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PRE 2010 DOCSCity of Fridley Appleation for Numbing mid Gas F'ithing Pent Dept. of Bldgs. Phone SII 4-7470 f �/ DESCRIPTION OF WORK Number, Kind and Location of Fixtures LOCation p� 12 z z 71� J m OO N 2 z o0 • R • N WATER HTR.5O GAS ELM Base 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ -S Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ 7 Z x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code City of 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 ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn-Z2)z '' `J J.Y'� Owner Kind of Building�l�r�° P Used as To be completed about Estimated Cost, $ 1 —New. Building Permit No Permit No. /ate Signed %aiT✓`y� �iT By Business Phone No ROUGH FINAL Description ................................................ TOTAL FEE az 21A SUBJECT PER City of Fridley 18370 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 20.,26-1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4 10 86 JOB ADDRESS 1388 - 66th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. pt. 6 & 14 Aud. Sub. #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joseph R. Menth 1388 - 66th Avenue N.E. 574-1677 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 X 8 DESCRIBE WORK Construct a 20' x 24' Addition to Rear of Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. i 1 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 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 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 $21/200 $10.60 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. $152.50 None PLAN CHECK FEE TOTALFEE $ 38.13 $201.23 t GNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDA EI - 1 PROPERL VALIDATED THIS IS YOUR PERMIT 4 ;WHEN iNSP a "� BATE Si U E FOWNER1I OWNER DE i IDAT i NEW [ ] City of Fridley Effective 4/1/8+ ADDN. L R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: 13 O g F r Legal DescriRtion:ln�. ofE. /6(o� •Peter o� [a'� Ld- �y . S�•Qr�-w'X10 Wij(6 /66' o'iD �o� � A l {�s.-_ I t Ada! a 4's sr. Owner Name & Ad ress: _ H� R. ✓✓1e..e Tel. # 57 '/62 Contractor: S e Le Tle1. # Address: S 4 rn e_ 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 C.�-© Width Height / S� Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground _ Sq. Ft. OTHER: Sox 7q, t-11 �, l� aav Corner Lot [ ] Inside Lot � Ft. Yd. Setback Side Yard Setback Type of Construction: /N CJ� F -r- e.- e— Estimated Cost: $` Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: — $ _ $ See Back Page for -Explanation DATE: 3-a �� 8 APPLICANT: Tel. # 5-9' 16 ? 7 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ l®e(Do $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ — fOTAL $ �I,C Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: e� /,do0 a1000 - 3a,� do )l6 isa,sv SUBJECT PERMIT NO. City of Fridley 2 0 3 8 8 THE TOP OF THE TWINS BUILDING PERMIT ' -,AT f -ReevPrab. COMMUNITY DEVELOPMENT DIV. ' •y r PROTECTIVE INSPECTION SEC. r CITY HALL FRIDLEY 55432 NUMBER 1 REV DATE PAGE OF APPROVED By 612-571-3450 910415 5/25/90 JOB ADDRESS 1388 - 66th Avenue N, E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. of Lo s 6 & 141 .S, #10 & Ft. of Outlot A, Dennis Addition sHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joe Menth. 1388 -• 66th Avenue N.E. 574-1677 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW JD ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 192 sq. ft. Addition to Dwelling and a 600 Sq1 Ft. Garage Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations: on plan, Before digging call for SEPARATEall utility locations UWlRiI �F �prT 454-0002 �� H,E,gTjIVGI ��� ()'J'RED REQUIRED BY LAW Fp �/b"VG AND sl GNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $13,750 $6.88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $153.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEEp $159_ 88 SIGNATURE OF CONTRACTOR 0 . TMORIZEDAGENT IDATEIPROPERLY WHEN VALIDATED THIS IS YOUR PERMIT Ss-90 �- BLDG INSP f)AT SiGN URE OF OE IIF OWNER BUILDERI (DATEI NEW [ ] CITY OF FRIDLEY Effective 1/1/90 ADEN [ R-1 AND R-2 - A= [ ] Building Permit Application constnr-tion Address: 1389 6(o"- A u -e— Fr i d l ty MO Wag,+ I/&. of 60 s /66' -P -6.%'f "n4 re v- of loi's (v %Ad lylp Legal Description: A-t-14lrs s.% *L I o I (.Jest /s .{ E-nsf /46 ' •f Gra f cat A Dei►h;s AMA'... . Owner Name & Address: _ 1 3S$ b(off Are ire i 4le-y Ma/ Tel. # 5'7(/-/677 Contractor: �se) �') Tlel # Add��s: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. .- �' ' !,r Vii_ 0 Length 1 (o Width 12- Height�I- _ Ft. w" i' a is $ • f> Length zS' 610 Width .a ' Height 8' LeIgth Width Hgt/Ground Sq. Type of Construction: Frarh t Estimated Cost: $ 1III f_27]!� Approx. Completion Date: M o v 19 4 o �I• -Fo k:N Ft. etit .3a'1 fa�• ; �•-1� 11�°gib ��Z cs�'I ��,?a1.0' %' '��. - v Corner Lot [ ] Inside Lot pc] Ft. !setback 36 11 ' side Yazd Setbacks iier et%sf;�4 ,.ae 6 ( O • Op ftWosed Driveway Width If New ening Is Desired: $ i + 6' See Back Page DATE: APPLICANT: Tel. # 5-754/677 CITY USE OILY Permit Fee $ Fee Schedule on Reverse side State Surcharge $ ► $.50/$1,000 Valuation SAC Charge $ $600 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ I 8 S17PULMCNS: 13 ,'7� a Cow �� Oct 2�9 Otto l S1na ELEVATION F" ROOF: 3 tab fiberglass shingles #15 Tarpaper 5/8 cdx plywood 2x6 rafters on 16' centers 14 collar ties 32 O.C. 2x6 ceiling joists on 32' centers }iea�ev 5•' zg®r 16 �a .ge �Qoar MMATIOM 8x 16 footings w/2 rebar 42' below grade. Er Dock with 4' top course cap, SIDE ELEVATION Front 5/8 rock to top WALLS; 1/2 siding \ #15 tarpaper Front 1" builtrite of 2x6 studs on 16" centers Garage Double top plate Treated bottom plate 1/2 sheetrock, R-19 insul, --------------------------- 4" slab ROOF: Stab fiberglass shingles #15 Tarpaper 5/8 cdx plywood 2x6 rafters & joish 16" o,c, &.0, 1x6 collar ties 32' o.c, 0 FLOOR; 5/8 particle board 5/8 cdx plywood 2x8 joists 12" o,c, over old old slab, Vented ::f FOUNDATION: C'l C 8x15 footings w/2 rebar 42" below grade. 8" block with 4" top course cap. L.- 1. ® . Date' 5 - P3 'yG This letter is to confirm that I have reviewed the plans of Joe Menth's addition and agree with the placement of the lot line as shown on the PLOT -PLAN. I confirm that his construction is more than 5 feet from the lot line dividing our properties. r �y Signed' Douglas Noerg 1376 66th Ave Fridley, MN 55432 and living space will have 5/87sheetrock /jtt , +k, .-.�..�.,� —4.J.,. 1 /-i -- -4-" 14..4--.-.4.d... /. FLOOR PLAN is 22 0' —01 16' 0' 5' 6'-01 rte— 9' 10'--• i 3' 0' Self closing door Ilk _G P Gara 16' N F, CV zoo I CN 66th Avenue Creek Ridge Lane 15' 0° 5 '► m GOD J C? OD U1 O < E 0 { 0 CL N #Q., mm z �+ rn aD N N � 0 Qj mm OL 00 00 U) o °D + ?+ a N a 0 z m Date: 5 - /9 - �o This letter is to confirm that I have reviewed the plans of Joe Menth's addition and agree with the placement of the lot line as shown on the PLOT PLAN. I confirm that his construction is more than 5 feet from the lot line dividing our properties. Signed: IAU� - Douglas N*berg 1376 66th Ave Fridley, MN 55432 AJL RONALD F. MEYER LAND SURVEYOR LAND SuwavING SUBDIVIOION DE31GN TELEPMON6 771-4886 088 JEBBIE ST. ST. PAUL. MINN. 88101 I hereby certify that this survey was prepared by me and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. Reg. No. 9051 I I ,.1 N. oil--- I I p 10.1 19•o h 3.7 422.5 I O 4:g.o N ap• 40.0 1 NI 10_1 19.0 nO'1 370 _ I_ I I c I d I' I ti If, .s Date: October 12, 1986 "fev. //-1?-86 Ho. Loc. I>enn is �lui� Outlot A, Dennis Addition, Anoka County, Minnesota, feet and excepting therefrom the West 492.5 feet. also Lot r teen Revised Aud.itor's Subdivision No. 10, Scales 1"=40' o Indicates iron monument placed excepting therefrom the East 249 except the East 249 feet and our except the West 75 feet. also That part of Lot Six, Revised Auditor's Subdivision No. 10, described as follows: Commencing at a point 467.5 feet East of the Southwest corner of said Lot Six9 thence North parallel with the West boundary line of said Lot Six, 140.25 feet= thence East parallel with the South boundary line of said Lot Six, 75 feet to the point of beginnings thence continuing East on last said course to the West line of the East 249 feet of said Lot Six$ thence South parallel to the East boundary line of said Lot Six, 15.75 feet; thence West parallel to the South boundary line of said Lot Six to intersect with a line produced South from the point of beginning parallel to the West boundary line of said Lot Six; thence North parallel to the West boundary line of said Lot Six to the point of beginning, Also known as Proposed Tract B, Registered Land Survey No. . SUBJECT PER City of Fridley 27514 AT THE TOP OF THE TWINS BUILDING PERMIT r , 1 _ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. -7� NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/1/98 JOB ADDRESS 1388 66th Avenue NE ° 1 LEGAL LOT NO Parcel BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. #1660 eV se SHEET ��� Auditor's Subdivision #10 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joe Menth 574-1677 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Town & Country Roofing 9403 Minnesota Ln N Maple Grove 55369 949-4233 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house 9.2 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlaymen¢t must comply with the State Building Code. 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 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 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 857 .50 DOES NOT PRESUME TO GIVE AUTHORITY TO YQIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STAT LOC AW REGULAT NG CON- STRU I NOR THE PERFORMANCE CONS R CTION. 32.00 Fire SC .86 I PLAN CHECK FEE TOTAL F Lice C 5.0 3 .36 N P OP BLD )NSP R LIDATE IS IS PER IT r)ATE SIGNAT R F CONTRACTO O AUTHORIZED AGENT IDA EI SIGNATURE OF OWNER)IF OWNER BUILDER) (DATE) AUG -13-1998 ...,.. l J ADDN [ l ALTS [1 08:42 FROM CITY OF FR I DLEY - --- - TO CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 8589320 P.01/02 =10;uvc 1/ 11!06 ConstructionAddress:L M La Legal Description: Owner Name &Address: - . ff1jV1_k-1k (� I 6:1LA A 4e Tel. # tcz� LX -v I' l Contractor: '� MN LICENSE nt521 Address• (s Tel. # CLl S--e4zz 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: 9 "9 5 -1 - Construction Type: o Estimated Cost:" n (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft a Ft x $ — $ DATE:/ APPLICANT: Tel. # SYS - x,33 CITY USE ONLY Permit Fee $ Z • �' Fee Schedule on Reverse Side Fire Surcharge $ g .001 of Permit Valuation (1/10th%) State Surcharge $ Seo $.501$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ , o v $5.00 (State Licensed Residential Contractors) Driveway E=w $ 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: FINA CITY TO: WILLIAM W. BURNS, CITY MANAGER JOHN FLORA, PUBLIC WORKS DIRECTOR BARBARA DACY, COMMUNITY DEVELOPMENT DIRECTOR FROM: RICHARD D. PRIBYL, FINANCE DIRECTOR SUBJECT: DEFERRED SPECIAL ASSESSMENTS DATE: May 1, 2000 We have recently completed a review of the Deferred Special Assessments. This memo outlines our findings. There are 9 deferred assessments affecting 7 different properties. These assessments have been deferred for a number of reasons. One property on 66h Avenue (13-30-24-13-0016) has 3 assessments which have been deferred until the property is split and presumably a house will be built on the new lot. These t assessments are for sewer and water laterals, street surfacing, right-of-way and storm sewer projects which were assessed in 1984. The assessments along with the accumulated interest now total $36,986.56. The next deferment is for a property on Viron Road (12-30-24-21-0002) owned By Dr. Wayne Dahl. The City Council deferred his street assessment in 1986 until "the property is sold, replatted or has new development in excess of 3,600 square feet". This assessment along with accumulated interest is $57,890.19. The property at 7570 Highway 65 (12-30-24-22-0006) has a deferred assessment for a sanitary sewer line. A portion of this assessment was deferred in 1990 until "redevelopment, when a building permit is issued". This property has recently changed owners and the new owners are concerned about the accumulating interest. The assessment is now at $28,632.95. The property at 5100 Industrial Boulevard (27-30-24-12-0050), which houses Echo Finishing, has a 1990 street improvement assessment deferred until "a building permit is issued". In 1994 a building permit was issued for this property however, the Chief Building Official at that time did not collect the assessment nor was a park fee collected. At the time the building permit was issued, the assessment was at $35,896.96. It is now at $63,198.51. The City also has 3 assessments that have been deferred under the Senior Citizen Deferral allowed by resolution 14-1995. City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# C;9�6 Residential Application City of Fridley See Back Side For Required Information Date �' a� Site Address: The applicant is: (cirice one ne Contractor Property Owner: In Se Address: / 39 8 G 6 - City: Thr " b ( f=:!t7 State: Zip: Phone: 76 763-5-75 A 7 7 6tR-76/ -3SF73 Fax: Contractor Information Company Name: Contact Person: Address: City: State: Zip: Phone: Cell: Fax: Email: MN Bond# & Exp Date Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: 6;0L_5 (Fi l e421 A e S - Equipment Installed: MFG: Model: Ht3zb Jf,agVNSize/BTU: o MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: X 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 $ Total Due $ 0.50 �� - S� 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 Signature of approved pian In case of all work which requires review and approval of pians. ,;I,/— Date: 7- / -5 7 'Q Approval Inspector Signature: Date: �d 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 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