PRE 2010 DOCSCity of Fridley, Minn. N9 10148
BUILDING PERMIT
Date: March 24, 1969
Owners Rodney Billman Builder Same
Address 151 Silver Lake load Address Same
New Brighton, Minnesota
No. 1453 Street
Lot 41 Block 1
LOCATION OF BUILDING
Windemere Drive part of Lot
Addition or Sub -Division
Innsbruck 5th Addn.
Corner Lot Inside Lot — x Setback 37 Sideyard
Sewer Elevation — 985.97 _ Top of Footing 990.52
Top of Riser 988.47
DESC
To be Used as:
Dwelling (nt 55' e
Garage
Type of Construction _'ram
SEWER LOCATI0i\\ X27' S utl
WATER LOQCA�T ON 1 ' So th
In consideration of theto me $f a
the proposed work in accordan th the descr
ordinances of the city of Fridley.
0' Sq. Ft 2186 ctL r, 28,930
10' Sq. p -t 696 Curt 6968
To be Completed
le
le
t to construct the building described above, I agree to do
above set forth and in compliance with all provisions of
$100.00 Sewer Connection Charge
In consideration of the payment of a fee of $A,40 ,permit is hereby granted to Rodney Billman
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 saki building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Official
Building UNPRM
Henry F. Muhihh
NOTICE:
This permit does not cover the cons ruction, Installation for wiring, plumbing, gas heating, sewer or water. Be am to we
the Building Inspector for separeto permits for them Hems.
City of Fridley, Minn. 12 0.6.
6431 University Ave. N. E,, Minneapolis, Minn. 55 2
BU IN PE
..-
Owners Builder Rodney Billman, Inc.
Address Address 151 Silver Lake Road
No. 1453 Street
Lot 41 Block
LOCATION OF BUILDING
Windemere Drive
Pari of Lot
Addition or Sub -Division Innsbruck 5th Addition
Corder Lot inside Lot Setback Sideyard _
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: 1,17 Z u
Dwelling Front 26' Depth 42' Height. Split Ent X7'2 nnFt 27,392
Garage Front 30' Depth 24' Height 10' Sq. Ft. 720 Cu. Ft. 7200
Type of Construction Frame _Est
+ Cost 30, 000.00 To be Completed 12-15-71
(34,856,40)
Elevation to be at least 18" above curb and 4' above catch-, in in rear
of lot. If walkout is built the floor will be a minimum 2' above catch
basin in rear of lot B#15,367.
Check Inspection slip for drainage requirements
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
$he proposed work in accordance with the description above set forth and in compliance with all provisions of
Ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 64.00 permit is hereby granted to Rodney Billman, Inc.
to construct the building or addition as described above. This permit is granted up=
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
Pridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
W.1thb, the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
Clarence Belisle w -
NOTICE
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or neater. Be sure to we
Building Inspector for separate permits for these hems.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: BUILDER: its
ADDRESS: ADDRESS:
NO:. STREET:U/i 24 te °
W 00 Y'&
LOT: BLOCK: ADDITI01������r?s
CORNER LOT: INSIDE LOT:SETBACK: r SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
,rLE0R7'10,1 —o Q6 A2- 1- 64,97' ,,9s, Ado • du -ed AAA 9t 494606, &-19 7-0-H 61SIlU 1,r
IqFogR OF LO -r - i,' uSgLA(nu- - /S dttlL r 7-9 --LOCR W, LU 6�c- )9 /Yedlm-u,-rh -
fi-60 LlE L,A-7'C-N Kl s r 9J / AJ P aF Lcs77-
DESCRIPTION OF BUILDING
To Be Used As:�,t,�,f,--��-�_�
Front: 7 6 Depth: � Height:
• g
Suare Feet •
q /Cubic Feet: 2-7, 3 % Z
Front : 3 d Depth: 2. Height • l
Square Feet; % 2--O Cubic Feet:_2
Type of Construction: Z�2r Estimated Cost:_p
To Be Completed:ellC�
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE : ' SIGNATURE :
J
(See Reverse Side For Additional Information.
CAF -Cllr .7k5/' I/- l P - v ✓R /F 1& 6 U/ /2f" Al /i_W ?S
City of Fridley
Applicafto for Nwibbig and Gas R"I" Pwmk
Dept. of Bldon. Phone 960-3
DESCRIPTION OF WORK
Number, Kind and Location of Fbftres
GASTEa N7ELEC.
1Mff
W%=AV/W-=========W==
. 0M-MOEM
EKNlomm MEMO
% MEN
PARTIALRATERATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
/®-
Number Fixtures ................
x $2.00
$
Future Fixture Opening ............
x $1.50
$
New Fixture Old Opening ..........
x $1.50
$
Catch Basin ....................
x $3.26
$
Water Heater (Up to 89,000 BTU) • • . •
x $3.00
$�
New Ground Run Old Bldg. ........
x $3.25
$
Electric Water heater, • ............
z $2.00
$
GAS FITTING FEES:
NO. RATE
TOTAL
Of
00
Ist 3 Fixtures .... • .... • .. • . • •
x $2.00
$
-
Additional Fixtures ..................
x $ .75
$
Gas Range to 199,000 BTU .. • ............
x $5.00
$
REPAIRS & ALTERATI® Refer to Code
Description ................ , ...........:............... 4
TOTAL FZE "—j 1
4-0
(SURCHARGE $_A)
v. n
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do 811 work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that ail the fact
and representations stated in this appli true and correct
on Minn _ � � 1
Owner F!) 6 ['X4u
Kind of Build'
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No. Permit No.��
Signed
By
Business Phone No "
ROUGH—
FIN
OUGH
FINAL -4/V -
Form 188-8 10M McClain Hedman & Schuldt Co., St. Paul. Minn.
646-6858 226-5121
THE JOHN J. RYAN CO.
1602 Selby Avenue St. Paul, Minnesota 55104
*urbeporI5 Jksewrtton Certif itate
3 herebp certifp that on December 11 , 1921-, 1 mabe a Mortgage 3£.oan
jinopection for Rodney Billman
the propertp locateb at 1453 Windemere Drive, Fridley, Minnesota
bohich is bescribeb as follobmo:
Lot 41, Block 19 Innsbruck 5th Addition. Subject to American Oil Co.
pipeline easement over the rear 20 feet thereof.
Anoka County
Cncroachmento xxx
3 founb that the folloboing builbing(s') House and 2 -car attached garage
is within the propertp limit% as set forth in the abobe legal btscription.
are
yor, No. 4489
John J. Ry egisteredeur
Paul J. C e, Registeredeyor, No. 4449
Aumber Aame Rodney Billman
Vropertp &je 82.47" x Irregular Fee $17.00
Form 188-8 10M McClain Hedman & Schuldt Co., St. Paul. Minn.
City of Fridley
Appi Wan for Numblag and Gm
Dept. of Bldgs. Phone WD -3450
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ........... x $1.50 $ _
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 $
Water Heater ;Up to 99,000 BTU) .... x $3.00 $
New Ground Run Old Bldg......... x $3.25 $
Electric Water Heater .............. : $Zoo $
GAS FITTING FEES: NO. RATE TOTAL
Ist 3 Fixtures ................ 2 x $?. op : 2.00
Additional Fixtures .................. x $ .?b $
Gas Range to 199.000 BTU ... ,............ x $5.00 $
install (1) gas gill (1) lite 6.00
REPAIRS B ALTERATIONS—Rales to Coda
117 Z=1=116".i. Tt b e. h iii'an
City of Fridley:
53-84-5915.51
The .undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that aA the fact
and representations stated in this application are true and correct
Fridley, Minn June 14, 1972 „ 19,..
Owner Jerry Les Dass
Kind of Buildingfr ane;
Used as residence
To be completed about .hing 12, 1972
Estimated Cost, $ 20.00
Old ANew. Building Permit No. Permit No.
Signe
By
Business Phone'"N'o NEC;ASCO
ROUGH
FINAL t
Description ...............................................
TOTAL FEE CEj�ts E`A" SUrcharge .507
.....
IN
.. .....ME01
.....MEMEN
........
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ........... x $1.50 $ _
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 $
Water Heater ;Up to 99,000 BTU) .... x $3.00 $
New Ground Run Old Bldg......... x $3.25 $
Electric Water Heater .............. : $Zoo $
GAS FITTING FEES: NO. RATE TOTAL
Ist 3 Fixtures ................ 2 x $?. op : 2.00
Additional Fixtures .................. x $ .?b $
Gas Range to 199.000 BTU ... ,............ x $5.00 $
install (1) gas gill (1) lite 6.00
REPAIRS B ALTERATIONS—Rales to Coda
117 Z=1=116".i. Tt b e. h iii'an
City of Fridley:
53-84-5915.51
The .undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that aA the fact
and representations stated in this application are true and correct
Fridley, Minn June 14, 1972 „ 19,..
Owner Jerry Les Dass
Kind of Buildingfr ane;
Used as residence
To be completed about .hing 12, 1972
Estimated Cost, $ 20.00
Old ANew. Building Permit No. Permit No.
Signe
By
Business Phone'"N'o NEC;ASCO
ROUGH
FINAL t
Description ...............................................
TOTAL FEE CEj�ts E`A" SUrcharge .507
97-81-879001
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
•
n
PLUMBING FIXTURE RATES: NO.
RATE
N
htiticr Fixtures
x
U
.
kU
$2.00
$
Water
x
$2.00
$
Catch Basin.
x
$5.00
H
..ki ro
u
$5.00
n
ro W
C�ppL,,
wl
$
Water Softener
Ho o f or
•w
W
U
J
New Ground Run Old Building _X
w
k
M
Electric Water Heater -_
-k L
k
0J
N
S
r
U
Ri
'1�
1st 3 fixtures
x
53.00
$
3.3ditional Fixtures
o
0:�
u.
9
.Gas Range to 199,000 BTU
,•N
$10.00
N
Id
••1
8
�
0
Aj N
x
lA
Ifl
each add. $100.00 or fraction
$2.00
$
State Surcharge
o
a
c
vi
A
Loi
w
c� u�
lq7
ug
D
I'lst
2nd
' 3rd
4 th
L
(R - Future Connection Opening
Connected with Sewor
1 (�1 - 11ev Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
htiticr Fixtures
x
$3.00
$
Future F -fixture Opening
It
$2.00
$
Ncv Fixture, Old Opening
x
$2.00
$
Catch Basin.
x
$5.00
S
r Nater Heater - to 99,000 BTU,
x
$5.00
$
100;000 -BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.90
$
New Ground Run Old Building _X
$5.00
$
Electric Water Heater -_
X
$5,00
$
.GAS FITTING FEES: '.
1st 3 fixtures
x
53.00
$
3.3ditional Fixtures
x
$1.00
9
.Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 8.00
RF.T1JCDO WnTM7 roa
Job Address �1L5w "•ilide�mere Oriole Lest
Department of Buildings
City of Fridley
Tel. 0571-3450
The undersigned hereby makes application form permit for the work F
specified agreeing -to do all work in strict accordance with the City (
and rulings of the Department of Buildings, and hereby declares that i
the facts and representations stated in this application are true ar,d
Fridley, Mn. 8-9-77 19_
OWNER
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 8-16-77 `
ESTIMATED COST 10.00 _
OLD - NEW BUILDING PERMIT N0. PERNIT NO. �Q_S
Company Mi
CO
Signed By'
Tel. No.
ROUGH INSP,
Data
FINhL INSP. - � ' /
Dato
APPROVAL FOR PERMIT r� ,
MINIMUM FEE FOR ANY PLUMBING PERMIT I9 $1.50
CITY OF FRIDLEY
Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1% of Value of Appliance or Work
RATE TOTAL
$ 20.00
$
$ 10.00
$
$ 10.00
$ 10.00
$
$
$ 10.00 $ /0,0,0
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $ / S• S�
Reinspection Fee ($15.00) $
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00,
PLUS $.50 STATE SURCHARGE
Attach stack verification form with. replacement furnace permits
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Job Address 10-3 e" -
Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432
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 application are true and correct.
9 Fridley, Minn. ' �� . 19 V�
OWNER
KIND OF BUILDING OCA/
USED AS
TO BE COMPLETED ABOUT 13 / - �d --
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name Size No.
Capacity Sq. Ft. EDR
Total Connected Load
BURNER - Trade Name
Capacity Sq. Ft. EDR
BTU
Kind of Fuel
Size No.
BTU
HP
HP
company .standard Heating & A/C
Signed By
Tel. No. 824-2656
' -
SUBJECT -
P
City of Fridley
F25 5
AT THE TOP OF THE TWINS
BUILDING D C D� AL"'v1 I T
r
r
RECEIPT NO..
COMMUNITY DEVELOPMENT DIV.
w�_____
i✓ � � PROTECTIVE INSPECTION SEC.
F
`--_• A ; '�';'� CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L J\ 612-571-3450
910-F15
5/13/02
JOB ADDRESS 1453 Windemere Circle W NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
41
1
1 Innsbruck 5 addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Steve Julkowski 1453 Windemere Circle West NE
—
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Eaco Construction 982 104 Ln, Coon Rapids, MN 55433
757-8508
a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20225452
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW 0 ADDITION 0 ALTERATION REPAIR
0 MOVE 0 REMOVE
8 DESCRIBE WORK
Remove existing deck; Construct an 11' x 12' Deck
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan.
WA R N", I N G
Before digging call for
all utility locations
454-0002
UIRED Y LAW
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$1,518
@
$.76
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-
$57.05
Fire C $1.52
STRUCj� OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTA F E
Licen IC $5.0
64.33
SIGNATURE OF CONTRACT OR AUTHORIZED AGENT IDATEI
E PRO1:� VALID E THIS IS }JhL- PEQ�-IT
4
S-GNATU RE OF OWNER IiF OWNER BU4 DERIIDAT I
DG INSo
TlATE
NEW [ j CITY OF FRIDLEY Effective 11V2002
ADDN [ ] 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: ✓ --7 6-3 its r,YJ a/c, Ph
Legal Description:
Tel. #
MN LICENSE #
Tel. #
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 I Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length_ Width Hgt(Ground Sq. Ft
7 77
OTHER: , Yin V .'P- g�4 IS-".)
00
Construction Type:_ �Y� f �,t9 �r ® Estimated Cost: $ ✓ -� /Y 16 —
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: 1 % APPLICANT:Tel. #
Call (763) 572-3604 for Permit Fees if mailing In applicationFax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$_ 67.,05
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by•Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ 611y, STIPULATIONS:
PA
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: ko6,m � ,
Legal Description:
Owner Name & Address: /� Tel, #
Contractor: yct MN LICENSE # /,, za
Address: ��� � U �--�� 1 sti Tel. # 2-�fu
Attach to this application, a Certificate of Survey : of the
lot, with the proposed construction drawn: on.it,twscale:
DESCRIPTION OF 11WROVEAIENT.,
LIVING AREA: Length Width
GARAGE AREA: Length Width
DECK AREA: Length
Construction Type:
Width
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
Cost: $ 0
$G1�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $__
DATE: °/< Z
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT: Tel. #
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 -(State Licensed. Residential Contractors) .:.
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Building
MECHANICAL
Permit No.:
Inspections
RESIDENTIAL APPLICATI®N
Received By: c_ 7
763-572-3604
Date vq °
CITY OF FRIDLEY
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER P20NTRACTOR
PROPERTY
NAME:
OWNER/
ADDRESS: ) q� a�J CITY STATI�VgIPS a-�
TENANT
PHONE:�C//P -j �� 9 ^ ( a qct D
CONTRACTOR
COMPANY NAME: S
CONTACT PERSON: -e-
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # / ,/EXP DATE �n y� C
�J�a
LICENSE WITH
ADDRESS _ / tl e7@ CITY S- �_OLL - STATEI YI /LIP
APPLICATION
PHONL1 J a_(Rc_L0 __'St�' 00 FAX
PERMIT TYPE
XSINGLEFAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
0 NEW REPLACEMENT 0 ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORKS 1 — 0-CJYI^2ivlS C�l
j`a.Se
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: MODEL: SIZEIBTU
MFG: MODEL: SIZEIBTU
MFG: MODEL: SIZE/BTU
4C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
NEW
TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_AIR
$35.00 _FURNACE $35.00 UNIT HTR $10.00
_BOILER
LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
_CHIMNEY
_DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00
PERMIT FEE.PROJECTS FOR UNDER $500. "; „ ; _ PERMIT FEEFOR PROJECTS OVIrR $504
Permit Fee $ 'S . ®
Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50
Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ 6,91's .ISO
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinance a d codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
to start without a permit; that the work will be in accordance with the
not a permit but only an applic do for a perm' ' andERINT
approved plan in the case of all w k which r 'rpproval of plan
SIGNATURE OF APPLICANT NAME DATE8
PLEASE NOTE; . SEP TE.PERMITS ARE REQUIRED FOR BUILDING, ELBCTRICAL AND MECI IANICAI✓ WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-5024977
M
City of Fridley Residential Mechanical Application Page 2
7
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.
JOE NAME: JOB ADDRESS,
Heating TD = 90 F +70 F indoor -20 F outside Cooling TD = 20 F +75 indoor +95 F outside
HEAT LOSS HEAT GAIN
SQ FT COEFF BTUH SQ FT COEFF BTUH
7777',"
Single 116`x'
Double 82N 23/19 33/24
Low E 40 NE & NW 43/34 65/54
Other E & W Z- 58/49 90/74 ,GG'
®r rW # 4,000 SE & SW 48/39 78/64
S 33/24 48/39 ldi
Doo u
300
1211 3
911
6" 5 12" 1
3#1 8 9" 2 --
611 3
3" 7 3" 4
1-1/2" 10 4zy ,
"
Z ; G ,3.
3
0" 6 1-1/2" 4
1 " 3.5
i ® @ c� � � . � � �i "� i "kin=- � • i # 600
Blw grade 1.5
Slab -grade Iin.Ft. 30/1 -in. Ft. r r - h 2500
SUBTOTAL 11 ISUBTOTAL � 6tZ
INFILTRATION: Infiltration CFM = .50 x cubic feet of house divided by 60
.50 x L x W x H / 60 = Infiltration CFM
NOTE:*Additional heating infiltration load should be calculated only if house is loosley constructed
Infiltration Infilt. CFK Coeff BTUH Infiltration Infilt. CFM Coeff BTUH
* 99. Sensible 22
Latent 1 24
Attic or crawls ace 10% Attic or crawls ace 10%
OEM
80% Furnace divide b .75
90% Furnace divide b.85�
95% Furnace divide by .90
FURNACE MODEL # LAIR COND. M
NOTE: Drawing or sketch including location of Condensing unit on back of this form
12/17/2007