AF - 37749City of Fridley, Minn. 114 2 8
6431 Lhiivertiity 3ve. V.I:., htinnca�lis, �1inn. i39._2
BUILDING
Dg}�; May 9� 1972
PERMIT
Otvner: astle �1ob_ile I�omes Inc__.___._ guilder
Addrnss -fi219-Uniuexs.i.ty..11x.enue..N..E..._.__..._ Address
LOCATION OF BUILDING
Na ���7 _ Strect _Geatsal...Avenue_N.E..___.__
I4t 28 _ Block ..._.___.._..z.._._.._....._..__...._ Addition or Sub�
Corner Lot ___. ._ Inside I.ot __% ._.. Setback ._._._
34�� IIevaGon _.—_8ffi�9L _ _ ......_ ��...__... %l�oi�ib�it
Wye Top of
Part of
._ SideYard .....�.. 5c_l4.'_ ._.--
l',b�i ___ $91.o1._(APESQx..) _.--
DESCRIPTION OF BUILDING
To be used as:
Dwelling___._......_ Front __._36..�._ DePth __.27�._.. Height .,.._12_�._. S9. Ft. __.1440_� �. Ft _17�280'
�.=a�P.� --._._-- Front . 24'_._ Depth _ 24.�__ Heleht .___10-'_. S9. Ft. __576' Cu. Ft 5�760'
v
7y�pe of Construction _Esame...�u_ .�SL"aB�Est. Cost __._$22�945__.._ __. To be Completed ._ _Dec.__19Z2......._
Pexmit issued subject'��
between garage and ho�is
4. Provide all appliance
7. Provide�6'6" x 10'10"
before proceeding with f
heet3ng and ai,r circuleE
model"will be be�fiE. 13
following �equirements : 1. Previie �-hour fire rated door
2. gw�i3a�eentral air conditioning. 3. Provide carpeting.
. 5. Provide`.landscaping. 6. Provide a hard surface driveway.
mesh in all $irst floor eiabs. 8. Verification survey needed
�ming. 9. Pro�ide 211 casement windows. 10. P�ter
�11, Prov�c�coad.aae)��atza unit..-i2�. Daa,ig8ate which
A 1 notation¢ in red on plans to be followed.
SEWER LOCATION: 2 7' N. of hole (76,th & Meadowmoor Terr.)
WATER LOCATION: 22 �5' N. of M ol 12.5' N. of Sewer Service.
In conaideration of the i vance to me oE a permit to construct the building described above, I agree to do
the proposed work in accordan with the description above set orth and in compliance with all provisions of
O:dinances oP the city of Fridley.
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In consideration of the
g__43_00__.____._ pernut is hereby �ranted to._ Ca_stle._Mobile Homes
to construct t il ' g or addition as described above. This permit is granted upoA
the express condition that the person to whom granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, sha11 conform in all respects �to the ordinances oP
F'ridley, Minnesota regarding ]ocation, construction, alteration, maintenance, repair and mocing of building�
}yithin the city limi[s and this permit may be revoked at any time upon violation ot any of the provisions of said
ordinances.
Cd�c�-4-�..�<-�!�c_��-- au;la;ng Ic,spector
_____..__----
CLARENCE BELISLE
NOTICE:
i This psrmit doas not eovar the consemc�ion, installation for wirin9, Plumbing, pat hwting, sswer or wabr. Bs sun to aw
'� Ih� Building Impeetor far saparafa parmib for ehes� ibms.
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APPLICATION FOR RESIDENTI;\L, .ALTER.4TION,
OR AllllIT'ION BUILDING PERMIT
CITY OF FRIDLt:l , �1ItitiESO'tA
// jN L
OWNER' S NAME :�;a b fi�P /t1p �;�� /y(j��'lr'� BU ILDER : �. �i, G 1-� 1
't
ADDRESS:�,'��% � L['��tJcri( t,} /�i�[ � ADDRESS: S.aw� t
/
N0:.�7 STREET: (�,tN ��r{!_ i�cIFR.'�i f- _.
LOT: �� BL(�K: v2 ADDITION;�E,µDncJMcx:�" T�✓uc P ,
CORNER LOT: INSIDE LOT: Y SETBACK: __� � SIDEYARD: .5 �- /�/�
Applicant attach to this form ltao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
llESCRIPTION OF BOILDING
To Be Used As:
L�' Front: 3(� Depth: `��', `� Height: /?
Square Feet:�'� y(] Cubic Feet: /
�Q� �,:,; Front: ;�y Depth: 2 �/ Height: /�,'
Square Feet; ,<� 7b Cubic Feet
Type of Construction:t�icwct l`?ti ��•�.L, Estimated Cost
To Be Completed: /Z�j�� Z_ � ' . � ��
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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.
c?��r/� i�� �%�N,`�'°`��' <.1`L.�
DATE: S �</��L-- SIGNATURE: �( '�i� ,_c.: y(� /T �,/"�,�v�"�7
(See Reverse Side For Additional Infoxmation.)
. ; � . . . . .
�� �' . C � Y Q--
BUILDI�G PE�.61IT FEE SCHEllULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for thc
erection of any Uuilding or structurc, or for any addition to any existing
building or structure, or for any alteration or repairs to any existing
building or structure, upon application therefore, require k?�e paymea' '., .-
applicant for such pexmit of fees to the amount herein belota set Fr��:_ti =.
the manner herein provided to-wit:
UNIFORM SiIILDING CODE: Type 1, 2& 4-$2.15 for each one tttousand rubic
feet, or fraction thereof, in such cubical contenks. 1j�pe 3& 5-$1.$5 1,r
A�.ch one thousand cubic feet.
AllUITI0�A1. I�FORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or zddition, is detexmined by multiplying the ground area
covered from a point six (6) inches beloco the floor lin� of the basemcnt
�:z the cellar to the average heights of the upper surface or to the averao��
,�d'sht of the roof surface of the main gable of e pitched roof.
For repairs or alteratiuns to an c,ieting struc w re, the lee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any pexmit as set lorth in Section 2 be
lees than $5.00.
VERIFICATION OF FOUNUATIO!�
NOTE: Pexmits for construction wi11 be issued a minimum of 24 hours from the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the 1ot, showing the location of the foundation, once it
tias been constructed, will be required before proceedinQ with the framing.
CERTIFICA"fli OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or eccupied until a Certificate
of Occupancy has been isaued.
Authority From
Ci[y EnQineer
City Engineer
UBC-Sec. 106
Page 23
UBC-Sec. 106
Page 233
UBC-Sec. 106
Page 233
UBC-Sec. 106
Page 233
Tel. Conv. with
State Bldg. Insp
Building Insp
1
2
RECOA4SENDATIONS FOR CONDITIONS TO BE MET
PRIOR TO PERMITS BE7�v* . T S i.D 7N
MEADOWMOOR ADDITION
Lot by lot determination by_Engineering Department of water table
and drainage requirements. �
Proof of ownership of 1ot to satisfaction of City.
3. Material descriptions be revised as follows:
a. Foundations- Footing concrete mix from 2,000 to 3,000 lbs. p.s.i.
or submit engineer apprwed data.
4
b. Exterior walls:
1. Wood frame from standard or better Fir to Group 3(UBC).
2. Sheathing - impregnated '� inch to nail base, ridgid board
or equivalent.
c. Floor framing - From standard or better to Group 2(UBC) to
meet span table 25T
d. Subflooring - 2 inch CD to be stamped 16_
e
f
Partition framing - standard or better Fir to Group 3(UBC)
on bearing walls.
Windows - Glider-Malta to be upgraded to manufacturer quarantee
minimum of 10 years.
g. Misc. -�610 - 11 roof trusses
Submit specification sheet.
Comply to all notations in red on plans by resubmitting revised
plans.
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City of Fridley, Minn.
643]. t;niccrsity Ave. N.P., Minne�polis, Minn. 55432
BUILDING PERMIT
Date: June 20, 1972
Owner: Castle_Mobile Homes.i_Inc....__..,___ Bu;lder
Addresa 62Z9_Universi�__Apenue N,E,_._._,_ Address
�r� �9
11522
LOCATION OF BUILDING
Na 7627_ Street ....__Centx'a1.._Ayenue N.E. ____...........__..____ Part of L.ot ....__.__......_..- ---
...... .. _...._._ ............. .. _...._....._..___..--'—
2$ Z _._........... Addition oc Sub-nivision . Meadowmoor Terrace Addition
I.ot _ Block _.._.._._—..._._._ . _ ... __..._..._..--..—....__._......._...._--
Coraer Lot ---...._ Inside Lot _ ..............7�...__._-- Setback ...._..........3$C_._..___. 5ideYazd ._____...5_! b'-.111.�--.__.____...__
..SE%kd IIevation —_-._.BSZ�11__._..._.._.__._....._-._..._._.._... �hG�SdahJo4J�fd•dt�6d __Min._ o f_.3_:_ abQ�z�water_._ta,ble
Wve Top of Footing (Water Table - 895.00 Approx.)
DESCRIPTION OF BUILDING
To be Used as:
Dwellin2 __._.._ Front 40_�..__. DePth _.__40�._ Height __���...... S4. Ft. 1376_�_ Cu. Ft ..__._-_.—
Ga'raee ---"-._..__. Front _22�...._.. DePth _ 24�._ Height ._._10.�._. S9. Ft. __528.� Cu. Ft _._.5280�
Type of Construchon ...._Wood., Frame_ __ __ 24�921. Dec 1972,
-. . Est Cost .___._..� ...__.. To be Completed . ....._.._ _. .
Stipulations: Provide a hard surface drive�oay and a verifying survey before capping.
Provide landscaping. Provide 211 casement windows. All notations in red on plans to
be followed.
WATER LOCATION: 12.5' N, of Sewer SEWER LOCATION: 217' N, of Manhole
In consideration of the issuance to me oP a permit to co� tru t�e buil��
'ihe proposed work in accordance with the deseription above set rt)1 and in
Ordiciances of the city of Fridley. �
12
I agree to do
nrovisiopC oP
In consideration of the payment of a fee of 56.00 •
$-..—..__.....__.....__...._.., perm3t is hemby granted to...__..�eaStl.e.._._.�gbile HomeS
—__._ .............__.._.._......._..__.. to construct the buffding or addition as desrribed above. This permit is granted upon
the express condition that the person to whom it is grunted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in a11 respects �to the ordinances of
F`ridley, Minnesota regarding ]ocation, construcfion, alteration, maintenance, repair and moving of buildingY
}yithin the city limits and this permit may be revoked at any time upon violation of any�of the provisions of said
ordinances.
/ /_. /i ! Il . .
� �P�toT
NOTICE:
Thia permit does nol cover �he canslr�ction, insfa11a1ion far wiring, plum6ing, gas heafing, sawer or wafar. Be �ur� �o sM
ih� Building Inspector for saparate permits for those itams.
r.
APPLICATION FOk RLSIllf:NTlt\L, ALTFRATION,
OR AllllITION ROI1.11ING PERt�1I�1'
CITY OF FR1llLli1', h1INNE50"PA
� } �.
OWNER'S NAME: �d���{ lti�G�L �/ ;�pr'�1�BUILDER: s7N��
ADDRESS: �p��-�J � �,J�.Sr�t �"J/' ���' ADDRESS: S/Q N��
NO:.'/62 � STREET: �� h�r u� ��%/� ,V � �C
LOT:��BLOCK: Z ADDITION:�F,OpoWM/oi I�Ph�hl<i Arl�
CORNER LOT: INSIDE LOT:�_SETBACK: 3s, SIDEYARD: S /O
Applicant attach to this form Pao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
llESCC2IP'PLON �lF BUILDING
To Be Used As:
,n�./ /�,� y Front: yV Depth: ' ' Height:_� �
Square Feet:1,`��( Cubic Feet:
-�—
(y�� Front: � '� Depth: 2� Height: / �;i
Square Feet; � ;{'� Cubic Feet• � ✓ � �'
Type of Construction; '',/"�. '" i-„ 'ii y Estimated Cost• $
...�., 2y/��� f'Z
To Be Completed; _ � � � � � . ,�_
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hexeby
declares that all the facts and representations stated in this application
are true and correct.
DATE:
SIGNATURE: �
r-- r`
(See Reverse Side For Additional Inforniation.)
� �;- , C� ? � �' F" -° -�'
/ ,� , y`%
�: :� ' � �
C` .
f��
BUILDItiG P�:R�tI'C FF:i: SCHt:llULt
SECTION 2. The Inspector of Buildings sha11, before issuing permits fcr �;�c
erection of any building or structure, or for any addition to any existing
building or structure, or for any alteration or repairs to any existing
building or structure, upon application therefore, require the payme-c t
applicant for such pernlit of fees to the amounC herein belosa set: -�_-. �-.-.�
the manner herein provided to-wit:
UNZFORM BUILDING CODE: Tj�pe 1� 2& 4-$2.15 for each one thousand cubic
ieet, or fraction thereof, in such cubical contents. 1j�pe 3& 5-$1.R` ',
�^c'� :>r.e rhn,lsa^.d cu6�.c feet.
.4DDITIi)VAL IVFORh1ATI0\
For the purpose of computing fees for building pexmits, the cubical contente
of any building or addition, is determined by multiplying the ground area
covered itom a point six (6) i.nches Uel.o�a the floor linc of the basemunt
or, the cellar to the average heights oL the upper surface or to the average
`eight of the roof surface of the main gable of a pitched roof.
For repairs or alteratiuns to an u::irting structure, the lee shall be at tiie
rate of $3.00 per each five hundred dollars ($500,00) or fraction tliereof ir.
the cost of all proposed work.
In no case shall the fee diarged Lor any permit as set forth in Section 2'
less than $5.00.
VERIFICAT'IOK OF FOUIvDA7'I01�
NOTE: Permits for construction will be issued a minimum of 24 hours from the
time of application, to a11ow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the Lot, showing the locatiun of the foundation, once it
hae been constructed, will be required before proceedin� with the framing.
CERTIFICATL OF OICUPAhCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building pexmit has been
issued; and said structure shall not be used or eccupied until a Certificate
oP Occupancy has Ueen issued.
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SPEfA LETYF:!:�
TO_-_Eonl:keeping� CnFtiierr-6.asessi::g _ _ FROM _-I;uildir.D Inspeceion_➢e�artmeu� _ _
SU?:[Ci �ui2diu� Pezsits P.ein� Foided _ _-_
MESSAGE DATE i�,ra 9� 19_72_
- rui_n'
PZeaee void i;ui2uiu, i'eixiits i13.,427 for 7:i13 Cei:tzEl e,veuue 1:.L, and �1I,423 for
7G27 Cei:tral Avenue ,�.L. Tlie o:aner ias decicled uot tv build tIie::e hos�es at t�is ti:.e_� -
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Tcoal-iiex�.y Electzi.c
307 Jaclsur�
�11. River, Minne3ota 55330
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£.e: Pern�i.t �rt�,��e� For 7G1$ Centrai Aver,ua
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Z:�: �.�.:�a�'�17 iil.�.>>�i1.iL.�
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HOUSE HEATING TEST RECORD D-19864
ADDRESS 7627 Central 9ve, N.E� __.APT. — FLOOR CITY SUBURB �ldley
OCCUPANT GOrdOri A W10❑ OWNER Ye�
HEAT LOSS DATE HTG. INST. GAS C0. METER BADGE
SOLD BY _. __ INSTALLED BY �edgwlCk Htg.
n n
Electrical Wark By —__ Gas Line By ._
TYPE OF HEAT GA FA ?! _HW STEAM — SPACE HTR. UNIT HTR —OTHER
GAS DESIGN
MAKE . �1111H0180❑ __ MAKE OF BURNER _
Model 11�7-1�-� ___ Model _. _._
Se��al 7233�58 Max. BTU Ratiny _
INPUT IOO�QO�i�HT' MAKE OF FURNACE
Model
CONVERSION
CONTROLS
THERMOSTAT`��i� Hea� Pl�g Vent Size 5„
Valve '�1�jj� __V$09�—_ _._ KIND OF LINER�11�.. SIZE B„ NONE
Limit.— —�IIl)9t18W _�iA'f 750n__.___,DraftHood—�t@£_�G�.1_—Regulator—�ASLtAI Ii�iOUA ____
O
LimitSetting�`.Q�—f_ _ .._— —.. __ Filters Sizel���_%�—Nomber � ___ .- ,—
Fon Setting 90�f R$r120�f.. .. _ __.. — Chimney Location Inside YPx Outside __._ __..__
Pilof Type �n��n1P Chimney Construcfion __ ME_�GLtIBStIIB
Pilot Make
Pilot Model — . Smoke Bom6 . _._
Pilot Timing 7ii SPrnntia _,___ Drah .— nK __
L.W. Cot Off — Door Prossore-- -
Wiring _
.Tesr Tog Ye9
Lighting Inst. YQA
Prossure 4-5"K!.�C PerceneCO 7•5d0— Date Tested _ 1QI9(_73
2 _ .
Inpue CFH—�Q� .._PerceM OZ ��8�- — Company Testing � t! 1��� .
Smck Temp. 44O�f p�rcent CO �•.0.� ._ Name oi Tester "� ___ —
Form 735
sue.ec- PERMIT�
Citv of Fridley �1319�
AT THE TOP OF TME TWINS
� ` ; BU ILDING PERMIT R
� COMMUNITV DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEG I '/)f)C C/�
I
1 �
� � "1 � GTV HALL FRIDLE� SSM132 NUM9EA ?E� CO1E �qGE Of A?GROVED BY
�---'�' ,'� 6�2-560-3a50
s�0-Fis 9/11/75 / /
ios nooaess 7627 Central Avenue N.E.
1 LEGAL LOTNO. BLOCK TfiAGTOFAO�ITION SEEATTHCHED
oesca 28 2 Meadowmoor Terrace sr+eeT
2 PROPEPTYOWNER MAILADDRESS ZIP PHONE
Marvin $pCg Segelstrom 7627 Central Avenue N.E.
3 CONTRAGTOR MAILADORESS en WOr 21P PHONE LICENSENO.
John Thury 443 W. Nzn�xXk Avenue St. Paul, 55118
a ARCHITECT OR DESIGNER MAIL ADDRE55 ZIP PMONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE UCENSENO
6 USE OF BUILDING
Residential
7 CLASSOFWORK
I NEW I_: ADDITION C ALTERATION C� REPAIR ❑ MOVE I; REMOVE
8 �ESCFIBEWORK
Repair fire xapaix damage, install bathroom in basement
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide combustion alarm system in hallway by bedroom. Install
redwood bottomplate on stud walls in basement. Inspection required of framing
before sheetrocking ceiling.
SCrERAI'F. PERMiTS REQUfRED FOR N,�I�;I;;;:,
HEATING, PLUMBING ANp SJGNS.
TVPEOFCONST OCCUPANCVGROUP OCCUPANCYLOAD
SEPPRATE PERMITS FRE REQUIRE� FOP ELECTRICA�. PLUM8ING, HEATING.
VENTILATING OR AIR GONDITIONING. WOOC� FLaIIIE�
THIS PERMIT BEGOMES NULL AIJD VO10 IF WORK OR GONSTRUCTION ZONING SO FT GU FT.
AUTHORIZED IS NOT GOMMENCE� WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABNNOONEO FOR A PERIOD OF 120 DAVS AT
ANY TIME AFTER WOFK IS GOMMENCEO. NO OWLG UNItS OFFSTiiEET FARKING
I HEFE6Y CERTIFY THAT I HAVE READ ANO EXAMINED TMIS APPUCATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TFUE AND CORRECi ALL PROVISIONSOf LAWS VALUATION SUFTAX
AND ORDINANGES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIED 1S�OOO $7•SO
WITH WHETHER SPECIFlED HEREIN OR NOT. THE GRANTING OF A PERMIT $
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OA CANCEL T�F PER411TFEE SAGGHARGE
PROVISIONS OF ANV OTHER STATE Ofi L CAL LAW REGULATING CON- 7j.00
STRUCT HE PE:IFORMAN OF STRUCTIOIJ�.. $
� / � % /� � �^ PLAN CNEGK FEE TOTAL FEE
� �`Y 1 �S$�. 5�
Si piWREaFCONieAC*OROA>u*4ar+iZ oGEmr ��F*E WHEN PROFERLV VALIDATED TMIS IS VOUR PERMIT
� •
`�" .��(,j.� t C,P ��CCt-z lGi `)-1/- IS�
�SiGNAiUREOLON'f�ERiILOWNFPBUILDEAI I�AiE�� B_G�. i� '�F�"c �
,�ri>>.ICn�r�oN r�>>; �,i;sii�i:��rrini., nL�ri�,itn�r.�orv,
ou ni�i�i�i��or: liui�.,�iuc ;��:a�,���r
cl�i��� ol� ��iz�nl.i:Y, n�lr�:�;i:so�r;�
T� � ,
ot;:;rii's nn��t�: /� � ��-�.h1��� -�suzi.v�R: --°- -�-
nvv,s:.•> : 7 � '�� �� �% � nDr,ii�ss :_ �J1.3 l� l�' , —� �
r:o:. G '� _
1
fOT: � f
COP.\liP, li0T
szR�rT:
��.
IILOCI•:: / � � P.DnITI0I3:
-�.,-sY--�
IT;SIllP I:oT: � S��rP4CI:: SILLYARll:
Appli.cant attach to L'hi.s Ioir: ;J`.rn Ccrtif=�:afcs of S�ira�Z oi I.ot nr�d proposc�'.
Uuil.li:ng l.ocatiun dr.a�ar. on tl��se. Cert?.i icates.
llLSCRIPTION OP 13U1L111"�G
To L'e Used As;
�,i /J�d;�'.F_ .t"fl�Ni�r l�ront:_ _lleptii
Square 7�cet:
I'ron t :
Dc ptli :
CuUic Fect:
i;ci^ht:
He �gl�t :
Squnre I'ect; CuUic Pcet-: ______
C � ';', iJ c('tSi1Nl �.
--r— O u o n �
'i`ype oi Construction: - � Estimated Cost: $ .� ________
__ / _.._�_
To lie Comp].etcd: �p�-. � � ��%�
1^lie unde;sic;ned hereby malces appli.c:tinn for a pexmi.t for t9�e worlc hercin
speci.ficd, zt;rccin� Co do all norl: in slricc accordance �oith tlte City oi
Pridley Oxdin.nc�s and :ul.in�s oI Ci�e Dc��ait�r.�nt of Pui!dinns, and hciuby
declazes Chat al l tlie facts ancl �eprese�;Y...tion:: : tated in Chi_� applic_tien
axe Lxuc and cor.rect.
�����,, , � � � �
n�zr:,�� /� /y �� _ sicnnTOr.r:_ -�--' � �c-�-�---
o � ,,
(See Rever�c Side Pbr Additional Infonation �i � .u; ,� ,,i,�: �r, �, . , „
=C..nc �"� � �,.tc, r�,r �.-l�,�F� � �`.;.���i � i�� f/flti «'ra�� Y>� i�,: ��.'; ,,ii,:.
��' i;��---
�;� .__
�, ,
/��'� ��/ � 6E�
;1 _ �t;���
�/��'o0 5«�z��rAZ��
�5 �
�.-�,
Y �%�� �
�ti'.�r3LL f:tOc1!(�c��� l�o��>>li�)LA�F_ cinl
SZ�u u43LL5 iA� �j�1Sfn)fti'; �_ „�.�
,C�� (1u�A't tl br= r-�1fli��id1G {)c'_r� , , •
f
�.t�t t� i�c�.K � ti�6 C'_� <<��v6
�i;ll.nin�c i�Liia;lr i�tsi, scii�:i�uLL
SPC'PION 2. Tlie Iiispector uf Buildings shall, beiqre issuing permi.ts for tlie
erecti.on of any Uuilding or sCructure, ur for any addition to any e�;isti.ng
building or strucCiire, or iur. any altcraCion ox repairs to any existing
building or strucCUrc, upon applicati_on tl�eref.ore, requi-re the payment by tite
applicai�L for such perniil of fees to LI7e amount ]ierein below seL Sortli and in
the manncr lierein provided to-=.ait:
llNIPOPS173UILDI\C COD13: Type 1, 2 C 4-$2.15 for each one thousand cubic
feel', or fraction tl�ereol, in such cubical contents. Type 3& 5-$1,II5 for
eacli one tliousand cubic feet.
AllllI'1'IO\';11, INPOI:AIA1'ION
I'or the purpose of computing iees for building pezmi_ts, tl�e cuhical. contents
oi any Uuilclin; or addition, is deterniinecl by multi.p'_ying the �round area
cocered from a p�int sis (6) inches uelo�a tlie f-loor line of the Uasement
ox tlie ccllar to the average hei�hL-s of. the upper surface or to Che average
liei�;ht oi the rooi si�rface of tl.e �;;ain gaUle of a pitched roof.
For repairs or alterations to an er,i.sting, structure, the fee shall be at the
rate o� ;3.00 per eadt fivc hundred dollars ($500.00) or fraction thereof in
the cost oi all proposed �aorl:.
In no clse sha71 the lee charged for any permit as set iortli in Section 2 be
less than $5.00.
VERIPTCA'PION O1' ]�OUND�TION
NOTE: Permits for const:uction e:ill Ur_ i.ssued a mi_nimum of 24 hours from L'he
tiaie of applicaCiun, to allo�a for proper review oi Lhe proposed structure and
o� thc construcLion site. �
A. CerCiLied Sutvey of the lot, sl�ocaii.g tliu locacion oi the ioundation, once iL-
has Ueen constructed, will Ue required Uefore proceeding with the iraming.
CLIt'1'IPIC/�T1: OI� OCCUPAVCY
Application ior a CerL-iPicate of Occupancy sha11 Ue made ten (10) days prior
to the use or occupancy oi any structure for wl�ich a building permit has been
issuecl; and said sCructur.e shall not Ue used or occupied until a Cerliiicate
of Uccupancy has Ucen issued.
560-3450
�i$� o f �i°[d�e�
ANOKA C�UNTY
6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55432
August 7, 1975
P1r. tfarvin Segelstrom
7627 Central Avenue N.E.
Fridley, Minnesota 55432 ✓
Re: Fire Damage to 7627 Central Ave. N.E.
Dear Mr. Segelstrom:
First, 7 would like to express the City's ,orr.ow over your recent
experience of having to 90 through a tr.agic fire at your home.
It is the policy of the City Yo inspecY. bur.ned structures to
determine the structural damages. Of course, this preliminary
inspection is not thorough enough to determine: all damages.
This is done after the burned wsmetic textures are removed.
Our August 7th inspection did, however, reveal that at least
three or four scissor trusses are probaYly char.red severely
enouyh to warrant their replacement and we also noted a very
questionable installation of a refriger.ant linee to the cooling
coil in the central air unit. It passes closer than desired to
a vent from the furnace and hot water }�eater. We would suggest
that this be corrected.
It will be necessary for you or your repair contractor to
obtain the proper permits before the repair construction
commences.
If you have any qucstions with reference to this matter, please
feel free to call me at 571-3450, F�c. 41.
Yours very tr�rly, ,\ _
\ ' �
(�� � � � �� (� �
/ �
.. � 1, �� � . 1 � `� �' f.� LL
DARRF,L CLl1RY.
Community Uevelopment Administrator
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CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (�) No ()
2. Is free from rust or deterioration Yes () No ()
3. Has no foreign objects lodged within Yes () No ()
4. Is securely supported
5. Meets all current Code requirements for size and
total BTU ccnnected
6. Has Total heating BTU's of
All other BTU's
TOTAL
Remarks
Com pa ny
Si9ned By
Ga te
Yes ( ) No ( )
Yes ( ) No ( )
s�e�ec* P �T
City of Fridley 2 6 8 4 2
a,THETOPOFTMETWINS gUILDING PERMIT
� • RECEIPT NO.
�
� � COMMUNITV DEVELOPMENT OIV.
r ° PROTEGTIVE INSPECTION SEC
i �����
�
� � "1 � CITY HALL FRIDLE� 55�3I NuMeEe AEV O�iE e�GE o� •>vu0vE0 e�
�...__Jl.'� `.+ 612-571-3450 si0-Ft5 7/27/98 / /
JOB ADORE55
7627 Central Ave NE
1 IEGAI �OTNO BLOCK TRAGTORADDITION SEEATT�CMED
DESLF. Z$ Z Meadowmoor Terrace Addition sNeer
2 PROPEHTYOWNER MAILAD�RESS ZIV VMONE
Bill Com ton 7627 Central Ave NE 784-6527
3 GONTRACTOP MAILADDRESS Z�P PMONE LICENSENO
r n E STE 107 Bloomin ton — 42 9
< PRCHITECTORDESIGNER MAILADDRE55 55431 ZIP PMONE LICENSENO
5 ENGINEER MAIIRDORE55 ZIG PHONE LICENSENO
6 USEOFBUILDING
7 CLASSOF WORN
❑ NEW G ADDITION O ALTERATION �7 REPAIR ❑ MOVE ❑ REMOVE
9 DESCRIBE WORK
9 GHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
rvPEOFCONST OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PEAMITS ARE REOUIRED FpR ELECTRICAL PLUMBING. HEATING,
VENTILATING OR AIR CONDITIONING
TMIS PERMR BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO.FT CU FT
AU�MORIZED IS NOT COMMENCEO WITHIN 60 DAVS. OA IF CONSTRUCTION
OR WORK I$ $USPENDED OR ABANDONE� FOR A PERIOD OF 120 DAYS AT
ANV TIME APTER WORK IS COMMENLED NO OWLG UNR$ OFFSTREET PARKMG
I HEREBY GEFTIFV THAT I HAVE READ AND E%AMMED THIS APPLICATION $TALLS GARAGE$
/ NO NNOW TNE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF lAWS yq��ATION SURTA%
AND ORDINANCES GOVERNING TMIS TYPE OF WORN WiLL BE COMPLIE�
WrtH WHETHER SPEGIiIED HEREIN OR NOT THE GR4NTING OF A PERMIT
�OES NOT PRESUME TO GIVE AUTMORITV TO YIOLATE OR CANCEL iHE pERMITFEE $ACCHAi1GE
PROVISIONS OF ANV OTHER $TATE OR LOCAI LAW REGULAiING CON�
$TRUCTION O THE FERFORMANCE Of CONSTRUCTiON '
X , / PLAN CHECNFEE TOT kFEE
4�iCl� �yc.rL�iti� �—� Z—S��' Licen SC$5.0 2.87
S�Ga4iUaEO�CON'a>C+OAOAS�rwOA4EDSGEai ���*E� EN ROP VA�I T O THIS IS OUR PERM�T
SGn<*UAfO�CWNfa���OWnEABUII�ER� �D�if� ' - B G iry5� �' ���
NEW I 1
ADDV [ J
ALTER [ ]
ConstructionAddress
Leeal Description:
CITY OF FRIDLEY
SINGLE F��IILY A.�iD DL�PLEXES R-1 Ai�ID R-2
BUILDING PER.'�SIT APPLICATION
� � Z�1 Cev�'�2'r�' /�iE' �I E
Effective 1/1/98
� '�
�';-,�� }�, ;l
;
Owner Name & Address: �; I � <<='�""p�-^✓� -�1bL-7 C��•�� �� ti E� Tel. # Z��`(-Cc�S Z�7
�
Contracror. ��-�� ti' � �1 EX �-i%iGi > MN LICENSE !t �"Z-�,Cy
Address: ��C� e{�"�� v� ���=. S. i Fc> I c'-1 Tel. 1f �l l'� Z 3 Z
LIV�G AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'TION OF I�i iPROVE�fENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width H;t/Ground _ Sq. Ft.
-�j- e�.: � ,'�'-'-�zif _ 2 �
je�:� -
Construction Type:��f'� �=� � Estimated Cost � ���"� ��� c� �
(Fee Schedule on Back)
Driveway Curb Cut `Vidth Needed: Ft. + 6 Ft =_Ft x$ _$
DA1'E: � - 7 � - `�� APPLICANT: �-�- < y✓e � f �dy-/ `�c"' Tel. ll � `dl `� Z'3 2
Pennit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
e
� �%�� �. ���,
�
5 .> r � •
� i. � � /
$
��
S
$
$
$
, � ,,
� „� c
CITY USE OiVLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (S[ate Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Suiwei3 a�p q�im Svipaa�old a�o;aq paJ�nbai aq ���m
pa»ruisuo� uaaq sey �i s�q 1� a�ao uoUepuno; aq�;o uoi�e�o� aq� �ui,hoys `io� a�;o ,ia,uns 3o a�e�iJiva� �
•a�is vou�ru�svo� aqa 3o pue a�nl�ni;s pasodoid aql;o Matnai
�adold io3 Mo�ie o� uotiE�?[dde 3o aw�l ay� iuoi; smoq �Z 3o wnuiTUitu e panss� aq �i�rt� uota�ni�suo� io3 s��uz�ad
NOI,L�'Qhf103 30 I�OI.L��I.3I?I�A
'SL'Si$ saun> >aa; q snid q�pim ,(en�aniiQ - qldap y�ui g y��,t� q�eo�dde
ap�M �oo; � e i�e�svc pve �a»nR pve q�n�;o �uama�eldai paE iznomag :,,g„ aiewaaiy
•ps £T$ samn �aa; 9 snid ylp�,h �eMan��Q -,Ciuo �a»nS pue qm� 3o avama�e�dai pue �enomag :,,y„ azeu�ai�y
(,SluO saaails qin� alai�uo�)
MO?I�S� NOISS�2Id�Q 1i�M�ARIQ
;oaia� uon�e�; io ppp`T$
teuoil?ppe q�Ea io3 SL'Z$ sn�d OOOb00`T� lsn3 a4> >�3 SZ'Zi05$
000`000`I$ $urpnl�a� pve o1 `,�oa�ay� uop�ei; io pp0`I$
�eaop[PPe q�ea �o; cz•� snld 000`005$ ls�y ay� io� SZ'L88Z$
ppp`ppS$ �v�pnpui pue o� `;oaiaq� uo�»e�; lo pp0`I$
jeuop?PPE u�Ea �03 00�5� S�Id 000`OOi$ �s�3 l03 SZ'L88$
000`OOi$ auipn��ui pue ol `3oaiaq7 uoTl�e�; jo ppp'i$
jeuorl?ppE q�ea �03 SZ'9$ sn�d 000'OS$ �SiB ��3 SL'bL5$
000`OS$ �uipnl�u� pue o� `3oa�aql uop�ei; �o
000`i$ [euo��ippe y�ea io3 00'6S Snld 000`SZ$ �s��� �03 SL'6b£$
000'SZ� �uipni�u� pue o7 `3oa�aqi vop�ei; io
000`I$ lEVOilippe q�ea io3 OS'ZI$ Snld 000`Z$ �Sii3 io3 SZ'Z9$
ppp`Z$ �v�pn��ui pue o1 ',�oaiay� uora�ei3
�o OOT$ Ieaou�ppe y�ea �03 SCZ� S�ld OOS$ �sn3 io3 iZ$
(ao�eq��ns snid iZ� si aa3 mmunny�) j��
S3H3
dn pae I00`000'I$
000`000`T$ o� I00`005$
000`OOS$ �� I00`40T�
000'OOi$ aa I00`OSS
OOObS$ o� i00`SZ$
000`SZ$ o� i00'Z$
000`Z$ o� I05$
OOS$ o� i $
anzdn �dioi
:�im-o� papino�d maiaq �aweu� ay� ut pue quo3 1as mo�aq uiaiay
7unouiE zy1 0� saa3 30 �tuuad q�ns �oa �ue���dde aq� �iq �vamried aq� a�mba� 'aio�a�acp votle�tldde vodn 'ainl�ru�s
�o outp�mq olli]SIX2 AIIE Ol 11Ed2] IO IIOI]EI2JjE AUL' ]O� 70 `airu�ruls �o nmp�inq �tn7stxa �ive o1 uoipppe �Cue
io� io `a�nl�ruls �o ouip��nq �Cue 3o uon�aia aq� io3 s��uuad �uinssr a�o3aq '�jeqs [et�t330 �ulPP.nfi 3alu� all.l
�'If1Q�H�S ��3 ,LII1Zi�d `J.'�IT Q'IIflfl
we�tt+
� City of Fridley
.
..THETOPOF,�E,W��S g�ILDING PERMIT
.
� ; y___..._ COMMUNITY OEVELOPMENT pIV
r � PFOTECiWE INSPECTION SEC
i
� �"°� � CITY HAII FRIOIE� SS�73 MuMeFa AFV 0�*E v�GE o�
�""-'�" '' 612-571-3450 910-F15 3/4/02 / /
108 ADDFE55 �627 Central Ave :VE
1 LEGAI �O1N0 BIOCI( TRACTOH�ODITION
oesca 28 2 Meadowmoor Terrace Additi
1 PaOOERTYOWNEF MAI�ADDRE55
Kathleen Steed, 7627 Central Ave NE, Fridley, MN 55432
7 GONiR�CTOA MAILADOFE55
Kathleen Steed (same address as above)
� ARCMITECTOR�ESIGNER MAILADORE55
ENGIN
6 USE OF BUILDING
Dwelling
1 C1A550F WORN
MAI� ApORE55
ERMIT NO: �
324�1
�>3 7
•vvnovFO er
SEEATT�LMED
SMEET
ziv vHOr+e
763-783-8671
ZIP VMpNE IICENSE NO
ZIP PHONE LICENSE NO
� NEW ❑ ADDITION ❑ ALTERATION j� REPAIR ❑ MOVE � REMOVE
i
B DESGRIBE WORK
Reside house & garage, re-soffit & fascia; replace windows
9 CHANGEOFUSEFqOM
ro
STIPULATIONS
Per Section 1402, 1997 lniform Building Code requires that a weather-
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Except�ons to this provision would be if sheathing is an
app-oved weatherproof panel or when the siding is an approved weather
barrier. Vir.yl siding is not a weatherproof covering unless the
manufacturer s.ates this in the application guideiines.
Call for inspection of wrap before covering.
Ven;ilation must meec Sta*_e Building Code.
Provide smoke detectors in a11 sleeping rooms aad on all levels of the
dwell'_ng per Section 310.9.1.2 oi the 1997 Un�form Building Code.
Caulking and flashir.g for all exterior openings.
SEPAR4iE PERMrtS ARE FEOUIRED FOR ELECTPICnL. PLUMBING. HE�TING,
VENi1L4TING OR RIR CONOITIONING
TMIS PEAMIT BECOMES NUIL ANO VOIO IF WORK OA CONSTRUCTION
/.UTHpqqED IS NOT COMMENCED WITMIN 60 �AVS. OR IG CONS�qUGTIpN
OR WOAK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 170 D�Y$ A7
ANY TIME AFiEA WORK IS COMMENCEO
TVPEOF�ONST �OCCUO4NCVGROUP �OCCUPaNC�LOnD
I MEAEBY CEFTIFY TMA1 I HAVE AEAO ANO E%AMINE� iMi$ AOV�IC�TION S��lLS
4N0 KNOW THE SAME TO BE TFUE AND COAAECi A�� GROVISIONS OF LAW$ yq�UAiION
nND OADINANCES GOVEFNING TMIS TVPE OF WOFK WIL� BE COMP�IED
WiT„ yJMEiMER SPECIFIEO MEAEIN OA NOT TME GAANtING OF A GEFMIT �Z3�OOO.00
DOES NOT vaESUME TO GrvE AUTHORiTr TO ViOLAiE OA C4NCEL TH! pEpMi7FEE
PAOVISIONS O� 4NY pTMEA $TArE OR LOCAL LAW REGULATING CON-
$iRUCiION pR THE �ERFOFMANCE OF CONSTAUCTION $3(j3.2rj
COa'a�ir0ap •�r„OaqEO�GEwr �0�*E� HE PR vvAl
/� ����
C,, �, ���� 5 `�- GG�-�
,u Fo.��pV,..f>B uDf4 �D�� �r �..co
CU FT
PARKING
nRAGES
NEW [] CITY OF FRIDIEY Effective 1/1/2002
ADDN [] 6431 UniversiTy Ave NE, Fridley, W1N 55432 (763) 572-3604 Bldg Insp
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Construction Address: ;� �' i � Y� !� � n' I' �- f� L i /�.� �
Legal Description:
Owner Name & Address: �{11 Gi � t t rJ S( F r i� Tel. #"7�• S',� �-��•�� �
Contractor:
LIVING AREA:
GARAGE AREA:
DECK AREA:
MN LICENSE #.
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length
Length
Width
Width
Height _
HgUGround
Sq. Ft.
Sq. Ft.
OTHER: � �t � � C•. >F � l f' S� i I"
%��r�1LRC'L� G��N ��Cl. �.
Construction Type: Estimated Cost: S :z �� }�(�1J� �
/
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ = S
n �
DATE: �� � G �� APPLICANT: �:,'j�i�'��-Lr -�.'� �f_��/L Tel. # ��G�J - 7�� � t�i�G%�
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
$ _� � �. ,���
.:
g > �. J ;l`
/
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ ] Not Necessary [ ]
STI PU LATI O NS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or strucmre, or for any
addition to any existing buildine or structure, or for any alteration or repair to any existin� building or structure,
upon application therefore. require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provided to-wit
TOTAL VALUE
$1 to $500
3501 to 52,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to 5100,000
$100,001 to 5500,000
$500,001 to $1,000,000
$1.000,001 and up
FEES
$23.50
S'_3.�0 for first ��00 plus �3.05 for each additiorial �100 or
fraction thereof, to and including $?,000
�69.25 for first �2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $2�,000 pius $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
�6-�3.75 for first $50,000 plus $7.00 for each additional
�1,000 or fraction thereof,to and including $100,000
$993.7� for first $100,000 plus $5.60 for each additional
51,000 or fraction thereof,to and including 5500,000
�3,233.75 for the first $500,000 plus $4J5 for each additional
$1,000 or fraction thereof, to and includinQ $1,000,000
$�,608J5 for the first $1,000,000 plus �3.15 for each additional
$1,000 or fraccion thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times �15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times �23.25.
VERIFICATION OF FOLNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacint� an existing furence, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
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, le�gth, number of elbows and tertnination. Yes (�3' No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
The existins� combustion air is sized and instalied to meet the current codes
and manufacturer's specifications.
VVII@il fcGUIfECi tG IiiSiaEi 8 f3@N GO�T�J�iSii3,� uii� ii'�`ll�� vE SIZE� 8i1(�i !^Sia�l°C�.
to meet the current codes and manufacturers specifications.
Yes (w} No ( )
Yes (j,�No ( )
i
Yes (v� No ( )
When installing a new ventinA svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace �/
Venting Tables for fan assisted and natural draft appliances. Yes (v�" No ()
Is the common vent and vent wnnectors sized and installed coRedly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes �o ()
Appliance Tvpe and Size/Common Vent and Vent Connector InformaUon
�
Appliance #1 Type �� -� ��� �-- BTU Input `��' r- Fan Assisted or Nat �l.l % i VC
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type
Vent Height Diameter inches
.4pp!i���.� #1 ��e.^.t Connsctor H=ight ft Len.g!h ft D�ar^.erer in Tyee
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Le�gth ft Diameter in Type
�--
AITFRATIf11JS•lnocr_rihol �;��S�L����/..� ���� �/ti'.rr/ j��/ (�.p.��
/ _ i
f" t� � �k ' � �� � - � 1� � 1,,,�, �_
HEATING CO: A.cL.���C'� !'�+II.�• 4 /���
��
Signed By: -/� 1=� Date :��� i�' �-
P
�
CI�iYOF
FRlDLEY
FRIDLEY MUNICIPAL CENTGR • 6431 UNIVERSIT'Y AVF:. N.G. f{ZIDLGI'. �1N SSd32 •(763) 571-3450 • FAX (763) 571-1287
August 23, 2002
Ms. Kadileen Steed
7627 Central Avenue NE
Fridley, MN 55432
Re: Fuial Inspection at 7627 Central Avenue N�
Contractor: Northern Hea[ing & Air Conditioning Inc.
Dear Ms. Steed:
A mechanical permit was issued on March 14, 2002 to inst�111 a fumace at your address.
According to d�e 1991 Unifonn Mechanical Code a final inspection shall be conducted on
the work authorized by �his pern�it. As of dlis datc the inspection has not been requested.
The permit fee dlat was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your pern�it open for �uiother 30 days and if we do
not hear from you within this time to set up tl�e inspection, we will mark the pernlit "no
inspec[ion callcd Por by homeowner after notiticalion" and �ike no CurU�er action.
To set up d�e inspection or to havc �uiy questions answered, please contact d�e Building
Inspection Division at (763) 572-3604.
D��IIl�l
Btiildin��
Inspections
763-572-3604
�.a � E i - �� -
SITT ADDRESS
THIS AFP�ICA\T IS�.
PROPERTY
ow�r.w
TEn.A\T
CONTRACTOR
SUBAIIT A C'OPY" OF
� oua srnTr.
LICENSE W1TH
AI'PLICATI0IJ
PERMIT TY'PE
TYPE OF WORK:
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FR�DLEY
� L'--7 1'O�]UR E-MAw[L� A�%DDAESS
�� 1 �� � / I��J I V F—
❑ OWNER �lCONTR.ACTOR
?JAME: ,(�'T.1!i-��-� �''-`-y"1
nDnr�ss qa, 9
PHONE: �VJ `� �f � "l • )Io�I I
TAME:
sTnTE�ic�se: Chamnlon ���1� r�x
ADDRESJ:--� B,,�a'I-�3�B5-�3�IC�
PHONE `p� V w�d Rf�. #'IOO F�
�SINGLE FAMILY
❑ NEW
❑ TWO FAMILY
�RFPLACE!vIEkT
Permit No::l�
Received Bv:
Date Rec'd�� �<<
DATE I �- "O")
_CiTS' ST.qTE ZiP
❑ 70WNHOUSE
DETAILED DESCR]PTION OF WORK �(�(��(`�C L_, \ A)(:tSE PQ
'-6
PER MS 166.66� the pemti' fee :s s minimum o($li.UO or 5% of the total cost up to 5500.00, whichever is ereater, for [he
improvement, installation or replacement of a residential fizrure, excluding the fixtures. ("Ihis should raflect only the wsl of labor )
Labor cost under $300 -$1 �.00. C.abor cost between S300 to 5�00 = cost of labor x.0� _
FOR PROJECTS N�'HL'IdE IABOR EXCEEDS $500, FEES ARE B.4SED Oti $I �.00 PER FtXTURE, EXCEPT WHERE NOTED. F[XTURES: (P.�DIC.4TL- iOTAL
NUMBER OF F.ACH BELOW�
BATH SINK.I,AV FLOOR DR411�5 . SHOR'ER N'ATER VIPMG
6.4TFiTUB GAS PIPING �rfncmucF��s� SN7MN[ING POOL WqTER SOFI'!JER ($35)
_ CLOTHES WASHER KITCHEN SRJK WATER CLOSET BACKFLON PREV. ($15)
_ D1SFM'ASHER _ LAUNDRY TRAY" _L�6ATER HE.4TER ($35) FOR [RRIGATION
_ WATER METER _OTHER
—_
PE}tM1'T FEE PROJECTS FOR UNDER $500 ` PERMIT FEE FOR PAOJECTS OYER �500
Pemiit Fze S . U., Number of fixtures @$10.00 x SI0.00 =$
Surchar[;c .50 Number of fixtures @$15.00 x 515.00 =$
TOTAL DLT $ �� Number of fixtures � 535.00 x$3�.00 = 5
State Surcharge = $ So
Tni a l = C
THIS IS AN APPLIC.ATIOiJ }�OR A PLRA7IT-NOT VALID UNTIL PROCESSED
1 hereby apply for a buildin; pe�mi[ and ] acknowledge [hat the information above is complete and accurate; that the work wil] be in
confemiance with the ordinances and codes of the City of Fridley and µ�ith the Minnesota Cons[ruciion Codes; that I understand this is
not a permit f?ut only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approvcd plan in the case of all work which requires review and approval of plans.
SIGNATURE OF MPUCANT
ELECTRICAL Atr'D
City of Fridley
Buil�lingInspections Department
6431 University Avenue NF., Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
TE -� ;I_(!�_
��1���''k
Building BUILDING �er�n;t No :�/�7—c�s!3�
Inspections RESIDENTIAL APPLICATION tze�e��e� By [�
763-572-3604 CITY OF FRIDLEY [�ateRec'd:��___
763-502-4977 FAX �..rr�-�mr i-i-�nn
i>nii _.3_3p �Q _ _..__ _ }���:ai_n�,,,i v�i,urss i_. '_�i_�ndel]r.�� 1.o�L-----
���, �,����<�.. ���.� C�ntC�l ��._Nt_ �c�cL�.A�►,�55�3�.--'�_
Tli1tiN'1'IJCAM�Lti ❑nN'NI(k C�C;UN'I12A('loH
PROPERTY OR'NER/ Nn�iF. �-j-�j ,�j{�_
'1'E.V!►4T - _- __ . __—._ _---- -.. —
vmmr.. `��?�7 c31 �UG_�i�.cn� {'�"IL�_� srnnll!tlUur,55!�E�
������v� i(�3. i�.5(���J
C'ONTRA(TOR NnMi.-�I�P_.IL..�'.. ! .5..�.LJ
SUBMR A COPI" OE (�� t-� �� �1
Y(A1RST.4TELICENSE [fn1t�IJClNSI a._ _ �,�j'S �-.L . ._....-_- ._CXi'nAli 31���1�1—
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INSL•'RA�iCE PHUNI� � • 1�.4ti � � `
PROPN:R'Cl' Tl'PF. 2Q�is'�,i i�-i nMii.vm'i�ti �n�siia�cn�,n� si�.i _�l �_ f-
❑ Iti�nFA'�111.1��NPU���n*151Kn<'llu!J STUItII?5��� _i1� P,Y1`�'2.
PERMITTYPE ❑.���!Hn<�N ❑c�w�aiisiun ❑wiHix�w.
❑ RAtiIiMPNT PINISH 'i�y� M IF ❑ INL11N 711.P
❑IM-CA O9fNNl�� ❑���111R
❑ tiN'IMMIN( 4 N M N.
Ti'P%:nFN�QRK: ❑!:}=.wtNMli�.tYYJti7RIK'��1tMi ❑AI�N�II<NJ
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ROOi7Nf. I ❑ f I(N ISI' t�N1.Y
N�.iMHI=RIiFSIMi.�1ti�:�.�C.y_ �H(ultiFal�A{tAt;i� HA.17:M}MNCM(wFLIN(iS11yAq"1
- I F.v� hl�+�a F'lan
GwRAGES ❑ AT1.4CAPDGAItAGF: . 1'm�xisY.l Ikar pinn
PROi'(ISIiDtiI/}.. ❑!)FIAC{IP.UGARAGI�: ). L�s�ufstrutliwlmrnihersiobeieai
rk�n�cxro rrn:icFi i---�
SID.WG � F�Nt NF W C�1NSlXUCI7l1N IN('l.UU1N(i DI?CKS.
❑ Vm.l ❑4d7n ADD177(NJS. & fK)RClltiti SUHh9 f.
❑/�Mmom ❑ I nm I �tlr 1'lar✓�u�'e� da.ump Ihe e�i�g �tu:Uacc
❑ � Ilher _-_- -... �42 I ❑ I-aA�w anl PnPu'nl Polay
f..n aY> o( a+rtm�clwn phW
K'INDOWS . I�.rkrgr Calculaiioru
INIfXItiIING111`IfNItiGS 07�� Oti.� L�K'iAII��NUI U'IVIH�R'S PnHK'INU��WS PRUVIDhU-VALIJ[SANU
pR F(lR N4: W� �PL'N WGS-I A� 4�'Rlisb �I/,!. � A� MnN1 II'AC 11 IRf-. S71CF:I�R ON WIM]OW.
._. . . _- . ._ _ . . _...... __-_ . ___ .
( IPFMNC; ('}InNGF:ti y�
_
IY[9f�H� N9N1%)W'I�)RPINSI�AI-I1�7) NI�ti1RPRfq'W7NIri)US
ALL FEES ARk: BASED ON �'ALl!AT(ON, �NCLUDI!VG THE COST OF I.ABOR AND MATERIAIS:
TOTAL JOB VALI'ATIO?V 7
Permn Pee G�� 2
Plan Rev�ew
Fire Surcharge
Surchargr
LicertSe Smcharge
SAC ('harge
Curb Cm Escrow
Erosion ConVOI
Park Fer
Sewa Main Chargc
NG 7"HF: 1997 U.B.0 F'EE S('HF.DULE)
8
S —�
S I�1
S �'���
a
S
S
5
See Back Pagefor Fee ticheclule
65�-0 of Hwldmg Permit Fee
W I times the to�al �ob valuadai
.0005 x Pamrt YnluadcM Mmvnum E�0
SS 00 (State Licensed Resid�ual Convactors)
52100 per SAC Ilnrt (Plans �o MWCC for de[ermmanon)
R�6fl= ftxS24=$
$450 Consef�adon Plan Review
Fee DHermu�ed bV EnKineenng
Agreanan neccssary 1 1 Non Necessary 1 1
Msice eYecb wrable to: Citr of Fridky
i 111� I� .1N :AI'YLII Tll� IN !T rµ q V9�.ILAUI-RC�I VAI.IU 11Y'l Ii. Pk� 1C9�Sti1-U
I heret+y applv for a building pexmit an� I a�k�wwledge that ihe mformation above is complete and accurate; that the work will be in
conform3rtce w�th the ordinanco and ccdec of the frty of Fndlev and w�th the Mmnesota Constrixt�on Codes, that 1 understand this �s not a
permit but only an apphcauon for a permn and work is not to start without a permit on site: that the work will be m aaordance wrth the
approved plan m the case of alt work wh�ch reywres re��ew and apQroval of plans
,elUtt.qfuR; �H� A!'IqJC'�M PNlh�l N-4,Aif � �f'�'j�l(1'����}�.4I?� y�����_
. ..._._. _._._._ _.______.. _ ,T7 _ __ -.
VLFAtiF NOII� SFPAR�ITF PFR�llTS aRl� RFO['1RFD FOR PLL'�MBING. F.LLC'TRICAL 4tiD MECHAMCAI.