PRE 2010 DOCSN
Village of Fridley, Min
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BUILDING PERMIT ', N° 1066
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Date: �y rfr� '.. �P �"j. P.. i
Owner , .. . , .:`:'::.: s Builder.............. ......- ... ,.... .
1,
Address Address .1. ............
P
II
LOCATIONOF BUILDING tl
No. . t+.i Street .. .. ... Part of. Lot, . ...... . .
Lot .............. lock . Addition or Sub -Division ..... •ih .... ....... ......... .
Corner Lot .. Inside Lot : ` .' Setback ,fir' Sideyard 111 :`'`. .
DESCRIPTION OF BUILDING
To be Used as:,
f . &Depth : .. Height .. ..�. ^* Sq. lti't. c..° Cu. Ft, .. .
Front ... Depth Height Sq. .. Cu. FL .......
Type of Construction : y .,.. � ......r•• -ems, Est. Cost ..................... To be ompleted . , . .... ,
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it
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rn consideration the issuance to me of a permit to construct the building d�,w ibed above, I agree to do
the proposed work in ccordance with the description above set forth in eompilian 'witty- all provisions' of
ordinances of the villa a of Fridley. f'
]h consideration o the payment of a fee of S. i ...., permit is hereby granted to ... , :'. `... ......
.......... ... to construct the building or addition as ri granted and lids escribed above,' This permit is granted upon
the •express condition t the person to whom it is agents, employees and workmen, in all work
done in, around and said building, or any pari thereof, shall conform in all &ts to the ordinances of
Fridley; Minnesota re g location, construction, alteration, maintenance, repair d moving of bu9ldbW with -
In the village limits an this permit may be revoked at any -time upon violation of any of the provisions of said
ordinances.
i
NOTICE:
This permit does not cover the construction, Install atlon or alteration Por wiring, plumbing, gas heating,
sewer or water. Be re to he 'Buiiding Inspector for separate permits ` th IoeItems.
it
BUILDING PERMIT I,
Village of Fridley, Minn.
!i No 2325
Date !
............. it
Own ,h
..✓.# Builder ........
T .............................
Address
Address ........
�
LOCATION OF BUILDING
11
No.. ,(/L t*t Gf.....
. ' Street S,47, . .. • ...4,T ............ Part
�I
III of Lot .......................
Lot ... Aw':'! /
Block ...fit, ......... Addition or Sub-Division .0
..; �i� :............... .
Corner Lot .......
.... Inside Lot AP% ......... Setback M00 . Sidey
I� �d /it. 0 . ..............
DESCRIPTION OF BUILDING
To be Used as:
Front�pDepth �.. Height /09.t. Sq.l F........ Cu. Ft........ .
............ . .....
e
Typeof Constructio
Front ... Depth ........ Height .. .. Sq. iFt......... Cu. Fi....
... .. ....
/
Est. Cost � Completed
„� ' ..% .�%+i ..'"':r..... To be
In consideration
iii •y
r
it
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the issuance to me of a permit to construct the building (described above, I agree to do
the proposed work
accordance with the description above set forth and in compliance with all provisions of
ordinances of the
ge of Fridley. Ili
AD In coni' tion
f the payment of a fee of $• . , permit is hereby gran
i; 0
to construct the building or ad dition as described above 'This permit is granted upon
the express condition
that the person to whom it is granted and his agents, emploees and workmen, in all work
done In," around and
pon said building, or any part thereof, shall conform in allzespects to the ordinances of
Fridley, 30mesota r
location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits
d this permit may be revoked at any time upon violation of l any of the provision of said
ordinances.
.. Building Inspector
NOTICE:
This permit d
not cover the construction, Installation or alteration for wring, plumbing, gas heating,
sewer or.water. 0
sure to see the Building Inspector for separate permits for hese Items,
r City oFridley, , Minn.*
BUILDING PERMIT No 4205
Date: ....._. 5EPTEIMER•-9:....5..9._....... ..................................
Owner: Frank J . ......Kear'hey...................-.......-__-_- Owner
Builder ............................._...._.. - - - ...._...._..._...__ _..... _....
Address ._6010._.3rd__St_.. N._E�............. .... __.................... Address
Minneapolis, Minnesota
LOCATION OF BUILDING
No- ----- .-6010........... Street ............. .. 3rd .._5St......1......Z............__.........................---•--......... Part of Lot ......-..................... ...... _..... --......................
_..
Lot ....._12—.1..3............ Block .........................6....................... Addition or Sub-Division.........Hynde....Pet'.k...................................................... ...........
Corner Lot .................................... Inside Lot
Sewer Elevation
Setback ............................................. Sideyard
........... Foundation Elevation ..................
DESCRIPTION OF BUILDING
To be Used as:
Detached Game Front .....-..-lb-�.. Depth ......._2 .Z_.. Height ........... � 9 t sq. Ft..............352 cu. Ft. 3.:.5�_..
..... .............. -...................................... Front ........................ Depth ........................ Height ....................... Sq. Ft......................... Cu. Ft.........................
Type of Construction ..........Fra.ne.............................. Est. Cost_ _ 056............................... To be Completed ....._One.._Yees'.....-.......
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above setf9gh and in comp ' ce iall
provisions of
ordinances of the city of Fridley.
e
In consideration of the payment of a fee of $....�x..e..00...__.......... permit is h`reby granted to...' -491M -----------------------
....._......._.-....-.......-..-....................................... 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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. ® l�
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these hems.
;,tea.
SUBJECT
P IT NO.
City of Fridley
26582
AT THE TOP OF THE TWINS
BUILDING PERMIT
f
COMMUNITY DEVELOPMENT DIV.
1 y PROTECTIVE INSPECTION SEC.
Y
r 1 �
1 1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7-13-98
JOB ADDRESS 6010 3rd St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
I2- 3
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Barbara Byram Weddel
°
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Four Seasons Roofing & Remodeling, 7930 University Ave N, Fridley, 55432, 795-9410
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20138780
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION M REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remove & Re -roof (20 Sq)
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
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$
1,668
$.83
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESU TO GIVE HORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF Y OT STA OR LOCAL LAW REGULATING CON-
$54.00
$1.67 (Fire SC
STRUCTION O E PERF CE OF CONSTRUCTION.
�/1�
PLAN CHECK FEE T AL FEE����
,License SC $ .00
$61.50
SIGNAT RE OF CONTRACTO RAUTHORIZEDAGENT 1 TE)
PROP VALI A D THIS IS YOUR PERMIT
A
INSP
/
1 -It
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [) ,- ;,,.: CITY, OF FRIDLEY
AT [ ) SINGLE FAMILY -AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION fqq a
ConstructionAddress: 66/6 3 RD ST,Wil—:
e
Legal Description:
Owner Name & Address: r4 m (.d e- Tel. # .
Contractor: rou k, re4So�S i�� , �a C. Re m o3e-f ovictLZC. MN LICENSE # 90138 780
Address:79 2-j Q U in Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION. OF Il"ROVENTM
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Angth Width Hgt/Ground Sq. Ft.
OTHER: 0�z P ®® h r\!4
12_
Construction Type: m®Ve Estimated Cost: $ 6D(05
(Fee Schedule, on Back)..
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
.n
DATE:. r — C/—q9 APPLICANT: Tel. # / T
TOTAL $ L
STIPULATIONS:
CITY USE ONLY
Permit Fee
$`7. ('
Fee Schedule on Reverse Side
Fire Surcharge
$ l ,
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary. [ ]
TOTAL $ L
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESSy? J �I 1✓ ,
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct.
(Side Vent — Fill Out Back) /a
Gas Piping (Needed with new furnace) $10.00 $
OWNER ��f/� � f���.,/���5
_Gas Range $10.00 $ '
.BUILDING USED AS
Gas Dryer $ 10.Q0 $
ESTIMATED COST 1,�q, 6�4, PERMIT NO.
*Air Conditioning —All Sizes $ 25.00 $'
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $ No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
Commercial/Industrial BTU HP EDR
1.25% of Value of Appliance or Work t $ Fuel Total Connected Load
State Surcharge .50 Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE
HEATING COMPANY ?�
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed Tel No.va`��P'
PLUS THE $.50 STATE SURCHARGE
Approved By Rough—In Date Final Datel2 4
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON
written permission from adjoining property owner. REPLACEMENT FURNACE
a �_ Va1 e -/d 4/1 ?V -
r
HIMNEY AND STACK VERIFICATI
The, undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes ()
No ( )
2.
Is free from rust or deterioration
Yes ()
No ( )
3.
Has no foreign objects Dodged within
Yes ()
No ( )
4.
Is securely supported
Yes (
) No ( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes (
) No ( )
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes (}
No ( )
8.
Has combustion air been provided for water heater
Yes ()
No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
r
CITY OF FRIDLEY PERMIT o.:12004�:01�2�6�
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 07/30/2004
572-36U4 YAX: 17631571-IL57
ADDRESS 6010 3 ST NE
PIN 233024220024
LEGAL DESC HYDE PARK
LOT 12 BLOCK 6
PERMIT TYPE HEATING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL AN AIR CONDITIONER.
# A/C UNITS 1 VALUE OF APPL OR WORK 0
# GAS DRYERS 0 # GAS RANGES 0
VALUE (FOR MINIMUM CALL) 0
APPLICANT
ROYALTON HEATING & COOLING
4120 85 AVE N
BROOKLYN PARK, MN 55443
(763) 424-8333
OWNER
LINDA ZIEN
6010 3RD ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulattiin. cons tion or the performance of construction.
ADDI cans t \ Date . I
Bldg
HEATING PERMIT MINIMUM FEE 0.00
GAS RANGE FEE 0.00
GAS DRYER FEE 0.00
AIR CONDITIONING FEE 25.00
HEATING REPAIRS/ALTERATIONS 0.00
STATE SURCHARGE, MECH FLAT 0.50
TOTAL 25.50
PAID WITH CHECK # 40052
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY BUILDING INSPECTION
6431 University Ave NE
Fridley, MN 55432
763-572-3604 FAX 763-571-1287
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Other Repairs or Alterations (List on Back)
1% of Value of Appliance or Work
Minimum Fee $15.00 for Residential or 5% of cost of
Improvement whichever is greater
,o ( ( q Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS Le D 10 C3 Ld S -L PJ 6
Fee Total
Owner P GL _ 7,
$35.00 $ Building Used As :; "n YYL�
$10.00 $ ESTIMATED COST L /6 d� PERMIT NO
$10.00 $ DESCRIPTION OF FURNACE AND BURNER
$10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
$25.00 BTU HP EDR
Fuel Total Connected Load
$ Burner Trade Name Size No.
BTU HP EDR
Commercial/Industrial/Institutional
1.25% of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 for Commercial/IndustriaVInstitutional
State Surcharge
TOTAL FEE
REINSPECTION FEE $50.00/HOUR
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.
$ 50 HEATING CO RO m•" =� ING
$ 5,50
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
rel #
fel # Lrta
FAX # - - Date O-'6
N 5110 �
�y�
Approved by Rough -in Date Final Date
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes O No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input Fan Assisted or Nat
Appliance #2 Type
BTU Input Fan Assisted or Nat
Appliance #3 Type
BTU Input Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By:
Date :
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 k'AX: ( 763) 571-1287
ADDRESS 6010 3 ST NE
PIN 233024220024
LEGAL DESC HYDE PARK
LOT 12 BLOCK 6
PERMIT TYPE ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-01220
DATE ISSUED: 07/30/2004
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL AN AIR
CONDITIONER.
# INSPECTIONS 1
APPLICANT
ROYALTON HEATING & COOLING
4120 85 AVE N
BROOKLYN PARK, MN 55443
(763)424-8333
LINDA ZIEN
6010 3RD ST NE
FRIDLEY, MN 55432
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 40052
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp.
Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
571-36U4 k'AX: (763) 571-1287
ADDRESS : 6010 3 ST NE
PIN : 233024220024
LEGAL DESC : HYDE PARK
: LOT 12 BLOCK 6
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-01320
DATE ISSUED: 08/12/2004
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. CHANGE SERVICE AND ADD
ONE CIRCUIT.
1;1 # 0-100 AMP CIRCUITS 1
APPLICANT
ALL MAIN STREET ELECTRIC
2697 E CTY RD E STE 480
WHITE BEAR LAKE, MN 55110
OWNER
LINDA ZIEN
6010 3RD ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
STATE SURCHARGE, ELEC FLAT 0.50
ELEC AMP SERVICE FEE 30.00
ELEC CIRCUIT FEE (0-100 AMPS) 6.00
TOTAL 36.50
PAID WITH CHECK # 7723
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Fridley Building Inspections Dept. Ph: 763-572-3604 F"3-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical -Permit#
Residential Application
City of Fridley
See Back Side For Required Information
Date Site Address:
The applicant is: (cirice one)
Owner, ontractor
Property Owner:
-5
I
Address: 11 9
Epp
City:
State: 4441 Zip: '
Phone:
Cell: Fax:
Contractor Information
Company Name:
Contact Person: 14.1- Itlj
Address:
City:
State: Zp:
Phone:
Cell: Fax:
Email:
MN Bond# & Exp Date
Type of Work (circle one):
New Replacement Alteration/Remodel
Detailed Description of work:
a —
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
A/C $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 $
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:
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 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
S. 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