AF - 37923�,
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City of Fridley, inn
BUILDING PER.MIT
Date: March 7, 1969
��; David Windmeir g�� Clemron, Inc.
Ad�esa A�r�e 4411 Central,_Ave • N. E.
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N° 1012�
LOCATION OP BUILDING
No. 7300 g�t Concerto Curve part of Lot
� 11 _ gl� 3 Addition or Sub-Division Mel odv Manor 2nd Addn .
Corner Lot _ Inaide Lot X Setback 35 � Sideyard . X� 17' f l0'
�� II��q� _ 865 .17 _ 868 i 7
Top of Footing
DESCRIPTION OF BUILDING
To i� v�a �:
Dwelling �ont 26' �P� 39' g�ggt 20' gq, �, 912 10]�, �
Garage Front 28 � Depth 23 � fTeight 10 � Sc!• Ft 6�' Cu. Ft 6440
Type of Construction Frame ��, �_ 26 000 To be Completed
SEWER LOCATION- 692 ' North of Manhole
WATER LOCATION - 82' North of Manhole
In consideratfon of the 3asuance to me of a peraift to construct the building described abave I ag�e to do
the ProPosed work ffi acc�rdance with the description above set forth and in compliance with afl proviaiona of
ordinances oE the dty oP Fri�ey. %_, _ �
00.00 Sewer Con.nection
In comsideration of the payment of a fee of $ 42 . 00 ��t ��by g�ranted to Clemron Inc .
to construct the buflding or addition as described above. Thia Permit ia granted upon
the express condition that the person to whom ft is granted and his agente, employees and worlQnen, in all work
dane in, around and u�n said building, or anypart thereof, shall conform in all reapecta to the orrlinanc:ee of
Fridley� Minnesota regardi�►g location, conatruct��on, alteration, maintenance, repair and. moving of bufldinge
witl�in the dty ]imits and thia perrmit may be revoked at any time u�n viola.tion of aay of the provisions of eaid
ordinanc�s. . � o ,
Official
Su9lding �
Muhich
NOTIC�
Thb peneit d� rtot eove� fhs coestrndioe, ieslall�tae fer �41ae, plambtee, ea 6eMiee, awsr er wafsu B� wra fo sss
tin BuiWieO In�peetor tor apanla paemih Por tbess t»mf.
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A -' _ �
APPLICATION FOR BIIII,DINC PII3MIT
CITY OF FHIDLEY, MINNESOTI
Ot� �S NAME . David Wir�dmeier BUILDHt Clemron, Iac.
ADDRESS ,A�DRESS F�.la.11 Central Ave . N.E.
LCCATION OF BIIILDING
N0. 7300 STREEi� Concaerto Curve, Melody Mancr 2nd
LOT 11 BLOCK 3 ADDITION 08 SIIHDIVISION M. M. 2Ad Add.
CORfiER LOT X INSIDE LOT 5EI'SAt'� �5 � SIDEX�RD 17 �- 10 �
S�'WF�{ EL�'YATION TOP OF FOOTING Curb minu� 6"
Appliaeat attach to this for� Two �ertificates of SurvQy of Lat and
propoeed building locatio� drawn on thee� Certificates.
DESCRIFTION OF S[III�ING
To Be IIsed Ae: Same es 7301 Tempo Terrace
Split Foyer
Re r� idenee Front 26 � Depth 39' Height " 7� 6f� - 8� 0"
10].l.� Upper
Square feet 912 Lower Cubic Feet
agrQ¢e Front 28 � Depth 23 � Hei�ht �I�� �-*
Square feet 6F.11#. Cubic Feet ���` �°'' �
Type of Conatruction FZ'etDe Eetimated Cost 26 i 000.00
To Be Completed 7-1-69
The undersigned hereby makee application for a permit for the work
herein epecified, agreeing to do all work in strict accordance with the
City of Fridley Ordinances and ruli:n�a of th� Department o£ Buildinge,
and hereby declaxea that all the ie,cts and ��::�re�eentations etatEd in
thie application are true and correcte ��
DATE
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B�TILDING PII3MIT FEE SC�ULE
SECTION 2o The Inspector of Buildinge ehall, before iasuing peraite
for the erection of any building or atructure, or for pny addition to any
exieting strueture or buildi.ng9 or for any alteration or rep�ire to sny
eaisti� 'b`uilding or structure, upon application therefore, require the
a � payment by the appliaex►t for such permit of fees to the amount t�erein
below aet forth and i,n the man,ner herei.n provided to-wit:
Uniform Buildi.� Code° Type 19 2, & 4-�'1075 for each one thousaad
aubio feet, or fraction thereof, in euch c�bical a�ntente. Type 3� 5-
;1�a50 fo� ea�h o�e thousend cubic feete
For the purpoae of computing feea for building permits, the cubical
Qoatents of any building or addition to a uniform height throughout by
multi�lying the ground area covered from a poin.t eix (6) inchea below
the �'7,00r line of the baeement or the cellar to the average height of
the upper eurface or to the avera,$e height of the roof eurface of the
main gable of a pitched roof.
Fo�e �e}�a,i�e or e,lteratione to an existing structure, the fee ehall be
at the ra�te of $3.00 per each five hundred dollaxs (i500.00) or
frac�i,on thereof in the cost of all proposed worke
I.n no caae eha,ll the fee charged for any permit as set forth in Section
Q 2 be le�e than $S,OOo
NSSSD Coxu�,ection Char�es based on location - Area 1 or 2.
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LOT 11 BLOCK 3 MELODY MAI�tOR 2''D ADDITION
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HOUSE HEATING TEST RECORD
ADDRESS ����' C���� APT.�`]� OR CI SUBURB�
OCCUPANT OWNER ( �?--�=
HEAT LOSS DATE HTG. INST. GAS CO. METER BAD #
SOLD BY INSTALLED BY -�� -� d
Eleetrieal Work By Gaa Line By
TYPE OF HEAT GA FA �HW STEAM SPACE HTR. UNIT HTR. OTHER
� GAS [jf�SIG � � J. CONVERSION
MAKE �-�-�� �-�' �--�� MAKE OF BURNER
Model �/ `�6f�'. �;f/� Model
Serial ��� ��� y' ��� Max. BTU Rating
INPUT � �� MAKE OF FURNACE
Modal
CONTROLS �t
THERMOST Hea lug Vent Size � � �.
Valve ? IND OF LINER IZE�_NONE
Limit � � Droh Hood Regulator
Limit Setfing �' !!Yy Filters Size Number
Fan Setting �. �� ��•-� � Chimner Loeation lnside � Outaide
Pilof Type Ch(mney Construdion
Pilot Make -� ,/
Pilof Model Smoke Bomb Wiring `� /`�
Pilot Timing ��6 Draft ��- Test Tag �
L.W, Cut Off �` �_ C S, D�or Pressuro— Lighting Inst.
��
Prsasum �m '� Ps�re°ent CO?� Date Teated �^-°Z 9 -
Input CFH��� � P�FE�tif�Z � � ��ompany Testing '
Staek Temp. '��Pereent CO � �<� Name of Tsster i��/�
Form 235
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M i T
r
i �
i �• COMMUNITY DEVELOPMENT DIV.
~ PROTECTIVE INSPECTION SEC.
� _'_
r ; " ';
� � �-�'1 : CITY HALL FRIDLE� 55432 NUMBER NEV. OATE
�""'� � ,'� 612-571-3450 910-F15 4/8/91
JOB ADDRESS �300 Concerto C�arve NE
t LEGAL �OT NO. BLOCK TRACT OR AqDITION
DESCR. 1.1. 3 Melody Manor 2nd Addition
2 PROPERTY OWNER MAIL ADDRESS Z�P
Daue Windmei�: 73QO Concerto Curve N.E.
3 CONTRACTOR MAIL ADDRESS Z�P
L& M Roofing 593 Bezwood Ave, Vadna,is Heights� MN 55127
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP
5 ENGINEER MAII ADDFESS Z�P
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION
8 DESCRIBE WOFiK
Reroof House/Garage (Tear-of�, 22
8 CHANOE pF USE FROM
STIPULATIONS
❑ ALTERATION � REPAIR
�
TO
PAGE OF
� �
20750
AECEIPT NO �
� C� (�ti �� �
APPROVED BY
SEE ATTACHED
� SHEET
PHONE UCENSE NO
484-2197
PHONE LICENSE NO.
PHONE LICENSE NO.
❑ MOVE O REMOVE
On all newr roofs or tear-offs and replacemsr�f roofs,
State Code requires fhat 2 la;�e�s of 15 Ib. fe�i,
mopped together, be ins;a;l�d to a p�int 2� i�che�
up from exterior wall line, ar the use of otha
approved underlayment membrane.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
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. OW
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUAT
UNITS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1 � 144
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $2�a O�
STRUCTI THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FI
�' �� " I
IGNATURE OF CONTRACTOii OR AUTNORI2ED AGENT IDATEI W�.{
� �DATEi
PANCY CaROUP OCCUPANCY LOAO
r CU. FT.
OFFSTREET PARKING
STALLS CaARAGES
SUFiTAX
$,57
SAC CHARGE
Fi.re SC $1.14
TOTALFEE
$30.71
A ID D THIS IS VOUR PERMIT
e � � � � o
� I]
� I ]
AL'I�2 � �
R-1 AND I�2
p,;ldir�g Permit Applicatiari
oa�.rt�� ��: 73U� Co� c�r'f� C'Gt��e
Effective 1,/1/91
� ����: ��f ll � 1 �� k �3 � �,� ��,� /��/� � �� .� ���
a �
owner r�a�e & Aaar�ss: �a v� G�%� c� �1� �1. # 7�� �/%
, -
oontractor: b- � Tel, # `���19�%
='?�?'�: �j g ��...PYu��rD � v-P !/Q�hacS 1Y��� �i�//�� �.l�l:L%
Attach to thi.s applicatian, a C7ertificate of Suxvey of the
lo�t, with ti�e prq�oEed �ian drawn an it tfl scale.
� r: �+� ��M • � •i' �,,�a;�l'/r���;��i
L1vII� ARFA: Le.ngtii Width Heic�t Sq. F't.
Q�RAC� AREA: I�gth Width Heic�t Sq- Ft.
DDCR ARIIsi: Les�gtii Wi�ith Hqt/ S�3• �
�
a►a�t: �.� ro n � �o er �� . T�. ��e � � ,�e l��r�� .°�
(brner Iat [] ?nside Iot [] Ft. Yd Setback Side Yard Setbacks
Z�pe of Oo�nstruckian: Fstimated Go�t: $ f ������� r l% �%�- ��
Approx. �letioaz Date:
Px�osed Driveway width If New Openir�g Is Desired: F't. $ $
Width + 6' See Back Page
� z�1. # `��f� �l � l 9 �
n�: � l� r�IC�,xr:
Piermit Fee $ � ! , D �
Fire S�azge $ /, / `�
state S�u�rharge $ � ��7
SAC Criarge $
Driveway ��csr�w $
Park Fee $
sewer Main ch�rge S
. �.
����� ;_� .. �.
$ ��, 71
�� �^
QTY � Q�Y
Fee Sciyec�ule oa� Rever�.�e Side
.001 x Permit Valuatian (1/lOth $)
$.50/$1,000 Valuatiaci
$650 per' SAC Unit
Alt. nAn Or Alt. p8" AbOVe
Fee Determined by II�gineer'irg
p,gre�et�t xeoes-�azY [ l xot xe�ssa�y [ l
------� On aIt new roofs or te�r-of�s ar.� repi.�ceme�t toafs,
��- ��%� St�tB C�ae requeres ih:�i 2 1ave�s o! 15 @, fe�i,
mopped to�etfier, be installed to a point 24 incAe3
up from exterior wali line, vr the us� of BtAer
approred unAe�taymcnt membrane.
� ,
�
: � 1 � � � � -f 1:��Y� 41 .. :i� : : � �.: I :N � 1 :a
�ve Qzief Huilding Official shall, before issuin� permits for the erectioaz of ariy
buildirg or stn�C4�ne, ar far any additian to any exist,ing buildir�g or �, or
for arYy alteratian or regair to anY e�stin4 builainl or �n�u�e, u�al aPPlication
therefore, require the payment by t2�e a�pplicant for axii pexmit of fees to the amu�nt
herein belcw set foYth and in the manner herein pmvided to-wit:
'!�0►I'AL VAIIJE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25, 001 to $50, �0
$50,001 to $100,000
$100,001 to $500,000
-��
$15 (M� �inimmn Fee is $15 plus �)
$15 for fiYSt $5� plus $2 far each adciitioa�al $100 or
fractiaa'► thereof, to and including $2,000
$45 for first $2,OOa plus $9 for each additional $1,000
oz' frdCtica'i thex�eof, to arid 3.nCludii]�g $25, 000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fractica� theet�aCf, to ar�d includiag $50, 000
$414.50 for first $50,000 plus $4.50 for each additional
$l, 000 or fractioai therecf, to arYi includirx3 $100, 000
$639.50 for first $100,000 plus $3.50 for each additional
$1, 000 or fractioa�► thereof, to ar�d including $500, 000
$500,001 to $1,000,000 $2039.50 for tl�e first $500,000 plus $3 for each additional
$1, �0 ar frdction t�ereof, to at�d includit�g $1, 000, 000
$1,000,001 airi up $3539.50 for the fitst $1,000,000 plus $2 for each additional
$l, �0 or fractioaz thereof
�tIVF�IY ffiPRffiBI�T F�CTmW
(aoa�rete �ri� S'tY+eets �lY)
Altexnate "A" : R�ava]. ar�d re�lave�exit of wrb ar�d gutter only - Driveway width plus
6 feet times $13.50.
Alternate ��g�� ; Re�aval ar�d replaveqnPnt of curb and gutter and ir�tall a 3 foot wide
approach with 6 itrh dept�i -�iveway width plus 6 feet t�m�s $15.75.
`�/�: �� r: M.��� •1" ��:U.i� _ Y•'.I
��; ts for o�tn�ct.ioa� will be is�ed a minim� of 24 hairs fr� the time of
applicaticai to allcw for proper review of the prq�ed stn�ure ar�d of the
oo�ctiaaz site.
A Oertificate of �vey of the lat, showing the locatioaz of the famdatioai a¢�oe it has
it has been vons�ucted will be requ,ired before prooeeding with the fYaming.
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THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
[`OMII�OI` �!F�!Tr ���T C�(`I�EGTnR AND GC�MBI ISTInN AIR VERIFICATInN
When teo�� acin� n exictinQ �ran ., 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 plasticlPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
'rne pY� i���a �eme�stien air is sized and installed to meet the current codes
and manufacturers specifications.
Whe11 requifed to ����� a new cemb�etien air; it will be sized and installed
to meet the cuRent codes and manufacturer's specifications.
Yes( ) No( )
Yes ( ) No ( )
Yes ( ) No ( )
When ip��`�"�� � ne�v ��entin��ye Pm, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does inGude AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes O No O
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
�.. .. .- .�. .i���.� -� .�. -� .��- • � •r�i. •�
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 T_ype _�, _,,,_ _��_ _,_`___.. BTU Input __�__.__ �, Fan Assisted or Nat a
Total Appliances Total Btu Input � -�
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
r � r•► .- .:�
HEATING CO:
Signed By: Date :
Building
Inspections
763-572-3604
DATE � / C� �o
srrE nDDxESS �
THIS APPLICANT IS:
PR�i ERTY OWNER/
TENANT
CONTRACTOR
o/S�UBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROFERTY TYP]C
PERMIT TYPE
BUII1DIi�TG
RESIDENTIAL APPLICATION
CITY OF FRI�LEY
YOUR E-MAIL ADDRESS
��i/G�"C�/Z7`z� C� �.l.�l,��i
❑ OWNER L9CONTRACTOR
�}-f�/� i� �: �� d- /�-/I!1'V
Ess: �?,,.� o C°�N���7a C'-'G
s: 7/0� � `7�3 S— �1�2 �
Permit No.: �-'�`�
Received By:
Date Rec'd: � 'l
� %DN�S p Cm ✓YI
N�:_ RENEWAL BY ANDERSEN TI n.� 5'Gtf F�t/ �f�i
STATE LICE 19ZO COUNTY RD. "C" WEST �� 3�5l�c��'o
anDxESS:_ ROSEVII.LE, MN 55113 CTfY STATE zrn
PH�� 651-264-4777
�G� F LICENSE #20130983 '
❑ T'WO FAI�_ 1RTF.S
❑ BASEMENT FWISH
❑ DECK
�rYrE oF woRx: o
DESCRIBE WORK BEING
SIZE OF IMPROVEMENT
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Alwninum
� Other
`J�'IlVDOWS �
IN EXISTIlVG OPENfNGS � Ol�To
OR FOR NEW OP£N1NGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WII�iDOW TO BE INSTALLED
❑ ROOF
❑ SIDING
❑ SWR�JG POOL
❑ ADDTI'ION
❑ REMODEI_lNG
LENGTH
❑ HOUSE ONLY
� HOUSE 8c GARAGE
O ATTACf�D GARAGE
❑ DEfACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
� • • • � � �•� +
� ,�. ��__ � / �
❑ DRAIN TILE
❑ OTf�R
N�
NUN�ER OF WIAIDOWS �
HEIGHT
B.'1SEMENT REMODELING SUBNIIT•
1. Existing Floor Plan
2. Proposed floor plan
3. List of str�cwral members to be used
F�
FOR NEW CONSTRUCI'fON INCLUDING DECKS.
ADDITIONS. & PORCHES SUBNIIT•
1. Site Plan/Survey showing the existing str�ciures
and proposed project
2. Two sets of consuuction plans
3. Energy Calculations
ALL FEES ARE BASED ON V,ALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCAEDUI:E)
TOTAL JOB VALUATION $ % 8'�C'�% OCCUPANCY TYPE ��j/'>
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due _
$ ,
� °I . �
$ S. cac�
$
$
$
$
e
$
See Back Page for Fee Schedule
6�% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuaxion (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclmowledge 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
germit but only an application for a permit and wo is not to start without a permit; that the work wiIl be in accordance with the approved
plan in the case of all work which requires revi w approval o€plans.
SIGNATURE OF APPLICANT �� pRINT N,qME !�I% SCJ�%��/'(!s DATE S%� (o
�
Page 2- Building Residential Application
BUII.DING PERMIT FEE SCHEDULE
The Chief Build:ing Official sha11, before issui.ng permits for the erection of any building or
structure, or for any ad.d.ition to any existing building or structure, or for �am�y al�ration or repair
ta any existing builda.ng or structure, upon application therefore, require the payn�ent by the
applicant for such permit of fees to the amount herein. below set forth and in the manner herein
provided to-wit:
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certifi.cate of Survey of the lot, showing the location of the e�cisting foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977