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PRE 2010 DOCS0 City of Fridley, Mmm BUILDING PE I N?55E10j Date: 51. «r... xa � Owner: �'* cry" �'' der Address _ _ _ _ Address /21 LOICA ION F BUILDING No. _ . _w ttreet Lot Corner Lot W inside Lot Addition or Sub-Divisio —Setback Setback : _ _ Y Sideyard Sewer Elevation __ __ _ _ Foundation Elevation DESCRIPTION OF BUILDING To Used ir N " Front Depth,0. Height Sq. Ft. Cut. _4, . Fro Depth ."Height ___ Sq. Ft. Cu. Ft. _ Type of Construction Est. c6st 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. 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, iNnnesota regarding location, construction, 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. I 1' '"�_ 'Building Inspector If NOTICE: This permit does not cover the construction, installation for whing, plumbing, gas beaflno, sewer or water. Be sure to see the Building inspector for separate permits for these items, 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEYo MINNESOTA Own . er.'. s' Nam�Z�, LZ ilder rl '-Address Address NO. art of Lot Lot BIOCK ,I Aaaixion or suoalva.sao m, Corner Lot Inside Lot SetbackSide-Yard SMMR ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To a used as:/ FrontDepth eight Sq. Ft.. Cu. Ft.6A 6 Front Depth Height Sq. Ft. Cu. Ft. Type of Constructi Estimated Co 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 ruling of the Department of Build- ings, and hereby declares that all the facts and represen�ions stated in this application are true and cor DATE ® .f -5__ -- (schedule of Fee Costs can be found on the Reverse Side). BUILDING PERMIT FEE SCHEDULE Section 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any existing building or structure, or for any alterations or repairs to any existing building or structure, upon application therefor, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: 2.1. For any such permit'for the erection of any fire -proof building, other than a garage, warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For any such permit for the erection of any -fire -proof garage, warehouse, factory or grain elevator, or for the erection of any fire- proof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof build- ing other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building `Permit $1.00 for each one thousand cubic feet. GAGES 2.4. For any such permit for the erection of any non -fireproof, garage, warehouse, factory or grain elevator, or for the erection of any non -fireproof addition, for similar occupancy, to any existing building or for each such building or addition. Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.00. For the purpose of computing fees for building permits the cubical con- tents -of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2-.5,4• .. For repairs or alterations to an existing structure, the fee shall be at.the rate of $3.00.per`each Five Hundred Dollars ($500.00) or fraction thereof in the cost of all proposed work. L._6. in no case shall the fee charged for any permit as set forth in section 2 be less t- $4.00. City of Fridley Application for Plumbing and Gas Fitting Porn* Dept. of Bldgs. Phone *#,4-7 DESCRIPTION OF WORK Number, Kind and Location of Fixtures F +' y�yl �^ Z* 3 �L N 6 H S Y 3 Y Z o ' Z S a Z Q U p 2 Q 3 , �V' w G �U' n4 Z Z (�9 O # F # N WATER HTR. GAS ELEG Base Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 $ Additional Fixtures .................... 1st .50 f Gas Range to 200,000 BTU .............. x 2.00 $ 2nd 3rd 4th ' Future Connection Openings New Fixture, Old Openings I Connected with Sewer Cesspool � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL � 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 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE, 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 Ordinance. and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are trued c9frect. Fridley, Alinn . k_,- `- lov Owner Kind of Buildin Used as To be completed about _ Estimated Cost, J, ,19--e / Old—New. Building Permit No— Permit Sign • - 1 7�1 Business Phone No- ROUGH o ROUGH FINAL r Application for Power Plants and Heating, Cooling, Ventilation, Refrtgeraflon 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. 60,000 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 or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR 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 'J�e ty J 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 $ Al' --!0jING $ 'TEM See Fee Schedule TOTAL FEE Dept. of Bldgs. Phone SU. 4-7470 M 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 are true and correct. Fridley, n Z/ loeo'__4 o 19 — Owner P Kind of Building % F Used as To be completed about Estimated Cost, $ old—New. Building Permit No. 5 /" Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS- te of Wate , Warm Air—No Z Trade Name J C_1_ - Size No -C a -r - Capacity OLl Sq. Ft. E.D.R 7 29 0 BTU H.P. a3 _ Total Connected Load L/0 Kind of Fue e BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signed -4. By MEMO PLUPASU A HEATT SWIG A ORA, MINN. TEL. HA. 1®1382 42 2M 7-59 Business Phone No ., INC. Job Name ze NEAT LOSS 4ALCULATIONS Job Address A., Weatherstrips .SH.V.E _ Guide Construction No. I Insulation W�indowo" Doors . Reference Out. Wall Int. Wall Ceiling Roof Floor i Kind How Applied Yeti No Y41410 19_ I Fl.l O Room I Length /!9 Width JV Height c,,' II Room I Length IQ Width OHeight Windows and Doors—Crackage and 'Area Room 1 Length Width Height No. of Lineal ft. Area No, of pane of pane lights of crack sq. ft. O jy 2 o L ® 117,417KA- Windows and Doors—Crackage and Area Coef. Btu Infiltration Coef. qO O 1Q iv 'Glass 19ray I Y ® 4 Exp. wall hir O Glass Net exp. wall /Y o Int. wall Exp. wall 7 Ceiling Floor Net exp. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.I Bz, PO, Room I Length J V Width. /0 Height Windows and Doors—Crackage and Area Room 1 Length Width Height. No. of Lineal ft. Area No. of pane of pane lights of orrack e,. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. o L ® 117,417KA- Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Coef. Infiltration Infiltration 19ray to 96 hir O Glass /Y 6 Exp. wall Exp. wall 7 Net exp. wall Net exp. wall Int. wall 7 ;k - jLILL a 0 Ceiling / �0 Floor Ceiling Floor / 0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .R Fl.l Reem I Length ® a Width / i Moiaht Windows and Doors--Crackage and Area . Room 1 Length Width Height. No. of Lineal ft. Area No. of pane of pane lights of orrack e,. ft. J I i o L ® 117,417KA- Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Coef.1 -,Btu Infiltration 19ray to 96 Glass Infiltration Exp. wall 4yo Exp. wall Glass 7 Net exp. wall Int. wall 7 ;k - jLILL go Int. wall Net exp. wall / Floor Ceiling Ca Floor „per Ceiling 423 *62 S" 0 Tbtal Btu. Windows and Doors—Crackage and Area Room 1 Length Wl th Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. o L ® 117,417KA- Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration 19ray Glass f� Infiltration Exp. wall 'ya J;2,0 Glass Net exp. wall rpe 1.916 0 Int. wall 7 ;k - Ceiling Net exp. wall / Floor Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 0 V` G r 'd H ' h Fl.1 Room 1 Length Wl th P elg t Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. -7 Ile Infiltration Glass Coef.: Btu Infiltration Net exp. wall 'ya J;2,0 Glass IfO AO 0 Exp. wall 7 ;k - Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1_I Rnnm I Length Width Height Windows and Doors—Crackage and Area /yam f'? d Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. ft. E.D.R. or sq. ins. W.A. leader area II Required sq. ft. E.D.R. or sq. ins. W.A. Leader area INC. Job Name ee HEAT LOSS vla ' U0118 Job Address Weatherstrips A.S.H.V.E, I Construction No. I Insulation Guide 1 Windows Doors Reference Out. WaU Int. Wall Ceiling Roof Floor Kind How Applied Yes—No I Yes—No 19— I 11 I Fl.l 1 IV Room I Length D ✓ Width ,/ Y He;.ht Room I Lensfth JAI Width / fl Height Windows and Doors—Crackage and Area I JZ v® I AO0 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 0, 0 %-,V- P 6 L - Net exp. wall Coef. Btu Infiltration ,� •. ? a a ® Al 0 Glass Floor 47 J5-cl A7S Exp. wall Net exp. wall tJ�� fie' P® Net exp. wall Exp. wall 00 Net exp. wall Int. wall 'PO D'' Net exp, wall Ceiling 6t Q► t4l / " Floor /Aj /4'j, Total Btu. 1 Z115F� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I F1.1 Aa-vnom.. Room I Length S7 Width „F) Height e a- WindO and Doors—Crackage and Area I JZ v® I AO0 Glass WidthHeight No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. %-,V- P 6 L - Net exp. wall /S 0 . /5'7 Coef. Btu •. Infiltration °l® 0 Floor Ala 'r, ® 0 Glass Net exp. wall tJ�� fie' P® // P Exp. wall 00 Net exp. wall fa 'PO D'' Net exp, wall Int. wall ef- 3 t4l / Jr Floor Int. wall /4'j, t Floor,/ Ceiling Floor (,�j &n --i Total Btu. I Zv 7. Required sq. ft. E.D.R. or sq. ins.. W.A. Leader area Fl. a - Room Length / Width /0 Height jE Windows arg Doors—Crackage and Area Width I Height No. of Lineal tt. Area No. of pane of pane lights of crack eo. ft. Infiltration I JZ v® I AO0 Glass 3-4- 5-0 %-,V- P Exp. wall - Net exp. wall /S 0 . /5'7 Int. wan Infiltration •. Ceiling °l® 0 Floor / 1 m0- / Al 2 Total Btu. 1-1-41 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ;1L '/ O "7-® 3� Coef. Btu Coef. Btu Infiltration 90 41 C)Y N O ®� Glass` Exp. wall Net exp. wall Exp. wall fie' P® // P lbq 00 Net exp. wall fa 'PO D'' Int. wall t4l Jr Floor Ceiling /4'j, t Floor,/ , Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area • rn 1 ` n _ --- l r ---L avf:-1.1- &Y- f..r_:.t. .. Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ;1L '/ O Coef. Btu Infiltration Infiltration YD 90 Glass / 0 Glass 0 Exp. wall - Exp. wall Net exp. wall /0 "5-0 Int. wall lbq 00 Ceiling fa Floor Ceiling Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F1.1 A Reem I Lenath 19- Width /9 Height 9 41 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of -pane lights of crack sq. ft. ;1L '/ O Coef. Btu Infiltration -p C, / 0 Glass Exp. wall �o Net exp. wall lbq 00 f6 Int. wall Ceiling t4l Jr Floor _ - S- A Total Btu. W ft. E.D.R. or sq. ins. W.A. Leader area CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1991 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 eplacement Furnace Gas Piping (Needed with new furnace) Gas Range Gas Dryer Rate TOTAL $ 20.00 $ $ 10.00 $- $10.00 $10.00 $ $10.00 $ *Air Conditioning - All Sizes $ 10.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commerci aUl ndustrial 1 % of Value of Appliance or Work $ State Surcharge $ .50_ TOTAL FEE $ S-0 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB t 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 9-276 ,1991 - OWN WE BUILDING USED AS ESTIMATED COST lJ✓ PERMIT NO. t DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units l Circle One (Steam) (Hot Water) (Warm Air Trade Name Size No. , BTU Y H _ EDR Fuel—� Total Connected Load Burner Trade Name Size No. BTU HP EDR finnond F_. Snns Elm. Inc. dba HEATING COMPANY Signed By WiwTel No. Approved By/ Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes �' No ( ) 2. Is free from rust or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes S,4 No ( ) 4. Is securely supported Yes " No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes No ( ) 6. Has total heating BTU's of 6�4zv All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date /1JScP 26 1994 - rl�n v A Air Cc! G SUBJECT PERMIT NO. City of Fridley 28463 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. ► COMMUNITY DEVELOPMENT DIV. L_____ e r � PROTECTIVE INSPECTION SEC c —1 e � + CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/28/98 JOB ADDRESS 160 Stone brook Fa - 4 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 g IPearson's Craigway, 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wesley D. Jensen 571-6260 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Westurn Cedar Supply 705 N. H 169 Plymouth 55441 541-0304 20014207 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION JEx REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 21 S Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 1799 $.90 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACGE PROV SIGNS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR TION OR THE PERFORMANCEAF CONSTRUCTION $56.75 FirCH C $1.80 PLAN CHECK FE TOE / - 4"�L is s S 5 5 SIGNATURE OF CON7RACTOR OR AUTHORIZED AGIV(DATE, ENO A ID HIS IS Y PE I S,GNATURE OF OWNEROF OWNER BUILDER, IOATEI BLD INS- BATE G 'NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: N&L A ox-', Legal Description: Owner Name &Address: �1)T Sr�CO ?). O�A)SFdv �5T. Tel. # QS -7 - GL 2-& 0 Contractor: MN LICENSE # ZOd /c,G207 Address: Tel. # SV/-®36� 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: Length Width Hgt/Ground Sq. Ft. OTHER: Construction TyEstimated Cost: $ -� / do (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT�✓c�y Tel. # ,� $ X80 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. Building Inspections 763-572-3604 763-502-4977 FAX MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR Permit No'�W q -®16 � Received By: SITE ADDRESS MODEL: SIZE(BTU THIS APPLICANT IS: ❑ OWNER O ACTOR PROPERTY NAME: NEW GAS GML $10.00 OWNERI FURNACE $35.00 GAS UNIT HTR $10.00 _CHININEY LINER $10.00 ADDRESS: ZIP TENANT GAS PIPING $10.00 VENTILATOR $15.00 PHONE: d CONTRACTOR CONIPANY NAME: tan and Heating Air Gonddloffing SUBMIT A COPY OF CONTACT PERSON:. �j��H� YOUR STATE STATE LICENSE # F17_R7d-7W DATE LICENSE WITH. ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERNIIT TYPE SINGLE FAXIILY 13 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK:I E3 NEW ACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SDN/BTU MF yk„ MODEL: SIZFJBTU�7078 MFG: MODEL: SIZE(BTU A/C $25.00 FIItEPLACE (GAS) $15.00 GAS RANGWOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GML $10.00 CBOIL ER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 _CHININEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 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 J NEW HOMES/ADDITIONS )(EXISTING HOME U MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) & Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/dFGC Chapter 3 with MNI Amendments 2. Make-up Air (See note below) a. IMC 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 WIOMES 4. Heat loss & cooling load per room a. Required on new Construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7612 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. JfAAS-t k-\, D 10/16/2009 Revision Data: 10/19/2009 Existing Construction: Pre 1994. Site Information Address 1: Project #: � Address 2: 1 �S40N Lot: Block: City: County: d ` o o� Subdivision: Application lnformation Business Name: Standard Heating MN Contractor License #: Contact Person: A:�tdsay-', Iwey- W -r- ev, , Office Ph: Fax: Cell Ph: 612-207-9705 /address 1: 130 Plymouth Ave N City: Minneapolis State: MN Zip Code: Combustion Appliance Water Heater: Natural Draft Input BTUs: 40,000 Common Vent Combustion Zone 2 Combustion Zone 2 Fumace/Boiler: Natural Draft Input BTUs: 96,000 Common Vent Other Combustion Agaliances Gas Fired Direct Vent Fireplace(s): No Gas Fired Power Vent Fireplace(s): No Gas Fired Natural Draft Fireplace(s): Yes Solid Fuel Appliance(s): One Exhaust Equipment Continuous Exhaust Ventilation Capacity (cfm): NA Clothes Dryer (cfm): 135 Exhaust Fan Rating (cfm): 50 Make -Up Air No Make -Up Air Required by Code Combustion Air Combustion Zone One: Minimum Combustion Air Requirements Met. Minimum Combustion Air Requirements Met. Applicant Nar Code Official x 1q,6' xera � Signature/Date: /0 It 0 / signature/Date: 0 2004 CentcrPoint Energy Minnt;gmcu. 2004 Mechanical Codc Guidriines. INV 9V£O: L L 60OZ/9Z/04 :81ea £/£ :a6ed 00£Z9£bZ49 UMo