PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn. N? 2970
Date.. ....... •" • •.... .. ........ .
Owner Builder ................
Address . ........... . ............. Address /.. �. .. `.... .
_y LOCATION OF BUILDING
No. . °� ! .. �. y Street .. �................................. Part of Lot ..............
°'�
Lot ..... P.� ...... Block . ....... Addition or Sub -Division ....... ... ..... .
! e/
Corner Lot ............ Inside Lot ............ Setback .... Sid and .......
DESCRIPTION OF BUILDING
To be Used as:
f �
..... .... Front .. Depth . Height ......... Sq. Ft. Cu. Ft. ........
Front ........ Depth ........ Height ......... Sq. Ft... Cu. Ft.........
e�
Type of Construction 01...... ..... Est Cost .. ®d �� ........... To be Completed ...............
PP
✓ I• i i �,
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 set forth and in compliance with all provisions of
ordinances of the village of Fridley.
payment $. 0!'�;ermit is hereby granted to Y t
In consideration of the a ent of a fee of .. ,Z.&F ....
....................... to construct the building or addition as described above. This pe ted 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 village limits and this permit may be revolted at any time upon violation of any of the provisions of said
ordinances. A _
NOTICE:
This permit does not cover the construction, installation or alteration for wlring, m , gas heating,
sewer or water. Be sure to see the Building inspector for separate permits for thep6jitIfis.
c
&A LOT' 2, 8Zacl< 5' ,�� �!®/ ®DI'
on
I
mm
CORNER SLEW
3t Al!!:!!�a
/®f
1'l
Application for Power Plants and:. Hearing. Cooling, Ventilation, Reh igereetion 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. 80,000 BTU ... — .................. 2.00 $ _
Replacement of Furnace ............................. §.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. EDR Steam....... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR 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 FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
e✓
AIR CONDITIONING 7�_ /J20
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $�
ALTERATIONS & REPAIRS TOTAL FEE $ �
ROUGH
FINAL of 'off 0 ^ 7.0'
Dept. of Bldgs. Phone SU_ 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 hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley
Owner
Kind of Building
Used as
19
To be completed about r
Estimated Cost, $
76�°°—
01 —New. Building Permit No. Permit No. +�Z/ o
DESCRIPTION OF WORK
HEATING or POWER PLANTS -Steam, -Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. It. E.D.R BTU H.P.
Total Connected Load Rind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E D.R BTU H.P.
(REMARKS -OVER)
C<Dp42 2M 7-59 Business Phone Ni
7�o u) -
.__247`P
7 �o
Application for Power Plants and. Heating, Cooling, Ventilation. ReMgeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII. 4-7470
GRAVITY WARM AIR: RATE TOTAL, Locatio 2—
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 $
MEC& WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $�
each add. 80,000 BTU ..... . .................. 2 $
Replacement of Furnace ............................. $
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. EDR Steam.......
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR 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 FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ......................—�_ x $1.50
Additional Fixtures ................. x .50
Gas Range to 200,000 BTU ........... x 2.00
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
$
TOTAL F$E $
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 hereby declares that all the facts
and representations stated in this application are true and correct.
19 —
Kind of Building
Used as
To be completed about 7— 5 /3
j
Estimated Cost, $ (g n dam----'^
(OPNew. New. Building Permit No. Permit No. �J
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Sa' a Ee-�10
o/ G'Y O S
SMB '�O
Capacity Sq. Ft. E.D.R- �2p �S B B H.P.
Total Conjected Load 9�?5 Kind of Fu
BURNER — Trade Name Size No
Capacity. Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
a.
By
2M 7.59
• .T 0
HEAT LOSS CACULATfONS _ U L P A It I NI FN I 0 F I N �;P I :t' C l ea: _ p MINNEAPOi.I MIME.
Weatherstrips A.S.H.V.I<-I+- T Construction No. _ Insulation
Guide_
Windows Doors Reference Out. Wall Int. Wall Ceiling -- Roof Floor Find — r How Applied
'Y'l:s--No _W; --No 19__.�- - - - —: - ------ - -
4 EI.Room Lenitth % Wi eh;" li Fl.l RoomLenKth Width Height
Windows and Doors--_Crackagt_and Area T
Width Height
No. of pane of pane
No. or 1.Ineal L.
IIKht9 .,t crack
q,r.ea
ey. ft.
P
?
�'�.
} N.
Coef. Btu
Infiltrationq G�,a.-
Coef.
Btu —
InfiltrationGlass
Int. wally
�...
ceiling
.-_--
[dip_ wall r
u ,i�,
Floor
Net exp. n.a11
�'�t
Or
qI
-�--� ---
dA
Int. wall
$ ;
Ceiling
Floor —
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
--»---
h
BC'
FIA Room l Length Width
Windows and Doom--Craekage and Area
a
M Idth Helrht No. of Lineal ft. Area
No. of pane Of panelights of crack 6y. fl.
Height
Windows and_Doors---Crackage and Area
—' Width Height No. of Lipesl it.
No. of pane of Vane IlKhts of cragK
Arse,
sq. It.
P
?
�'�.
} N.
Coef. Btu
Infiltrationq G�,a.-
Glass i`
Eipew--a-I-I •#-- " ;',5 , I � t`" Vic•
Net exp. wall
-'
Int. wally
ceiling
.-_--
Floor
-
_Total Btu.
htryuire.d sq. ft. E.D.R. or aq. ins, WA. Leader area
FI.I �� - fdo m I Length Width Height
Windows and Doors—C_rackage and Area'
Y.-R'ldth }lelbht 11; Lsneal tt. Area
No. of pens _.f pe rib u,i' 4e of orach sq. ft:
_ Coef. Btu I� - - f, Btu
InfYltratlon _ '' �S f" �I- t I _Infiltration --- -'
Glass
p. walls�`+ i� �r. Exp. wall --
Not exp. wall� �° ".� �, �� 4 � Net exp. wall
IRt. oval) ry► ed" 4 # �"�'` C '1. int. wall
Ceiling__
._.� -- -
N lae►r Floor
Jowl Btu.$�— .......:� � � Total Btu.-
T�egy�iredD- R or sq. ins. W.A. Leader}orea _° _ Required sq. ft. L.D.R. or sq. ins. W.A. Leader' area.
Room Length Width - - Height Room I Length W1€ll i�eight
Wiadows and Doors--Crackag_e and Area c,ws and Doom-CrackSicand Area
Width el,tht - No of I.Ineal M Arco,,..., •--��'"'""Q', - - \VIJih lie 4bt No�nf r,lnttsl it. Arlen
Np. of�nnn of rano Ilphlb of crot+t� �T 7f - �r �r ":�
It rysno of yaftp Ilhta r,f Ctpt1 r1•
.- ,..-.... tee_„ ,.. ...�...-+..��. .-
Coef. Btu Goof 13tu
itthMtratiotY -----�-�--
Infiltration
I a Glass
ym,,,�..,�.�...+..eP..r.�...,.«e.-ua.,.+a-�-,•� ,.w> _ ..,�aa.--� -. r,w. � ....... ,_. ., a*..w.f�-,y�.,.:, =„p..m...,p,.,r.
wall FjP wall
ihlt,A#tp. wal`� Nest ewa
el)
lra...�..�...:1�..,.- ..�. .�.�..y.,,.....e�.�. .� Int. wall
�r
GAt to celllflg
S _
Floor'!Floor
�1"Qa BLu`z:, Total Btu,
! ' .fired , ft.:..DA. or' ins. W.A. Leader area Requited aq. ft. E.D.R. or sq. ins. W.A. LoAder Arti
Building
Inspections
763-572-3604
DATE (e) /1 I
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR
❑ OWNER
ADDRESS: %V'1.--,ITY C—ii
PHONE: 5'77 l - ? � .
COMPANY NAME;-- STANDARDAM40#140NM
Permit No.:
Received By:�
DWM'DCT 2 3 2
CONTACT PERSC X&P, ; t., 410 WESUAKF STREET
STATE LICENSE# Wk2f4
MN 55408
VM STATE ZIP
ADDRESS:
PHONE
FAMILY ❑ TWO FAMILY
❑ NEW bV7LACEMENT
DETAILED DESCRIPTION OF WORK
FAX -
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
'rn
PERMS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up'to $500.0%.; h chevei is greater, for the
improvement, installation or replacement of a residential, fixture, excluding the s•..(IY�is should re:,, only.the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $SOD = Cost'oflabor x .05 ,.
FOR PROJECTS WHERE LABOR EXCEEDS $5 FEES ARE BAS�O,N $10.00 PER FIXIURF,.WEEPT WHERB NOTED. FI�IVRES,: (INDI/CpATE TOTAL
NUMBER OF EACH BELOW) MODEL: 3 Z®' SIZFJBTU(� z`" u
Equipmentinstailed MFG: MODEL: SIZFlBTUP
MFG:
MFG: MODESIZEIBTU
L:
A/C $25.00FIREPLACE (GAS) $15.00 GAS RANGFIOVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILER $35.00FUR4ACE $35.00 GAS L Tr HTR $10.00
GHIMIIIEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
MIM"'. c, n "" GAS PIPING $10.00
VENTILATOR 515.E
i aTRirvTm �' I ll
Permit Fee $ Number of flaRtures @ $10.00 x $10.00 =
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00= $
TOTAL DUE $ Number of fixtmues @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 Z: x $35.00 =
State Surcharge = $��
Total = $
THIS IS AN APPLICATION FOR APERMIIT-NOT VALID UNM PROCESSED
I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be it
conformance with the ordinances and codes of the City of Fridley and with the A4mnes0ta 'Construction Codes; that1 understand this is
not a permit but only an f a ark is not to start without a permit; that the work will be in accordance wiitth�tho
approved plan in the case fall o w 'ch ew and approval of plans.
SIGNATURE OF
��LCity 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
❑ NEW HOMESIADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR -N-EW/EXISTIR ;HOME,S .-,ta
1. Combustion Air (See note beld'j�
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropanoUGC 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 . an 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 EneW Code 7670 or 7672
6. Duct Design Pef1MC 1346.0603:2
a^ ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustioni and make up air calculations
From: City of Fridley To 9528903351 Page: 2/5 Date: 10/21/2008 8:13:57 AM
'! Building
MECHANICAL
Permit No.
j Inspections
RESIDENTIAL APPLICATION
Received B
763-572-3604
CITY OF FRIDLEY
DaMMSEP 4 20
763-502-4977 FAX
EFFECTIVE 1-1-08
DATE YOUR E-MAIL ADDRESS S %A� i rt AJ8}--yGrrp
/
SITE ADDRESS 9q-72 N - R- % K S1-
THIS APPLICANT IS: ❑ OWNER G?CONTRACTOR
PROPERTY
NAME:�,_��-�¢
OWNER/
ADDRESS: &r77- NF- %FL CITY F STATE FJZ1? 23
TENANT
-1i"
PHONE '/ f7j S 77—JA�
CONTRACTOR
tI
COMPANY NAME:_ ` lk I I '
F4 ZNOTE
1
CONTACT PERSON: c K c �-iowt4 N
SEPARATE CITY
STATE LICENSE P EXP DATE
LICENSES ARE
KEQAND H FOR CAS
WW,i
ADDRESS S Sr IS CITY
l Z.S W ' �� ti � STATErr�NLIP Sg3?Y
AND H4'AC,
/
SUBMIT COPY OF BOND
PHONE FAX
AND INSURANCE
PERMIT TYPE
W"' OLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
C NEW 1114EPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
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
improvcmcni, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
OR
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 SIZE/BTU _
MFG: MODEL SIZE/BTU
_
MFG: MODEL' SIZE/BTU
_
$25.00 —FIREPLACE (GAS)$15.00 _GAS RANGE/OVEN $10.00
_ASC
TO AIR EXCHANGEER$IS (WOOD)$35.00 NEW GAS GRILL$ 10.00
_AIR —FIREPLACE
$35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00
_BOILER
LINER$10.00 DRY ER$ 10.00 _POOL HEATER $35.00
_CHIMNEY _GAS
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
PIRltitl[`f .FEE:PRi?i1Z TS 1 f}R UN;F3Ett $5€ttl<.. ......:
;. 1'.UtR.R!1IZ'fi Ff3R Fill M.
Permit Fee $__
Number of fixtures (ate $110.00 _ x $10.00 = $
Surcharge $ 50
Number of fixturcs @, $15.00 x $15.00 = $
TOTAL DUE $
OR Number of fixtures @ $25.00 _ x $25.00 = $
Number of fixtures @ $35.00 _ x $35.00 = $
State Surcharge = $ .50
MINIMUM S50
_
, SU MINIMUM $15.50 Total = $
h
THIS [SAN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I heresy apply for a mechanical pernnt 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 or Fridley and with the Minnesota Consiniction Codes; that 1 mnderstand this is not a pennit but only an application for a permit and work is not to
start withtint a pernriC that the work will be' ace rdan with the app ved plan in the case ofall work which requires review and approval ofplaas.
SIGNATURE OF APPLI( ANT` PRINT NAME_ M. V4 h%DATE�
APPROVED BY DATE
<PLEAS�`�(QTIr::;SEPAR�TL PERMIT;�AItEt`tiE iJIE�.EL��OR:�i,Tll,loll*ft.�tfil.�Ei�''`E�i�AL��ii�:�L:�il!��;L�fJ�I�...
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
)9
Date: 9/28/2009 Revision Date: 9/28/2009
Site Information
Address 1: SC l 7-
Address 2:
City: County:
Agalication Information
Business Name: Valley Aire Inc.
Contact Person: Mike
Office Ph: 952-890-4301 Fax: 952-890-3351
Address 1: 7125W. 126th St.
City: Savage State: MN Zip Code: 55378
Existing Construction: Pre 1994.
Project #:
Lot: Block:
Subdivision:
MN Contractor License #:
Cell Ph:
Minimum Mechanical Code Requirements Met
Will you be replacing or adding a water heater, fumace, or boiler?
Will you be installing a decorative solid -fuel appliance?
Will you be installing an exhaust fan 300 CFM or greater?
F„rNort-t-
You have met the minimum requirements for make-up air and combustion air as
required by the international mechanical code, as adopted by the state of Minnesota
with amendments.
Applicant Name (pri
Code Official (print).
J
Signature/Dail
3ignature/0pt9
NO
NO
NO
i
s !!!!!, i0as-IN
Cs 2004 CrenterPnint F.nerov Minnewmcn. 2004 Mechanical Code Guideline-. Paoe 1