PRE 2010 DOCSv
City of Fridley, Minn.
BUILDING PERMIT
Date: ... �1...®..............
Address.....................................
N® 3396
Builder �...�°:^-ea�!`�:�.CR
Address .............................................
LOCATION OF BUILDING
N0'5-403�. Street .. .... ....... Part of Lot � ............................ ..
Lot ... /0.... Block ........ ......... Addition or Sub -Division Cvjae I-af ...... .:�.e�-tel
... Inside Lot ...X....... Setback ..�Sideyard ....: ..
Corner Lot ......... ..................
DESCRIPTION OF BUILDING
• < •r
t�
1114; o!Y Front .Q Depth . eHeight Q 07.0 Sq. Ft. ��._. ® Cu. Ft.
.................... Front ........ Depth ........ Height .... Sq. Ft......... Cu, Ft.........
Type of Construction ........ wt. cost 3& / ?' ..!�-To be Completed ....................
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth d in compliance with all provisions of
ordinances of the city of Fridley.
v
In consideration of the payment of a fee of $.J......, permit is hereby granted to .................
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. ® �--
.......... Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
Application for Power Plants and Heating, Cooling. Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations -up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations -up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines -to 400 sq. ft. IDR Steam ......
8.00 $
Furnace Shell & Line -to 640 sq. ft. IDR Hot Water ...
e�
8.00 $
Each add. 200 sq. ft. IDR Steam ......................
2.50 $
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
OIL BURNER to 3 gal. per hour ........................
5.00 $
over 3 gal. per hour -See Fee Schedule
GAS BURNER (up to 400,000 BTU) .......................
5.00
GAS PIPING (Up to 3 Fixtures) ..........................
1.50
(Add 50c each over 3)
AIR CONDITIONING $
FAN. HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE $ % ;Z
REMARKS:
Dept. of Bldgs. Phone SII 4-7470
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 ereby declares that all the facts
and representations stated in this application a and correct.
'dley, Minn 195
Owner �- 195—
Kind of B' 195—
Used as
To be completed about
Estimated Cost, $ 3 n cs o -
Old -New. Building Permit No. /
DESCRIPTION OF WORK
HEATING or POWER PLANTS -Steam, Hot Water, Warm Air -No
Trade Name Size No
Capacity Sq. Ft. E.D.R A) H.P.
Total Connected Leo Kind of Ft
BURNER -Trade Name L Size No- c-�
Capacity Sq. Ft. E.D.R BTU H.P.
Sign
B,
agED-11 POST IM -8-58 Business Phone No
-50 -ST N E: - CENTRAL SUPPLY CO. 7 _ - � ",` 1, ox.
HEAT LOSS CALCULATIONS 2929 Fourth Ave. So. LO. 0705 Minneapolis 8, Minn.
Weatherstrips A.S.H.V.E.
Guide
Windows Doors Reference
Yes—No I Yes—No 19
Construction No.
Insulation
Out. Wall I Int. WaIll Ceiling
Roof Floor
Kind How Applied
Exp. wall
FL k k . Room I Length S - Width
"Height
1 Fl. T Roomlength
S !:Width
— Haight
Windows and Doors—Crackage and Area
Coil. , - L -� Z
Windows and Doors-Crackage and Area
Total Btu.
Width Height No. of Lineal ft. Area
No. of pa. of pone lights of crack sq. ft.
Width . Height No. of Lineal ft. Area
No* of pane of pane lights of crack aq.
( 12—
I 2-0 Z
Net exp. wall
Int. wall
S, I
Q1
M
Coef Btu
Coef Btu
Infiltration
Coil.
Infiltration Z
117
Glass
t .-
Glass
b,
Exp. wall 10- y
Exp. wall
Net exp. wall
Int. wall
(
Net exp. wall
Int. wall
Floor
Floor
Ceil.
1
Cell. L3
1 11 Z %
Total Btu. j
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I FL (?,IE t> Room I Length 6 idth l0 12 Height
FI. I CS 1c Room I Lengthl� Width % t=Height
Windows an i Doors—Crackage and Area
Windows and Doors--Crackage and Area
I I 1 Coef Btu I I
Infiltration 10 Infiltration
Glass Glass
Exp. wail X Exp, wall ZA a
Net exp. wvII 1.1� 12. 1 cf � (,, I Net exp. wall
Int. wail
Floor
Ceil. L—iAa Ip
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. V ¢ Kj T RoomLength I`6 � Width �� _ Height
Windows and Doors—Crackage and Area
Required sq. fi. i`Alt. or sq. ins. W.A. leader area
Int. wall
Coef I Btu
I ITC, I•
Floor
Cell.' 4 O t4 3c)
Total Btu. % (�
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. jj-�V*V,%T Room I Length 1 0 Width I1 Height ef
Windows and
Doors---Crackage and Area
Coef I Btu
Infiltration
401 19 (e O
Glass
Exp. wall
Net exp. wall"
1 Z D
Int. wall
Floor
(,(,o
Coil. , - L -� Z
O Zai
Total Btu.
Required sq. fi. i`Alt. or sq. ins. W.A. leader area
Int. wall
Coef I Btu
I ITC, I•
Floor
Cell.' 4 O t4 3c)
Total Btu. % (�
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. jj-�V*V,%T Room I Length 1 0 Width I1 Height ef
Windows and
Doors---Crackage and Area
Width Height No. of Lirmal ft. Area
No. of pane of parrs lights of crack sq. ft.
`�- 2.4-
Coef
Btu
Infiltration
40
(,(,o
Glass
b+7
Exp. wall
1
Net exp. wall
Int. wall
S, I
Q1
M
Floor
Coil.
L
117
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
_ #Z
CENTRAL SUPPLY CO.
HEAT LOSS CALCULATIONS 2929 Fourth Ave. So. LO. 0705 Minneapolis 8, Minn.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
WindowsDoors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Yes—No Yes—No 19
t F1. Room I Length _ Width Height FI.Room I Length 5 -Width G- Height
Windows and Doors—Crackage and Area
Windows and Doors--Crackage and Area
Width Height No. of lineal ft. Area
Width No. of ltrroal ft. Area
No. of pane of pane lights of aaek a—ft. No. of pare lights of sack M.
- - - - Coef Btu
Infiltration 1 L
Glass GL 1 :� 2- <
Exp. wall -
Net exp. wall 1 131
Int. wall
Floor
Ceil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
\ FI. I \-As tir=> Room I Lenath \-1, 4 Width 1 i1 12 Halaht
Windows anJ Doors-Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef Btu
Infiltration v
Glass
X
Exp. wall ,ZL} Z Ci 3
Net exp. well Z, Z,0Int. wall
Floor
Ceil. to % IX 4 � o 260
Total Btu.
Required sq. -it. E.D.R. or sq. ins. W.A. Leader area
FI. I14V dot V—t T- Room I Lenath 14, Width \-\ N leh*
Coef I Btu
Infiltration 40 r :l to b
Glass
00
Exp. wall
Net exp. wall \ Z \
Int, wall
Floor
Coil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Lead--
eadarea
MI
Doors--Crackage and Area
Width Height Na. of Liereal ft. Area
Pane of pane
No. of palights of crack sq. ft.
ft.
Coef
Coef
Btu
Infiltration
40(
ci U10
Glass
p
0
Exp. wall 24
z
Net exp. wall
Net exp. wall
Z
Z
Int. wall
Int. wall
Floor
Floor
Coil. - �t i _-
Coil. x
Ir
10
Total Btu.
Required sq. -it. E.D.R. or sq. ins. W.A. Leader area
FI. I14V dot V—t T- Room I Lenath 14, Width \-\ N leh*
Coef I Btu
Infiltration 40 r :l to b
Glass
00
Exp. wall
Net exp. wall \ Z \
Int, wall
Floor
Coil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Lead--
eadarea
MI
Haight of pane
l Zo Z
Coef Btu
Infiltration Z 4-�
Glass
Exp. wall y
Net exp. wall ( L
Int. wall
Floor
Coil. - _ 2 - CI 7
Total Btu:
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I FI. I • Room I Lenath 1 k -- Width i n tO Heiaht
Windows and
Doors--Crackage and Area
Width Height Na. of Liereal ft. Area
Pane of pane
No. of palights of crack sq. ft.
ft.
Coef
Coef
Btu
Infiltration
40(
ci U10
Glass
p
0
Exp. wall 24
z
Net exp. wall
Net exp. wall
Z
Z
Int. wall
Int. wall
Floor
Floor
Coil. - �t i _-
Coil. x
Ir
10
Total Btu:
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I FI. I • Room I Lenath 1 k -- Width i n tO Heiaht
Windows and
Doors--Crackage and Area
Width Height Na. of Liereal ft. Area
Pane of pane
No. of palights of crack sq. ft.
width Height No. of Lineal ft. Area
No. of pane of porno lights of crack sq. ft.
Coef
Coef
Btu
Infiltration
40(
ci U10
Glass
p
0
Exp. wall 24
z
Net exp. wall
Net exp. wall
Z
Z
Int. wall
Int. wall
Floor
Floor
Coil. - �t i _-
Coil. x
Ir
10
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. II,.\v0 k t-, Room I Lenath 1 I:[ Width %1 Hei.ht IC
Windows and Doors—Crackage and Area
Width Height Na. of Liereal ft. Area
Pane of pane
No. of palights of crack sq. ft.
Coef
Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Z
l D
Int. wall
Floor
Coil. - �t i _-
Z
l 0
Total Btu.
Required sq. ft. E.D.R. or sq. ins: W.A. Leader area
HEAT LOSS CALCULATIONS
Weatherstrips
A.S.H.V.E.
Width Height No. of Lineal ft. Mea
No. of pane of pane lights of sack sq. ft.
Width Height No. of lineal ft. Area
No. of pane of pane lights of hack sq. ft.
Guide
2- c) L �Z
Windows
Doors
j
Reference
C
Yes—NO
Yes—No
19
4
R Fl. I %'�k az- %�, Room I Lencith
CENTRAL SUPPLY CO.
2929 Fourth Ave. Se. LO. 0705 Minneapolis 8, Minn.
Construction No. Insulation
. Wall Int. WaIll Ceiling I Roof I Floor Kind I How Applied
Width < Height Q 11 v;--', FI. �&rr-U Room I Length .` I: Width ` Helaht
Windows and mors—Crackage and Area
Doors—Crackage and Area
Width Height No. of Lineal ft. Mea
No. of pane of pane lights of sack sq. ft.
Width Height No. of lineal ft. Area
No. of pane of pane lights of hack sq. ft.
� 1
2- c) L �Z
Exp. wall y p
Coef Btu
Infiltration
Coef
Btu
Infiltration
t Z
4
"
Glass
00
1-(n
Floor . 13 ZC 1 b -
Coil.
Exp. wall k X Q
Exp. wall - S--
I IWO p
Exp. wall Z
Net exp. wall14
3
H4
-5o
Int. wall
Floor 'j e S
Z%
'p
Ceil.
Floor 1 I_
Total Btu.
Requires sq. n. L.w.m. or sq. ins. W.A. Leaser area I
RFI. I REN Room I Length 1'i !!!t Width In .r HelAt
Windows and Doors--Crackage and Area
Doors—Crackage and Area
Width Height No. of Lineal ft. Mea
No. of pane of pane lights of sack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of sack sq. ft.
Width Height No. of Lineal ft. Aron
Ne. of pane of pane lights of sack sq. ft.
2- c) L �Z
Exp. wall y p
Coef Btu
Infiltration
L -o O
Glass
0
Exp. wall 24,
Z.44
Net exp. w( ill
2654
Int. wall
1411rp(p
Floor . 13 ZC 1 b -
Coil.
A 1'
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I. L4+,,t Room I Length l 1, Width jr 11: Height
Windows and Doors--Crackage and Area
Width Height No. of Lineal ft. Area
No, of pane of pane Ilghts of sack sq. ft.
/1 1 -) /1_ I A _ I i I . — In .
I I Coef I Btu
Infiltration 64:1
Glass O
Exp. wall 1 otic -p
Net exp. wall
Int. wall
Floor 1y. l 4- Z
Coil. �—
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and
Doors—Crackage and Area
Infiltration
Width Height No. of Lineal ft. Area
No. of pane of pane lights of sack sq. ft.
Width Height No. of Lineal ft. Aron
Ne. of pane of pane lights of sack sq. ft.
2- c) L �Z
Exp. wall y p
Net exp. wall I
i -
Coef
Btu
Infiltration
Z.44
Cell.
Q- S
Glass
1411rp(p
Exp. wall - S--
I IWO p
Exp. wall Z
Net exp. wall
3
H4
So4
Int. wall
Floor
Int. wall
'p
Ceil.
Floor 1 I_
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. I1-3eRoom I Lengthti.± Width Ir,1,*Heiaht
Windows and Doorsr-Crackage and Area
Coef I Btu
Infiltration
Width Height No. of Lineal ft. Area
No. of pane of pane lights of sack sq. ft.
1A 40r
Exp. wall y p
Net exp. wall I
i -
Coef
Btu
Infiltration
s
Cell.
40
C16
Glass
I IWO p
Exp. wall Z
3
Net exp. wall
Z Q ^
Int. wall
Floor 1 I_
dr
2 -
Coil.
Coil.
e
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
3 FI. I�-tV A 14 t-IRoom j Ch SWidth j, -j THeight
Coef I Btu
Infiltration
Qi L< 0
Glass -
Exp. wall y p
Net exp. wall I
i -
Int. wall
Floor Z
Cell.
Total Btu. U
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
#4
CENTRAL SUPPLY CO. - i
HEAT LOSS CALCULATIONS 2929 Fourth Ave. Se. LO. 0705 Minneapolis 8, Minn.
Weatherstrips .4 ui V.E. Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. WaIll Ceiling Roof Floor Kind How Applied
Yes—No Yes—No 19
FI. I 1AAyr%.1_ Room I Length ` {.Width ` Height 6 11 1:1 1 C, 91 rT
Windows and Doors—Crackage and Area
Area
Width Height No. of lineal h. Area
No. of para of parte lights of crock sq. ft.
Width Height No. of lineal ft. Area
No. of parte of pane lights of crack sq.
In 0 Z.
3- L 20 X'_
G '( K �O
Coef Btu
Infiltration
Coef
Btu
Infiltration
1,)-
Aro
Glass
Int. wall
(,,
vcoo
Exp. wall
-
Zi 0 o
Net exp. wall
Int. wall
4
b 4
Floor '
Z
�-
Ceil.
Int. wall
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
12 Fl. Room I Lenath 6, S:-Widthl f,1iHaiaht
Windows- ami Doors—Crackage and Area
Area
Width Height No. of lineal h. Area
No. of para of parte lights of crock sq. ft.
Width Height No. of Lineal f►. Area
No. of pane of pare lights of crack sq. ft.
4 Cp 3�
3- L 20 X'_
G '( K �O
Coef Btu
Infiltration
Coef
Btu
Infiltration
Exp. wall Z
Aro
15 p
Glass
Int. wall
vcoo
Exp. wall Z4 =
-
Zi 0 o
Net exp. we+ll
Exp. wall /
Int. wall
Net exp. wall
�-
Floor
Int. wall
Coil.
_-------
Floor (X
Total Btu. Lo
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
��Fl. I1.1Vk-t44?' Room i Length) Width I 1 +_Heiaht.
Windows and ors—Crackage and Area
Area
Width Height No. of lineal h. Area
No. of para of parte lights of crock sq. ft.
Width Height No. of Lineal ft. Area
No. of pone of pare lights of crack sq. ft.
4 Cp 3�
3- L 20 X'_
G '( K �O
Coef Btu
Infiltration
Coef
Btu
Infiltration
Exp. wall Z
Infiltration
41 V b
Glass
Int. wall
,` p
vcoo
Exp. wall 1
��
-
Zi 0 o
Net exp. wall
Exp. wall /
Int. wall
Net exp. wall
�-
Floor $`'� .� 1 4
Int. wall
Coil.
_-------
Floor (X
lotai etu. Co
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Length 1 1 Width < Heiaht I.
Windows and Doors--Crackage and Area
Area
Width Height No. of lineal h. Area
No. of para of parte lights of crock sq. ft.
4 zo 2L
L l® F 1
3- L 20 X'_
G '( K �O
Coef Btu
Infiltration
40 22 O
Glass
Coef
Exp. wall Z
Infiltration
Net exp. wall SAI
12 (o
Int. wall
t9d
Floor
Coil.
Total Btu.
Required sq, ft. E.D.R. or sq. ins. W.A. Leader area
FI. 14?, QNNP Room I Length ► \ Width ([_ HeiahA_
Windows and D rs- Crackage and
Area
Width Height No. of Lineal ft.
NO. of pane of Porte lights of crack
Area
sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of parte lights of crack sq. ft.
3- L 20 X'_
G '( K �O
Z
'+—I
Coef
Btu
Infiltration
Coef Btu
Infiltration
t9d
Glass
Glass
-
Zi 0 o
Exp. wall t Zlc
Exp. wall /
Net exp. wall
�-
Int. wall
Int. wall
Floor (X
Floor 4- yc
1
3 Zp
Coil.
Coil.
Total Btu. - C6
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
\?-, Fl. I>^Ii)I,)t Room I Length 1 4 Width I I S Heiaht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft.
NO. of pane of Porte lights of crack
Area
sq. ft.
Z 32
L1
X*
Z
Coef Btu
Infiltration
Glass
Exp. wall /
112—
/LNet
Notexp. wall
Int. wall
Floor 4- yc
1
G
Coil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
s
BEAT LOSS CALCULATIONS
Weatherstrips
Windows Doors
Yes—No 1'es—No
ALS .H.V.I.
Guide
Reference 1
19
Fl. S 1,pgk1�,(toom I Length
Windows andDoors—Crackage or
Width Height
No. of pane of pane
No. of lineal
lights of as
�— )—
C)
Ar -O 2
1 �2
zq I 2
5^
1 2®i
F
Infiltration
22�- 3
Glass
CENTRAL SUPPLY CO. • " S
2929 Fourth Ave. So. LO. 0705 Minneapolis i, Minn.
Construction No. Insulation
Int. Wall Ceiling Roof Floor Kind How Applied
FI. I Room
Windows and Doors --C
G v o Width I Height N
No_
of noxa of 'ane 11
Coef I Btu
*k4I % " 11 Infiltration
Exp. wall A -d Y, L -0
Net exp. wall Z,0, 1D O
Int. wall
Floor K 4 1 "2 T3 2
Ceil.
Total Btu.
FI. I Room I Lenath Width Heinht
Windows ami
Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of tons lights of sack sq. T.
Width
No. of Pam
Height No. of lineal ft. Area
of tone lights of crack sq. ft.
Coef Btu
Infiltration
Glass
Exp. wall
Coef Btu
Infiltration
Glass
Exp. wall
Net exp. `' wvIl
Exp. wall
Int. wall
Floor
Coil.
Int. wall
Total Btu
Required sq. -14. E.D.R. or sq. ins. W.A. Leader area
FI. I Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of tons lights of sack sq. T.
lhaol ft. Area
of crack sq. ft.
Coef Btu
Infiltration
Glass
Exp. wall
Btu
Net exp. wall
Int. wall
Floor
Ceil.
Exp. wall
Total Btu.
Exp. wall
Net exp. wall
Int. wall
Floor
Coil.
Total Btu.
Height
Coef I Btu
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Room I Lenath Width He.ini,4
Windows and Doors Crackage and Area
Width Height No. of
No. of pane of tone lights
lhaol ft. Area
of crack sq. ft.
Coef Btu
Infiltration
Glass
Coef
Btu
Infiltration
Int. wall
Glass
Ceil.
Exp. wall
Net exp. wall
Int. wall
Floor
Coil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. I Room I Length Width Heiaht
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
Glass
Exp. wall
Net exp. wall
Int. wall
Floor
Ceil.
Total Btu.
Required sq, ft. E.D.R. or sq. ins. W.A. Leader area �� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Building
MECHANICAL
Permit No.: l '`
Inspections
RESIDENTIAL APPLICATION
Received
763-572-3604
r(13
It NOV 2
CITY OF FRIDLEY
Date c`'
763-502-4977 FAX
EFFECTIVE 7-1-2010
DATE l� - - I D YOUR E-MAIL ADDRESS i r
SITE ADDRESS .Sty LIS S X 13 .STT N LQ
THIS APPLICANT IS: 0 OWNER-BLONTRACTOR 67
PROPERTY
NAME: 1 .S I-e_
OWNER/
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TENANT
PHONE:
CONTRACTOR
COMPANY NAME: YD 5 S r *,t1 11V C A 14 r t ` vl k S C C C
SUBMIT A COPY OF
CONTACT PERSON:
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
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ADDRESS: W q & 1�_ V✓A't � CITY 05-'--e0 (R/ ZIP . A
APPLICATION
—STATE
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City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME 0 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.