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PRE 2010 DOCS - NEW HOMEBuilding $ BUILDING See Back Page for Fee Schedule Permit No.: Inspections � C r RESIDENTIAL APPLICATION Received By: 763-572=3604CITY 15 '� . p 5 OF FRIDLEY Surcharge Date Recd: DATE d !0� YOUR E-MAIL ADDRESS License Surcharge SITE ADDRESS $5.00 (State Licensed Residential Contractors) THIS APPLICANT IS: ❑ OWNER CONTRACTOR \! 115-flt?0 PROPERTY OWNER/ NAME: $ TENANT ADDRESS: CITY STATE ZIP $ PHONE: $450 Conservation Plan Review CONTRACTOR NAME: M'SUB�- , �C�` _ C� STATE LICENSE # Z%Z7-0i 3 EXP DATE ADDRESS: JR2- r Ue" AC -4139 CITY&Alwh� ' STATEAZ IP� Y OF YOURS ATE LICENSE WITH APPLICATION PHONE 743 — ZZ— FAX Z-- Z6 PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE i4 "11 . Make checks payable to: Citi of Fridley Attach Sti ulations ❑ O FAMILY/NEW CONSTRUCTION STORIES I -- PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: W ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: C* SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2• Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ /S /5d , � Y OCCUPANC3 TYPE y Permit Fee $ 1 �1':�4 , See Back Page for Fee Schedule Plan Review $ � C r 65% of Building Permit Fee Fire Surcharge $ 15 '� . p 5 .001 times the total job valuation Surcharge $ 'lc A '0 3 .0005 x Permit Valuation Minimum $.50 License Surcharge $��C' $5.00 (State Licensed Residential Contractors) SAC Charge $ \! 115-flt?0 $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ , �C�` _ C� Fee Determined by Engineering Sewer Main Charge $Agreement necessary ( ) Non Necessary ( ) Total Due $ i4 "11 . Make checks payable to: Citi of Fridley Attach Sti ulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ci Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applica ' n for ermit and w not to start without a permit; that the work will be in accordance with the approved plan in the case of all rk whi ' s approval of plans. /_ ��// SIGNATURE OF APPLIC PRINT NAME%l495r&2 i,d/le— DATE 46 Building A- 0 `)L BUILDING /SSS C1� Permit No.: Inspections, $ ESTDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE t YOUR E-MAIL ADDRESS SITE ADDRESS �� ,3/f S� /Ifs® '//�" THIS APPLICANT IS: ❑ OWNER)CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR NAME: B&VIZI 1045 STATE LICENSE #' ZO of 3 EXP DATE 313(le 5x - ADDRESS: ��IZ r7.�� a05 �'f3% CITY �� STAT&AjIP SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PHONE 7,z— FAX Z— 26 PROPERTY TYPEINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: W ❑ ADDITION ❑ MAINTENANCE/RE AIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2• Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ 59 THE o1- C FEE d 5 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ A- 0 `)L $ /SSS C1� $ $ e �. $ $ ocl - CU See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ci affridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applica ' n for ermit and w not to start without a permit; that the work will be in accordance with the approved plan in the case of all rk whi s approval of plans. ��G�®`� � SIGNATURE OF APPLIC T PRINT NAM DATE REScheck Software Version 3.7 Release 1 b Compliance Certificate Project Title: CADD FILE #06213 $LuMJ40ErF-9, Report Date: 06/06/06 Energy Code: 2000 Minnesota Energy Code Location: Anoka County, Minnesota Construction Type: Single Family Glazing Area Percentage: 13% Construction Site: Owner/Agent: GATEWAY WEST, NORTH BLOCK FRIDLEY, MN Designer/Contractor: Permit # Permit Date Ceiling 1: Flat Ceiling or Scissor Truss: 1108 44.0 0.0 30 Wall 1: Wood Frame, 16° o.c.: 1960 19.0 0.0 97 Window 1: Above-Grade:Vinyl Frame:Double Pane with Low -E: 279 0.330 92 Door 1: Solid: 38 0.070 3 Wall 2: Wood Frame, 24° o .c.: 327 0.0 10.0 36 Basement Wall 1: Masonry Block with Empty Cells: 1056 11.0 0.0 60 Window 2: Basement — 5.6 ft2:Vinyl Frame:Double Pane with 18 0.320 6 Low -E: Floor 1: All -Wood JoistlTruss:Over Outside Air: 69 0.0 10.0 5 Floor 2: All -Wood Joist/Truss:Over Unconditioned Space: 187 30.0 0.0 6 Furnace 1: Forced Hot Air. 90 AFUE Compliance Statement Statement of Compliance: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements In REScheck Version 3.7 Release 1 b and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Builder/Designer Project Notes: BLUMHOEFER RESIDENCE 1650 SQ.FT. 2 STORY Company Name Date CADD FILE #06213 Page 1 of 1 Permit # Permit Date REScheck Software Version 3.7 Release 1 b Compliance Certificate Project Title. CADD FILE #06213 f 3Lu✓ w)ef-EiZ Report Date: 06/06/06 Energy Code: 2000 Minnesota Energy Code Location: Anoka County, Minnesota Construction Type: Single Family Glazing Area Percentage: 13% Construction Site: Owner/Agent: Designer/Contractor: GATEWAY WEST, NORTH BLOCK FRIDLEY, MN Compliance: Passes Maximum UA`. 417 - Your Home UA: 335— 19.7% Better Than Code (UA) Ceiling 1: Flat Ceiling or Scissor Truss: 1108 44.0 0.0 30 Wall 1: Wood Frame, 16" o.c.: 1960 19.0 0.0 97 Window 1: Above-Grade:Vinyl Frame:Double Pane with Low -E: 279 0.330 92 Door 1: Solid: 38 0.070 3 Wall 2: Wood Frame, 24" o .c.: 327 0.0 10.0 36 Basement Wall 1: Masonry Block with Empty Cells: 1056 11.0 0.0 60 Window 2: Basement — 5.6 ft2:Vlnyl Frame:Double Pane with 18 0.320 6 Low -E: Floor 1: All -Wood Joist/Truss:Over Outside Air. 69 0.0 10.0 5 Floor 2: All -Wood Jolst/Truss:Over Unconditioned Space: 187 30.0 0.0 6 Furnace 1: Forced Hot Air: 90 AFUE Compliance Statement Statement of Compliance: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in REScheck Version 3.7 Release 1 b and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Builder/Designer Project Notes: BLUMHOEFER RESIDENCE 1650 SQ.FT. 2 STORY Company Name Date CADD FILE #06213 Page 1 of 1 n, np )r.,. r. Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By - 763 -572-3604 CITY OF FRIDLEY Date Rec' DATE - o,6 YOUR E-MAIL ADDRESS SITE ADDRESS �41� I 2y9 Irr THIS APPLICANT IS: ❑ OWNER 1*ONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR NAME: Dl D STATE LICENSSE # �� $ yS EXP DATE l a -016 SUBMIT A COPY OF YOUR STATE ADDRESS: oTfO (/R7,44&A Dsi> C CITY L [=.OAS STATESLIP SSd l% LICENSE WITH PHONE FAX—,2d,3- AX°763-APPLICATION APPLICATION PERMIT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: W ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK zt/r ,4k& L 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 $5001 FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERENOTED.':FiX' URES: z�IDICATE TOTAL OF EACH BELOW) TH BER SINK/LAV % FLOOR DRAINS SHOWER _ WATER PIPING BATHTUB GAS PIPING (NEW C/TYLlCENSE) SWIMMING POOL WATER SOFTNER ($35) _ _ CLOTHES WASHER / KITCHEN SINK TjWATER CLOSET _ BACKFLOW PREY. ($15) -7 DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER Me AN Permit Fee $ Number of fixtures @ $10.00 x$10.00=$ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ o? THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and wor,k is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work ch irp4 revAw and approval of plans. / SIGNATURE OF APPLICANT �/�,-S'�%%J� .1-1/DATE PRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 M Building Inspections 7.63-572-3604 DA MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS SITE ADDRESS 5Z13 . }- THIS APPLICANT IS: 0 OWNERiCONTR ACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: Permit No.. Received By:� Date Recd: J" NAME: ADDRESS: CITY STATE ZIP PHONE: COMPANY NAME:_ C � CONTACT PERSON: /i M STATE LICENSE # Sn W3 PHONE �G3) of a8 v yga 0 SINGLE FAMILY 0 TWO FAMILY PNEW 0 REPLACEMENT DETAILED DESCRIPTION OF WORK EXP DATE CITY (� � ( STATE %31 AzlPy�'� FAx763) d 13 —r %K 0 TOWNHOUSE 0 ALTERATION/REMODEL j-pl-k 4-ihaee. 4- 1, 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 fixtures. (This should reflect only the cost of labor ) improvement, installation or replacement of a residential fixture, excluding the 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 WHERENOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) MODEL: MFG: SIZE/BTU Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: LA/C $25.00 _FIREPLACE (GAS) $15.00 SUBSTU GAS RANGE/OVEN $10.00 NEW GAS GRILL $10.00 )C AIR TO AIR EXCHANGEER 515 FIREPLACE (WOOD) $35.00 FURNACE $35.00 GAS �T HTR $10.00 BOILER $35.00 _CHIMNEY LINER $10.00 _,GAS DRYER $10.00 _POOL HEATER $35.00 VENLATOR 515.00 TI _ DUCT WORK $10.00 GAS PIPING $10.00 aErC I, .I'1it7,�llk,L7°.:Ic L!eiiip,�?'.•u!vt.•'s- r^'w,,,.?„mr r�<�-- ;^•.� .,.. m—.w,...,. t._. _. -_ _ Permit Fee $ Number of fixtures l X$10.00=$ Surcharge $ 50 Number of fixtures @ $15.00 1 x $15.00 =$ /5-vrJ TOTAL DUE $ Number of fixtures @ $25.00 ! x $25.00 = $—C' Number of fixtures @ $35.00 h x $35.00 =!Clixo State Surcharge = $ 50 Total = $-9-S THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. ` SIGNATURE OF APPLICANT PRINT NAME Pe DATE City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC 0 NEIN HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or propan&UGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air.' calculations City of Fridley 6431 University Ave NE / d 1 Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977aco _ Water- and -Sewer- Permit Application ew Connection DUtility Line Repair/Relocation Existing)4-,Vater and Sewer Connection Date: U Job Address: 5131 - 3 YGk St. Nt Name of Applicant (Plumber): TD aXCON 0,t1 V) UI l Y1 C Name of Property Owner: 1$� 1)-efpO nt Existing Structure Permit # Permit Type: Sewer Fee: 5p.011 Water Fee: 5D • 10 Meter Fee: Repair Fee: Relocation: State Surcharge: ru SAC Charge: Special Assessment Fee: Total: $ 10 D .�-10 Applicant Signature: Inspector approval: Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See Engineering Cost of Water Meter See Utility Billing SAC Charge $1550 State Surcharge $ .50 Water Tap See En ' eerin 04/04/05 t')/7plr --'-N Building Permit Fee BUILDING Permit No.: Inspections $ l f ?j_ 0 RESIDENTIAL APPLICATION Received B�: 7b =572-3604 .001 times the total job valuation CITY OF FRIDLEY Date Rec'd: DATE 101 it& I orb YOUR E-MAII. ADDRESS 'i $5.00 (State Licensed Residential Contractors) SITE ADDRE S 5 � I &V";' $I''— THIS APPLICANT IS_ ❑ OWNER CONTRACTOR PROPERTY OWNER! NAME: ADDRESS: CITY STATE --ZIP TENANT $450 Conservation Plan Review PHONE: CONTRACTOR NAME: �11rLDidnt N.vma, kne. STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 1!61a1 iaz it 6J£, # 0CPIY EGL[na, STATEJJ9ZIP WITH APPLICATION PHONE tt aa. FAX PROPERTY TYPE JKSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMII.Y/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE 'DECK ❑ SIDING ❑ OTHER ❑ SW M1*1I VG POOL TYPE OF WORK: XNEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:. f` SIZE OF IMPROVEMENT f ! LENGTH o2 WIDTH � HEIGHT Sq. Ft. r ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I. Existing Floor Plan PROPOSED SIZE: El DETACHED GARAGE 2. Proposed floor plan 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING 1997 U .0 FEE SCHEDULE) TOTAL JOB VALUATION $ o'``ff OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ l f ?j_ 0 65% of Building Permit Fee Fire Surcharge $ 1-90 .001 times the total job valuation Surcharge $ . 9 q .0005 x Permit Valuation Minimum $.50 License Surcharge $ —S QC) $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$— $Erosion Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1 1-7 r3F Make checks payable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a perml and work ' not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which reyujrevi prov of laps. � SIGNATURE OF APPLICANT G� PEVIEVVED �� r.,� AritA �Id�, Date: 10/11/2006 Revision Date: 10/11/2006 Site Information Address 1: 5931 3rd St. Project #: Address 2: Lot: Block: City: Fridley County: Hennipen Subdivision: Application Information Business Name: 4 Seasons Heating & Air Inc. MN Contractor License #:Bond #578793 Contact Person: Tim Reagan Office Ph: 763-238-4826 Fax: 763-213-1176 Cell Ph: Address 1: 22713 Buchanan St N.E. City: E. Bethel State: MN Zip Code: 55005 New Construction House Details Square Feet: 1650 sq. ft. Avg. Ceiling Ht: 8 ft. Number of Bedrooms: 3 Ventilation : Exhaust Total Ventilation Capacity: 60 cfm. Minimum Continuous Ventilation :60cfm. Ventilation: Exhaust 60 cfm. Combustion Appliance Water Heater. Direct Vent/Sealed Combustion Input BTUs: 45,000 Independently Vented Furnace/Boiler: Direct Vent/Sealed Combustion Input BTUs: 80,000 Independently Vented Other Combustion Appliances Gas Fired Direct Vent Fireplace(s): Yes Gas Fired Power Vent Fireplace(s): No Gas Fired Natural Draft Fireplace(s): No Solid Fuel Appliance(s): No Exhaust Equipment Exhaust Ventilation Capacity (cfm): 60 Clothes Dryer (cfm): 135 Exhaust Fan Rating (cfrn): 80 Make -Up Air Total Make -Up Air Required (cfm): 11 Passive Make -Up, Round Rigid: 3 inches or Insulated Flex: 4 inches Combustion Air Minimum Combustion Air Requirements Have Been Met Applicant Name (print): Signature/Date: r^�''~� J Code Official (print): L,+N-u4i Signature/Date:1�3� o C9 ® 2004 CenterPoint Energy MinnWco. 2004 Mechanical Code Guidelines. Page 1 T -CI eLS=90 90 TT 400