Loading...
PRE 2010 DOCSPermit Fee paid on Permit ;'11,315 for 1560-1570 69th Avenue N.E. City of Fridley, Munn. 1=337 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: February 22,_ 1972 Owner: Mop- Creek T)eyelopmant rompany Builder Approved rnntrantors, Tne- Address _B.5_WeB.t Ron& (!ircle Pineg im. Address 1052 Osborne Road N_E_, Fridley 786-3680 1638,1636, 1634 1632 No. _ Street — Parcels 10 & 200, Lot _.�. _ _ Block _._. LOCATION _ 68th Avenue N.E. Section 13 Addition or Sub -Division OF BUILDING Part of Lot Corner Lot _.__.....__. Inside Lot _..._..r..._ Setback Sideyard. Sewer Elevation _ v_ _ _ Foundation Elevation __._.. DESCRIPTION OF BUILDING To be Used as: Each Unit 4 Townhouse Units Front _ 20_ Depth Height 21' Sq. Ft. 1213' Cu, Ft Front — Depth Height Sq. Ft. Cu. Ft. Type of Construction ood Frame Est. Cost See #11, 315 To be Completed 1 year In consideration of the issuance to me of a permit to construthe building described a e I agree to do the proposed work in accordance with the description above se_PV and in comp ante wi provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ See ;'kll__,_31, permit is hereby granted to Rice Creek Dev. Co. 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. CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building inspector for separate permits for these items. C SUBJECT IIT N -` City of Fridley 27025 AT THE TOP OF THE TWINS BUILDING PERMIT r ZRE&RFTO- COMMUNITYY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 1'j 612-571-3450 910-F15 8/6/98 108 ADDRESS 1632-38 68 Ave NE 1 LEGAL LOT NO.BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Parcels 0 & 100 Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rice Creek Develo ement 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO AAAmerica's Best - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 1M REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 4- lex 37 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 STALLS 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 3085 $1.54 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGS PRVISIONS O ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST CTION TH PERFO ANCE OF CONSTRUCTION, $87.25 Fire SC $3.08 I PLAN CHECK FEE TOTAL FEE Sh �r - 1 91.87 GNATU EOFCONTRACTORkJALTHORIZEDAGENT I ATEI WHEN PROPERL ALIDATED THIS IS YOUR PERMIT _ ', O JZia p I GATE SIGNATURE OF OWNER,IF OWNER BUILDER) (DATE) Prepaid Plan Check $ Estimated Cost $ Receipt # Effective 1/1/98 CITY OF FRIDLEY R-3, COMMERCIAL & INDUSTRIAL @ � I BUILDING PERMIT APPLICATION Construction Address / 9 3a 39 611' zz �v� �� Zoning Legal ,e;.- . Owner & Address Tel# CaVTRACIOR & ADDRESS h d A,�s Ir is j&0S ?k //9 C �c 7.,d 8/ 1 Tel# %0? 0/00 # Engineer,�¢oafs�.� e 6s 34 ®Reg.# Architect RJ BUILDING CONSTRUCTION TYPE OF WORK [] New 0Addition 0Alteration -Describe j it D© 172 sus `T,gr O L° -F OFC. AREA: Length Width Height Sq. Ft. wHsE AREA: Length Width Height Sq. Ft. arRER AREA: Length Width Height Sq. Ft APPLICANT - � Tel # 207 D/ 00 Date 6 VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ C08� Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Construction Type occupancy yup Air Conditioning [] Yes [] No Fire Protection Provided [] Yes [] No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee Plan Check Fire Surcharge State Surcharge SAC Charge Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Escrow $ 707AL $ l� See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th o) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1000 per SAC Unit (Plans to MWCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot ATTACH STIPULATIONS CITY OF FRIDLEY MOVING [ ] 6431 University Ave NE Fridley MN 55432 (763) 572-3604 FAX (763) 571-1287 �I a 0 Effective 1/1/04 WRECKING 0 PERMIT APPLICATION 'OSI Job Address: 16-32- Legal Description::- Owner & Address: ` it -k gaw AU&MT C -O Tel. #952-a-5Y-77yr Contractor: Ate AocL Ce*4PAlj� WS Tel. # Address • 11q60 Ceuvw— 4JIS, State License # yYL„j DESCRIPTION OF BUILDING HOUSE: Length Width 2 �J Height I (fl Sq. Ft. lyyy Cu. Ft. 111'S ZD GARAGE:Length Width Height Sq. Ft. Cu. Ft.�_� OTHER: Length Width Height Sq. Ft. Cu. Ft. � Estimated Cost $ Approx. Completion Date CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITIES FOR DISCONNECTS BEFORE WRECKING MOV] Water Bill Paid: Moving Route: TY LOCATIONS. CALL ALL Yes [zor Collect [$ ] Signature Iz6r—&- The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and herehv declares that all facts and representations stated in this application are true and correct. ALL Movin Wrecking Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost Move a building out of City....... $ 20.00 of wrecking at the rate of $6.00 for each $500.00 or fraction. PERMIT FEE: '� MINIMUM $20.00 STIPULATIONS: J 7 V1 - CITY CITY OF FRIDLEY INSP. DIV. 6431 University Avenue NE Fridley, MN 55432 (763) 572-3604 M HYDRANT RENTAL AGREEMENT (Effective April 1, 2004) X JOB SITE: 163 Z f 3L/ 6z�-6 �'(�(� N(:� Applicant: AJAK)ca Foot poi e, f c-- Tel. #: 76 3 - 57z - zc 0 Address: &IL(C0 h" PLS Service Charge: $50.00 Water: Minimum $10.00, Tanker: $10.00 per fill RENTAL CHARGES $1.25/1000 gal. with meter TOTAL CHARGES Receipt # . OD95 z EQUIPMENT USED & DEPOSITS HELD Meter Deposit: $200.00 Meter # $ Meter Reading: Start TOTAL GALLONS End Equipment Deposit: (wrenches) $150.00 List Equipment Borrowed: Above Equipment Returned to: x $1.00 = TOTAL DEPOSIT CHECK Signa ure ate I/We agree to make the above deposits and pay the water and service charges for the use of hydrant connections and equipment borrowed. In the event that the above meter or equipment is lost or damaged, the cost of repair or replacement shall be made by the applicant stated in this agreement before the deposit is refunded. Date Deposit Check # Signature Deposit Amount Returned By Date ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE VALUATION 1632 RICE CREEK RD NE 133024440002 UNAVAILABLE LOT BLOCK HYDRANT RESIDENTIAL DEMOLITION f 2005-00952 06/21/2005 ADVANCE COMPANIES INC WATER LINE REPAIR/RELOCATION 50.00 6400 CENTRAL AVE NE WATER PERMIT FEE 12.50 FRIDLEY, MN 55432 TOTAL 62.50 (763) 572-2000 PAID WITH CHECK # 98126 PHILLIPS LEVI F 1632 RICE CREEK RD NE FRIDLEY, MN 55432 Building BUILDING Permit!+To.: + D Inspections COMMERCIAL/INDUSTRIAL Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: < '� Cl / DATE ! -Z� "©J YOUR E-MAIL ADDRESS SITE ADDRESS 16. zZ 3`�, 3G� 3K ��� Au >oL:� ? —�—� TENANT - Suite No. PROPERTY OWNER NAME: ADDRESS: S1C ) �Z ECCDKI NCS (Ox) /kI& S CITY A6C0gtAW"STATEMk9IP — $ $450 Conservation Plan Review PHONE: q.) -.Z - $5Y- ?7 r ARCHITECT NAME: LAmk-*-i' Al2Cfk1 T-C:CT5 Special Assessments ADDRESS:13r3 J 6XccvJ 157 ,llc; _CITY1,k*141Ca STATEMZlP 55_3tM CONTRACTOR NAME:Qt)Aoc jxn- l c ADDRESS:64M 1. VFAAe- MO P9 CITY PILL STATFBANZIP_2V 3 Z- ft + 6 ft = ft x $20 = $ notal Due PHONE:7 63 -5-7?- - ZCIIfy FAX 763 - 57,? - q73 3 Make checks payable to: City of Fridley Attach Stipulations *NOTE: CITY LICENSE REQUIRED FOR MULTI FAMILY/COMMERCIAL/INDUSTRIAL JOBS PROPERTY TYPE TOWNHOUSE ❑ COMMERCIALANDUSTRIAL ❑ INSTITUTIONAL ❑ MULTI -FAMILY PERMIT TYPE ❑ ADDITION ❑ NEW CONSTRUCTION ❑ OTHER REMODEL ❑ ROOF ❑ SWIMMING POOL PLEASE SUBMIT: SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION 2. SURVEY/SITE PLAN LICENSE APPLICATION SCHEDULE 3. LANDSCAPE PLANS 7. PERFORMANCE BOND 4. ENERGY CALCS AMOUNT $ If BUILDING TO BE USED AS:OFF E sF WHS sF OTHER SF TOTAL SIZE: STORIES FIRE PROTECTION (Y2AC(Y DETAILED DES RIPTION OF WORK 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 of all work whish require r w and approval of plans. `�_ 912 SIGNATURE OF APPLICANT Oda f PRINTNAME / DATE ALL PEES AKE BASED ON VALUATION Sq. ft. x $ Cost/sq. ft. = Valuation $ Sq. ft. x $ Cost/sq. ft. = Valuation $ Sq. ft. dpon -X$ Cost/sq. ft. = Valuation $ TOTAL JOB VALUATION: $ USE , ;7- OCCUPANCY TYPE _-Z7" Permit Fee $ S' See Back Page for Fee Schedule Plan Review $ baeg 65% of Building Permit Fee Surcharge $ . 40 (.0005) times the total job valuation - Minimum $.50 -ire Surcharge $ 1 . CO .001 x Permit Valuation (1/10%) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Special Assessments $ Agreement necessary( ) Non Necessary( ) -urb Cut Escrow $ ft + 6 ft = ft x $20 = $ notal Due $ Make checks payable to: City of Fridley Attach Stipulations L UI■ W _ €o e3osauwy� '(a�pi�� '3N •any 4389 bE9L T MI. w w EAr S3WOHNMOI )RIND 3DIN E g= € F gA AI 5 F �o in a asodo� 3 � d pl. q p �o o a W a � ¢o W O z 3 O _ o W ' - u - i ' w V < Mir z u ` w t a 3N IS U� s 3N'any Pl;-O z/ i Z\ L SII■ elosauu!W '(aIP!JA '3N 'and 4199 b£9l 78 Z£9t a S3WOHNMOi >13321J ]DIN g€ aoi plmgaN pasodoad -. (A.iItl3A 01311),8-,lf - F- s _I m= S v O < f �p - r z y z a dl, I o Y o° F \N 3 ?€g I N N o� w � ( — W.a.6 Wi— v e Op �� II �I II w o � I za Ip. m - ,i N 6 a 0 o �I �r I m m n„ 9` a J 'z U op mN 0 wSu 11 �I TN �m rc F a � o v r n w m� rz x a w „Z/4 Z 4l ` 113 EmPZtl-ia�aiy\sa o4um 1 N � la .awo a1�1 F IIS. a;osauulW 'AaIpiJ3 '3N •any y389 b£94 '8 Z£91 - 4 €� w S3WOHNMOi >133AD 3JIN ; UI■ z elosauu!W 'Aa iiLD an w a IP. 3N V 4389 4£9l '8 Z£9l w F bw € � oe<. _ O ° g .�h S3WOHNM01 �i3321� 3JRl - � E Z z Nug�I _o - = e �b ao3 :p1!nga21 pasodbad a p m i �/ NryF oo x; <_,2-a a z 5 a s\ °a- zo 5 w n� - - a o w 4-: 111 ea-OMW '�( MJJ IN •any 4389 b£9L I Z£9LS3WOHNMOl >I33ND ]DINjogpUngas pasodoad m rc o o n n I I €F I o e I � m `x x x x ,I w zz�s-b m. � oam i z i I 3°l0 mu m m r m m m I I I »3 0 I t- v I d (J - � Z x z zumw I « uwNa u I n I nN e 0 I o 0 0 K Oax i I n n� n � z AD pl 3 v x w 1 F— ILIa3n311NVJ W > OLLVJOI 1N3rv3Ja0.iN0a ltl 41105 53a0J 1f10a� V SR/m 3JaojNl3a bNuslx3 HJ 3N5 X3 3NOM1 a€ w rvN m < r a • m , owaao a o o m m € u dip x gap 11 5 _ o � m a o a 0 s ' 3 mN a o LL 0 z w p m 3 m o � m 0 z A p �wwm<�a o m m z sMv�s-a J=la\sa v i,Na,J aw I� e3osauu!W 'Aa�pij j '3N any 4389 bE9l S Z£91 Z a S3WOHNMOi >I33ND 3DIN - E aOj plingaN pasodoad Z)Z C� Q o Q F H K -- Qn / � U d a a0 2-1 r - -. � ax �_ o � \ — E I o III ii � l � ll�l �' - 19999 999 H _ g LL i a E€E EE �a � II44 d�o i o o. f a a - ops _ d � 3$o LL � a Q. g i omya Nom - oEd '6n a € on nn on 5 r Building PLUMBING Permit No.: - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE 10 — ZI -GO 1– YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER SC&TRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: rye, a 6 c} STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: lOe.S'.� ` Si, /�`:�C• CITY MICM G STATE/9 ZIP LICENSE WITH PHONE 7 U— Vq 7 - Zc 01 FAX 76?— 41117 7 -F 7C,' APPLICATION M40' WNHOUSE PERMIT TYPE ❑ SINGLE FAMILY ❑ TWO FAMILY TYPE OF WORK: W ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK ado G / ! 2 mh A% 4c� , 1-cQ 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 improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) 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) Z BATH SINK/LAV DRAINS _ SHOWER WATER PIPING _FLOOR BATHTUB _ GAS PIPING (Asm crrrzrcENsE) SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) I DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00 La x $10.00 = $ 1 D Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $35.00 _ x $35.00 = $ , 00 State Surcharge = $ 50 Total = $ BSS - S 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 ofall which requires review and approval of plans. �work SIGNATURE OF APPLICANT / PRINT NAME T �/_=.2�1s�/c DATE PLEASE: NOTA 'E f TE ' ...;REQIJD FOR BIII T}TN" ,yT1i1I WC» ..... City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL permit No.:_ Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd:_ DATE 1 O- 2 1 p� YOUR E-MAIL ADDRESS �-- TMS APPLICANT IS: O OWNER m2GNTRACTOR PROPERTY NAME: OWNER/ ADDRESS. TENANT PHONE: COMPANY NmMm: ' d- t] 'i CONTRACTOR CONTACT PERSON: i'I kz SUBMIT A COPY OF YOUR STATE STATE LICENSE W LICENSE WITH ADDRESS: hoscg -L s-, w+= APPLICATION PHONE % 3 — N5i 7 — 2 0 31 FAX EXP DATE PERMIT TYPE 0 SINGLE FAMILY 0 TWO FAMILY 1I1,916WNHOUSE TYPE OF WORK: aNiW 0 REPLACEMENT 0 ALTERATION/REMODEL STATE ZIP L _STATE /V^`'LIP 5.?7(o DETAILED DESCRIPTION OF WORK 2,246, a t I i PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) 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) MODEL: a&/1A03(o 7n SIZSIZE/BTU%0z000 Equipment Installed MFG: �`t-�-- dn�MODEL: SIZE/BTU Tn� f MODEL: SIZEBTU C'' GAS RANGE/OVEN $10.00 � A/C $25.00 _FIREPLACE (GAS) $15.00 1 - AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 1 FURNACE $35.00 " _GAS UNIT HTR $10.00 POOL HEATER $3500 CHIMNEY LINER $10.00 _GAS DRYER $10.00 _ -FDUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $Number of fixtures @ $25.00 x $25.00 = $2 C 0O0 Number of fixtures @ $35.00 x $35.00 = Cisp0 State Surcharge = $ 50 Total = $ 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 of all work which requires review and approval of plans. SIGNATURE OF APPLICANT c (�`j`" PRINT NAME City 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 NEW/EXISTING HOMES 1. Combustion Air (See note below) 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 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 Building Inspections 7.63-572-3604 DATE --%.n SITE ADDRESS d 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 E-MAIL ADDRESS O OWNER Permit No.: _Z-060 - 005,Y Received By: Date Rec'd: r4fuvm' STATE ZIP ADDRESS: CITY PHONE: COMPANY NAME: CONTACT PERSON: STATE LICENSE #_ PHONE ❑ SINGLE FAMILY ❑ TWO FAMILY p NEw ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK EXP DATE / —PITY FAX ��5� �1� - V. �qOWNHOUSE ALTERATIoN/REMODEL G PER Me ent, ins the permit fee a a minimum of a r s d nt al fixture, exc uding thfixtures e total cost up to $(Th sshould reflect only the cost of labor ) 0, whichever is greater, for the improvement, installation or replacement x .05 = — Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor __ FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) MODEL: SIZEBTU Equipment Installed MFG: MODEL: SIZEBTU MFG: SIZE/BTU MFG: MODEL: GAS RANGE/OVEN $10.00 A/C $25.00 _FIREPLACE (GAS) $15.00 NEW GAS GRILL $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 GAS UNIT HTR $10.00 BOILER $35.00 —FURNACE $35.00 —'POOL HEATER $35.00 CHIMNEY LINER $10.00 —GAS DRYER $10.00 _VENTII,ATOR $15.00 DUCT WORK $10.00 CGAs PIPING $] 0.00 M ■T1jri�,Permit Number of fixtures @ $10.00 x $10.00 = Fee $ oo Number of fixtures @ $15.00 x $15.00 = $ Surcharge $ .50 $ �- Number of fixtures @ $25.00 x $25.00 = $ = $ TOTAL DUE Number of fixtures @ $35.00 x $35.00 State Surcharge = $ 50 Total = $ 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 ordin es and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is not a permit but only an a 'cation f rmit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case all wo req ' es review and approval of plans.`/ Jam" � DAT �•G SIGNATURE OF APPLIC PRINT NAME .�_.<_•__._. �:_ pmts.�.,va;+.-a,r8ixrr'd+:i%a,r�'vi '~a���lt�7rr'i�`��TI[,�`3�'I'. '('�'�➢ City 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 HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) 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 TGC 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. RCCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations