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PRE 2010 DOCSApplication for Power Plants and.'.bleating, Cooling, Ventilation, .Rehigeralion 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 $ yeach add. 80,000 BTU ................:...... 2.00 $ Replacement of Furnace ............................. 0.00 $ 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. fVi9DR 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 0 ROUGH FINAL See Fee Schedule TOTAL FEE Dept. of Bldgs. Phone SII. 4-7470 City o Fridley: - fined hereby makes application for a permit for the work herein spec' unde Being to do all work in strict accordance with the City Ordinances and r ling of the Department of Buildings, and hereby declares that all the facts and r resentations stated in this application are true and correct. \. �/ % Fridley, inn _ / 196j- Ownery(,�° �}�'`u ' ° (/ Kind of Building i Used as To be completed about 00 Estimated Cost, $ © Old—New. Building Permit No. Permit N DESCRIPTION OF WORK HEATING or POWER to Hot Water, Warm Air—No !:!�' zz: Trade Nam Size Nva Capacity Sq. Ft. E.D.R 600 JMT H.P. Total Connected Loa f Fuelccs � 77 BURNER — Trade Nam Size No Capadty Sq. Ft. E.D.R BTU H.P. Signe By y 4.42 1M 7-59 • Business Phone No (REMARKS -OVER) City of Fridley, Mian.. BUILDING PERMIT N° 5298 Date: I Owner :'2"a Builder Address Address — j N O BUILDING' No. �� -47-StreetX4 0-- —#, Part f t --- Lot _ Block _..._..........�_ ddition or Sub zDivisign Corner Lot ._ Inside Lot Setback w Sideyard Sewer Elevation Elevation _. w Foundation Elevation DESCRIPTION OF BUILDING T be Vse Front Depth Height Sq. 3:'t.Cu. Ft. Cu. F lDepth H t Tyre Sq. t. y i o cti .of o be Completed retro en Est. Cest ! 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 grdinances of the city of Fridley. ' '44 In consideration of the payment of a fee of $Y- , permit is hereby granted to— to o 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. „ A F f� il�il ��Ili.+a�•�4 f� � � NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be euro to a" the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Qvmer Is Name P l C4,- k V.... Builder, Address LOCATION OF BUILDING No. L Street Part of Lot Lot Block b Addition or Subdivision Corner Lot _,Inside Lot ✓ Setback Side -Yard L Z SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Sq. Ft. t)-< ® Cu. rent 3 V� Denth 3 r Hei Ft. Sq. Ft. Cu. Ft. Type of Construction /Z n Estimated Cost L Z: 0000 To be Completed 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 repres stated in this application are true and correct. 14 �.IF IM - (A Schedule of Fee Costs can be found on the Reverse Side.) L( • 1 City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAI,,,,, Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Beater (Up to 200,000 BTU) ...... x 2.00 New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $—/-- Additional e `s tJ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ _ TOTAL FEE $.1 6A Dept of Bldgg& Phone SU 4-7470 Location v/ 1 � 7 2 721 s Al- 0 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, Minn JUN 1(9 1961 is—. Owner 1,41 L L C / / gt3 Kind of Building Used as W' To be completed about Estimated Cost, $ Old New Building Permit No `=' w V Permit No. T Signed LONDON PLUMBING CO./' By. Business Phone No ROUGH 7-'/%– &/ FINAIs az 2M 7.59 q Is1 Is� � .n xy 3F ZZ y0`Za ou QpZ �o �Z tg 0� 3 J (9 � U}a Z t90 , P • N WATER HTR. GAS ELEG Base 1st 2nd _ 3rd l�T= _ 4th • Future Conaeclion Openings New Fixture, Old Openings Coaaected with Sewer � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAI,,,,, Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Beater (Up to 200,000 BTU) ...... x 2.00 New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $—/-- Additional e `s tJ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ _ TOTAL FEE $.1 6A Dept of Bldgg& Phone SU 4-7470 Location v/ 1 � 7 2 721 s Al- 0 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, Minn JUN 1(9 1961 is—. Owner 1,41 L L C / / gt3 Kind of Building Used as W' To be completed about Estimated Cost, $ Old New Building Permit No `=' w V Permit No. T Signed LONDON PLUMBING CO./' By. Business Phone No ROUGH 7-'/%– &/ FINAIs az 2M 7.59 x pe:: Application for Power Plants and.: Heating, Cooling. Ventilation. 19hig ranlion tod 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 .............................. .P.00 $ Repairs & Alterations—up to $500.00 ...:e ............ 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. EDR Hot Water ... 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 FITTING FEES: NO RATE TO L 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING VAN HEATING SYSTEM `VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH- OUGH FINAL— FINAL See See Fee Schedule k- $ TOTAL FF E $� 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 hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Used a: Tobec Fridley, Minn_ JUN 3 01961 , 19 Estimated Cost, $ -::r-41e 9 ew wilding Permit No, L Permit No. r DESCRIPTION OF WORK HEATING Warm Air—No 0 A Trade Nam Size No -;",12 :2 Capacity Sq. Ft. E.DA BTU H.P. Total Connected Load Lfc?, Sind of Fun BURNER — Trade Nam '` ��� Size o ",V Capacity Sq. Ft. E D.R� BTU H.P. �j EO. SEDGWI K HTG. & AIR-COND. CO 1001 Xenia AV. S. Minneapolis 16, Minn. Signe B5 142 YM 7-59 Business�Phone to (REMARKS—OVER) AppRearion for Power Ptmts and: Heating. Coding, Ventilation..Refrigeration tmd Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work ......................... Replacement of Furnace ............................ Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ........... .each add. 60,000 'BTU ... _. ................ . Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ... :............ Repairs & Alterations each add. $500.00 ........ 1 .... STEAM or HOT WATER SYSTEM RATE TOTAL. 8.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ IZ 2.00 $ _ 0.00 $ 5.00 $ 2.50 $ Furnace Shell & Lines—to 400 sq. ft. IDR 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 79L 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ VAN HEATING SYSTEM See Fee Schedule `VENTILATING SYSTEM $ +ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL 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. Owner Kind of Used a: To be c Fridley, Minn JUN 3 01961 ,19 Estimated Cost, $ 9 j� ew uilding Permit No. ` v Permit No. DESCRIPTION OF WORK HEATING a , , Warm Air—No Trade Nams ° �✓'✓ Size a' Capacity Sq. Ft. E.D.R ��_Z AP BTU H.P. Total Connected Load uft, JS13 Kind of Fuel BURNER —Trade Nam yJ2®) Size o 'r "0 Capacity Sq. Ft. ED ��� BTCT H.P. r� EO. SEDGWI K HTG. & AIR-COND. CO �'19®/ 1001 Xenia AV. S. Minneapolis 16, Minn. Signe x az 2M 7.59 1;usine3s�Phone o (REMARKS—OVER) HEAT LOSS CALCULATIONS :a ,'S DEPARTME� Weatherstrips A.S.H.';N•E. Guide Reference Out. Wall Construction N Int. Wall Ceiling Windows__Doors es—�No I s—No Roof Floor Kut ` — How Applied Fl -1 Room Leng Width Height Windows and Door s—Cracka a and Area Width Height No. of Lineal f . Area No. of pane of p ne sights' of crsack sq. ft. / 4 Ar Z 40 A/ ! _ Width Height No of Lineal ft. Area No. of pane of pane lig is of crack aq. ft. 3 %"2 Coef. Btu Infiltration Glass ""`¢' ►r8 j e d Exp. wall / x Exp. wall Net exp. wall Net exp. wall Int. wall Ceiling Ceiling Floor Floor Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Total Btu. Room I Len.?Widths Height 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 r, d Room l Lengths/ Width fj Height Windows and Doors—Crackage :and Area Width Height No. ofLipeal ft. Area No. of p e of ane light's of crack eq. fQ Coef. Btu Infiltrations, �r` /;. / Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Iftu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.4 v&i.s Room I Length r Width,4' Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lighta of crack sq. ft. Coef.1 Btu Infiltration ,� Glass S -V / 6-7--7 Exp. wall % 6 ?6. Net exp. wall o Int. wall 04 Ceiling y L Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ►FF� r :a ,'S Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. jcy v '.',,,,�FAPOLIS. MILAN. o• Insulation Roof Floor Kut ` — How Applied Width No. of pane Height No. of Lineal ft. Area of pane lights of crack ft. F1.1 tea` RoOMI en Wid HeighttT Windows and Door rilickage and Area Width Height No of Lineal ft. Area No. of pane of pane lig is of crack aq. ft. 3 %"2 Coef. Btu Coef. Btu Infiltration Glass Exp. wall F.— Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI Room I Len.?Widths Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room I Length/Ct �` Width Heightel Coef. Btu Infiltration Width No. of pane Height No. of Lineal ft. Area of pane lights of crack ft. Glass 7V71 d Exp. wall x Coef. Btu Net exp. wall �,✓ Int. wall Ceiling x I,D Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room I Length/Ct �` Width Heightel Windows and Doors—Crackage and Area Width No. of pane Height No. of Lineal ft. Area of pane lights of crack ft. 7V71 4sq. ! Coef. Btu Infiltration �,✓ Glass Exp. wall 2,,ZUeLx Net exp. wall P,—U?Ij- Int. wall Ceiling }t aP" t;! L Floor Total Btu. T-7-7 — ft. E.D.R. or sq. ins. W.A. Leader area D•56 9 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied e�—No ;"Y-,es—No 19— FI �. Room Lengthsa' Width°'r ' 8 Height oe Fl.� Room Length Width Height Windows and Doors—Crack a a and Area Width Height No. of 'Lineal f . Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration ~ _ d y; `' Af Glass, �y h Exp. wall Net exp. wall Int. wall Ceiling.,_. ;� � 7_ �� FloorF ry� Total Btu. re' Required sq. ft. E.D.R. or sq. ins., W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Cracka a 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 Ceiling Floor I Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FM Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp, wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 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 Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FU Room I Lenitth Width Height 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 Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. iris. W.A. Leader area F1.1 Room I Length Width Height 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 Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area • City of Fridley, Minn. BUILDING PERMIT Date: July 20, 1965 JOHN M. THUIRER Builder N° 8247 ;q 4,6( MOM CONST. CO. Address 6767 - 7th St. N.E. Address 6495 Pierce St. N.E. Fridley' Minnesota Fridley.9 Minnesota LOCATION OF BUILDING No. 6767 Sheet 7TH STREET N. E. Part of Lot Lot 2 _ Block 6 Addition or Sub -Division RC. Terraeb Plat 4 Comer Lot ._ Inside Lot —Z Setback 35' . Sideyard J'Y" stage SewerSewer Elevation ____ — Foundation Elevation To be Used as: House G DESCRIPTION OF BUILDING Front 42 Depth 26110 Height 81 sq. Ft, u34 Att. ars egFront 20 Mph 21d6n Height 8� Sq. Ft. 430 Type of Construction Frame Est. Cost .&16s500*O0 —To be completed _ REBUILD FROM CAP DUE TO STORM DAMAGE Cu. Ft. Cu. Ft. 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�t forth�Jt, and ce M ail provisions of ordinanoEs of the city of Fridley. R!WIILWIi'&AA!srAih�� In consideration of the payment of a fee of $ 10400 , permit is hereby granted m JOHN M. THUL 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 location, construction, alteration, maintenance, repair and moving of building` withino n� city limits a� permit may be revoked at any time upon violation of any of the provisions of said ALLEN G. JENSEN Building Inspector • NOME 1Ye psm it den not eery dhs conetreedon, hntatiatlon for wkb& plimilft, on heathm www or wafer. Be strte to eee the euiidiae Wpmr for eepude pencils for three hate. APPLICATION FOR BUILDING PERMT CITY OF FRIDLEY, MINNESOTA OWNER'S NAMEBUILDER r ADDRESS_ 6 -7 6, - 7, It,— ADDRESS rLOCATION OF BUILDING Isco. 1p % �/7 Street 7 �' Part of Lot LOT BI�OCR ADDITION OR SUBDIVISION._���� f0 ` � Corner Lot LOT Setback° Side -Yard �' p�� SEWER ELEVATION FOUNDATION ELEVATION. Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: lk "A" Front e/at- Depth o'`_%@ 4Height Sq. Ft. /13 Cu. Ft. Front Depth Height Sq. Ft. yid Cu. Ft. Type of Construction Estimated Cost To be completed fLev- The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict 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��d SIGNATURE .l (Schedule of Fee Costs can be found on the Reverse Sidw. REQUEST FOR SIDEME VARIANCE Double garage 3 feet from side line. By adding a double garage the side line setback on the garage side of home is reduced to 31 feet. This lot does however abut on park property and there willCl never be a house erected on this side. t Building MECHANICAL Permit No.: InspectionsRESIDENTIAL APPLICATI®N Rec '.V 763-572-3604 Dat CITY OF FRIDLEY , 763-502-4977 Fax EFFECTIVE 2-19-09 DATE YOUR E-MAIL ADDRESS SITE ADDRESS W THIS APPLICANT IS: ❑ OWNER PROPERTY .`CONTRACTOR NAME: I i lV ENNER/ 1 ADDRESS: + -3 CITY F STATE�ZIP PHONE:-70,57,1W CONTRACTOR COMPANYNAME: Sharp Heating & A.C. CONTACT PERSON: Floyd Joswick SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE WITH ADDREs9221 University Ave N E ciTYFridley sTATENN Z25 5432 1PPLICATION PHONE 763-572-0459 FAX763-572-0164 PERMIT TYPE 16INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ?(REPLACEMENT ❑ ALTER4TION/REMODEL DETAILED DESCRIPTION OF WORK L FEES ARE BASED ON $10.00 PER FIXTL?RE, XCEtT WHERE NOTED. FIXTiRiES: (IN a OTAL NUMBER OF EACH BELOW) Equipment Installed MFG: �PIt� MODEL: b b o SIZE:BTU 7� MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE;BTU _A C 525.00 _FIREPLACE (GAS) S15.00 RANGE%OVEN S10.00 _GAS _AIR TO AIR EXCHANGEER S15 FIREPLACE (WOOD) S35.00 _NEW GAS GRILL S 10.00 _BOILER S35.00 3CFURNACE S35.00 UNIT HTR S 10.00 _GAS _CHIMNEY LINER S10.00 _GAS DRYER S10.00 HEATER S35.00 _POOL _DUCT WORK 510.00 " GAS PIPING S10.00 VENTILATOR S15.00 Number of fixtures (a) $10.00 x $10.00 = $ Number of fixtures (& $15.00 x S15.00 = S Number of fixtures (a) $25.00 x $25.00 = $- Number of fixtures @ $35.00 _L x $35.00 = S State Surcharge = $ .50 (MINIMUM FEE $35.50) Total = S 3J .,5%( 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 o all work which lures review and approval of plans. SIGNATURE OF APPLICANTJbAPRINT NAME DATE PLEASE NOTE: SEP TE PERMITS A REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK Ulty of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 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 constriction 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. Building BUILDING Permit No.: 2E2 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 FAX CITY OF FRIDLEY7 cid Min ! 763-502-,4977 EFFECTIVE 1-1-2010 DATE D -" q- / t20 I() YOUR E-MAIL ADDRESS L M L KI ® ^ I /4-O 4 • C-0 1vA SITE ADDRESS 6 76!7 7 'U' 3T, /V E. THIS APPLICANT IS: ❑ OWNER ACONTRACTOR PROPERTY OWNER/ NAME: c7O I-4 iJ Z %) aA.wS K I TENANT ADDRESS: 671. % 7'r11 cS'Tn �. / `t f . CITY F (Z I -b L 6 Y STATE M AJZIP -SS 3 PHONE: 76 3- AIM S 7/^ 7 y a 3 CONTRACTOR NAME: C012C-4- i C,X -r 2 / B 2S I M('_ SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # v�� t!& 3 �o� 9 7 EXP DATE AND CERTIFICATE OF ADDRESS:� CITY5—, IS AVL STATEM1'JZIP-14&-U-z-0 INSURANCE PHONE - 9 FAX -5 - 33 O - PROPERTY TYPE ,K SINGLE FAMILY/NEW CONSTRUCTION SIZEgp-, �GZ ❑ TWO FAMILY/NEW CONSTRUCTION STORIES__L__ PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISHROOF 13DRAIN TILE 13DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFINGQ HOUSE ONLY IE BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES C� ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 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. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (U,MNG THE 997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ , ©O `' L OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ b $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ I "l Make checks savable 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 permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work w ic quire rev w and approval of plans. SIGNATURE OF APPLICANT PRINT NAME M 10- ev IJ L Ca L-& DATE VST 1 -2010