PRE 2010 DOCS49 33
City of Fridley, Mkm N° 10466
BUILDING PERMIT
Date: October 23, 1969
Owners Eugene Olinger Builder Roy 'Bi ljman Tn�
Address Address 151 Silver Lake Road
New Brighton, Minnesota
LOCATION OF BUILDING
No. 34— Street Trol-lbagen Drive ____ Part of Lot
Lot _ _ 10 _ _._^ Block 4 Addition or Sub -Division T n17 R r, i rrk 5 t -b A d i ; on
Corner Lot ._ Inside Lot —. X Setback ___ Sideyard
Sma Elevation __ 9.27.08 _ juaRUSM Elevation 986-019 CApi rax) _Min
Wye 6' Riser = 983.08 Top of Footing
To be Used as:
Dwelling Front 53'-6" Depth 26'&28' Height 20' Sq. Ft. 1443' Cu. Ft. 28,86 �
Type of Construction
Front Depth Height Sq. Ft. Cu. Ft.
Frame Est. Cost Wo 000,_0Q__ To be Completed December 28, 1969
Provide hardsurfaced driveway. Note Pilaster.
SEWER LOCATION: 150' S.E. of Manhole
WATER LOCATION: 161' S.E. of Manhole
In consideration of the issuance to me of a permit to construct ft building described above, I agree to do
the proposed work in accordance with the description above set and in compliant' with all provisions of
ordinances of the city of Fridley.
$100.00 Sewer Connection Ch a 'L 77
In consideration of the payment of a fee of $ 44.00 , permit is hereby granted to Rodney Ri 1 lman Inc.
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 bufldings
within the city limits and thus permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
Tills permit does not sover the cont♦ eflon, lnstallWon for wiring, plumbing, gas heating, rower or water. Be are to ane
the Building lnspeetor for separate permits for than Nem
STATEMENT OF UNDERSTANDINC
1. I have been issued City of Fridley;
Building Permit No. A), Dated.
Plumbing Permit No. Detect;
Electrical Permit No. Dated;
2. I understand that this building, plumbing or electrical permit does not
constitute authority nor relieve me in any way of my responsibility for
assuring myself that in digging on private or public property that I shall
not cause damage to a public sewer, or watermain, or to gas pipes, telephone
cables or electric cables. Also, that I shall notify immediately the owner
of the facility if any damage is caused to any underground or above ground
facility or utility.
3. I understand that at least 24 hours before digging, I am responsible
contacting the following Municipal Departments and Public Utilities offices
who will provide information on locations of installations or easements,
(The 24 hour advance notice to be waived for emergencies involving public
health).
Electrical Underground Cable:
De -energizing lines
Telephone;
Address:
Gas Underground Pjpes;
Telephone: Day:
Weekends & After Hours;
Address.
Northern States Power Co.
330-6170
4501 - 68th Avenue North
Minneapolis
Minneapolis Gas Company
372-4900
372-4920
739 Marquette Avenue
Minneapolis
STATEMENT OF UNDERSTANDING
Underground Telephone Gables•
(South of Rice Creek and
West of T.H. #65)
Telephone;
Address;
Northwestern Bell Telephone
561-2703
1101 - 65th Avenue North
Brooklyn Center
(North of Rice Creek and all of the area
East of T.H. #65)
Telephone;
Address;
Water and Sewer:
Telephone;
Weekends & After Hours;
588-2705
2643 Central Avenue N.E.
Minneapolis
City of Fridley Engineer
560-3450
560-3457
PAGE 2
Address; Civic Center, 6431 University Ave.N.g.
Fridley
4. I further understand, that upon my request, any of the above agencies will
provide data and stake lines and stake underground installations of the
municipalities or public utilities concerned. The decision as to the necessity for
staking and stake lining will be that of the Public Utility or the City Engineer
or his designated representative in the instance of water and sewer pipes. (Staking
to be done during normal working hours only, except when public health is in jeopardy,)
5. 1 understand that it is my responsibility to ensure that I am not constructing
an obstruction on or over Municipal or Public Utilities Easements or installed
facilities, without written authority to do so,
6. 1 understand that underground installations thatI have exposed may be checked
a
by their owner, prior to backfilling and that 1 am responsible for coordinating
with the owner for time and date of inspection. I further understand only the
owner or his designated representative may waive inspection prior to backfilling,
STATEMENT OF UNDERSTANDING
7. T understand that I am responsible for providing and placing such
barricades and lights or reflectors as required by Minnesota State
Statutes and the City of Fridley City Code around excavations and/or
obstructions as are necessary to ensure public safety.
S, I understand that I will backfill, tamp and repair all excavations
made in streets or easements and restore existing surfaces to its
original condition, in accordance with specifications provided by the
City of Fridley Engineer and shall be responsible for any repairs to
excavation areas necessary within one year when such repairs are necessi-
tated due to faulty workmanship or materials applied.
9. I further understand that I will ensure that water curb boxes are
marked clearly with a stake and red flag and that any curb box damaged
during construction shall be repaired or replaced at no cost to the City
of Fridley.
PAGE 3
10. I fully understand that when excavating operations involve the use of cranes,
booms, or other apparatus that extend into the air, the same may come into
contact with overhead electric lines, and that the.safety
regulations of the Industrial Commission of Minnesota require that any
operator "prevent such mechanical equipment from operating within 15 feet of
any energized power lines". I will notify the owner of any energized power
lines of any proposed operations within 15 feet of said lines and will not
commence work in that area until the owner's representative has come on the
site and has informed me that the lines are de -energized, otherwise protected,
or that I must work outside of the 15 foot prescribed clearance because the
lines cannot be de -energized.
11, I fully understand the above responsibilities and that I can be found liable
for damages,
"(DATE )
RTY OWNER)
(SIGNATUR9
'OF CONTRACTOR OR PRO
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNM IS NAME BUILDER
ADDRESS ADDRESS �e% ��,��/21
LOCATION OF BUILDING
-
NO o
LL
d
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT 1/ SETBACK SIDEYARD 4.
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front _K_ Depth Height
Square feet Cubic Feet
Front Depth Height
Square feet Cubic Feet
Type of Construction Estimated Estimated Cost
To Be Completed
?e
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 LZ-/' 2,.2- % ��G SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side.)
1 D '=T :'fl il$il 1 .
SECTION 2, -The Inspector of Buildings shall, before issuing permits
for the erection of any building or structure, or for any addition to any
existing structure or building, or.for any alteration or repairs 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 =mer. herein provided to -wit:
Uniform Building Code: Type 1, 2, & 4 ® $1.75 for each one thousand
cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5
$1050 for each one thousand cubic feet.
For the purpose of computing fees for building permits, the cubical
- cz h:t-ents of y-buii-ldii oT``a�d-diti= t6` -a un'if'orm heigITtthrOi aUt -b)r------ - -
multiplying the ground area covered from a point six (6) inches below
the floor line of the basement or the 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.
For repairs or alterations to an existing structure, the fee shall be
at the rate of $3.00 per each five hundred dollars ($500000 or
fraction thereof in the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section
2 be less than $50000
NSSSD Connection Charges based on location - Area 1 or 20
r� fi
P
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k'
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T�
Ah N® 5053
Original Permit for PLUMBING AND GAS FfrTING 4
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit, Fes
DFSCREMON OF WORK
Number. Kind and Location of Fixturt es
fa
City of Fridley Alov&r L66- AA/ .19-k-9
Stories
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WATER HTR.
GAS
ELEC.
Basement
1st
/
2nd
3rd
4th
Connected with
Gas Piping for Openings
Permission is hereby granted to do the plumbing and
gas fitting in the building described in the statement hereto attac , upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
nspector.
Final Inspection Date
Inspector.
as SRA -6-69.v
Owner Q L tgli % & -e
Location /QY 2 L��
Kind of Building,��
Used as L t,') E, Lu io G
To be Completed '19—
Estimated
19_
Estimated Cost
Old ew. Building Permit No. fid, 4/ & L
Date
Inspector of Buildings.
orig;W
PERMIT for Power flants and Heating. Cool=
ing. Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of _ / Heating Plants C� _d 04–) to be ' falls ltered—repaired
Make t . 2 ,Size_ f
Oil fired , Coal fired—,- Gas fired L� ; Gas Authorization No.
Remarks _ ,tA-.A�®
Approved
Final Inspection Date , 19_
Inspector
y9L 7_�
Permit N® 4630
Fee $ /%ao®
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn., �c2a , 19
Owner L &LLMAAJ
Location /'Z-,3 � 72o LL t4,qa &`J tie.
Kind of Building jRA(Y)&_
How Occupied AW & L L 1 ilk C.,
Work to be Commenced—, 19_
To be Completed i�' ,192d
Estimated Cost, $ �'
Old- eui Building Permit No.
Permission is hereby granted to to install—erect—use the material and devices described in the
above statement. This permit is granted upon t express condition that the person to who it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in The operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifications s fort to the approved application for this
permit on file in the office of the Inspector of Buildings. .1 .. - I � _ _ I 'V A ,
42 aM IWv -✓' �Vector of Buildings
Applaefto r P®e► s Veoffidons Reffiftew0ba and
Air C®esMoni eg Devices
GNAVITY 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 $
CH. WARM AIR
Furnace Shell & Duct Worts to 120,000 BTU ............
$10.00 $
each add. 60,000 BTU .......................
uo $
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. E'DR Steam .. .$10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $
Each add. 200 sq. ft, EDIT 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 1N,000 BT) .............. ., ........ 804
over 189,000 BTU See. Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
Ist 3 Fixtures x$ 2.00
Additional Fixtures x .75 $
Gas Range to 199,000 .......... Ism $
CONDi`IONING $
FAN HEATING SYSTEM ,See'Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS &REPAIRS TOTAL FSE
$ ,
71re_ r
Dept. of 19. Phone 1
City of Fridley:
The undersigned hereby makes application for a permit for the work hereic
specified, agreeing to do all work in strict accordance with the City Ordinanm
and ruling of the Department of Buildings, and hereby declares that an the facts
and representations stated in this application are true and correct.
Owner
Find of Building
Used as
To be' completed about
Estimated Cost, $7�
Old—
.AV.Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER Hot Water arm Air Noz �G
Trade Name ��tll�� Size No-
Capacity Sq. Ft. E.D.R ' BTU H.P.
Total Connected Loa ` Kind of Fue
BURNER —Trade Nam s Size No4&6!f�
Capacity Sq. FL E.D.R BT IJ H.P:
AL
(REMwaus—OVER)
N. WELTER H EATI N G CO.
4637 CHICAGO AYE.
%INNEAPOL.8 - -
Business Phone N
Coef.I Btu
t Infiltration r
oG
?7 7
P, Glass
4-0
Exp. wall /' ( 2
HEAT LOSS
Ceiling
Net exp. wall
",
CALCULATIONS
DEPARTMENT OF BUILDINGS
"" "k"'
FINN.
Weatherstrips
A.S.GH.V.E,
uide
Construction No.
Net exp. wall
Insulation
Total Btu. w
Windows
( Doors
Reference
Out. Wall
Int. Wall Ceiling Roof Floor
Windows and Doors--Crackage and Area
Kind I How Applied
Yes o
Yes o
19_
Length Iv
eight
Fl.� -oom
Length : " ---Width
Height
;i Windows and oors—Crackage and A
Windows and Doors—Crackage and Area
tVldth Height No. of Lineal ft.
No. of pane of pane Ilghte of crack
Width
No. of pane
Hright No. oP Llneal ft. Area
it p:u:e lights of crack aq. ft.
2 9
Coef.I Btu
t Infiltration r
oG
?7 7
P, Glass
4-0
Exp. wall /' ( 2
ZLIQ-
Ceiling
Net exp. wall
70
Int. wall
F7.
r Room I I Pnat K Width - e' eight
Ceiling t G:
Exp. wall y
1 Floor
Net exp. wall
Total Btu. w
Int. wall
Required sq. ft. E.D.R. or aq. f . W
ader area 9
F1,1 I Room Length
_f/:�
Width Height
Windows and Doors--Crackage and Area
Width Height No. of Lineal ft.
No. of pane of pane lights of crack
Area
sq. ft.
d2Q0
f .
c
i
c' G
Coef. Btu
Infiltration 72 . -7 .3 G
Glass
oG
Exp. wall
Net exp, wall
Int. wall
Ceiling
X
Floor
: Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F7.
r Room I I Pnat K Width - e' eight
iWindows and oors—Crackage and Area
Width I Raight No. of Lineal ft. Area
No. Ot pane of pane lights of crack eq. It.
r
Coef. Btu
Infiltration
Glass -5.0 r a 0
Exp. wall
Net exp. wall r ��
Int. wall
Ceiling /X !/ < —
Floor
Total Btu. ,
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ,
LP—IM-1-65
' zltt F f t i t l {t":qr
Coef. Btu
Infiltration '; O
Glass z, 2 V D
Exp. wall:
Net exp. wall / c, 6
Int. wall
CeilingZ
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area y
R- e-20- _-, RP,.,r., i r -,h '> P W.A.1, s.
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.
Btu
Infiltration 'L_
-
Glass
,5_,0
6 G
Exp. wall y
Net exp. wall
Int. wall
Ceiling 27-
c
Floor
_C
Total Btu.
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
n-1 m I Length W _ Width / _ Height g
Windows and Doors—Crackage and Area
Wldth Height No. of Lineal ft. Area
No. of pane of pane Ilghte of crack sq. ft.
Coef. Btu
Infiltration
Glass oc
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor � b' G
Total Btu.
Required sq, h. E.D.R. or sq. ins. W.A. leader area
DESCEEPTION OF WORK
Number, Kind and Locm4ion of Fixtuns
2nd - -.
3rd
4th-
opentalp
Now Fixture, Old oveninp
City of
• a
-�s
Dept. of Mdg& Phone
Wc
T/®
WATER 4/T'R.
City of Fridley:
5 Z a n F W GAS ELEC. lPnderSl
The
o fined 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 are true and correct.
- - - - Fridley, Minn-
Owner
inn Owner
U
— connected with --- --- — Kind of Building �
sewer
Cesspool
Used as
To be completed about
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures
_
x $2,00
Future Fixture Opening
x $1.50
$�6
New Fixture Old Opening
x $1.50
$
Catch Basin ..
x $3.25
$
Water Heater (Up to 99,000 BTU)
/
.. _ L—
x $3.00
$
New Ground Run Old Bldg.
x $8.25
$
Electric Water heater
: $2.00
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..... .... .........
x $2.00
Additional Fixtures ..... ..............
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
REPAM & ALTERATIONS—Rater to Code
Description ............................. �i
TOTAL FEE
Estimated Cost, $
Old -(FN Building Permit No..—PermitNo.
Signed. _^
By-..-
Business Phone No- % ti . d 40
ROUGH d/
F•INAIr
HOUSE HEATING TEST RECORD
ADDRESS _ PT." 00 1 SUBUR
OCCUPANT OWNER �" .
HEAT LOSS DATE HTG. INST. GAS CO. METER B #
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA FA _&--9'W_ STEAM SPACE HTR.
G S DE
MAKE '�_ MAKE
Model '-- Model
OF BURNER
Serial T -- Max. BTU Rating—
INPUT MAKE OF FURNACE
Model
UNIT HTR. -OTHER.
CONVERSION
CONTROLS
A
THERMOSTt Plug
Vent Size
Valve
IND OF LINER
_,t -NONE
Limit 6 S
Draft HoodRegularor
Limit Setting ?.~
Filters Size71-
►lumber
Fan Setting % :n—.0f,0",&
Chimney Location
Inside L---' Outside
Pilot Type4T2
Chimney Construction
k_
_
Pilot Make
Pilot Model w—
Smoke Bomb
Wiring
Pilot Timing J
Draft
Test Tag
L.W. Cut Off
D r Pressure—
Lighting Inst. '
e �
Pressure P.f cegnt 0 / Date Tested ow
Input CFH Pl�e7Pt � %� i4ampany
Testing
Stack Temp. — ,S:7geV Per of CO
Name of Tester
Fg��m�,235 0�
f[,O `� �E���-lam
i F.r �''�` ,
���t1 J"®Zt���
Sek')- l c, -e ��L�w.,
Application for Power Plants and Bleating, 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 ..................
5.00
$
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$ 200 $
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 $
�. V 06
6-L- -
Dept. of Bldgs. Phone 560-3450
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.
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New. Building Permit No. Permit No.
HEATING or POWER PLANTS- Steam, Hot Water, Warm Air—No
Trade Name . Size
a
Capacity Sq. Ft. E.D.R BTU H.P.
Total Conn�,cted Load Kind of Fuel
BURNER —Trade Name Size No
Capaci ® E.D.R ®/ ®BTU _ ® H.P.
RA
41
Ae.2,4ec
RAY N. WELTER H EATI N G CC
��'•�� �� Signed 4632 CHICAGO AV&.----
/� MINNEAPOLIS 7. MINNESmT^
By
C4130.142 Business Phone No.�)���
(REMARKS -OVER)
SUBJECT
MIT
City of Fridley
AT THE TOP OF THE TWINS
BUILDING P E R M I T
r
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV
1 L PROTECTIVE INSPECTION SEC.
13-27r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
4/2/97
1
JOB ADDRESS 1534 Trollhagen Drive NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
10
4
Innsbruck 5 Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Lisa Zeller 1534 Trollhagen Drive NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Full Deck 1420 Marigold Cir, Victoria MN 55386 443-2485 20006700
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 j ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construction of an 18' x 17' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
WARNING
Before digging call for
all utility locations
454-0002
REQUIRED BY LAW
TYPE OF CONST..
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,714
$1.36
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-
$74.75
Fire SC $2.71
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
F
SIGNATURE OF CONTRACTO OR AUT ORIZED AGENT (DATE)
WHEN PROPERLY V#tJDATeD THIS IS YOUR PERMIT
BLDG NSP Da TE
SIGNATURE OF OWNERUF OWNER BUILDER) 'DATE)
NEW [ ] Effective l/l/97
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PEFMT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: k,_OTel. #
Contractor: FIA, d \ 2 \C I MN LICENSE # ®3 0o ®lA e�O
Address: ac� _®4-' `Ar sl\ tAspt%. z ka. Tel. # `' 4t 1 _ xq 9 S`
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EM PROVEMM
LIVING AREA: Length Width Height Sq. R.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length q ' O " Width (`)' 0 Hgt/Ground ol I Sq. Ft.
OTHER:
Construction Type: e Estimated Cost: $ o) -d- 00.0®
(Fee Schedule on Back)
Driveway Curb .Cut Width Needed. Ft.- + 6 Ft Ft x $ -:
DATE: l APPLICANT: .`� ��. Tel. # . �-/gj-a �,
CITY USE ONLY
Permit Fee
$ -N %
Fee Schedule on Reverse Side
Fire Surcharge
$ . V.
.001 of Permit Valuation (1110th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$J , c'
$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 [ ]
TOTAL
STIPULATIONS:
l�
I Iro JS
se
c AN<
porch
12.501
11.06°
6.00°
5.00°
3.56° 7.06°
Of
7.06°
E). 94'
17.22°
hopd�
V
6° step
2x6 cedar
decking
5.38°
5.06°
2 — 2ri8
headers
2Y8 joists
16 ° ° r)c.
18.
18.00°
footing detail
spacing betweer
picket not. to
excee 499.
811maximum ris(
91 'minimum t}Jr(
) V
step detail
a
CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2001
5431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE p
OWNER
N Residential
Rate
TOTAL
Furnace Shell and Duct Work, Burner -
BUILDING USED AS
Also Replacement Furnace'
$ 30.00
$
PERMIT NO.. Mn
(Side Vent • Fill Out Back)
ESTIMATED COST
Gas Piping (Needed with new furnace,
$ 10.00
$
_
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range
$ 10.00
$
O
No. of Heating Units Circle One (Stearn) (HvCWater) (Warm Air)
~ Gas Dryer
$ 10.00
$
Trade Name Size Nti. .
BTU HP EDR
"'Air Conditioning - All Sizes
$ 25.00
$ _
Fuel Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name Size No.
1% of Value of Appliance or Work
$
BTU HP I EDR
W
A :ommercial/Industrial
1.25% of Value of Appliance or Work $
U_
0 Stale Surcharge S .50
u TOTAL FEE
0
r` VIIINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
. 1EFRIGERATION/AIR CONDITIONING PERMIT 1S $25.00
v 21LUS THE $.50 STATE SURCHARGE
N
1EINSPECTION FEE $47.00/Hr
Q
m
T -Air Conditioners can not be placed in a side yard without
Nvritten permission from adjoining property owner.
Q
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 Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
LAkk y I U. AES L) - C) t
9303 Plymoum ve. ME
HEATING CO Golden Valley, MN. WQ7
SigneTEL#
Approved By1r6 Rough -In Date Final Date
BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION
MAY -23-2001 12:43 FROM CITY OF FRIDLEY TO 5423101 P.04iO4
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verges that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and fi�estopped 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 -LAMA 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 manufacturers specifications. Yes ( ) No ( }
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturers 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: (Describe)
VU\N� .re
FLARE HTG. & A/ ,
9-03 Plymouth Ave. Na
HEATING CO:
Signed By: Date : 0`
TOTAL P.04
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE ®I
Fridley, MN 55432
763-572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLnnR
Effective On Jan 1, 2001
® �'8 MY - R
•
R
�
R'F
•
�®
PLUMBING FIXTURE RATES: NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture _
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range*`' �
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
/0-00
JOB ADDRESS IS- 3 q 7-;-o h q 2,'n tl�I"'
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
_/ aL — I'S , 200
Owner -a te Vt Fu l /ry- 4- /- [ Sq z e- He "-
Building
e" -
Building Used As R PS t a,e •1`t' -
Estimated Cost zfJ�OO s PERMIT NO.
PLUMBING CWPANY ) GU -4"I / (et LQ, (U v-/.).
SIGNED
Approved By
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
531--9606
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 existina combustion air is sized and installed to meet the current codes
and manufacturers specifications. Yes( ) No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No ( )
When installina a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
f
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
February 28, 2003
Glen Fuller & Lisa Zeller
1534 Trollhagen Drive NE
Fridley, MN 55421
Re: Final Inspection at 1534 Trollhagen Drive NE
Contractor: Budget Plumbing Corp.
Dear Mr. Fuller & Ms Zeller:
A plumbing permit was issued on December 18, 2001 to install five plumbing fixtures at
your address. According to Section 4715.2800 of the State Plumbing Code, a final
inspection shall be conducted on the work authorized by this permit. As of this date the
inspection has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
SUBJECT
PERMIT NO.
City of Fridley
1
32355
AT THE TOP OF THE TWINS
BUILDING
PERMIT
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
SEC.
r PROTECTIVE INSPECTION
E �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
_
I CITY HALL FRIDLEY 55432
'•�
612-571-3450
91041!
12/10/01
JOB ADDRESS 1534 Trollhagen 'Dr NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
10
4
Innsbruck 5th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Glen Fuller/Lisa Zeller, 1534 Trollhagen Dr, Fridley,
MN 55432 763-571-3136
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Sawhorse, Inc., 4740 42nd Ave N, Robbinsdale, MN 55422 763-533-0352 2302
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
e USE OF BUILDING
Dwelling
7 CLASS OF WORK
❑ NEW ❑ ADDITION X] ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Kitchen remodel
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plans.
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
I 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
$30,000.00
$15.00
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-
$441.75
$30,00 Fire SC
STgUCTlO R THE PERFORMANCE OF CONSTRUCTION
PIAN CAHECK E
TOTAL FEE
$5.0 L tens
$491.75
SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI
WHE PLY
V LI ATED THIS IS YOUR PERMIT
BL G 'NSR
It -,/,o
- - TATE
S-GNATURE OF OWNER,IF OWNER BUILDERI IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY ,(763)
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Effective 1/1/2001
2 604 Bldg Insp
Legal Description:
Owner Name & Address: Z e -e Tel. # Z63 -S71 -3 n�
Contractor. MN LICENSE#
Address: y7VD Y2 /Y Tel. # 2,!�j-
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA �\
GARAGE ARE
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
v
Construction Ty; V` �o � Estimated Cost: $
�5
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $—
D
DATE:/� ��—o/ APPLICANT: Tel. #,6'1,? -:;2-2l7 VJi�9
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee > (�/ 7 � $ ~� Fee Schedule on Reverse Side
Fire Surcharge 30.00 .001 of Permit Valuation (1/10th%)
State Surcharge $.50/$1,000 Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ �S • 00 $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 [ ]
TOTAL $ _
STIPULATIONS:
1
SUBJECT
City of Fridley
3
Z34
AT THE TOP OF THE TWINS
BUILDING
PERMIT
`
• _ _____ COMMUNITY DEVELOPMENT DIV.
T L V
PROTECTIVE INSPECTION SEC.
r � �
E � i
NUMBER
REV
GATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
4/28/03
JOB ADDRESS 1534 Trollhagen Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
4
Innsbruck 5th Addition
SHEET
2 PROPERTY OWNER .MAIL ADDRESS
ZIP PHONE
Lisa & Glenn Fuller 1534 Trollhagen Drive NE
763-571-3136
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Carlson Roofing & Remodeling 533 79 Ave NE, Spring Lake Park, MN 55432
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
612-840-4499 20287533
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION [ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House & Garage (25 Sq) Tear-off
9 CHANGE OF USE FROM 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
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 1 HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS 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
@
$2,894
$1.45
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-
RU TION OR THE PERFORMANCE OF CONSTRUCTION
$83.25
Fire SC $2.89
PLAN CHECK FEE
TOTAL FEE
icense SC $5.00
1 $92.59
SIG RE OF CON'RACTOR OR AUTHORIZED AGENT (DATE.
HEN PROPERLY VALIDATED THIS IS YO R PERM.
S.GNATURE OF OWNER..F OWNER BUILDER. IDATEI
DG INSo
HATE
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: /s 3 Z/ q V e-
Legal Description:
Owner Name & Address: .6 -Tc, Fi lfc1� Tel. #
Contractor: S Cdr gen kgo 4; an
Address: 0'31 1)91" ha e A
MN LICENSE #
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 H t/Ground Sq. Ft.
OTHER: ° �rL� e
v
;0
Construction Type: ec P' 'o'ftrt ��6£ �7P Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE:�' �e' 3 APPLICANT: t� Tel. #
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 83,,EW Fee Schedule on Reverse Side
$ i .001 of Permit Valuation (1/10th%)
$ /,= $.50/$1,000 Valuation
$ $1275 per SAC Unit
$ 6 $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
MECHANICAL
Permit No..-
o.:Inspections
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: le—A :-Lb
763-502-4977 FAX
EFFECTIVE 1-1-2oio
DATE IOL -f C YOUR E-MAIL ADDRESS i �1 JJ� (S T h -E� ,c� w5 I • CQ
{
SITE ADDRESS Of rn LP , n tai ® �--
THIS APPLICANT IS: [3OWNER ,CONTRACTOR
PROPERTY
NAME:
OWNER/
ADDRESS: L 3 e- 1 F�o��-e !� CITY
) � '��' � c�{ � � � STATE P
TENANT
,
--�
PHONE:
CONTRACTOR
COMPANY NAME: S ^ ,LXA~
n
CONTACT PERSON: e
SUBMIT A COPY OF
STATE LICENSE # - EXP DATE
YOUR STATE
LICENSE WITH
ADDRESS: C5 CITY W c9. c, STATE_ftd,IP; j
APPLICATION
PHONEa7
PERMIT TYPE
ksrNGLEFAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW Al REPLACEMENT ❑ ALTERATION/REMODEL
DFTAILEDD DEQ TION�OF�WORK C' "
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANULJ 2006 ASHRAE HANDBOOK
36, ddb +U
Equipment Installed MFG: ^ nZ� MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZE/BTU
/A$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
_BOILER $35.00 _FURNACE $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 VENTILATOR $15.00
� �� � � Y ,,. £ 5 �� '4 ;-: T' ( k Zx. � '.}} �' Y "Y-� •ZIr�\ x _ 1 4 ni �. -z. Mf i€��• � �
'� y twr5 YT � ����� � �� � Nds3f -`yy�' 4y 4 � �'V' 3 �'� �,� � ✓�y'ti �' � � i� ��8
�&Z,
„ 3 s
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 work which reqlires review and approval of plans.
!!��
SIGNATURE OF APPLICANT PRINT NAME re a , t).%ATE
APPROVAL INSPECTORS SIGNATURE DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
4. Heat loss & cooling load per room
a. MN Rule 1322, Sec. N 1104.4.13
5. Ventilation
a. Per MN Rule Chapter 1322. Sec. 1104
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.