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PRE 2010 DOCS4)360 City of Fridley, Mmm X9 9739 BUHDING PERMIT Date: May 17, 1968 Owner: Homedale Blders Builder Homedale Blders. Address 5217 Wayzata Blvd.. Address 5217 Wayzata Blvd. LOCATION OF BUILDING No. 7524 Street Tempo Terrace _ part of Lot Lot 31_ Block 6 Addition or Sub -Division if 11 3xXMelody Manor kkgk 4th Corner Lot _ ___ __ _ inside Lot — x Setback 35 _ _ Sideyard — 10' - 5 r Sewer Elevation 880.12 .—M- 883.12 Top of Footing To be Used as: Dwelling Front 46 Depth 24/28 Height ._._.20 Sq. Ft.1152 Cu. ft23,040 � Garage Front 18' Depth24' —3t— Height 10' Sq, Ft 432 Cu, F, 4320 Type of Construction Frame Fat. Cost 20 000 __ To be Completed Oct . 1968 SEWER LOCATION -83.5' S. W. of Manhole WATER LOCATION - 73.5' S. W. of Manhole In consideration of the issuance to me of a permit to construct the building described above I agree to the proposed work in accordance with the description above setfpm and in mpliance with provisions ordinances of the city of Fridley. W/ _� 7 MOD Sewer Connection Charge In consideration of the payment of a fee of $ 46.00 , permit is hereby granted to._._Homedale Blders . 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 violation of of :the provisions of said ordinances. i CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, phrmhing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permhs for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAMEBUILDER ADDRESS: % _ _ 1.1DDRESS. LOCATION-. QF : BUILDING. -NO._`r STREET _ LOT=r BLOCC' ADDITION Q;SDIVISTflN ao �" ... t: 01 CORIZR LOT INSIDE LOT SETBACK `w 0 SIDEYARD% SEWER ELEVATION T#O OF FOOTING' Applicant attach to this' fo,ii 'Two' Certificates of Survey -of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front z - Dcpt_1%ight�' Square feet / S�7S Cubic Fera 'v- - /� Front ---r---��--�4 Dep - Heigbtell / �I -— �-----t4 ark t -- Sq'uare feet. Cubic Feet _ Type of Construction Es4imated 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 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). Ir• -BU.=I.M IUMT 'FZ9,,,,9.M4ZDULF­ I U SECTIOW_21`:`, The Inspector, of Buildings shall,.. befo'6'Asi ii. As permits for the erection I of any building or structure, or for any..addition to allY existing -'a. -iructureor building, or for any alterationor repairs to any existing building or structure upon a:pplicat.ioh therefore, require the . f * permit of fees to the amount herein the payment by the ApPlidaiat' oV.s.ch below set forth and in the manner herin provided to -wit: Ty .1, 2, 4 4— $l Jt 4,6r.each one thousand cubic feet* or fraction thereof, in such cubical conk6nts. Type 3.-& 5- $1.50 for each, oi�q_thousand cubic- ,,.f0et-. For the,. itirpose. of. ej6jkitin& -fdOb f6rbuildLhg-pGrmtts,' the cubical contents of any built-, or ddO.t i6n;fe a uaff6rklAkht'thioughout by nultiplying, the ground area covered from a point six (6) inches below the floor line of the baseiiht- or"'. Che ijili' r - to the average height of the upper surface or to the average height4f the roof surface of the main gable of a pitched roof. Tor repairsor -alterations to an 'existing structure, the -fee shall be at the rate of $3.00 per eachfive hundred.dollairs ($500.00) or fraction thereof in.-, the �.doit of, 411,proposed work. in no case shall thqjeo charge& -for -any permit ..as -set forth in Section 2 be less than $5.00. NSSSD Connection Charges based on location- Area I or 2. 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 ...........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ..................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $_-_— Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE $ Dept. of Bldgs. Phone 560-3450 Location����. City of Fridley: The undersigned hereby makes application for a permit for the work herek 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,-jand correct. Fridley, Minn -� Owner Kind of Building Used as To be completed about Estimated Cost, $ 1 Old a Building Permit No. Permit No. DESCRIPTION OF WORK BEATING or PO -PLANTS—Steam, Hot Water, arm Air No Trade Nam �"(" ���' Size No Capacity Sq. Ft. E.D.R '�� BTU H.P. Total Connected Loa Kind of I 6 _ BURNER — Trade Name- Size No - Capacity— o Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS— VER Sign Y N.WELTER HEATING CO. 4637 CHICAGO AVE. ByeAbIbAK—AIRDLIS M. MINNEZOrA ae Business Phone No_��� City of Fridley Application for Plumbing and Gas Ming Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... --7 x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $100 $ GAS FITTING FEES: NO. RATE TOTAL 20' 1st 3 Fixtures .......................... 3 x $0 $�� Additional Fixtures x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ TOTAL FEE $ Dept. of Bldgs. Phone 560-3490 City of Fridley: 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 application a °e true and correct. dley, 1%r=19 Owner Kind of Used as To be completed about Estimated Cost, $ Old—New. Building Permit A Permit No. Signe By Business Phone No --9 22 2 ROUGH Y �j oS 8� z +�� U Ci < �°d W (�9Sa i �U' O • R • N WATER HTR. GAS EIEC Base l 1st 6 2nd _ 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer ❑ Cesspool El PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... --7 x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $100 $ GAS FITTING FEES: NO. RATE TOTAL 20' 1st 3 Fixtures .......................... 3 x $0 $�� Additional Fixtures x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ TOTAL FEE $ Dept. of Bldgs. Phone 560-3490 City of Fridley: 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 application a °e true and correct. dley, 1%r=19 Owner Kind of Used as To be completed about Estimated Cost, $ Old—New. Building Permit A Permit No. Signe By Business Phone No --9 22 2 ROUGH HOUSE HEATING TEST RECORD ADDRESS'>"�' FJoOOR CITYU UR OCCUPANT OWNER HEAT LOSS DATE HTG. INST. GAS CO. METER BADG SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA FAHW STEAM SPACE HTR. UNIT HTR. OTHER GASIGPCONVERSION MAKE �** ��® �' �- MAKE OF BURNER Model Model Serial �� °�� % ��- Max. BTU Rating INPUT ey jne!!%j MAKE OF FURNACE Model CONTROLS A THERMOSTAT r,!P 7Jp��eat Plug Vent Size ® a� Valve 14k968;9 KIND OF LINER ZEA—NONE Limit 9:52A—SE Draft Hood-4� Regulator Limit Setting . Filters Size dumber Fan Setting 17 - Pilot Pilot Type Pilot Make Pilot Model Pilot Timing-�� Chimney Location InsideOutside Chimney Construction Smoke Bomb Wiring Draft Test Tag L.W. Cut OffDoor Pressure Lighting Inst. e�€eP Pressure P dr�°' CO d —�D Tested Input CFH ,�� Y7 Ppony Testing t Stack Temp. Percent CO , ®r 0 Name of Tester Form 235 Applicatim for Power Pian is and Heathag. Cooling. Ye n. R rali®n and Air Conditioning S"ems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......... ..... $10.00 $ Replacement of Furnace 6.00 $ Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3.00 $—___ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ........ ..$10.00 $ each add. 60,000 BTU .................... .. 3.00 i Replacement of Furnace ..... 6.00 $ Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 .... .. &W $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 33.00 Each add. 320 sq. n. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ — over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 1M,000 BTU_) ... $.00 $ over 199,000 BTU See Fee Schedulo GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 7,00 $ Additional Fixtures x .78 $ Gas Range to 189,000 x$ 5.00 $ AIR C®I4DITIOIdINa FAN HEATING SYSTEM TING SYSTEM ALTERATIONS It REPAIRS ROUGH FINAL--/ f`` r �4 V' See Fee Schedule TOTAL FEE$' (SURCHARGE $_,50) Dept. of Bldgs. Phom SM -MM City of Fridley: The undersigned hereby makes application for a permit for the work :hereir specified, agreeing to do all work in strict accordance with the City Ordibancee 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_ / 1S (honer -- Kind of Building Used as _ . ___ ._._. . ��� To be completed abut/— 7 Estimated Cost, O dew. Building Permit No. Permit No.��/I - r OF WORK team, Hot Water, Warm Air—No Trade Name F1 (C' y Sin No fl(O IV Capacity Sq. Ft. E.D.R BTU_`_- ' HY Total Connected Load Kind of Ftael BURNER — Trade Name Size No capacity Sq. Ft. E.D.R BTU (REMARKS -OVER) Ideal Sheet Metal inc 544 .Summit St. N.E. Shull MPI& Minn. 554.81 Business ftme No—'2 �' �� SUBJECT City of Fridley 2 5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. `y -------COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. q1J3 NUMBER REV DATEPAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7-13-98 JOB ADDRESS 7524 Tem o Terra e 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 31 3 Melody Manor 4th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Norm Woods 780-4260 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Quality Contracting,]YNYIN/IIl'YW-YAidIldli4iYllId illdI111iidIIffli 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 11412 W. River Rd, Champlin, MN 55316 427-7733 7035 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 Tear-off and re-roof (23 Sq) 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,918 . 96 DOES NOT PRESUME TO GIVE AUTHORITY TO VIbLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF A Y OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OPwfAE PERFORMANCE OF CPOSTRUCTION. $62.25 Fire SC $1.92 N CHECK FEETOT FEE IZ4��: —zz&jy Licens SC $ .00 $70.13 -, %iGNATURE OF CONT ACTORORAUTHORIZED AGENT (DATE N OP VALID THIS IS YOUR PERMIT -- U -,C— F- 5 k:5=L B INSP GATE SIGNATURE OF OW NER�IF OWNER BUILDERS IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY..OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �-� a Legal Description: Owner Name & Address: o o v", (J ®O s Tel. Contractor: 0, I ®rrc� c/ �c MN LICENSE # 70 Sr Address: / r{ (2 .c J to c � � � Tel. # Z�'Z 7-7 ? 3� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EAPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: 23 sz r Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: Ln C,- ® tJ` w ®tea " Estimated Cost: $ � (Fee Schedule, on Back) Driveway Curb Cut Width Needed: Ft. + 6 F = Ft x $ _ $ DATE: APPLICANT: Tel. —7 r7 K� CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ s 4e $.50/$1,000 Valuation SAC Charge $ �� $1000 per SAC Unit License Surcharge $5.00 (State Licensed Residential Contractors) Driveway 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 [ J TOTAL STIPULATIONS: BUII.DING PERNIIT 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 $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for "first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $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. MECHANICAL Permit No.: 1 - Cid Building Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDL.EY c DATE YOUR E- RESS SITE ADDRESS ;k - THIS APPLICANT IS: ❑ OWNER CONTRACTOPA THIS PROPERTY NAME: 8 r S OWNER/ ADDRESS: .9- (i�TY • STA ZIP TENANT PHONE: n — O CONTRACTOR COMPANY NAME;__ STANDARDHEATING&A' _ CONTACT PERS( ;! ; L 410 WEST LAKE STREET SUBMIT A COPY OF}�, MN 55408 YOUR STATE STATE LICENSE II 2.824 -STATE ZIP LICENSE WITH ADDRESS: APPLICATION PHONE FAX PERAM TYPE SINGLE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE rl NEW REPLACEMENT ❑ ALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK Q GZ 1 aC. PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the only.the cost of labor ) improvement, installation or replacement of a residential fixture, excluding the fuctures..(This should reflect -Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 FOR PROJECTS WHERE LABOR EXCEEDS $500 FEES AREBAjEDGN.$j0.00 PER FIXTURE, EXCEPT WHERE NOTED. NX URE .: (INDICATE TOTAL �� NUMBER OF EACH BELOW] � �✓� MODEL: S�- S u Equipment InsWied MFG. . . . MFC,: MODEL. MFG: MODEL: SLMBTU AIC $25.00 _FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 NEW GAS GRILL $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 BOILER CHU,,MY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 GAS PIPING $10.00 VENTILATOR $15.00 DUCT WORK $10.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ 50 Number of fixtures @ $15.00 x $15.00= $ Number of fixtures @ $25.00 x$25.00 = $ TOTAL DUE $ Number of fixtures @ $35.000 x $35.00 = $,:35-M Surcharge = $ .50 Total = $� THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowl a that the information above is complete and accurate; that the work will be in Hnnesota-Constmction Codes; that i understand this is conformance with the ordin and codes of oFridley and with the but ` o d wor is not to start without a permit; that the work will be in accordance with the not a permit only an R approved plan in the a of all 'ch r i revi and approval of s. �rnQ � ATE SIGNATURE OF APPLI REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC NEW HOMESIADDITIONS 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 NIN 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 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 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 Building PLUMBING Permit No.• Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE Sho YOUR E-MAIL ADDRESS SITE ADDRESS `7�'f Te ry\pr, % i-fqC'L ME—, , THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: 37 OWNER/ ADDRESS: STATE �� 3 TENANT ��Z PHONE: CONTRACTOR NAME:_— to fV SUBMIT A COPY OF STATE LICENSE # ( EXP DATE I YOUR STATE ADDRESS: Cf Y\ c3 e , CITYC STATEWI��> �y LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW )(REPLACEMENT DETAILED DESCRIPTION OF WORK 2 PER MS 168.665 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 FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) _ BATH SINIULAV FLOOR DRAINS _.. SHOWER _ WATER PIPING _ BATHTUB —, GAS PIPING (Amw craucnz) — SWIMMING POOL _. WATER SOFTNER ($35) CLOTHES WASHER —KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) — —DISHWASHER _ LAUNDRY TRAY „WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER I'FR+ItR t l'ltf)JFCTS FOR. Ul'�I3F11$50Q PER1ti+IIT FEE F(bR PR€) S VERi500 Permit Fee $ Z�—,: f,�0 Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ -5-_- > �? State Surcharge = $ .50 Total = $ TnI S 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 ak work whicq ' es r vie and approval of plans. SIGNATURE OF APPLICANT �+ - PRINT NAME i` PLWEN(J1L: SSP T1r P R1VfITS"ARE 2E UIRID FOR BUILDiNG;'ELEGTRiCAL AND IViECkI hNICAL OIti ' City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977