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PRE 2010 DOCSCity of Fridley, Mi BUILDING PERMIT N? QD31 Date: ;X -e, 11 -- 10 Owner: Builder Address Addres O BUILDING No. o225„ _ StreetMNf -- Part of _ — Lot L__ Block_ _ _ Addition or SubZz,�;Sideyard L Corner Lot _ �� Inside Lot J01back r _. Sewer Elevation _____ _ r Folfndation Elevation DESCRIPTION OF BUILDING To U d �25"Autel it Front Depth Height Sq. Ft.r�cu. Ft. "W0 FiCcnif+�a DepthHei ht Sq. Ft. Cu. Ft. Type of Construction , Est.Cq$o/�,Ar __ To be Completed _ 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 city of Fridley. In consideration of the payment of a fee of $ 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 within the city limits and this permit may be revoked at any time upony�olation of any of the provisions of said ordinances. i /”' Building Inspector NOTICE: This permit doe not cover the construction, installation for whing, plumbing, gas heating, ewer or water. Be sure to we the Building Inspector for separate permits for then hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Subdivision Corner Lot _Inside Lot Setback Side -Yard SEWF•R. 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. Cu. Ft., 02 •:$-- ,/w --- Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost 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 representations stated in this application are true and correct. /i n /i !1 _ a 1 1 � L DATM % /oL / SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) ATTENTION OF: CITY OF FRIDLEY ' 6431 University N. E. Minneapolis Minn. 55421 612-560-3450 DATE October 29, 1974 SUBJECT PE,BAA• City of Fridley 12829 AT THE TOP OF THE TWINS BUILDING PERMIT ,' ;, RECEIPT • COMMUNITY DEVELOPMENT DIV. r L ------- INSPECTION SEC. PROTECTIVE ILi/3 1 . � /---1 CITY HALL FRIDLEY 55432 IL NUMBER REV. DATE PAGE OF APPROVED BY ---- A , 612-560-3450 910-F15 112/3/74 JOB ADDRESS 251 - 60th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16,17 6 1 Hyde Park SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Walter Hronoski 251 -60th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. McCall & Company 5435 Lyndale Avenue South 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION R7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Repair fire damacie 9 CHANGE QF USE FROM TO STIPULATIONS .See attached list of stipulations SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 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 ISTALLS 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 1.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $18.00 ® % PLAN CHECK FEE TOTALFEE �����7 $19.50 SIGNATURE OF t6NTRACTOR OR AUTHORIZED AGENT IDATEIWHEN PROPERLY VALIDATED THIS IS YOUR PERMIT ., d LAJ a -1 7 r BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION.- OR LTERATION; OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: I,el Ilam' 1/ ///'G /I 60.5 /rr f BUILDER: ,AIA C �V ADDRESS:Sl - �e,�`APR. �Y' ADDRESS: NO:-. � / STREET: /� � / � /A/ C, LOT: /7 BLOCK: ADDITION:.___�1Vd�- 8 CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: 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: l / J' ", P7 Front: -Depth: Height: T, r t -- Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: To Be Completed: ,/ A_ 111 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict 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: PY SIGNATURE :J`r (See Reverse Side For Additional Information.) k 251 - 60th Avenue Recommendations by the Plumbing & Heating Inspector to bring structure up to Code: 1. Kitchen sink to be vented. 2. Lavatory and bathroom to be replumbed. 3. Power fan be installed in bathroom. 4. Vent wash tray in basement. 5. Remove basement water closet or provide cleanout. 6. Install temperature and pressure relief valve on hot water heater. 7. Revent hot water heater. 8. Revent basement space heater. 9. Hook up cold air to furnace. Recommendations by the Building Inspector: 1. Reinspection needed when all burned wood has been removed to determine what needs to be done. Recommendations by the Electrical Inspector: 1. Install new service and rewire entire house. 11 r City of Fridley Appli=Van for Plying end G= remg ienrilt Dept. of Bldgs. Phone 580-3450 DESCRIPTION OF WORM Number, Kind and Loce eon of Fixtures N �� � N�;► Or ra 3 U .n Ua U V I WATER Me. As ELM Base Ist 1 2nd _ 3rd 4th • Futuro Connection Openings W la - i Sector New Fixture, Old Openings cesspool PARTIAL RATE SCHEDULE PLUMBING FACTURE RATES:� O• $ E2.00 $ ,(TOTAL Number Fixtures .............••• x U Future Fixture Opening ........... x $1.50 $ _. New Fixture Old Opening.....:.... x $1.50 $ _ Catch Basin .................... x $3.25 $ Water Heater 'Up to 99,000 BTU) .. • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater........... a $2.00 $ SAS FITTING FEES: NO. RATE TOTAL Ist3Fixtures .••••••••••••••••• x$2.00 $ • Additional Fixtures .............. x $ .75 $ Gas Range to 199.000 BTU ........... x $5.00 6 - REPAIRS is ALTERATIONS—Refer to Code Description ......................................... 0- TO`rAL FEE City o1 Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and riling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and �c7orrect Fridley, Minn �� '3 / 19, /%� OP7 orf Owner , Kind of Building Used as 1�90 To be completed about Estimated Cost, $ `-- Old—New. Building Permit No. Permit No. Signed/ ---/T- e-- y c /a Q 7` BE�l�� ,,1 Business Phune No ROUGH FINAL .50 State Surcharge City of Fridley SUBJECT PERMIT N ® 3140 AT THE TOP OF THE TWINS BUILDING PERMIT i. COMMUNITY DEVELOPMENT DIV. r , PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 812-580-3450 RECEIPT NO. NUMBER 910-F15 REV. DATE $-13-75 PAGE OF APPROVED BY JOB ADDRESS 251 - 60TH AVENUE N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16_17 6 1 HYDE PARR SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE WALTER HRONSKI 251 - 60TH 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING RESIDENCE 7 CLASS OF WORK ❑ NEW 13 ADDITION ❑ ALTERATION INX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK REROOE 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. SHINGLES THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 ISTALLS 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, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $600.00 50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTIO OR THE PERFORMANCE OF CONSTRUCTION.' $5.00 r/3 PLAN CHECK FEE TOTALFEE $5.50 SIGNATURE OF COMTRACTORO T RI2 ENT (DATE) WHEN PROPERLY ALDATED THIS IS YOUR PERMIT BLDG INSP 8-13-75 DATE SIGNATUREOFOWNER(IFOWNER BUILDER) (DATE) '- ► f F� APPLICATION FOR RESI•DENTIAL., ALTERATION, OR ADDITION•BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:BUILDER:64� o ' ADDRESS: ;2.<-1 �� 1 �l_ ADDRESS: i - p d' -2 e� , o STREET: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this *f orm Wo Certificates .-if Surve.•of Lot and.proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height: Square Feet: Cubic.Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: estimated Cost: $ 0 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 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: %, SIGNATURE: (See reverse Side For Additional Informati �� ® 0 SUBJECT PER City of Fridley 19374 AT THE TOP OF THE TWINS BUILDING PERMIT - � REC Y------ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. -'-1,•� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 4/5,/88 JOB ADDRESS 251 - 60th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 16,17 6 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kurt Marks 251 - 60th Avenue N.E. 571-8463 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE K❑ 8 DESCRIBE WORK Construct a 324 sq. ft. Addition to Duelling (Approx. 18' x 241) 8 CHANGE OF USE FROM TO STIPULATIONS See notations on plan WARNING Before dtoOg call focal utilitim TELEPHONE - ELECTRIC - GAS Etc. SEPARATE PERMITS -RE 'REQUIRED HEATING REQUIRED BY LAWWIRING, .PLV� FOR BING AND SIGNS. 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 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 ISTALLS 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 $15,750 $7.88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $116.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAN CHECKFEE TOTALFEE $ 29.13 $153.51 SIGNEOF TRACT OR AUTHORI' DAGENT DATE I WHEN PROPERLY LI ED THI IS YOUR PERMIT SiGNA EOF OWNERIIF OWNERBUILDERI IDA EI BLDG INSP D E NEW [ ] ADDN. [ ] ALTER. [ Construction Addre Legal Description: Owner Name & Addre Contractor , k1 City of Fridley R-1 Ak R-2 Building Permit Application Effective 4/1/86 Tel. s: ,#� A0 Tel . # % 2— Address:- j r Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. PTI�OF IMPROVEMENTL2L-7�R a LIVING AREA: Le rig h Width Height Sq. Ft. Z GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: O © /-/� �✓n Estimated Cost: $ O Approx. Completion Date: �6,0 y .lo3 = iS • oL Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation �0 DATE: �2.� APPLICANT: 7_/.J Tel.S�% Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS• CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 559 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ? g - -11 V . SO Q r 1 If fr . - � �`.i'� it � _ _ ��-• �' ��"� -/J- �,. =�� � i - �+�- - -r`- • - �� - ..p•: ? - "fir. 4;: ± :f -� f �! - �_ f i.. /, ' �' ',,:. f, �,� ; �r� 1 �-1 r• a. r r.. is -.{� r -t. r. - i- ;.. +.Nw , 1 Q r -6 m 7v x "TJ � I 1 t 1 N 1 . . . . . _ . . . . . . .0 . . . _ . . . . . . . -�- r � - d d V 6 0 a N M S � 6 0 a N M 1k CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2001 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS_ �� 1��y9 �l RATE SCHEDULE OWNERx Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL l.�,U.}-�� 1/�G� BUILDING USED AS $ 30.00 $.� ESTIMATED COST ��� .(1l`� PERMIT NO.. a� / $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units II Circle One (Steam) (Hot Water) ( arm ) $ 10.00 $ Trade Name Size No. V6rl-l'Olfll✓ BTU (_o®. "0 HP EDR $ 25.00 $ Fuel_ t.. Cn. Total Connected Load State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ $ .50 $ 3D,a Burner trade Name Size No. BTU HP EDR 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. EE x-13-01 BLAIVIF HTG. A/C ELECT��qq .,T(i�l . 13552 VENTRAL AVE. N.L. HEATING C 0KA MN 55304 n Signed L Approved BY4 Rough -In Date Final Date BACK SIDE MLfST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Nk 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 ( ) No ( ) Appliance #1 Type Y r ffi-U BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat_ Appliance #3 Type BTU Input Fan Assisted or Na -- 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) BLAIMF FRIG, A/C ELECT., INC. 13552 t;ENTRAL ME. N.E. HEATING CO: AMOFSA, MN 55304 l Signed By: !K4A A; 0 Date : SAI ADDRESS_ozrl Le OCCUPANT K�ll1A-Aft.- VNA &N- tt- HEAT LOSS DATE HTG. INST. SOLD BY Electrical Work By OA6& TYPE OF HEAT GA FA—)CL HW STEAM SPACE HTR. aJ GAS DESIGN MAKEyt>J Model Serial INPUT tJ0 CONTROLS THERMOSTAT g� Heat Plu Value W-14 -a R -AK isf` C Umit bj:jgEltd Limit Settina 14 v Fan Setting Pilot Pilot Make Pilot Mode ' Plot Timing q5, SEC, L.W. Cut Off Pressure Percent COQ Input CFH I., 1, S -JJ 7 Percent % Stack Temp.!rc Percent CO�/Gf�- APT. FLOOR Cd -JA SUBURB OWNER INSTALLED BY Gas Line By — UNIT HTR. � OTHER Company Testing Name of Tester y Pressure Percent CO2 Input CFH Percent 02 Stack Temp. Percent CO CONVERSION Vent Size KIND OF LINER SIZE �� NONE Draft Hood �T v�1si Regulator Filters Size Number Chimney Location Inside Outside Chimney Construction Smoke Bomb Wring Draft Test Tag Door Pressure Lighting Inst. Date Tested�"� X "67 Company Testing Name of Tester y Pressure Percent CO2 Input CFH Percent 02 Stack Temp. Percent CO Building MECHANICAL Permit No.: UQ Q)V d I 0.7 Receiiieti.l� ,J U L Inspections p RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDL.EY Date Rec'd: DATE © YOUR E-n�IA�I 'S ��/ SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: �P t ST . TENANT PHONE — COMPANY NAME; _ CONTRACTOR CONTACT PERSC 410 WE 1 LAKE STREET SUBNIIT A COPY OF �i, MN 55408 YOURSTATE STATE LICENSE II -tl24- STATE ZIP LICENSE WITH ADDRESS: APPLICATION PHONE FAX PERNITT TYPE TYPE OF WORK: 1 ❑ NEW FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ REPLACEMENT *I.,TBRATIONMMODEL 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, fot the improvement, installation or replacement of a residential fixture, excluding the fn4tures.. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cos Of lab0r ' X .OS FOR PROJECTS WHERE LABOR EXCEEDS 55(0, FEES AYEBASED ON $10.00 PER FDCnMF, EEX--CEPT OTED. FWRJM.: (INDICATE TOTAL NUMBER OF EACH BELOW) I C.C� O� SIZE/9TU EquipraentInstalled MOD < �-1SIZ.F�+BTU' MFG: MODEL KEG: MODEL: SIZEBTU A1C $25.00FIREPLACE (GAS) $15.00 GAS RANGE(OVEN $10.00 TO AIR EXCHANGEER $15 -REPLACE (WOOD) 535.00 NEW GAS GRILL $10.00 BOII ER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00 CHIMNEY LATER $10.00 GAS DRYER SI0.00 POOL HEATER 535.00 DUCT WORK SIM GAS PIPING $10.00 VENTQ.ATOR;15.00 Permit Fee , $ Number of fixtures @ $10.00 x _ Surcharge $ .50 Number of fixtures @$15.00 x $15.00•= $ TOTAL DUE $ Number of fixtures @ $25.00 :Zx $25.00 = $�� Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $------5-0 Total = $ a rare is AN APPLICATION FOR A PEROT-NOT VALID UNTIL PROCESSED I hereby apply for a building perp* and I a� conformance with the ordinances and c not a permit but only an or a approved plan in the of 1 whic 1; SIGNATURE OF that the information above is complete and accurate; that the work will be in of Fridley and with the Minnesota Construction Codes; that i understand this h A is not to start without a permit; that the work will be in accordance with th iew and approval of II /� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MINT 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS BUSTING HOME F] MAKE-UP AIR REQUIRED FOR NEWEXISTINQ-ROM _11 - 1 �_.S . - -,, i, : 1. Combustion Air (See note bel a- Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting Gas appliances IFGC Chapter 5 with NN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 1=l�g ioa� . : 4. Heat loss& per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per1MC 1346.0603.2 iL ACCA Nlamml D I NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations