PRE 2010 DOCSSUBJECT
PERMIT NO.
City of Fridley
�-W
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�
ECEIPT N
______ COMMUNITY DEVELOPMENT DIV.
r`�
1 � PROTECTIVE INSPECTION SEC.
1 . �
CITY HALL FRIDLEY 55432
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
,j 612-660-3450
910-F15
8/22/.77
JOB ADDRESS 5662 West Bavarian Pass N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
2
Innsbruck Villages SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Darrel A. Farr Development Corp. 7286 - 72nd Lane North 560-8110
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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
Ek NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 271 x 28' Townhouse and a 21' x 22.' Garage (Matterhorn)
9 CHANGE OF USE FROM TO
STIPULATIONS Combustion air may be required in furnace area.
WAR141AW
SEPERATE PERMOTS REOURED E.QR WIRING, Before digging call local utilities
HEATING. PLUMBING AND SIGNS. TELEPHONE - EL LEC T FOC - GAS Eta;.
REQUIRED BY �.. �.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-1
796+4-62
O 2 O Total
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I
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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$25,795
$12.90
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-
S N OR THE PERFORMANCE F CONSTRUCTION.
$80.80
$375.00
PLAN CHECK FEE
TOTALFEE'
$20.20
$488.90
SIGNATURE OF CONTRACTOITOR AUTHORIZED AGENT (DATE)
W EYPR,,ERLY VALIDATED THIS IS YOUR PERMIT
BLDG. INSP DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) -(DATE)
1---- 1161 t 1,1:,i\I 1117N 1•V1: '1:11J1III;: J .1f.1,, A!,1I*.I rAI1U.x,
Olt All1)I'I'10X BU I LMNG I'Ii.MM IT
CITY OF I I f l)LE , MINNESOTA
!dell, 06 BUILDER: Samar_
�_D ;_Ess : 'Z2tj Las. ADU�:ESS �.�1�s_i�9�r. •.3"'.S"•4°� 8
LOT � BLOCK: Z._ ADDITION:,. ��,�,�jrrt�G� Ll.- Waste5
CO-10—Er, LOT: INSIDE LOT:- ` OOOO SETBACK: SIDS 6aD :
Applicant attach to this fora Two Certificates of Sunre_y_ of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To -Be Used As: r ' ` ,40 �r.b
1Ojoa»he+use_ Front: Depth oQ9 Height: QC)
Square Feet; 1=2_ Cubic Feet: AT& -5- ,
Q i!AQ e,. Front: 07/ Depth: Height: /0
Square Feet; olfo L Cubic Feet;
Type of Construction: W00CL &ytwe' Estimated Cost: _$ a6oac>
To Be Completed: _ C/� G-1 Z 9 7
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict•accordance with the City�of
Fridley Ordinances and.rulings of the Department of Buildings-, and hereby
declares that all the facts and representations stated in this application
are tree and correct. '
DATE: l _ c� '� �� SIGNATUP.E: rszt�.:-asP�
(See Reverse Side For Additional Information.) '
c-- 2 0
CT-
O,�
c-- 2 0
LAI
CITY OF FRIDLEY
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
The undersigned hereby makes application for a permit for the work herein
.AIR
CONDITIONING SYSTEMS AND DEVICES_
PARTIAL RATE SCHEDULE
specified agreeing to do all work in 'strict accordance with the City Codes
each add. 50,000 BTU
'
GRAVITY WARM AIR:
RATE
TOTAL
Job Addressg
C% cam" Z -L'
Furnace Shell & Duct Work
$12.00
$
7.00
Replacement of Furnace
7.00
$
4.00
Repairs &Alterations -up to $500.00
7.00
$
Department of Buildings
Repairs & Alterations each add. $500.00
4.00
$
City of Fridley
Boiler & Lines up to 100,000 BTU
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell &Duct Work to 100,000 B2R1
$12.00
$
specified agreeing to do all work in 'strict accordance with the City Codes
each add. 50,000 BTU
4.00
$
and rulings of the Department of Buildings, and hereby declares that all the
Replacement of Furnace
7.00
$
facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00
7.00
$
'27
Repairs & Alterations each add. $500.00
4.00
$
Fridley, Minn. des' ' 0 19
STTAM OR HOT WATER SYSTEM:
OWNER
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
USED AS IQ We 1,1"&4'
• each addn. 50,000 BTU
6.00
$
TO BE COMPLETED ABOUT ✓ _ _
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ /oz,
OLD - BUILDING PERMIT NO. _ PERMIT NO. l�
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
lst 3 Fixtures _ - x
$ 3.00
$
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
HEATING or POWER PLANTS, Steam, Hot Water, Wazm Air- No.
AIR CONDITIONING r�r�1�lad .
$
Trade Named�1.V4 size No.
FAN HEATING SYSTEMS see Fee schedule
$
VENTILATING SYSTEMS
$
Capacity Sq. Ft. EDR BTU L; �-e 6) HP
ALTERATIONS & REPAIRS
7
State Surcharge
$ .50
Total Connected Load Q3 ,/(v 2 Kind of Fuel �� ls
TOTAL FEE
$ 5" 5e,�-
BURNER - Trade Name Size No.
ROUGH INSP. REINSPECTION FEE
Capacity Sq. Ft. EDR BTU HP
Date ($10.00)
FINAL INSP. Zz r s�
Company
Date
�
Signed By
APPROVAL FOR PERMIT
Tel. No.
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
PLUS $.50 STATE SURCHARGE
HEAT LOSS CALCULATIONS
Weatherstrips A.S.H.V.E. Construction No,
Windows 0 Doors Guide put Wall Int. Wall Ceiling Roof Floor n
Reference
Yes -No Yes -No 19 -
P
FI. Room I Length ,f _ Width 3g HeightF Room Len th
�FI.�e�f le 9
J
Windows and Doors-Crackage and Area ��7indows and Doors-Crackage ano
No. Width He'c f No. of Lineal ft. Area z.m Width I Ho'ght No, of Lineal ft.
of pane of pane lights of crack sq. ft. No.
r!! 1 of pane of pane lights of crack
/ �-,�
I
Coef
Btu
Cnef
B to
Infiltration
� ` �
Infiltration 2 g
Glass
I
Exp. wall
Exp. wall'PNet
exp. wall
Net exp. wall p
F�
-
• Int. wall
-
Int. all
w
-
I
Ceiling
Ceiling
Floor �.� ?:e a l5 .�
Floor
Floor
Total Btu.
Required sq, ft. E.D.R. or sq. ins. W.A. Leader area
C' VJ
Total Btu.
Required sq. ft. E.C.R. or sq. ins. W.A.Leader area
FI.C�ar'� Room Length �� Width 0 HeightFIFA
a Room I Length /LP' Width Height `
Windows and
Doors-Crackage and Area
Vilin ows and
Doors-Crackage
and Area
No. Width
of pane
Height No. of Lineal ft.
of pane lights, of crack
Area
sq. ft.
No. y�;,dth
of pane
H.•� I9' t No. of
of pang fights
T—
lineal it.
of crack
Area
sq, ft.
Coef,
B to
l --
Coof
Btu
Infiltration
Infiltration
�--—
Glass
—
—
Glass
- ----- ----- ---- — — —�
Exp. wall
Net exp wall
--
Int. wall I I
i l ing — -. --- ---- - -- -- - — -
Total Btu.
- _
Exp. wa l l -- --
-
--
Net exp. wall -- -
_
�_._
Int. wall
_—___J_----
Ceiling
-- — - -
Floor�-
Tota l Btu. _
Required
y
sq. ft.. E.D.R. or sq. ins. W.A. Leader area
$
(
- _-- -- --
Required sq. ft. F.C.R. or sq, ins. W.A. Leader area
I. Room ! Length Width
'"Heigh
Room Ler, th f ct°' Width
Viindows and Doors- Crackage and Area
-r --- --
-r- r �r �y .., q. t Ni. t Li i- rl rt. Area
N ,. :)f o-"! f,6: r 'Ipght Of E Crack meq. ft,
Height
d
D v,
�yf
Windows and Doors-Crackage and Area
No. Wroth
of pane
Height�No-
of pane I
of
��ghts�ef
i:eal h.
crack
!.-e,,
tiq. it.
--k�-
Coef!• Btu----
-- -----
coefl Btu
Infiltration j
1 _
Inflitrati0n
z
Glass -
Glass
Exp, wall �+� -
7t2 0
Exp. walIp�
Net exp. wall
Net exp' wall
Int. wall I
Int. wall - - --
_Ceiling
------
Ceiling
Floor
Floor, I✓ °4
�° ` ,"
t1 I
�
7/' ,! Bou.
a
Total Btu.
f
^q. ft. E.D.R. or sq. ins. W.A. Leader area !
,'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
t
fr
�j c t.
a V
HEAT LOSS CALCULATIONS
_ MINNEAPOLIS, MINN. �
Weatherstrips A.S.H.V-E. Construction No. Insulation
Windows ° Doors Guide put Wall Int. Wall Ceiling Roof Floor Kind How Applied
Reference
Yes -No Yes -No tg - --
FI. J i Room Length Width 6¢� Height Fl.,1 - Room Length �� Width �' Height
Windows and Doors--Crackage and Area Windows and Doors-Crackage and Area
No, Width Height No. of Lineal ft. Area —
of pane of pane lights of crack sq, ft. Width Hwght Nn. of Lineal ft, Area
qr- No' of pane of pane i lights �.9 of crack sq. ft, r
Coef
Btu
Coef
Btu
Infiltration
°i
Infiltration
Glass®
Glass
-
Exp. wall
Exp, wall
-
Net exp. wall
Net exp. wall --
Int. wall
--
Int. wall
-
Ceiling �i� fi ,�
Floor
Ay.
�~ �
Ceiling — .'.`
Floor
P
Total Btu.
r
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R, or sq. its. W.A. Leader area
FI. 1 l Room
Length Width'® Height
Fl. a Room Length Width Height,
Window
and
Doors-Crackage
and Area
`' p"�
Windows and
"
Doors--Crackage
and Area
Coef Btu
No.
Width
Of pane
Height No. of
of p ne lights
Uneal ft.
of crack
Area
sq, ft.
No. W+dth
of pane
' Height
of pane
No. of
lights
t meal ft.
of crack
Area
sq. ft.
—+-
Coef
Btu
Infiltration
p
Infiltration
Glass,�3
Glass ----
f�
Exp. wa I I ®� �� �,>�
Exp, wa I ! � �''
Net exp will
Int. will
- ---- - -
Ce ng
Floor -
Total Total Btu.
D. - - . ---
Required sq. ft. F.Q.P. or sra. ins. W.A. Leader area
Net ex wal I
p' 1
_. — - --
Int. wall -
---
Ceiling-
Floor
Total Btu.
Required s ft. E.D.R. or
q q. q. ins. W.A. Leader area I
- " 'p
�g1
-
n
—
FI. r - Room Length Width ,°� Height
FI. R-om I Length width
Windows and Doors--Crackage and Area
--
- - --� + J - + �, iT r ii f;. Area
No. - of i—� —T-
f�,� r -7-
II�yYI�f rick-sn. ft.
Height
-
Coef Btu
Windows and Doors-Crackage
No. Width Height I No. of
of pane of pane lights
\
and Area
Lineal h. A•e•a
of
of crack sq. ft.
'Coef'.
Btu
� -T-- ---
------�--------
-
Infiltration
Glass -- -----�------�---�----
Exp. wall �.----
Net exp, wall
Infiltration
Glass — -_-----
Exp. wall
Net exp. wall
Int, wall ..---
Int. Wall I
Ceiling®(� j�
---
! ®
- --
Ceiling -- ---- -4�
---------------
Floor
Floor i
To4al Bou.
Total Btu.
Required sq. ft. E-D.R, or sq. ins. W_A. Leader area
Required sq. ft. E.D.P. or sq. ins. W.A. Leader area
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Job Address _ �.�,; I�A- KLF-'
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this applizAtion are true and correct
OWNER
KIND OF BUILDING
USED AS
am
Fridley, Mn.
"Au—
TO
Au
TO BE COMPLETED ABOUT
PARTIAL RATE SCHEDULE
ESTIMATED COST
X
d
Water
y
q
y
y
%6
x
S%1
E.14
CM
rt
q
of
si
rt1 $4
p,
C1.
44
$
Company
Heater
Cr
N
.N
N
.•i
C
E+
tll
C
W
3
O
U'
O X
Signed By
U
Catch Basin
d
x
$5.00
$
G!
O
'�
.Oi
N
$5.00
C
N
••i
O
O
• i
•N U1
•V
$10.00
$
O
U)
U
w
5
ro
q
roro
P1
.14ro
U)
3
$4 o
Q W
4
U)
1
W
ro ro
U M
o ro
to
ro
0
4)
O
as
lec
Date
Electric Water Heater
x
$5.00
$
Z
GAS FITTING FEES:
I
FINAL INSP. 3 -30- 8�I
i
1st 3 fixtures
1st
x
'$3.00
I
' Date
F
E
x
$1.00
$
Gas Range to 199,000 BTU
x
$0.00
$
2nd
'
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
3rd
$2.00
$
MINIMUM FEE FOR ANY PLUMBING PERMIT IS
$7.50 PLUS $.50 STATE SUFE
State Surcharge
$ .50
TOTAL FEE
$ •�(J
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
Job Address _ �.�,; I�A- KLF-'
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this applizAtion are true and correct
OWNER
KIND OF BUILDING
USED AS
am
Fridley, Mn.
"Au—
TO
Au
REINSPECTION FEE
($10.00)
TO BE COMPLETED ABOUT
PARTIAL RATE SCHEDULE
ESTIMATED COST
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO.
PERMIT NO. 22942
Number Fixtures
%6
x
$3.00
$36.00
Future Fixture Opening
x
$2.00
$
Company
New Fixture, Old Opening
x
$2.00
$
Signed By
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$ 5--60
Tel, No.
k-31
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
ROUGH INSP.
Date
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
FINAL INSP. 3 -30- 8�I
1st 3 fixtures
x
'$3.00
$
' Date
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$0.00
$
APPROVAL FOR PERMIT a
'
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
MINIMUM FEE FOR ANY PLUMBING PERMIT IS
$7.50 PLUS $.50 STATE SUFE
State Surcharge
$ .50
TOTAL FEE
$ •�(J
REINSPECTION FEE
($10.00)
1978
3 � 3. wt3 c
r, i
0431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE (612)ST1-3450
Mr. Jim London
Darrel Farr Development Corp.
7286 - 72nd Lane North
Minneapolis, Mn. 55428
Re: Final Inspection at 5662. West Bavarian Pass N.E.
Dear Mr. London:
A final inspection was made on February 3, 1978 of the above address and
the following items were noted which must be completed before the structure
can be finaled out;
1. Provide sod in the front and side yards by June 30, 1978.
2. Provide a hard surface driveway by June 30, 1978.
3. Provide anchor bolts in the garage by.June 30, 1978.
4. Replace temporary wiring by June 30, 1978.
We will expect the above items to be completed on or before the scheduled
date when a reinspection will be made to determine compliance. If you have
any questions on these items, please contact me at 571-3450.
Sincerely,
L
RON HOLDEN
Building Inspector
RH/mh
SUBJECT
P IT NO. _ .
City of Fridley
1o
18096
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
Ly _ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
i ��'���;•� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
---.�
L 612-571-3450
910-F15
7/2/85
JOB ADDRESS 5662 West Bavarian Pass N.E.
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
4
2
Innsbruck Villages
I
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Judity Skillin 5662 West Bavarian Pass N.E.
221-2704
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Dundee Nursery 16800 Highway #55, Plymouth., MN 55446 559-4004
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10 ' x 18' On Ground Deck.
9 CHANGEOFUSEFROM TO
STIPULATIONS
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. T.
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
$900
$.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
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$16.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$16.50
RE OFCONTR CTORo UTHo DAGENT I ATEI
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI ``
BLDG INSP
ZDATV
NEW [ ]
City of Fridley Effective 4/1/84
ADDN. [ ]
�R-1 AND R-2
ALTER. [ ]
Building Permit Application
Construction Address:C�A�l�gicl7�t�-�C
Legal Description:
Owner Name & Address: Qlr
"SR((-s-(A--1 966tS & && y='K Tel. # 2.'ZI " 270y
1DJ
Tel. #
Contractor: (Vt3ta--- 1--uVaC,54-t
Address: (GL40 W'e
Rymcqu;((
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 l8' Width !U Hgt round ani Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [
] Ft. Yd. Setback Side Yard Setback
Type of Construction: IM ,Gft&VA)a
Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
I'P
DATE: G �� APPLICANT �-�.-� Tel. # 'SSci � 106
CITY USE ONLY
Permit Fee $ 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:
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE
SCHEDULE
m
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
ro
$ 5.00
$
x
d
$ 3.50
Water
Old Opening, New Fixture
us
9
Beer Dispenser
_
k
a
Blow Off Basin
O
1-111
$
w
$ 5,00
Heater
•.'+
u
H d
N
ro
S
k
m
F
ro
�
Sump or Receiving Tank
_
1_
x F' In N
a
Water Treating Appliance
_
u
$
Hot Water Heater
_
$ 5.00
0
.q
�
"a
'+L
.0
G
3
O
U ." .� .e
ml �
yes ( i No
U
y
m
w
_
•0
v
W
D
ro
�m
�
ro
3
w o
raw
ro i ro
ro
V
8
u
as
lec
m
W
cC
N
N
w
U pq�..p 3
0
o
�
1st
2nd
3rd
4th
(R) - Future Connection Opening
Connectyd with Sewer
(*) - New Fixture, Old Opening
Water
RATE
SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
$ 5.00
$
Future Fixtures
$ 3.50
$
Old Opening, New Fixture
$ 1.50
$
Beer Dispenser
_
$ 4.00
$
Blow Off Basin
_
$ 5.00
$
Catch Basin
$ 5,00
$
Rain Water Leader
_ _
$ 5.00
S
Hydraulic Valve
_
$_ 5.50
Sump or Receiving Tank
_
1_
S 5.00
S
Water Treating Appliance
_
$ 7.00
$
Hot Water Heater
_
$ 5.00
$
Gas Range
_ _
$ 10.0e
$
Gas Dryer
$ 10.GO'
$
Back Flow Preventer Required. . .
yes ( i No
( )
Type
_
$ 5.00
$
�'0 � 6 o
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
Effective Date May 1, 1988
The undersigned hereiy 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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
OWNER
KIND O
USED A
Fridley, Mn. ij� 5c 19
TO BE COMPLETED ABOUT
ESTIMATED COST
-
OLD - NEW BUILDING PEFMIT NO. PERMIT NO. /' Ile
Company •
Signed By // L?Z ✓ .
Tel. No.
ROUGH INSP.
Date"
FINAL INSP.
Date
APPROVAL FOR PERMIT
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
li of Value of Fixture or Appliance $ f
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00
�i'�3?� PLUS THE $.50 STATE SURCHARGE
Reinspection Fee
State Surcharge $ .50
$
($15.00) TOTAL FEE $ f �.
SUBJECT
City of Fridley
(72
0 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
RECEIPT NO.
�•
______ COMMUNITY DEVELOPMENT DIV
~
r PROTECTIVE INSPECTION SEC
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
"""�"� •'' 612-571-3450
910-F15
4/5/96
JOB ADDRESS
5662 West Bavarian Pass NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
2
1 Innsbruck Villages
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Judith Skillim 5662 West Bavarian Pass NE
571-0843
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Columbus Exteriors Inc 2131 111 Ln NW Coon Ra ids
MN 55433 868-9195 3509
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Townhouse
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION 0REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Vinyl siding/Aluminum Trim
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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
$5,470
2.74
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC
$5.00
$125.46
SI E OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY LIDAT D THIS IS YOUR PERMIT
-BLO 'INSP
Aaea
DATE
SIGNATUREOF OWNERIIF OWNER BUILDERI IDATEI
ADDN H CUT or 1
ALTER bd SMLK FAMMYE 1. k:f Ics ,
SAMWS PemlAppfication
9 Ca4 71 r , �
5662 West Bavarian pass
Judith Skillim
Td. f 571-0843
Cir. Columbus Exteriors, inc.MWUCjjt=# 3509
2131 1 th 1,;Q NXg 929D -Ha M -X 55433 Tel. 8fig-9j 95
Aftwh In tl& qVficMkM. a Cftdfimft Of SMVcY Of dle
it, via &t p Wo" c=Wwfion dmwe an it to ede.
rdo
Imp
.�
PeruCirt.� -&-_
�f��-.�/�
" ►&Uvb
@$
$ cJ AlT
g. 7
SAC Chup
$
Ikem &wcha W
$ J Dy
�'�j���//��
Y+�ii v"y liiYaV7T
EWICM 1
Pee
$
Main CWW
$
TMAL S, s.
STMULATfON'S:
C®LU'vGUS W 7ERiCRS, INC.
'NG
2131 -111th Lane N.W.
Coon Rapids, MN 55433
Larry - 868-9195
SuBjECT
PERMIT NO.
City of Fridley
� � �
4 8r
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
i �
• _ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
j
CITY HALL FRIDLEY 55432
NUMBER-
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/7/96
JOB ADDRESS
See Below
1 LEGAL
LOT NO.
TRACT OR ADDITION SEE ATTACHED
DESCR.
Variou
JBLOCK
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Various
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Columbus'Exte968-9192 3509
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Townhouses
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside 44 Units (11 Buildings) -
9 CHANGEOFUSEFROM TO
STIPULATIONS %°�.y�"'• �
5600,5602,5604,5606 West Ba i.an Pass; 5601,5603,5605,5607 West
Bavarian Pass; 5610,5612,5614,56 16 eat-Baver-#ee-Pass; 5620,5622,5624,5626 West
Bavarian Pass; 5620,5622,5624,5626 North Innsbruck Ct; 1521,13,1525,1527
Trapp Court; 5650,5652,5654,5656 West Bavarian Pass; 5660,56 2,5664,5666 West
Bavarian Pass; 5661,5653,5655,5657 West Bavarian Pass; 5671,5673,5675,5677 West
Bavarian Pass; and 5681,5683,5685,5687 West Bavarian Pass
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
44 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
$228,800
$114.40
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-
$1,532.25
Fire SC $228.80
STRUCTION R THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$1,880.45
SIG OF CONTRACTOR OR AUTHORIZED AGENT iDATEi
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
BLDG SP r,ATE
S,GNAiuRE OFOW NER,iF OWNER BUILDER) IDATEi
SUBJECT
City of Fridley
3 0 7 4 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
�• COMMUNITY DEVELOPMENT DIV.
i
� Y •.....,
r PROTECTIVE INSPECTION SEC.
LIF
1
NUMBER
REV
DATE
13/17/00
PAGE OF
APPROVED BY
1 + / •"f ! CITY HALL FRIDLEY 35432
�•'''
' ^ . �'' 61 ?,,-571-3450
910415
Joe'AooREss" jbb
- West Bavarian Pass NE
I '' LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1-4
:4 2
Innsbruck Villages
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Stock Roofing Inc. 3840 205 Ln Anoka MN 55303
213-1455 3112
-7'ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
.- Residential Townhouse Garage
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION RO REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof Garage Building (20 S) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIREO 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. OWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,748
.87
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•
Fire SC $1.75
STRUCTIO OR TH .; NCE OF CONSTRUCTION
$63.15
GYJ
PLAN CHECK
TO L FEE
Licen SC $5:00
0.77
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN R
VALI THIS IS PERMIT
_
/
S.GNATURE OF OWNER,IF OWNER SUIIDER, IOATEI
OLD INSP
ASE
SUBJECT
City of Fridley
33345
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
f PROTECTIVE INSPECTION SEC.
NUMBER
NEV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
2/20/03
JOB ADDRESS 5662 West Bavarian Pass NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
OESCR.
4
2
1 Innsbruck Villages SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jon Engebretson 5662 West Bavarian Pass NE 763-502-9467
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55426 952-933-6300
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 Q REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace five windows within existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings.
PaTmilt Inspection Cards
Will Be Ma"lled
To Homeowner To Post
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
'HEREBY CERTIFY THAT 1 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
@
$3.32
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6,652
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTA EE
Ci ense
1 $14 9'. 2 2
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT `. IDATE,
HEN ROP VALIDATED THIS IS YOUR P RMIT
?a a 3
NSP z r�
SIGNATURE OF OWNER, IF OWNER BUILDER, DDATE,
NEW [) CITY OF FRIDLEY Effective 1/1/2002
ADDN (J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg insp
ALTER () SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 56 6 ;� UV !4 ycf (t l 0 !'i� AI
Legal Description:
Owner Name & Address:
Contractor.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
MN LICENSE #
t oU�L Tel. #
Attach to this application, a Certificate of Survey of e
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
2�7
n
�a
Construction Type: KLo Estimated Cost: $
S
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: 11 APPLICANT. Tel. # '6 a�
Call (763) 572-3604 for Permit Fees if,_man ap�04x
iliplicati to 76315714287 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
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ a Fee Schedule on Reverse Side
$ 6,65- .001 of Permit Valuation (1/10th%)
$ �$.50/$1,000 Valuation
$ $1200 per SAC Unit
$ $5.00 (State .Licensed Residential Contractors)
$ Alt. 'W or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ . Fee Determined by 'Engineering
$ Agreement Necessary [ ] Not Necessary [ J
S�
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
Urinal
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
vvasn a nt1 > > rioor
rain
Tra l�air>.....Shower I�I��::>:>i v I`au[:t�k<:<:::::,..I iWasher
�_ _....- .
PLUMBING FIXTURE RATES: NO. RATE
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 () Nc
Type
3 $ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$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
Lllu,�livc: UIi JGII I, LUUJ
Gas Nlir>`:«< water Heater
Ranoe F« Gas Elec
TOTAL JOB ADDRESS
C�- 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.
20
Owner / �./l�d •�
Building Used As
Estimated Cost _ PERMIT NO.
PLUMBING
SIGNED BY
Approved By Rough -In Date
Final Date
$ .50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
$ �,= PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VFNT, VENT CC)NNFCTQR AND COMRI ISTIC)N AIR VFRIFICATION
When r nla .i an existing furan _P, 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 O 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 manufacturers specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The PYA ic!�ng enmhustinn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes( ) No( )
When required to install a new cnmhustinn air. it will be sized and installed
to meet the current codes and manufacturers specifications. Yes () No ( )
When ins alling_a new venting-qystam, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
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 #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
HEATING CO:
Signed By: Date :
J 11 c it;, 1. l I Y Ut— t—K I IJLtY
CITY OF MPLEY
6431 University Ave NE R-3/COMMERaAL/INDUSTRWPUBLIC/INSTIMIONAL
Fridley, MN 55432 BUILDING PERMIT APPLICATION
(763) 572-3504 FAX (763) 571-1287 _
CONSTRUCTION
Legal
P.02/03
Zoning
Tel# .-
6
Tel# (1_l
)hAJ X6//6
Architect Reg.# Engineer Reg.#
BUILDING CONSTRUCTION
OFC. AREA: Length
Width
Height
Sq. Ft
WHSE AREA: Length
Width
Height
Sq. Ft.
OTHER AREA: Length
Width
Height
Sq. Ft.
APPLICANT �T A A Tel A�Z ' � "3 70 Daft.
VALUATION
Sq. Ft. x $ Cosk/Scl. Ft. =Valuation
Sq. Ft. X $ Cost/Sq. Ft. - Valuation
Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ �� TOTAL VALUE
Building Use Construction Type Occupancy Group
Air Conditioning []Yes ONo Fire Protection Provided []Yes []No
Performance Bond Amount $ See Reverse for Schedule Received []Yes []No
PERMIT FEES® J
Permit Fee $_�.L/ See Fee Schedule on Reverse Side
Pian Check $ 65% of Building Permit Fee
Fire Surcharge $ .001 x Permit Valuation (1/10th %)
State Surcharge $ $.50/$1,000 Valuation (See Sched. for > $1 Million)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
Erosion Control $ _ $450.00 Conservation Plan Review
Park Fee $ Fee Determined By Engineering
Spec. Assessments $ Agreement Necessary 0 Not Necessary
Curb Cut Escrow $ feet x /foot
TOTAL $
ATTACH STIPULATIONS
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lie N 3903
Insured: John Engebretson
Property: 5662 Bavarian Pass
Fridley, MN
Claim Rep.: JEFF BOLGER
Estimator: Jeff Agness Business: (952) 646-3870
Title: Owner
Company: Total Service Company
Business: 6314 Cambridge St
St Louis Park, MN 55416
Company: Total Service Company Business: (952) 646-3870
Business: 6314 Cambridge St
St Louis Park, MN 55416
Claim Number Policy Number Type of Loss Deductible
4497MA 0 Fire S0.00
Dates:
Date of Loss: 01/10/05 Date Received: 01/10105
Date Inspected: 01/13/05 Date Entered: 01/19/05
Price List: MNMN2135A
Restoration/Service/Remodel with Service Charges
Factored In
Estimate: 2005-01-19-1613-E
U1 ,> 7, Z'
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
2005-01-19-1613-E
Unit 5662 Engebretson
First Floor
Room: Master Bedroom
Subroom 1: Offset
Missing Wall: 1 - 515" X 810"
Subroom 2: Closet
Missing Wall: 1 - 610" X 6'8"
DESCRIPTION
R&R 5/8" drywall - hung, taped, floated, ready for paint
Acoustic ceiling (popcorn) texture
Seal/prime the walls and ceiling - one coat
Paint the walls - one coat
R&R Batt insulation - 4" - R13
Visqueen vapor barrier
Seal stud wall for odor control (white pigmented shellac)
Seal floor or ceiling joist sys. (white pigmented shellac)
Seal underlayment for odor control
R&R Batt insulation - 10" - R30
R&R Underlayment - 5/8" particle board
R&R Baseboard - 3 1/4" hardwood - molded w/detail
R&R Interior door - solid oak - paneled - pre -hung unit
R&R Bifold door set - solid fir 4 or 6 panel - Double
R&R Casing - 2 1/4" hardwood
Detach & Reset Door lockset - interior
R&R Trim board - 1" x 2" - installed (hardwood - oak or =}
OAK BIFOLD STOP
R&R Closet shelf and rod package
R&R Carpet
ROOM NOTES:
1. MILLWORK IS UNFINISHED
Room: Hallway
Opens into 0
Opens into 0
LxWxH 13'7" x 11'0" x 810"
LxWxH 5'5" x 1'0" x 8'0"
Goes to Floor/Ceiling
LxWxH 8'2" x 2'0" x 8'0"
Goes to Floor
QNTY UNIT COST TOTAL
551.17 SF@
2.03=
1,118.87
171.17 SF@
0.78=
133.51
663.17 SF@
0.37=
245.37
492.00 SF@
0.39=
191.88
217.33 SF@
0.87=
189.08
500.50 SF@
0.30=
150.15
492.00 SF@
0.60=
295.20
171.17 SF@
0.77=
131.80
171.17 SF@
0.41=
70.18
171.17 SF@
1.40=
239.64
171.17 SF@
1.95=
333.78
59.50 LF@
4.29=
255.25
1.00 EA@
395.84=
395.84
1.00 EA@
396.47=
396.47
21.00 LF@
2.92=
61.32
1.00 EA@
22.12=
22.12
21.00 LF@
2.80=
58.80
8.50 LF@
26.74=
227.30
171.17 SF@
OPEN ITEM
LxWxH 5'2" x 3'0" x 8'0"
2005-01-19-1613-E 01/31/2005 Page: 2
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
Subroom 1: Offset
Missing Wall:
Subroom 2: Closet
Subroom 3: Closet 2
DESCRIPTION
1 - 310" X 810"
Opens'into 0
LxWxH 3'0" x 2'3" x 8'0"
Goes to Floor/Ceiling
LxWxH 2'0" x 2'0" x 8'0"
LxWxH 210" x 210" x 810"
QNTY UNIT COST TOTAL
R&R 5/8" drywall - hung, taped, floated, ready for paint
324.92 SF@
2.03=
659.58
Acoustic ceiling (popcorn) texture
30.25 SF@
0.78=
23.60
Seal/prime the walls and ceiling - one coat
324.92 SF@
0.37=
120.22
Paint the walls - one coat
294.67 SF@
0.39=
114.92
R&R Batt insulation - 4" - R13
97.33 SF@
0.87=
84.68
Visqueen vapor barrier
127.58 SF@
0.30=
38.27
Seal stud wall for odor control (white pigmented shellac)
294.67 SF@
0.60=
176.80
Seal floor or ceiling joist sys. (white pigmented shellac)
30.25 SF@
0.77=
23.29
Seal underlayment for odor control
30.25 SF@
0.41=
12.40
R&R Batt insulation - 10" - R30
30.25 SF@
1.40=
42.35
R&R Underlayment - 5/8" particle board
30.25 SF@
1.95=
58.99
R&R Baseboard - 3 1/4" hardwood - molded w/detail
36.83 LF@
4.29=
158.01
R&R Interior door - solid oak - paneled - pre -hung unit
1.00 EA@
395.84=
395.84
Detach & Reset Door lockset - interior
1.00 EA@
22.12=
22.12
R&R Closet package - hall/linen (4 shelves 3' wide)
2.00 EA@
134.27=
268.54
R&R Light fixture
1.00 EA@
54.10=
54.10
R&R Smoke detector
1.00 EA@
45.67=
45.67
R&R Carpet
30.25 SF@
OPEN ITEM
ROOM NOTES:
1. MILLWORK IS UNFINISHED
Cabinetry - oak face frame for linen closet
4.00 LF@
87.50=
350.00
Stain & finish full height cabinetry - faces only
4.00 LF@
28.10=
112.40
CABINETRY IS PRELIMINARY PRICING PENDING ACTUAL
VENDOR PRICING TO CUSTOM MATCH EXISTING
Room: Bathroom
DESCRIPTION
R&R Batt insulation - 4" - R13
LxWxH 77" x 510" x 8'0"
QNTY UNIT COST TOTAL
138.58 SF@ 0.87= 120.57
2005-01-19-1613-E 01/31/2005 Page: 3
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
CONTINUED - Bathroom
DESCRIPTION
QNTY
UNIT COST
TOTAL
Visqueen vapor barrier
138.58 SF@
0.30=
41.58
Seal stud wall for odor control (white pigmented shellac)
100.67 SF@
0.60=
60.40
R&R 5/8" drywall - hung, taped, floated, ready for paint
138.58 SF@
2.03=
281.32
Acoustic ceiling (popcorn) texture
37.92 SF@
0.78=
29.58
Seal/prime part of the walls and ceiling - one coat
169.25 SF@
0.37=
62.62
Paint part of the walls - one coat
131.33 SF@
0.39=
51.22
Detach & Reset Toilet
1.00 EA@
145.19=
145.19
R&R Tub/shower faucet
1.00 EA@
208.30=
208.30
R&R Vanity - Premium grade
3.00 LF@
175.60=
526.80
Stain & finish vanity - inside and out
3.00 LF@
37.74=
113.22
Detach & Reset Vanity top - one sink - cultured marble
3.00 LF@
20.87=
62.61
Detach & Reset Sink faucet - Bathroom
1.00 EA@
71.78=
71.78
R&R Baseboard - 3 1/4" hardwood
10.00 LF@
3.48=
34.80
Stain & finish baseboard
10.00 LF@
1.05=
10.50
R&R Base shoe - hardwood
15.00 LF@
1.59=
23.85
Stain & finish base shoe or quarter round
15.00 LF@
0.85=
12.75
R&R 1/2" Cement board
70.00 SF@
4.73=
331.10
R&R Tile tub surround - 60 to 75 SF
1.00 EA@
1401.30=
1,401.30
Detach & Reset Bath accessory
2.00 EA@
16.29=
32.58
R&R Interior door - solid oak - paneled - pre -hung unit
1.00 EA@
395.84=
395.84
Detach & Reset Door lockset - interior
1.00 EA@
22.12=
22.12
R&R Door stop - Wall or floor mounted
1.00 EA@
16.46=
16.46
Detach & Reset Mirror - 1/4" plate glass
9.00 SF@
4.84=
43.56
Detach & Reset Shower curtain rod
1.00 EA@
15.48=
15.48
R&R Light fixture - High grade
1.00 EA@
79.17=
79.17
R&R Exhaust fan
1.00 EA@
153.63=
153.63
Seal underlayment for odor control
37.92 SF@
0.41=
15.55
SEAL SUB FLOOR
Vinyl floor covering (sheet goods)
42.00 SF@
BY OTHERS
R&R Underlayment - 5/8" BC plywood
37.92 SF@
3.07=
116.41
2005-01-19-1613-E 01/31/2005 Page: 4
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
Room: Kitchen
DESCRIPTION
LxWxH 11'0" x 9'0" x 8'0"
QNTY UNIT COST TOTAL
Seal & paint acoustic ceiling (popcorn) texture
99.00 SF@
0.83=
82.17
Mask and prep for paint
40.00 LF@
0.88=
35.20
Room: Dining Room
DESCRIPTION
LxWxH 13'2" x 9'3" x 8'0"
QNTY UNIT COST TOTAL
Seal & paint acoustic ceiling (popcorn) texture
121.79 SF@
0.83=
101.09
Mask and prep for paint
44.83 LF@
0.88=
39.45
Room: HALL 2
DESCRIPTION
LxWxH 6'4" x 310" x 810"
QNTY UNIT COST TOTAL
Seal & paint acoustic ceiling (popcorn) texture
19.00 SF@
0.83=
15.77
Mask and prep for paint
18.67 LF@
0.88=
16.43
Room: Living Room
DESCRIPTION
Seal & paint acoustic ceiling (popcorn) texture
Formula Sloped Ceiling 17'0" x 15'6" x 1210"
QNTY UNIT COST TOTAL
270.70 SF@ 0.83= 224.68
2005-01-19-1613-E 01/31/2005 Page: 5
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
DESCRIPTION
Mask and prep for paint
CONTINUED - Living Room
Basement
QNTY UNIT COST TOTAL
65.93 LF@ 0.88= 58.02
Room: Family Room
LxWxH 27'0"
x 914" x 8'0"
Subroom 1: Offset
LxWxH 19'0"
x 516" x 8'0"
Missing Wall: 1 - 19'0" X 810"
Opens into 0
Goes to Floor/Ceiling
Missing Wall: 1 - 7'0" X 810"
Opens into E
Goes to Floor/Ceiling
DESCRIPTION
QNTY
UNIT COST
TOTAL
R&R 5/8" drywall - hung, taped, floated, ready for paint
415.83 SF@
2.03=
844.14
Acoustic ceiling (popcorn) texture
356.50 SF@
0.78=
278.07
Seal/prime the walls and ceiling - one coat
969.83 SF@
0.37=
358.84
Paint the walls - one coat
613.33 SF@
0.39=
239.20
R&R Batt insulation - 4" - R13
118.67 SF@
0.87=
103.24
Visqueen vapor barrier
118.67 SF@
0.30=
35.60
Seal floor or ceiling joist sys. (white pigmented shellac)
356.50 SF@
0.77=
274.51
Seal stud wall for odor control (white pigmented shellac)
118.67 SF@
0.60=
71.20
R&R Interior door - solid oak - paneled - pre -hung unit
2.00 EA@
395.84=
791.68
Detach & Reset Door lockset - interior
2.00 EA@
22.12=
44.24
R&R Door stop - Wall or floor mounted
2.00 EA@
16.46=
32.92
R&R Smoke detector
1.00 EA@
45.67=
45.67
Detach & Reset Light fixture
1.00 EA@
35.83=
35.83
R&R Baseboard - 3 1/4" hardwood
67.33 LF@
3.48=
234.32
2005-01-19-1613-E 01/31/2005 Page: 6
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
DESCRIPTION
CONTINUED - Family Room
QNTY UNIT COST TOTAL
R&R Carpet 356.50 SF@ OPEN ITEM
Room: Rough Framing
DESCRIPTION
QNTY UNIT COST TOTAL
FRAMING & ROUGH CARPENTRY - SUBCONTRACT 1.00 EA@ 4000.00= 4,000.00
ROUGH FRAMING IS PRELIMINARY PRICING PENDING ACTUAL SUB BID. FRAMING TO INCLUDE:
UNIT 5660 -
1. REP ATE ENTIRE ROOF TRUSS SYSTEM 37' LONG X 27' FLAT AT BEDROOMS AND SLOPED OVER REST OF UNIT.
2. REPLACE EXTERIOR WALL SHEATHING AS NECESSARY WHERE TRUSS ARE BEING REPLACED.
3. REPLACE DOUBLE FIRE ROCK WALL ON TRUSSES BETWEEN UNITS.
4. REPLACE ROOF SHEATHING ON ENTIRE UNIT AND STAGGERED INTO ADJOINING UNIT AS NECESSARY.
5. REPAIR AND OR REPLACE EXTERIOR WALL FRAMING AS NECESSARY - EXTERIOR WALLS OF 1ST FLOOR
BEDROOMS.
6. RE -FRAME CHIMNEY STACK AS NECESSARY.
7. REPLACE WALL PLATING AS NECESSARY.
UNIT 5662 - BID FOR THIS WILL ONLY BE A ROUGH ESTIMATE AS WE CANNOT DETERMINE EXACT SCOPE AND
COS IL WE GET INTO THESE REPAIRS. WE WILL NEED TO ADJUST OUR BILL ACCORDING TO TIME AND
MATERIAL IT TAKES TO REPAIR THE FRAMING AT THIS UNIT.
1. REPLACE 2X10 CELING JOIST AS NECESSARY.
2. REBUILD INTERIOR CHIMNEY CHASE WALL AS NECESSARY.
3. REPAIR OR REPLACE PORTION OF EXTERIOR WALL DAMAGED THAT IS ATTACHED TO ADJOINING UNIT.
Room: Roofing
DESCRIPTION
QNTY UNIT COST TOTAL
ROOFING - FLAT ROOF REPAIR OVER UNIT 5662 1.00 EA@ 2000.00= 2,000.00
2005-01-19-1613-E 01/31/2005 Page: 7
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
CONTINUED - Roofing
DESCRIPTION
QNTY UNIT COST TOTAL
ALL ROOFING IS PRELIlVIINARY PRICING PENDING ACTUAL SUB BIDS
Grand Total Areas:
3,079.33 SF Walls
1,099.13 SF Floor
987.33 SF Long Wall
0.00 Floor Area
0.00 Exterior Wall Area
0.00 Surface Area
0.00 Total Ridge Length
1,106.32 SF Ceiling
122.13 SY Flooring
514.67 SF Short Wall
0.00 Total Area
0.00 Exterior Perimeter of
Walls
0.00 Number of Squares
0.00 Total Hip Length
4,185.65 SF Walls & Ceiling
366.67 LF Floor Perimeter
379.60 LF Ceil. Perimeter
0.00 Interior Wall Area
0.00 Total Perimeter Length
0.00 Area of Face 1
2005-01-19-1613-E 01/31/2005 Page: 8
ServiceMaster / Total Service Company
6314 Cambridge Street St Louis Park MN 55416
952-646-3870 Phone 952-646-3832 Fax MN Lic # 3903
Summary for Fire
Line Item Total
21,720.90
Material Sales Tax
@ 6.500% x
8,183.72
531.94
Subtotal
22,252.84
Overhead
@ 10.0% x
22,252.84
2,225.28
Profit
@ 10.0% x
22,252.84
2,225.28
Grand Total 26,703.40
Jeff Agness
Owner
2005-01-19-1613-E 01/31/2005 Page: 9
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Permit# ;ear -
Residential Application
City of Fridley
See Back Side For Required Information
Date '6,Site Address:
The applicant is: (cirice one)
Owner 6 ontracto
Property Owner:
Address:
City: jr," d
State: INNS/ Zip: ,S15 V-�-
Phone: .-
ell: Fax:
Contractor Information
Company Name:
Contact Person:
1
Address:
City: ,AI&
State: Zip:
Phone:
Cell: Fax:
Email:
MN Bond# & Exp Date
Type of Work (circle one):
New Replacement Alteration/Remodel
Detailed Description qf work:
eV
Equipment Installed: MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU:
Please check all that apply:
_Fireplace (gas) $15.00 New Gas Grill $10.00
___AIC $25.00
_Fireplace (wood) $35.00 _Gas Unit HTR $10.00
_Air to Air exchanger $15.00
_Furnace $35.00 _Pool Heater $35.00
_Boiler $35.00
—Gas Dryer $10.00 _Ventilator $15.00
_Chimney Liner $10.00
_Gas Piping $10.00
Duct Work $10.00
Gas Range/Oven $10.00
Permit Fee $� ' (Total from above -Minimum fee $35.00)
Surcharge 1 0.50
Total Due $ 0545— Make check payable to City of Fridley
This is an application for a permit- not valid until processed.
I hereby apply for a mechanical 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 case of all work which requires review and approval of plans.
Signature of Applicant: Date: 1- %�
Approval Inspector Signature:
Date:
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
Revised 6/14/2005
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 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
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas TMC 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
Building
MECHANICAL
Permit No.: _
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Datfd:
DATE _ S - 0_1 YOUR E-MAIL ADDRESS
k! _
SITE ADDRESSS(Dlo c� ���5� �e�V�rlC CRSS Ivy
THIS APPLICANT IS: ❑ OWNER NCONTRACTOR
PROPERTY
NAME: Dov% G5�
OWNER/
ADDRESS: Sl , CITY QFr i c� �---c-a STATEffWIP�-3-A
TENANT
PHONE: ��� • S®�• �� ��
CONTRACTOR
COMPANY NAME: CENTERPOINT ENERGY
SUBMIT A COPY OF
CONTACT PERSON: JOANN Z INKEN
STATE LICENSE # EXP DATE
YOUR STATE
LICENSE WITH
ADDRESS: 9320 EVERGREEN BLVD STE BITY "COON"'RAPIDS sTATEMN zzP55433
APPLICATION
PHONE 7 6 3 - 757 - 6202 FAX 763-757-6701
PERMIT TYPE
YkSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑' ICREPLACEMENT ❑ ALTERATION/REMODEL
DTAILFiD DESCRIPTION OF WORK �+rt�� ` �tA ce E 1 N
1 ®re.V �-
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 $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG-QAr W- MODEL: <; tv SaFU)— LOLv
- �®�00
MFG: err C« MODEL: L[_O�`$ SIZEIBTU Z "tov\S
MFG: MODEL: SIZEIBTU
_LA/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
—AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
—BOILER $35.00 FURNACE $35.00 UNIT HTR $10.00
—GAS
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCTWORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 1 x $25.00 = $ 2_5,CP
Number of fixtures @ $35.00 _ 1 x $35.00 = $ _-Is.
State Surcharge = $ .50
Total = $ O. S�
THIS IS AN APPLICATION FOR A PERMrr-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 requires review and approval of plans.
�\
SIGNATURE OF APPLICANT , vT NAME ROGER ROFFHEIN DATE q - S -0-7
City of Fridley
Building Inspections'Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
119
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
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.