APPLICATION FOR A PERMIT -NUT VALID UNTIL PROCEgSHD 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 pen -nit 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 ofalI work which requires review and ap r_o_val of plans. SICINATURI? (7F A1'NLIGAN' 5 PR,* NAMB DATE &Y64 rd WUZ2:TT 900E 90 -urf ZBZTTZ=Z: 'ON MA fialp?ad do fiTTO: WOiyd 17 From: unknown Page: 1/1 Date: 8/14/2007 4:12:00 PM__ NEW I 1 CITY OF FRIDLEY tive ADON [ ] 8431 University Ave NE, Fridley, MN 55432 Ette�,360 4ldg 4 ALTER () SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 572-Insp BUILDING PERMIT APPLICAMN (763j 571-11287287 Bldg Fax Construction Address: y ' Legal Description: GZ Owner Name 8 Address: Contractor. MN LICENSE* Address: fmo �- f� Attach to this application, a CertiFrcMte of Survey of the Jot, with the proposed construction drawn on it to scale, . DESCRIPTION OF IMPROVEMENT LIVING AREA: Length —�` Width Heights Sq. Ft GARAGE AREA: Length �^ Width Height__ Sq. Ft DECK AREA: Length Width O,m� �^ HgNGmund _ Sq. Ft. Construction Type: k4r" lrnated Cost: -t ' Cr Drivdway Curb Cut Width Needed: Ft. * 6 F Ft x DATE.• it APPLICANT• Tal. # - �G'L%Sr Call (763) 672-3604 for Perrnit Fees if mailing In application. Fax to 783-571-1257 if using credit card and we will can ydu fide rani number, CITY USE ONLY - Permit Fee $ Fee Schedule on Reverse Side Plant Review $ 65% of Permit Fee Fire'Surcherge $ .001 Of Permit Valuation (1/10th%) State Surcharge $ $.501$1,000 Valuation SAC Charge $ $1350 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary[ ] Not Necessary [ l TOTAL $sr1PULArIONS: B.IAlding BUILDING Permit No.: 2,0_0 151 Inspections RESIDENTIAL APPLICATION Received By: onUI , 763-572-3604 Plan Review $ 65% of Building Permit Fee 6 6 CITY OF FRIDLEY Datew": T-�= 00 763-502-4977 FAX Surcharge $ EFFECTIVE 8-19-09 License Surcharge DATE /G— 09 YOUR E-MAIL ADDRESS SAC Charge SITE ADDRESS $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR Erosion Control PROPERTY OWNER/ NAME: Won Park Fee ADDRESS: CITY STATEZIP05,= TENANT $ PHONE: Total Due CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAIVDLY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES El HOUSE & GARAGE 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: 13 Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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) IUlALJUIf VALUAllUIN a uuuurAAUY 1 YrE Permit Fee $ See Back Page for Fee Schedule Zz Plan Review $ 65% of Building Permit Fee 6 6 Fire Surcharge $ .001 times the total job valuation zg Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ Zsc' "— —1-0ft 41 -ft =13 ft x $22 = $ Z$;o Erosion Control $ $450 Consation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 7 I — Make checks Davable to: Citv of Fridlev 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 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 the case of all work w 'ch a uires review and approval of plans. (� SIGNATURE OF APPLICANT . PRINT NAME , e,, DATE���j —} PH. 763-421-6417 PROPOSAL SUBMITTED ADDRESS: P CITY/STATE/ZIP: PHONE (S) : ESTIMATORS AL CZARS OF TAR, INC. 18475 RUM RIVER BOULEVARD, ANOKA, MINNESOTA 55303 PROPOSAL AND CONTRACT Tn f L 1✓ l /1 v f %� F aS L DATE: FAX 763-783-9183 NAME: MAP: PROPOSED SPECIFICATIONS: CZARS OF TAR, INC. SITE PLAN AREA OR SEE ATTACHED PROPOSES TO FURNISH ALL LABOR & MATERIAL NECESSARY TO COMPLETE THE FOLLOWING: p (��w 0/0 L`Lv`lf—(L PLACE 111. REMOVE & HAUL AWAY: _-- ASPHALT ___ SOD/DIRT--- CONCRETE -___ OTHER Q [12. NEW EXCAVATION TO BE ----- INCHES BELOW / Z FINISHED GRADE [13. INSTALL CRUSHED CLASS 7 AGGREGATE BASE AS NEEDED TO ESTABLISH A ----- INCH GRADED AND COMPACTED BED. ❑ 4. SWEEP AND CLEAN DRIVE, APPLY TACK OIL AS NEEDED. OVERLAY EXISTING DRIVE WITH g u l --_INCHES HOT ASPHALT ❑ S. GRADE EXISTING BASE ADDING AS NEEDED, AND i COMPACT. [36. PAVE WITH_____ INCHES OF HOT ASPHALT MIX I 2341A OR 2341 B COMPACTING TO A ______ ( j' FINISHED�AT. 7. OTHER__ �e W -1 0-r I r� & As_ rR 2' Ar- A co f r 1 _X ----------------------------------- do -&t�--Ar ,(AMB I �. Tu� -------------------- --------------- /I tv�r rf AarcfN%y` G� F 0 j2 / -v -L ALL OFF WORK TO BE COMPLETED IN SUBSTANTIAL AND WORKMANLIKE MANNER FOR THE SUM OF: ,6 ��1, 1p V f L n 9 Si V t�- 0/2 ae Dollars 8 Payment to be made as follows: `V % down % after base work is complete and balance due upon completion. Any unpaid balance will accrue interest at 1.5% per month, 18% annually. All material Is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involv- ing nvolying extra cost will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Czars of Tar Inc. carries public liability and workman's compensation insurance. Notice of lien: Persons or companies furnishing'labor or materials for the improvement of real property may enforce a lien upon the improved land if they are not paid for their contributions, even if such parties have no contractual relationship with the owner. Minnesota law permits the owner to withhold from his contractors so much for the contract price as may be necessary to meet the demands of all other lien claimants pay directly such liens and deduct the cost thereof from the contract price, or withhold amounts from his contractor until contractor furnishes to the owner of claim for mechanics lien signed by persons who furnished any labor or material of the improvement, and who provided the owner with timely notice. The owner hereby waives all further requirements of notice under Minnesota statute 514.011. Your driveway carries a _—I— year structural guarantee. TE_ ZZ, Signature of Owner SIGNATURE OF CONTRACTOR I AGREE TO THE TERMS ABOVE AND BACK NOTE: This proposal may be withdrawn by us if not accepted within Z G I days. Building MECHANICAL PennitNo.:00k) IdM Inspections RESIDENTIAL APPLICATION Receive) 763-572-3604 Date'R�c d. Oil CITY OF FRIDLEY 77)FAX 1763-502-4977 EFFECTIVE 7-1-2010 _(0 DATE 1�3y YOUR�E--MAIL ADDRESS SITE ADDRESS 2 -Milli % c! , THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: VI h roe r OWNER/ ADDRESS:7Z% /Vl i-rrlfl%t0pi 1A CITY r- I STATE ZIPttL)72 TENANT PHONE: 7D// 3 CONTRACTOR COMPANY NAME: P/`� fTti /Ov1 CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICEN Ep# EXP DATEn�, LICENSE WITH ADDRESS: / Zc) Z A /T w, f CITY An ® q STAT IPJ 7V_? APPLICATION PHONE 702— 4IL1~-3ar®V FAX �%� `fZ.J-390 9 PERNUT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK E' rP <n r a r� FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUA JI , 2006 ASHRAE HANDBOOK. EgWpment Installed MFG: q ^ Cr F MODEL: SIZEBTU MFG: C4rPt-/11C MODEL: 2WC1476' SIZEMTU00 MFG: MODEL: SIZE/BTU V/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 BOMER $35.00 URNACE $35.00 _GAS UNIT HTR $10.00 ✓F CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 •.� � F£ � R�S4," f t'L'i, b. fiR t N � I?3 i �' � � �. ^ 2 ,£ T E 2 } x � igam 1E 1V 1 z i t vk-k✓.F k,�hFb, { i R -'2'" w. ^� 3 5 to '1 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 all rk wh)cp requires review and approval of plans. L SIGNATURE OF APPLICANT &4PRINT NAME J®fA11/CIPGCQr DATE 3® APPROVAL INSPECTORS SIGN DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977. 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. N1104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Design Per IMC 13 46.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.