PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT S®4'7'7 4
Date:
Owner:!"j...:e.�..�'� ..., Al.— .: rd)?
Address �• --•- "i... c°_ .. .- A �+�.+' + o
Builder 0..: ......_. - r
Address ,"�+�.,...........::x�., _:..,.._..�
LOCATION F BUILDING
No. , w:..._.....,. Street _/'..:�..,' ..:_.__ ......_...._.............. Part of Lot ...... ::.........
-::.._.... _.._... ---......._... _
... e
:..,..._ Block .._... k:.. ._.. Addition or Sub -Division ... ,y. �'......
Lot............„� .:.. - .. ,�+ti' �...:.f... jrA 'Y” .. e. .......... -.....
Corner Lot .._ ................................ Inside Lot ...... Setback .a ., .......... Sideyard ... .._:._ ..2. ............ ............ .......
SewerElevation ...................... ............................. .............. ................................._ Foundation Elevation ................. .................. _............. _............. _............. _............. _..
DESCRIPTION OF BUILDING
To be Used as:
A Front-- ;---.. Depth Height J...0 Sq. F
_........ ...... _............. _........... :........... Front ....... Depth............Height Sq. Ft. ............. Cu. Ft. ..... _.........
...._..
' � 6" 'gyp..
Type of Construction .r. ..... Est. Cogt ..ZYWV .:........... To be Completed ............. .........................
THIS PER.Mi!T DO1=.S NOT _AUTHOR .' VIOLAT-
ION OF AiNY A E LA:,,D C;OVEN,INTS AND
BUILDING RESTMCT+ONS.
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 city of Fridley.
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 to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violatioof any, of the provisions of said
ordinances. e� ye7/
Building Inspector
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 home.
4
._ .:y"r ,, f:....%. r _s -.�• •fie.
'a1
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
M�+��.
Owners Name KFUM Aa F" Builder
Address I®Avc- Address 1��FZ--&FQ&—AE LL "A
LOCATION OF BUILDING
NO. �_�„ Street a 6-��r art of Lot
Lot Bto ,2— Addition or Sub.Div. R i VFr-
Corner Lot, Inside LotSet Back Side-Yard--_/S,-
SEWER
ide-Yard 9.S ® ,.....,.._
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as: .1&-s i aw- �
+— Front > Depth / 3 r Height
Sq. Ft. 10 -ja n —Cm,. Ft. .
Front Depth_ ,,r.,__ J18ight
Sq: Ft,. Cu. Ftp
Type of Construction ie�t:2 =-F-A&C: 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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions.stated in this application are true and c rrect.
DATE \,A u- rn ,Q— (�a I -- SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
W
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SU 4-1
DESCRIPTION OF WORK / 7�
Number. Kind and Location of Fixtures Locaflon `
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
�n
� r
Number Fixtures ......................
N
pTOTAL
$ / •� . J
Future Fixture Opening ................
x 1.20
"alit
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
J
(3Z
�U'
(7
�U'
R
•
N
WATER HTR.
GAS
ELEG
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
-
$ /i 4;~o
Additional Fixtures ....................
3 tom-.
"p
Gas Range to 200,000 BTU ..............
a
U
<
U�'
4a
O
Base
/r
/
1st
2nd
_
3rd
_
4th
• Future Connection Openings
Connected withI Sewer
New .Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
Number Fixtures ......................
—9 x $1.50
pTOTAL
$ / •� . J
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
$0
New Ground Run Old Bldg. ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
x $1.50
$ /i 4;~o
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEF; $ 49 M
City of Fridley:
uI�
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 are true and correct.
Fridley, Minn_.
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Old—New. Build
ROUGH
FINAL
d z 2M 7-59
Business Phone
City ®f Fridley, Minn.
BURDING PERMIT N® 7319
Date:
Ovine : Builder ` --
Address Address
LOCAT OF BUILDING
No. Street P Lot
Lot ��__ Block m� A clition or Sub- on
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation
Elevation
DESCRIPTION OF BUILDING
To
sg o
Front Depth Depth – Height Sq. Ft. Cu. Ft. ==
Fmont Depth Height.
Sq. Ft. Cu. Ft.
Type of Constructio _ Fast. Cost — 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 city of Fridley. 1221
In consideration of the payment of a fee of , permit is hereby granted to
the express condition that the��n to whom i� or addition as described above. This permit is granted upon
peso 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 regarding location, construction, alteration, maintenance, repair and moving of buildings
wry � �
city limits and this permit may be revoked at any time upon violation of any of the provisions, of said
NOTICE:
Sk perm* does not cover the constwction, hwtailation for wiring, p1 mbing, gas heating, smw or water. Be sure to we
the Building Mgmter for separate pamhs for these items.
APPLICATION FOR BUILDING PEZ1*1IT
CITY OF FRIDLEY.- MINNESOTA
OWNER'S NAME T ��5Je BUILDER
ADDRESS A`:R �_) ADDRESS
LOCATIO OF BUILDING
No. e Stre Par.t -of Lot
Lot Block Addition L,,Subdivisio
�
Corner Lot Inside Lot ��etback Side -Yard
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:
° Front "� D�o.t1i eight
Sq. Ft. ,�� ��
cu. Ft.
Front Depth Height
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
SIGNATURE
X
,j Schedule of Fee Costs can be found on the Reverse Side).
41 Fill a
Power Puts and N Tinge Ventliations R
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: MTN TOTAL
Furnace Shell & Duct Work ................ $10.00 $
Replacement of Furnace . ... 6.00 $
Repairs & Alterations—up to $300.00 6.00 $
Repairs & Alterations each add. $300.00 3.00 $—_—
MECIL WARM AIA
Furnace Shell & Duct Work to 120,000 BTU ........ ..$10,00 $
each add. 60,000 BTU .................... .. 3.00 ;
Replacement of Furnace .. .... &00 $
Repairs & Alterations,—up to $500.00 &00 $
Repairs & Alterations each add. $500.00 . .. &00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00
$.
Furnace Shell & Line—to 640 sq. ft. EDR not Water
10.00
$_
Each add. 200 sq. ft. EDR Steam
8.00
$
Each add. 320 sq. ft. EDR Hot Water
3.00
$
OIL BURNER—to 3 gal. per hour
8.00
$--
—over
over 3 gal. per hour --See Fee Schedule
GASB (up to 199,000 BTU)
&00
wer 199,000 BTU See Foe schedwe
GAS FITTING .
NO RATE TOTAL
1st 3 Fixtures
X$ 2,00
$
Additional Fixtures
x .75
$
Gas Range to 199,
x$ SAO
$
AIA CONDITION11110
FAN HEATING SY8TZK See Too 8dwdule
VENTILAT176 SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH (SURCHARGE
Dept, of Bldgs. Phone 5e0-3480
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 Ordinancef
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are, true and correct
Fridley, Minn=� // 19;��?
Owner _
Kind of B. ding
Used asTo be completed about ___
"7 J
Estimated Cost,
I ew. Building Permit No. Permit No.
Trade Name
she tj
L/i D
Total Connected Load Kind o1 Fue G'
BURNER — Trade Ala+ Size No
(REMARKS -OVER)
53-84-s-915.51
1
Base
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number FixtuFes ................
x $.00 5
Future Fixture Opening ..... • .. • . •
x $1.50 �
New Fixture Old Opening .• .• . • • • • .
x $1.50 t
Catch Basica ....................
x $3.25 b
Water Heater (Up to 99.000 BTU) ....
x $3.00 $
New Ground Pun Old Bldg.........
x $3.25 $
Electric Wates Heatm ..............
a $2.00 $
GAS FITTING FEESs
NO. RATE TOTAL
lot 3 Fixtures ................
: $2.00 $
Additional Plixtum .............. �.
: $ .75
Gas a to 1 . BTU . e ..........
($�
x $5.00 $
State Surcharge
$ .50
REPAMS a ALTERATIO ev to Co&_
D=aipdon ......
5.00
TOTAL YZIC $ 5.50
City of Ridley:
The undersigned hereby makes application for a permit for the work here!,
specified, agreeing to do an work in strict accordance with the City Ordinance
and ming of the Department of Buildings. and hereby declares that all the fact
and representations stated in this application are true and correct
Ridley, Minn 4-12-73
Owner James D. Erdman
Kind of Building Frame
Used as Res.
To be completed about 4-19-73
Estimated Cost, $ 10.00 Q
VOW—New. Building Permit No. Permit No. �/ O
Signed
&.00«: ,.
By
Business Phune No
ROUGH
7- % �
J
SUBJECT
P .
City ®f Fridley
r 17520
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
r
RECEIPT NO.
• __ COMMUNITY DEVELOPMENT DIV.
L
INSPECTION SEC.
PROTECTIVE
NUMBER
REV.
DATEPAGE
OF
APPROVED BY
"1 CITY HALL FRIDLEY 55432
j 612-571-3450
910-F15
5/91/84
JOB ADDRESS 176 River Edge Way N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
2
River Edge Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dennis A. Gruhlke 176 River Edge Way N.E. 571-4680
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS 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
X
8 DESCRIBE WORK
Reside HouseAdd 1 window
9 CHANGE OF USE FROM TO
STIPULATIONS
if
TYPE OF CONST.
OCCUPANCY GROUP
OCCI'PANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Plywood
THIS PERMIT BECOMES NULL, AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
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
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1/000
$•50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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-
$17.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$18.00
INA URE OF CONTRA GT Ro A r, oRlzE A4EN TT(DATE)
ALIDATED THIS IS YOUR PERMIT
�WHENRLY
T E OF OW OF OWNER BUILDERI (DATE) T. Y
BLDG WSP UA
J
NEW [ ]
City of Fridley Effective 4/1/84
ADDN. [ ] �R-1 AND R-2
ALTER. Building Permit Application
Construction Addro
Legal Description: -> . c -e z �`
Owner Name &Address : De V) Y) l es V` V 6V
i-�'�-- YIPI�^m& Tel. # % -`_ _1;72-12 �s 0
Contractor: A -M Tel. #
Address
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 Sq. Ft.
GARAGE AREA: Length Width _ Height Sq. Ft.
DECK AREA: Lth ` Width Hgt/Ground Sq. Ft.
OTHER: ,, r,
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: M ( e k ° ®" Estimated Cost: $
Approx. Completion Date: `7 -
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: `c3 4 APPLICANT: VI,VIc-�. 4-- c�j�l�t'` LL� — Tel. # 67/-4 �>kb
CITY USE ONLY
Permit Fee $ 96 D Fee Schedule on Reverse Side
Plan Check $ & 25$ of Building Permit Fee
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ ��•
STIPULATIONS:
suedEcr
Fridley
City of Fr
27516
AT THE TOP OF THE TWINS
B U I L D I G
PERMIT
Q
r
' ,
RECEFPT NO—
_ COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
j 612-571-3450
910-F15
91
98
f'
JOB ADDRESS
176 River Ede Wa NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
2
River Ede Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Dennis Cruhcke
571-468
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Town & Country Roofing
-
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 gc REPAIR
❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage 17 Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1456
$.73
DOES NOT PRESUME TO GIVE AUTHORI Y TO V ATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PR OV SIONS OF ANY OTHER STATE LOCAL L W REGULA NG CON-
STRU TION OR THE PERFORMANCE 0 CONST U TION.
$48.50
Fire SC
$1.46
v
PLAN CHECK FEE
TO7A , EE
Vd13x&,k_
Lice 5.00
$ 5.69
$IGNAT CO TRA TO O 11DA11.
EN FFIROP
VALID HIS IS
PEI I
BUOG INSP
•
MATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI I
PLG -13-1998
L
ADDN j ]
AMM [ J
ConsttuctionAddress:
Legal Description:
Owner Name & A
Contractor, m
Address:
08:42 FROM CITY OF FRIDLEY TO
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
8589320 P.01i02
rrLWUVC IlIlva
MN LICENSE # z z
Attach to this application, a Certificate of Survey of the
Iot, with the proposed construction drawn on it to scale.
DESCRIPTION OF ndpROvEMENT
Tel. #
LIVING AREA: Length, Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: "I o -'t „(�) a ,t1 00
� Estimated Cost: $ Sz/ 7 / Y-<6
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $W_ _ = $
DATE: 1 y APPLICANT: LL,,j. L�C � Tel.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ S O Fee Schedule on Reverse Side
$_ / • yc .001 of Permit Valuation (1110th%)
$ ?3 $.501$1,000 Valuation
$ $1000 per SAC Unit
$_ ®- ®� $5.00 (State Licensed Rcsidential Contractors)
$ Alt. "A" or Alt. "lB" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ )
$ s"s'
Building
Inspections
763-572-3604
DATE
SITE ADDRES _
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERNIIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
O EMAIL ADDRESS
❑ OWNERCONTRA OR
NAME: ISI -s
ADDRESS: V Q
PHONE: `% G
COMPANY NAME: STANBARB Np
CONTACTPERSO V� M&ELak410 Wi
Permit No.
Received By:
Date Rec'd:
n
MIFTNI
STATE LICENSE #
ADDRESS: $ %, MN 55408
2- 24- STATE ZIP,
PHONE
FAMILY ❑ TWO FAMILY
❑ NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK
FAX
❑ TOWNHOUSE
❑ ALTERATIONIREMODEL
PER MS 16B.665 the permit fee is a minimum of $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 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FMTUUpREE, EXCEPT NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) MODEL: i- l t;)-7SIZEIBTU G6) WC)
Equipment Installed MFG: SIZE/BTU —L
MFG: MODEL:
---��
MFG: MODEL: SIZE/BTU
,L�A/C $25.00 _ IREPLACE (GAS) $15.00 GAS RANGEJOVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILER $35.00 JKFURNACE $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 _VENTII,ATOR $15.00
. ....x .. v..�. :...
Permit Fee $ Number of fixtures @ $10.00 x $10.00 -
–
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ to Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ 50
Total = $
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 ape d work is not to start without a permit; that the work will be in accordance with the
approved plan in thecase o 'ch r review and approval of ans.
IC N �1'YlQ ATE 5-1-210—k
SIGNATURE OF APPL
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
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NE:W/EXIS.TIN 4 HOME$
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropaneUCTC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. MC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a_ Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per BMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations