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City of Fridley, Minn. BUILDING PERMIT N0 4255 Date: ........... _._. _.........................�_ Owner: .......... Builder ..._...... ..._-- .......... ... Address....._ ............._.......-....-......-_..._..._. __.._____ __._..--._............. Address LOCATION OF BUILDING No. ...... 1, Street .. -.......... .... (!_/................ ...!.._.'.................. Part of Lot - _.... . ............ ......... ... _...... _. _ Lot........R`..................... Block ....._.................................. Addition or Sub -Division ....... Lr2� - CornerLot .................................... Inside Lot ....................................... Setback .................... - .............. ........ Sideyard..... _............. -............................ _............. _........... t SewerElevation .................................................. _..................................................... Foundation Elevation .................... _............. _.............. ............................ .............. _.. DESCRIPTION OF BUILDING To be Used as: Front-l..:..� Depth../.eight ./.``.....`.�Sq. Ft. J Cu. F�1!R� / [ :.. ...................... Front �... ..�....� Depth ®.�. ®Height ./..�%...� Sq. Ft. ' Cu. Ft. T....�._ - G� Type of Const tion ................................................... Est. Cost..... . ............... To be Completed .................... .............. _........ ........ In consideration of the issuance to me of a permit to constru a building des a ve, I agree to do the proposed work in accordanwith the description above set ynd in co ce th aIl�provisions of ordinances of the city of Fridley. In consideration of the payment of a fee $ �i�.'-.-...._' 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 revolted at any time upon violation of any of the provisions of said ordinances. f �— Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. 4 -�k el?� 9--"' 0, Vo Application for Paver Plants and Heating. Cooling, Ventilation. Refrigeration 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 $ MECI-L WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ 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 $ Y OIL BURNER—to 3 gal. per hour ........................ 5.00 $ A over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ ® 0 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 See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ �� REMARKS: 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. % Fridley, Minn -�� _�'60 19�® 9Owner ✓etr� l 195— Kind of Used as To be completed about /-5— Estimated Cost, $ Old—wilding Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Wartt —No � Trade Name �2Size No Capacity Sq. Ft. E.D.RF i®®® BTUH.P. Total Connected Load 7-,e R"Kind of Fuel ,�➢''�cdQ� BURNER — Trade Name Size No a'op Capacity Sq. Ft. E.D.R QW1 0 10 BTU H.P. SUBURBAN HEATING & SHEET METAL 8419 CENTER DRIVE N. E. Signed MINNEAPOLIS 21, MINN_ 11 POST tM-12-58 Business Phone No ----&!&Z I>S6 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied No No 19.�� p - " F1.1 - Room I Lengt Q / Width ^4, Height QV 171.1 Room I Length -V Vfidth j/ Height / Windows an Doors—Crackage and Area Width Height I No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 40 Coef. Btu Glass Exp. wall Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. Net exp. wall ,© y Int. wall Ceiling jjtkV p p Floor Infiltration Total Btu. 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Glass F1. oom ( Length y/ Width / Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. ® 772.,k ,640 Exp. wall -Coef.1 Btu Infiltration Net exp. wall Glass /47 Exp. wall Int. wall Net exp. wall Int. wall Ceiling Ceiling 4F Floor Floor Total Btu. c� Required sq. ft. E.D.R. or sq. ins. WA. Leader area,® / Fl.l Room ILenfrth 3 ` Width /]J Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. No. of pane of pane lights off crack Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. 3 2e y Coef.1 Btu Infiltration 3 , 0 y Glass /p a 3 Exp. wall y �p Exp. wall Net exp. wall 9, /47 Z 73 Int. wall /AV-?� Int. wall Ceiling wiL 4F 647 Floor © O Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 /,6 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. No. of pane of pane lights off crack Area sq. ft. 3 2e Coef. Btu Infiltration e L Coef. Btu Infiltration / /p a Glass Exp. wall y �p Exp. wall Net exp. wall ab o Net exp. wall Int. wall /AV-?� Int. wall Ceiling wiL /0 Ceiling Floor © O Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area L'1 1 /,Q _ /J D....... 11 .. th 1 % f Q/;,Ith a* z N.66 0/ Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3 2e Coef. Btu Infiltration e L ® L Glass /p p Exp. wall y �p Net exp. wall Int. wall Ceiling wiL /0 zagyo Floor Total Btu. Required sq. ft. E.D.R. or sq. ios. WA. Leader area C9 I .n 777 Dom... I r ---&L d/ wmt6 / N...hj %7 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft Coef. Btu Infiltration Glass Exp. wall /p p Net exp. wall �p Int. wall Ceiling Floor sueJEcr PERMIT NO. City of Fridley 26070 2 6 0 7 0 AT THE TOP OF THE TWINS ?_ BUILDING PERMIT r 1.COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. / 1 � � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/20/98 JOB ADDRESS 860 66 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Meadowlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stanley/Betty Auslund 860 66 Avenue NE 571-5154 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 502-4777 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20040630 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Q ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 4 windows in home with pocket insert windows 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet theState Building Code - in each sleeping area and on each level of the dwelling. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,820 $.91 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- Fire SC $1.82 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $59.50 PLAN CHECK FEE TOTALFEE License SC $5.0 $67.23 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY BLD INSP ALIDA D THIS IS YOUR PERMIT DATE SIGNATURE OF OWNER )IF OWNER BUILDER) IDATEI NEW [ J Effective 1/1/98 ADDN [ l CITY OF FRIDLEY �� ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �® BUILDING PERMIT APPLICATION �J ConstructionAddress: X60 •66 Av E . Legal Description: Owner Name & Address: Lien-� S I rqo . Tel. # •511 • SI T4 • • Contractor: (LE#�6 eJ Ak 66 AvE r-4 . Fct.► otz{ N . s 3z . Q y P�,�► pER s rj MN LICENSE # -Z,�3 0 Address: 32 —13 4=° A\1E r4C F'fZ 1 O(t-q /Yl rel 974-3 Z Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: DESCRIPTION OF 11\1PROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. P1 -A cs`-- ArNi r40uw3 i rJ 44omc H i TA -fb ucn-T- frit Se&r KI H=c 45 Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: 15'' ( C� • `'l % Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge OJ Estimated Cost: $ (Fee Schedule on Back) Ft x $ _ $ APPLICANT: TI m S QA k -2!N4 Tel. # 95-� Z`uJT� $_ 'S,00 TOTAL $ , CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ J Not . Necessary [ J STIPULATIONS: �,�� fcE��/^I��j L SUBJECT P City of Fridley 2 8332 AT THE TOP OF THE TWINS BUILDING PERMIT r R ' ` iCOMMUNITY DEVELOPMENT DIV. ------PROTECTIVE INSPECTION SEC. PROTECTIVE � i1 = A �r"',•� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BV --__ L J� 612-571-3450 910-F15 10/20/98 JOB ADDRESS 860 66th Avenue NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 1 Meadowlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stanley Auslund 571-5154 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Seal Guard Systems 9199 Central Ave NE Blaine 55434 717-0700 20093688 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ox REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (27 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the 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 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 2§r-8E)- $2,313 $1.16 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 $74.75 Fire SC $2.31 PLAN CHECK FEE TOTAL FEE Lice SC .00 143.22 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI H N P RLY VALIDA ED THIS IS YOUR PERMIT BAG INSP GATE SGNATURE OF OWNERJF OWNER BUILDER, IDATEI L L J ADDN - [ ] _ Xr-:OF FMI" r ALTM SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �/ O Legal Description: V2 N E, J�ecave UU98 ` Owner Name & Address: RLS Tel. # 6q l— �515' Contractor: e(- I C ?� MN LICENSE # :286q 3C� atf Address: q I qq Ctnira-I AE, 5�I L) Tel. # 9 l rl — d' 7CO Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:_� kv � Estimated Cost: $o (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 1136 q 6 APPLICANT: Tel. #'/) 7- Q '160 CITY USE ONLY Permit Fee f. �7 �� $ Fee Schedule on Reverse Side Fire Surcharge„3 ( $ .001 of Permit Valuation (1/10th%) State Surcharge /"$ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge 9g $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 3 $ a STIPULATIONS: SUBJECT City of Fridley 30540 AT THE TOP OF THE TWINS BUILDING PERMIT O COMMUNITY DEVELOPMENT DIV./-J/�(J 7� I" PROTECTIVE INSPECTION SEC. l td 1 . , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 11/22/99 JOB ADDRESS 860 66th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Meadowlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stanley Auslund 571-5124 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118 Snelling Ave. M is 55406 721-6628 2179 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 99x REPAIR _ ..___.-d MOVE ❑ REMOVE 8 DESCRIBE WORK Reside house 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. Inspection Carols permit Will Be Malled To .Homeowner To Post 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 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 1 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 $1946 $.97 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 $69.25 Fire S $1.95 PLAN CHECK FEE TOTAL F Lice ns $5.0 $77. 7 SIGNATURE OF CON'AACTOR OR AUTHORIZED AGENT iDATEo N PE -PERMIT *2 BLDG fNSP - OATE S-GNATURE Of 0VVNEA0F OWNER BU40ERi iOATE, �qq -�a- q NEW �] 5 ' / (. , 9 Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMH.Y AND DUPLEXES R-1 AND 0-2 () BUILDING PERMIT APPLICATION *ConstructionAddress:'aan Legal Description: Owner N Contractc Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 0 Tel. #,5771 -EIaq MN LICENSE # C9 Q2 Tel. # 73�-CAo-,'21R Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: 0 d Estimated Cost: $ kq, 41riveway (Fee Schedule on Back) Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �� APPLICANT: �/`� /�Z� Tel. # CITY USES ONLY / V Permit Fee $ °SS Fee Schedule on Reverse Side Fire Surcharge b.4rj .001 of Permit Valuation (1/10th`%v) State Surcharge $� $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 6.00 $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 • STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 REPRINTED ON 1/12/2006 ADDRESS : 860 66 AVE NE PIN : 143024140072 LEGAL DESC : MEADOWLANDS ADD : LOT 2 BLOCK 2 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : X ALTERATION NOTE: INSTALL NEW CARRIER FURNACE, MODEL 58DLA-070-1-12 # FURNACES I APPLICANT RIVER CITY SHEET METAL INC 8290 MAIN ST NE STE 39 FRIDLEY, MN 55432 (463) 754-2199 OWNER AUSLUND STANLEY & BETTY 860 66TH AVE 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 regulating construction or the performance of construction. Applicant Date Bldg Insp PERMIT NO.: 2006-00064 DATE ISSUED: 01/10/2006 FURNACE SHELL/DUCT WORK STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 15605 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 35.00 0.50 35.50 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 64431 University Ave NE Fridley MN 55432 Mechanical Permit# Z0660-6064Py Residential Application City of Fridley See Back Side For Required Information Date /-d V -0G Site Address:. 960 - lole th 19:/ &9� The applicant is: (cirice one) Owner ontractor Property Owner. 5,�% ,&&SGIti11fJ Address: City: State:_A/ Zip: `52aG 2_ Phone: S Cell: Fax: - Contractor Information River pity Sheet Metal, Inc. Company Name: Contact Person: 39 al •9 S Address: Fridley, City: _Fnx(783) 7 "22 8Phonello 3-7SI(--A/f Cell: Fax:71i3-7SY-- R -Me' Email: MN Bond# & Exp Date Type of Work (circle one): New cECejcem Alteration/Remodel Detailed D scription of work: 1e- alt. ; Equipment Installed: MFG: ro?PAiE 14 Model• 07e;-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 $ :95-.00 (Total from above -Minimum fee $35.00) Surcharge $ 0.50 Total Due $, 3,15". QU 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. k Signature of Approval Ins Applicant: Date: /—,0 y D� pector Signature: Datelr- -66 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 1FGC 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