AF - 37927�
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City of Fridley, Minn.
BUTLDING PERMIT
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N° '70'75
na�: ;�5.� �
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Ovaaer: .�L� � �� � e� �� Buflder ��-�a.....�... e
AdBress Addrese
`o Tio F Bui �in�c
No. Street art of Lot
Lot �_.�__ Block _�— Addition or Sub-Divleion
Coraer Lot _ Insfde Lot �.� Setback _��..�� Sideyard � � � � � �—
Sewer IIevation �� � � � � F�lon IIevation ��` °Z �
''v,° �� f� �7/��
,
! DESCRIPTION OF BUILDING
T Used •
Front -�� Depth � Height � S4. F't. /
Fro t.�— Depth fTeight ��� Sq. F't
�►pe oP c°tion �-
� F�t. ��,.�`.�. To be Completed _
. /� �'' /�,I
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In considerat[on o4 the isauaace to me of a permit to c
the proposed work in acc�r�dance with the d�scription above
ordinances oP the dty of Frldley.
Ea conatderation of the payment oP �, fee of
l above I agree to do
with a'lt proviaioas of
ia hereby �raated to
to construct the buflding or addition as descrYbed above. This permit is granted upon
the expresa candition that theperson to whom it is grented and hia agents, employees and worl�nen, in all work
dane in, around and upon said building, or anypart ttiereo� shall confora► in all reapects to the ordtnancee of
Fridley� Minnesoffi regardin� lpcat[on, conatruct�on, alteration, maintensuc�e� repair and moving of buil��
wri� � dty Ifmits and ttua permit may be revoked at aqy tiy�e �� viq�a6�on of aay of the provia�lona of sa�d
/ 1 f I
Bufiding Inspector
Nonce�
16b psemi� dea eot eewr ths eoasfrodiee, hwtaq�lien ter rrh�e9. P��+�6. 9a 6�aHeg, sawr er wNsr. 8� wro h iee
tln Boildto8 losp�efsr isr aparab p�rmhs for Ik�ss h�.
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APPLIC�TION FaR BIIII�DING PE�IIT
CITY OF FRIDI�Y, MINNESOTg
• . - �� _ �.: ;�f .�-;� ���'�`� � � _
�ddress
HUILDING
No. f�/C� Street �����(����� Part of Lot
Lot /F`� Block � Addition or Su'�li�v3.sion -__� ���
f
Corner Lot Inside Lot t/'i 3etback �S � Side-Yard /� �
SEWER ELEVATION FOUND�TION ELEIiATION
�pplicant attach to this form Certific�.te of Survey of I�ot and proposed buildiu�
location.
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DESCRIPTION OF BUII�DING
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Type of
To be Completed
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The undersigned hereby makes applica.tion for a permit for the work herein specif3ed,
agreeing to do a11 work in strict accordance with the City ardinanc�s and ruling of
the Department of Bui].dings, and hereby declares that all the facts and reprg� ntations
stated in thia apl�].i�atior�are true and correct. �, � �
DA7.'�
(� Schedule oP Fee Coats can be found on the Reverse Side.)
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BTJILDING .PERMIT �E SCHEDIIIE
Sectioa 2. The Inagector of Buil.dings shall, before issuin� any permi�t for t.be
erection of any buildin� or atructure, or for any addition to any ex3.sting buitd-
ing or structure, or for an�r alte.rations or repa3rs to any exi�t�.ng bu3lding or
structure, upon applicat3.on therefor, require the payment by the applicant for
such permit of fees to the amount herein below set forth and in the �ter h�ein
provided to-�wit:
2.1. For s,ay such permit for the erection of aay f3s�-proof buildiug, other then
a garage, warehouse, factory or �rain elevator, or for the erect3on of any ffrar
proof addition, for similar occupancy, to aDy exi.st9,ng bu3lding she].1 be et the
rate of �1..L�0 for each one thousand cub3c feet, or fraction thereof, fn sueh
cubieal contents. �
2.�. For eny such permit For the ere�t3on of any fireproof gersge, �ehouse�
factory or grain elevator, or for the ereation of ang Pireproot additioa, f�
eimil.er occupsney, t� eny exiating build3rig ahel.t be et the rete of �►1�25 fOP
each one thousand cub�.c feet� classified as ��firepraof� by Section 502 0� the
Minneapolis Building Code.
HOtTSffi
2.3. For any such permit for the
ths.n a garage, werehou$e, faetory
sddition, for similar ocaupanoy,
eacsh one thouea,nd cubio feet.
GARBGES
�
erect3oa of aoq non-fireproof bui].d3.ng �th�
or gra3n elevator, or aAy ao�f3repraor
to any exist3ng build3ng. Permit �1.00 for
2.�,. For any euch permit for the erection of aay non�firepro�f gsrage� warehause,
factory or graa.�..n elevator, or for the erectioA o� a� nen•firepre0�' gdd3tiou, for
similar occupancy, to any existing buildia� or for ea.ch euoh building o'r addStiop�,
Ninetg Cents for'ea.ch one thousarid oubic feet or f�action thereQf, ia the cubioal
con�ents thereof with a minimum of $4.00.
For the purpoae of computing Yees for building permits the cubical copteut.s ei auy
build3ng or additiori�to a un3fbrm height throughout by multiply3eg the greuad eses
covered frc�m a point s3x (6) 3.nches below the floor line o� the 'baaement or ael7.ar
to the ave�ra�e height of the upper surface or to the e,vera�e hei�ht of the roef
surface of the main ga.ble of a p3tched roof.
2.5. For repe�3.�s or alterations to an existing atructure, the fee she�ll be dt tho
rate of �3.00 for each Fine Huhdred Dollers ($500.00j, or f�e.etion thereoP i.0 the
coat of e11 p�oposed work.
2.6. In no case shall the fee char�ed for any permit as aet forth 3,uu Seetion 2 be
less th�n �4.Q0•
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Land Plo��nin9 6875 H�hnocf �CS ALE.
Land Surveyin� Minneo�o�s 2/,
SnrlsTestm9 EN G I NEE R I N G� I N C. "'����°'°
c,��i � ti�,�,�;�i su��f 4-6'0�
E���neerinr� E%19ineers � , Survec�ors
certs�icafe o� sus�e �or - E�: M DEYELOPMENT C0.
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t�IOTE �-
t. Eleva4ions SY+ewh ora Prapos¢d
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o nEtvoTES IRoN � UENoTE5 DRAINAGE � UTILITY EA5EMEt�T
LOT 10 BLOCK � 3 MELODY MANOR 2'� ADDITIO�I
��noka Coun}+� — Minn¢'o�a�
/ hr�by c�rfi�y f(h� fhis �s o fi�a a�d mr�cf npr�sarrfofrrari o�'a su�ry �'flae b�or,.,do�es y�� abo,r alsu�bed to�,d, ee�d
�/fr �a�caf�inn q%U bvildri�s ,lhitar� , a�dl nSI�✓E p�vp0�%nndlff ,��a�, �nm ar r►.toid /ar�d. As surveyrd � r� �his _ obt�
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City of Fridley, inn N° 8 5 9 8
BUILDING PERMIT
Date: NOVENIBER 12, 1965
�r: MEL FOSSUM B�� J, R. PAULSON' BUILDER, TNC,
Ad�re� Ad� 320 North Ed�ewood
Minneapolis 27, Minnesota
LOCATION OF BUILDING
No. 7310 S�t CONCERTO CDRVE Part of Lot
Lot �0 _ Block 3 Ad�iition or Sub-Divlaion -- �LODY MANOR, 2nd Additian
Corner Lot _ Inside Lot x � Setback .� Sfdeyard'
3ewer IIe�Btlon — Foimdaa�on IIevation
DESCRIPTION OF BUILDING
To be Used as:
�Yont DeP� Height Sq. �'t. C�. FL
�iont Depth ITeight Sq. Ft Cu. Ft
Type oP Constructlon Frame �y� �_ 18 25 0 __ To be Completed
REBUILD HOIISE AND GH�C GARAGE � STORM DAMAGE
In c�sideratlon of the fsauaace to me oP a permit to construct the buildin� described above I agree to do
tha proposed work in ac�rordan� with the d�acription above � o��th�:�d� compl�lence with afl proviaiona oP
�'dlnancea oP the dty oP Fridle . �� �.��
In ca�nafderatton oP the payment oP a Pee oP � 1�0--� permit 9s here�+Y granted to J. R. PAULSON
BUILDER, IftC. to canatruct the building or addition as described above. This �t is grantsd upon
the exAress conditton thst theperson to whom it ie granted and hfe a�ent�, employees an worl�nen, in all work
done in, around and upon eaid buildia�, or any pert thereo� ahsll ecnPorm in all respects tfl the o�dinancee oP
Fridley, Minaesota �egardin�g location, conatructlon, alteration, maintenance� repair and movin� oP builain�e
o��� dty ]imits and tbis permit may be revoked at any time upon vlolatlon oP aay of the provlsiona oP sa�d
ATT•F.N G� JENSEN 8��6' �
n NOTIC6a
'nds p��b dea eo� aewr fha ao�uaN�. datalNHon fe� �ririno, p�umbWO, �a 6saHn9, aw�M or wabr. � w� h a�
th� 6utidl� in�or to� apuaN � hr f6�a Ihen.
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ADDRESS
. . . ._. . �
APPLZCATIOPQ FOR BUILDINQ PERMIT
CITY OF' FRIDLEY, MINNESOTA
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LOCATION OF BUILDZNG �
'.-N°�____.��,�� Street_ _._..�P�-Lo ���...�
� ��j `��-�_
L�T�_____�LOCK � ADDITION OR SUBDiVISION /�����' ��t�ret�� �
Coraer yot`_Insid� LaT � Setback Side�Yard
SEWER �LEVATTON .FOUNDATiOR.�LEV�TION�� .,.__
Applicant attach to this for•m Two Certificates of Survey of Lot and proposed
building location drawn on these Cestificates.
DESCRIPPTON OF BUILDII�TG
To used as; �
Front Depti��_�eight
,oLe l � ���� � � ,�? .
��;e���T " Sq. Ft. Cu. Ft.
Fzcrat Depth ��geight
Sq. Ft. Cu. Ft.
Type o� Coagtruction �� Estimated Cost �� Z��
To be completed �� � s — � �
,.—._,.,
q'he �ders3gned hereby makes application for a permit for the work herein specifierl,
agreeing to do all work in strict accordaace with the City of Fridley Orciiaances
and rulings of the Degartment of Buildings, and herebq declares that all the facts
and representationa atated in this application are true and correct.
������
(8chedule of Fee Costs can be faund
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Reverse Side).
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gttn.nr.Na PEIiffiT � _ S�•B "
SE_CTION_2. The Iaspector of Buildinge ahal.l. before ieauiag ang �rmit for ehe
erecCion of any building or atructure, or for any addition to any existing build-
ing or etructure, or for any alteraCiona or repairs to any exietin� building or
structure, ugon applicativn therefoxe, require the paymeat bq the applicant for
such permit of fees to the amount herein below set forth and ia tha.me.�er heureia_.
provided to-wit:
2.1. For any auch permit for the erection of any fire-�praof building,
other than a gara�e, warehouse, factory or graia elevator, or for the erection
of any fire-proof addition, for �imilar occupancy, to any exfsting building,
�ball be aC the zate of $1.40 for each one thousand cubic feet, or fraction
thereof, in euch cubical conteaCs.
2.2. For any such permit for the erection of any fire-proof gara�e,
warehou�e, factory or graia elevator, or for the erectioa of anq f3re-proof
addition, fox similar occupaacq, to any existiag building shall be at the rate
of $1.25 for each one Chousaad cubic feet, classified as "fireproof�' by
, Section 502 of the MinrieapaLis Building Code.
HOIISES
�
2,_ 3. For any such permit for the erection of any non�€ireproof building, -
otber than a�arage, warehouee, factory or gra3n elevatos, or aay aon-fireproof
addition, for aimilar occupaacq, to any existing building - permit $1.00 for each.
one thousaad cubic feet.
GARAGES
2 4_ For any auch perm�tt for the erection of any non-fireproof gar8ge,
ware6ouse, fectory or grain elevator, or for the erection of anq noa-fireproof
addition, for similar occupancy, to any exisCing building or for each such
buildin� or addiCion - ninety cents ($0.90) for each one thousaud cubic feet
or fraction thereof, in the cubical contents t�ereof with the mia3mum qf $4.00.
For the purpose of camputing fees far building permits, th� cubicai eonCents
of any buildin� or addition to a uniform he.ight throughout by multiplying the
ground area covered from a point aix (6) inches below the floor line of the
basement or cellar to Che average height of Che upper surface or to the average
height of.the roof su,rfaee of the maia gable of a pitched roof.�
2` For repairs or alterations to an existiag structure, the fee shall
be aC t6e rate of $3.00 per.each Five Hundred Dollars ($500.00) or fraction
thereof in the ceat of all propoaed work.
2_ In no case shall the fee charged for any permit as set forth in
Section 2 be less than $4.00:
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Date: APril 29, 1970
City of Fridley, Minn-
BUILDING PERMIT
pwaer. John W�� Gassner ' g�� Same
A� 7310 Concerto Curve N.E. Ad�g Same
LOCATION'OF BUILDING
No. 7310 S.�t Concerto Curve N,�E. ,� p� of Lot
Lot _ Block Addition or Sub-Division �
Corner Lot — Ins�tde Lot x Setback _._._ Sideyard
Sewer Elevatian
Foundation IIevation
��"`"`" �
�: 1061�
DESCRIPTION OF BUILDING
To be Used as:
PQrch Addition �t Depth Height Sq. Ft. C�u. F't
Front Depth I�eight _.._.. Sq. F� Cu. F't.
Type of Construci3on= Frame �� $1, 000 . 00 To be Completed 9/ 1/ 7 0
.s ` �
In cona3deration oP the isauance to me of a permit to c ct the bwilding described above I agree to do
th� proposed work 9n accordance with the description above forth and in comp�ance with a�l pravis�tona of
ordinances of the dty of FridleY• !l f �� I/,�
In conaideration oP the payment of a fee oP $ 6. 00 ��t � b�by �� � Joha W. Gassner
to construct the buflding or addition as described above. Thisp�rm� t is granted upon
the egpress condition that theperson to whom it fs graated and his agents, employees an� worlmnen, in aII work
dane in, around and upon eaid building, or any part thereof, shall conform in all reapecta to the ordinances of
FridleY� Bdinnesota regarding location� conatrucL�Ton, alteration, maintenance, repafr and movYng of bufldings
wio��� dty limits aad this perrmit may be revoked at any tiine upon violation of aay of the provis�tona of said
�
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Buildin8' Inspector
HA.NK F . M[Jf1ICH
NOTIC�
'11�s psrmit d�s eo1 eevse t6e son�eaeHon, Installadon fse �rhtee, plumhing, ea heMtng, sswer er wa�ar. 8� suro to �
t69 Bnildtng le:ptetar for apsrate parmi�s Po� t6as It�ms.
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNEA' S. NAME :�A 3 3NE� � To�11�1 W BU�LDER: S6t1�' .
annx�ss:,3to �ow�eero Caeud- ann�ss: 5�.,.��
N� s e /�/O SiI�L'1:/1 i� ONC���O
LOT; BLOCK: ADDITION:
CORNER LOT: INSIDE LOT:�,_SET�ACR: SIDEYARD: "
Applicant attach to this form �o Certificate� of Suavey of Lot and proposed
buildiag �ocation drawn on theae Certificatea.
HESCRIPTION OF BUILDING
�Be Usgd A�: .
o l'�
�D'YI Fron� Depth : Height :
Square Feet: Cubic Feeic:
Froat: Depth: Height:
Square Feet; Cubic Feets
Type of Conetructions �Yo � P , Eatiwated Coat: $/p��v. °� �
To Be Completed : 9`t `1 p
T�e undersigaed hereby makea applicatinn for a permit for the work herai,a
epeci�ied, agreeing to do �ll work in attict accordance with the Citq o�
Fridley Ordinances aad ruliags of the Depart�n� of Buildings, aad �►eseby
declares that all the facte and repreeentations atated in thie applicatioa
ase true �d correct.
nA�: ' 2 4 19'Z o SIGru�:
� (See Reverse Side For Additional Informa on,�
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lBUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspectox of B�ailding� shall, before #.s�uing pexn�its foz the
erectioa of any building or etxuc�ure, or fo� axay additiaa to aay exieting
buildin,g or structuse, or for any alteratio� or rep�irs to any existing
buildiag or sCructure, upon applic�tian �herefosre, �require the payment'by the
applicaat for auch permit of fees to the amount herein below set forth and ia
the manner herein prwided to-wit:
UDTLFOR2i BUILDING CODE: T�ipe 1, 2� 4-$2.15 for each oxie thousaad cubic
feet, or fraction the�ceo£, in such cubical content�. Type 3� 5-$1.85 for
each one thouesad cubic feet.
ADDITIONAL INFORMATION
For the purpose of camputfng fees for buildia� p��ite, ths cubical conteats
of any building or additiona is determined by mmaltiplyiag the grouad area
c�ered fram a point eix (6) inch� below tlac� floor lfn� of the baseaeat
at the cellar to th� aver�ge heights of �hs upper susf�� or to th���ve�sg�.►
�heigiat of the roof surface of ti�e m�in g�bl� of a pitch�d roof.
For repairs or altexations �o an �isti�g �tnac�aar�, �'th� f�e ��all b� at �he
rate of �3.OQ per each £ive eaundged doll�ag� ($5�0.00) or ��cti�n there�of in
tlie coet of all propoaed work. _
Ia ao caen ehall the fee ch�r�ed for �ay pes�it a� �et for� imm Sectioa 2 be
lees thaa $5.00.
VARIFICAT�OA1 OF FOidAiDATiON
I+I�TE: .Pmsmite for c�anstructiaai will be iasued a m�imum of 24 hour�a fsom ths
tiaa of applicatian, to allow for proper review of the proposed etsuctura aad
of the canetivction aite.
A Certifi�d Surveq of tho lot, �hawing t,he lo�at�.on of th� fouadation, �nca it
hs� ��bean constructed, will be required befoffie �eoc�edia,*t vith tiae fsaming.
CERTYFICATE OF OCCUPANCY
Application for a �ertificate of Occupancg �hall b� madn ten (10) daye prior
�o tine use or occupaa�y of � etructure foP wbich a bufldiag permit ba� beeu
., �:seued; aad eaid �tructu�ce shall not be used or occug�'�d until a Cartificate
of Occtitp8acy hae been ieeued.
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SUBJECT PERMI, . �
c�ty of Fridley 2168
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T '
t
; � CEIP .
� ' COMMUNITY DEVELOPMENT DIV. ���/ �
� �L --_-'-�
r � � PROTECTIVE INSPECTION SEC.
1 i i
� /'��1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�•"'� � ,�� 612-580-3450
910-F15 6/7/73 � �
JOB ADDRESS 7310 Concerto Curve N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. j,O 3 Melody Ma.nor 2nd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
J. W. Gassner 7310 Concerto Curve N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
►S8S11@
4 ARCHITECT OR DESIGNER MAIL.ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUIIDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK Construct 40' x 16' Sw3.�ing Poo1
9 CHANGE OF USE FROM TO
STIPULATIONS �intain 10 foot horizontal cleaxance or go underground with the
house electrical service. See Health Inspector's memo dated June 6, 19 3
having 10 stipulations.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TMPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOC�. Fi�2
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTAUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R�Z
OR WORK IS SUSPENDED OR ABANDONED FOR A PEFiIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET 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 VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �1�2SS .C3
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- 9, OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � �
PLAN CHECK FEE TOTA� FEE
$9.63
���' NATURE CONTRACTOROR UTHORIZEDAGENT IDATEI EN PROPERL V IDATEp TH�S IS YO R ER IT�
, � � � ��'��•v � �' - �3
IGNATU OF OWNER (IF OWNER BUILDERI IDATEI BLDG iNSP DATE
���v', �-
, ,.�G / �
�O
A�PLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
owr� � s rlar� : .� � , �'� � s ,v � 2 $uzLn� s ��-c G`
ADDRESS :_ 7 C� ( r� �t1C��,��a �P u ADDRESS •
N0: .�� io STREET; Ca .vc E2 T�
LOT • % U BLOCK: � ADDITION:�i._ t���y /`/�7ti c,e �2 ` H,/)�rsai,J
CORNER LOT; INSIDE LOT: �'e SETBACKs SIDEYARD;
r
Applicant attach to thia form 7�ao Certificates of Survev of Lot and proposed
building location drawn on theae Certificatese
�ESCRIPTION OF BUILDING
To Be Ueed As;
, , �
-�.�rtz u�,��°�Front: �6 Depth; f So Height: ��
___
Square Feet : ( o Cubic Feet :_ ,�j� � Q
Front• Depth: Height:
Square Feet; Cubic Feet:
1�►pe of Conat�ruction: %,�!�,Q� --�j � Estinrated Cost; $%�,�-�'j, °�
n
To 8e Ccnnpleted: _�t� � y �, ��� 3
, The undersi�ned hereby makes applicativn for a permit for the work herein
epecified� a�reei� to do all work in st�ict accordance with the City of
Fridley Ordinaace� and rulinga of the Depaxtment of Buildings, arid hereby
�r 9 U(� declares that all the facts and representat�.o�a stated ia this application
�3 are true aad correct.
�, g.�3 '
na�: � �°� siGru� •
��
e
- �.
(See Reveree Side Fpr Additional Info�at o.) .
- i� /� �a�-�`'� , C.:�,�.� � :L2-�...Cx�vt,Cz� �'L �0 .C.La'�CQc�1, —
�2c5-�-e.-� ..C,�J,t.�,�v -��(�c.t..¢R� ,�e�Z,e,�e,e.�J • �-e_e�
���in'z.o , �r�.e� (o , � 9 �3 od
i �
BUILDING PERN1�� �EE SCHEDULE
SECTION 2. The Inspector of Buildings s�all, before issuing pernnits �or the
erection of any building or structure, or for any addition to any existing
building or stxucture, or for any alteration or repairs to any existing
building or at7cucture, upon application �herefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in
the m,anner herein provided to-wit;
U1�IFORM BUILDING CODEo 'Ij'pe 1, 2& 4�$2.15 fo� each one thousand cubic
feet, or fxaction ther�of, in such cubical contentse Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
�or t�e purpoae o�E camptating fees for building permita, the cubical contents
o£ any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or tl�e cell�r to �.he �verage heights of the upper surface or to the avera�e
heigl�t of the roof surface of the ma.in gable of a pitched roof.
For repaira or alterations to aan existing structure, the fee ahall be at the
rate af $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cest of a17. proposed work.
Tn no caee shall the fee charged far ainy pe�nit as sa� forth in Section 2 be
leas than $5.OQ,
V�RIFICATION OF FOUNDATION
NOTE: Permits fox con�truction will be issued a mini�uum of 24 houra from the
time of application, �o a11ow for pxoper xeview of the proposed structure and
af tt�e aonstructioaa s�.��o
A Certifisd Survey of the 1ot, showing the location of tlie foundation, onee it
has b�een constructed, wi11 be xequired b�fore proceedin$ with the framing.
CERTIFICATE OF OCCUPANCY
Appliaatiox� for a Cextificate of Occupancy shall be ipa.de �ten (10) days prior
to tha uae ar occupancy of any atructure for whic� e building pertnit has been
i�sued; aud said e�xucture shall not be used or oc�up�.ed until a Cextificate
of Occupancy ha� been f.ssued.
[and Plann,ny
lo�nf Sur�vPClin�
So�l.s lesl�i�9
C�wl b Aluna,�,ol
En�ri�ecr�n�
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��� (B7S Hr9hn�y �CS NE.
�t9u�n��ofv,is 21,
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En9ineers � Sur vec�o�s
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- NOTE •.- �
�. Eleva4ions S4�own ars Pro�ev.ea
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I.0 T 10 �i.0 CK 3 1l�Ei� ODY M��R 2�� ADD �'T' IO,�
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SUBURB�ItJ ENG;NEERING . INC.
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Swi.a�mic�g Pcal Sti�latione ,
l�z. J. �. Gseener .
�1�10 6oucerCo Cuave bi.B.
p18n �av'iews . .
1. Yard og stepo to poo2 muot be fenced o� otherwiae psoteeted.
Z. No divir� Board. -
3• A turnover rata of 12 hcrare is. requ�re�d. I�eA't �heck, this b�cau�e
no pump or filter is ind�cated. We es� getting 7 to 9 house turnover
oa private pools.
�• Ot�a eki�s snd two i�lot,' � 8 mini.�m ebauld be prwided.
5. P�cavido e b�Ck siphonc�ge devi�a on w8ter linq ineide cf hota� to puteids
epi�ot if garden hos� ea�ed Co fill pool.
8. AlI elnetricel woxk �� be epproved by tbe 81�ctri�l Inepector.
i. Psavicte �tepet from poal.
8. �CO�i�1et A te�t kit snd eefety e�uip,nent,
9. �&�etic t�ill be prwidQd aa aha�m ou the Sket�b.
10. No el�cttical line8 ailo�ed wer pc�o1 e� noted.
0
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P'LANS �PPROiI�D � 6, 1973
HAkiVEX 1. A�C�i�
HEAL7� LbI�PECTO�
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CI�Y OF FRIDLEY
HEALTH AND SAFETY INSPECTION
Bus irrES s rur� : Ls .� n�� :_�,�� �, / 5 7`3
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OPERATOR : �, , �
ADDRESS : ,�,�/t� ',�= �a� �► l� _ _ _ o �1'E OF' BUS . e
On this da.te, the hea.lth authority made an investig�tion of the subjec� fac�Yity.
The deficiencies noted at this time and the neceasary corrective measurea are
�iven below. If you have any qu��tion� concernia�g this �at�er, please feel free
to call on us at our o€fieea (City Hall, 6431 Univexsity Avenue N.E., Fridley)
Telephone 1Vo. 560-3450, Ex. 41.
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COIYlPLIES WITN OFFICIAL STAN011RDS ' LJ �-�I � v L��) `
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NATIONAL
�,u,c�oo� ,, , � Standard Models Available
�NS��T"TE . 1/3 H.P. -- 9'la sq. feet filter area
• 1/2 H.P. —133/a sq. feet filter area
' (with off-on switch)
_` '� ` , • 3/4 H.P. — 203/a sq. feet filter area
;.
(with off-on switch►
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3 Position Valve —
Diatomaceous Earth Backwash Filter
HAIR AND LINT POT
Again Dough�y provides more — a larqe 5'h-inch, weighted, re-
movable basket assures adequate protectioa for the pump from
debris. The tremendously increased area provided by Doughbay's
basket assures continued flow even thouqh substantial amounts
of material may be trapped in the basket.
SPIN-SURE° PUMP IMPELLER
Pat. No. 3,594,102
Another poughboy first! This impeller completely eliminates
the problem of corrosion of the steel motor shaft while running
in the water chamber of the pump.
The rust and corrosion protection feature� mentioned above is
actually a secondary benefft. The primary ;� _
function of the SPIN SURE� impeller is to ,`_`
provide safety for you. By totally encasing � �
the steel motor shaft in an insulating material -�� �� �''� y
there is absolutely no possibility of electric ���� ��
current being transmitted through the motor � h�
shaft into the water chamber of the pool ��
and subsequently into the swimming pool. �
FiEAVY DIJTI( PIJNiP ,4�9D f!li01'OR
Doughboy's new
whisper quiet
pump is the re-
sult of proper en-
gineering and the
application of hi-
icnpact molded
products to pro-
vide a pump which
is impervious to
pool chemicals
and completely corrosion free. The combination of the SPIN-
SURE� impeller and the heavy duty pump provides greater
flow during the entire filter cycle.
R E L I E F-O-MAT I.C°
Pat. IVo. 3,608,725
This EXCLUSIVE DOUGHBOY
FEATURE removes the necessity
for manual release of air from
the filter system on a daily basis,
as the automatic system is in
operation at all times.
�ALANCED FILTER
�LEMENT ASSEMBLY
The newest and most efficient inter-
lockinq element construction known
to the swimmuiq pool industry.
The ELEMENTS ARE SPACED
ONE FULL INCH APART to provide
proper flow and distribution of the
�ilter aid and to assist in a high level
of efficiency for filter cleaning.
, Y ±�
Each individual element grid has scientifically engineered orific-
inq to provide for total hydraulic balance through the entire
element assembly. It is the coupling of this hydraulic balance
in each grid with the balanced design of the POSI-LOCK�
manifold itself that provides a totally balanced system.
��_
POSI-LOCK� ` �`�.�, , �, .
13RID MANIFOLD �``���qk
Des. Pat. No. 218,51� Pat. No. 3,536,195
This EXCLUSIVE DOUGHBOY, FEATURE provides for the
positive rotation of the grid assembly. Each qrid and each spacer
is indegendently locked to the permanent manifold system, thus
assuring positive element rotation to provide proper cleaning.
Another important feature of the POSI-LOCK� manifold is
balanced hydraulic flow during filter and backwash cycles.
THREE POSITION BACKWASH VALVE
DOUGHBOY'S EXCLUSIVE THREE-POSITION V.ALVE is de-
signed for complete filter cleaning with the minimum amount
of effort on the part of the operator.
Doughboy's valve has a positive locking position in all three
operating zones; thus, avoiding the inadvertent movement of
the handle during �ilter operation.
By merely rotating the handle in a clockwise
,o,� direction (apprnximately one quarter of a turn)
- with a sliqht upward pull, the valve will find its
~ _ own internal guideway and slide upward to the
PUMP �`�� next position.
FlLTER
. � S'
1. FILTER POSITION
With the valve in this position the wat� flow pattern is
that which is required for normal filtration of the swim-
ming pool and is also conect for the addition of the
iilter aid to the unit.
- - 2. BACKWASH POSITION
_ �;
PUMP :� �L�., R With the valve in this position the entire force and flow
__ „ of the pump surges on a reverse pattern thru the element
--= assembly for proper cleaning. The process of cleaning
wA� the grids from the inside out combined with positive
tati th ultim t' cl
_� ; ro on assures e a e m eaning.
CLEAN-O-CATOR° Y 3. VACUUM TO WASTE
BACKWASH II�IDICATOR GAUGE k The Vacuwn to Waste position is designed to allow you
:� �� to vacuum an extremelY dirty swimming pool dii�ectly
Pat. 1�l0. 3,622,00� �?�, out the waste port without contaminatinq the filter unit
This EXCLUSIVE DOUGHBOY FEATURE itself. Ia addition to this very important funetion, you
P""P may also empty the pool by using a vacuum set or
provides a complete non-mechanical indica- ;o =° ott►er suitab�e suceion liae and a
tor to tell the o rator when the filter unit �fi'° �!� ` � P�P� �e en�e
Pe �-�_ r volume of the water without the necessity of forcing it
is in need of backwash cleaninq. WA�� through tk►e element assembly.
�Doughboy Recreational
■ Domain Industries, Inc. 10969 JEHSEY BOULEVARD / CUCAMONGA, CALIFORNIA 91730
Printed in U.S.A.
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sue�ecr
City of Fridley ^U ILDING PERMIT
AT THE TOP OF THE T1N�NS K
LJ
�
� �
� �` COMMUNITY DEVELOPMENT DIV.
J� 1�• i PROTECTIVE INSPECTION SEC.
r � � PA6E OF
� i i---1 � CITY HALL FRIDLEY 55432 NUMBER nEV DATE
�___.�' '•� 612-571-3450 9t0-Ft5 6/16/98 � �
10B ADORESS 7310 Concerto Curve NE
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL
DESCR. Z�p
2 PROPEFiTV OWNER MAIL ADDRES$
Richard/Sheila Hanson 7310 Concerto Curve NE Z'P
3 CONTRACTOR MAII ADDRESS Me dowbro k R �
Wellington Window & Door Co 3928 St Lc
4 ARCHITECT OR DESIGNER
MAIL ADDRESS Z�P
ZIP
5 ENGINEER MAIL ADDRESS
8 USE OF BUILDING
Residential
7 CLASSOF WORK � NEW
8 DESCRIBE WORK
Window Replacement - F�isting Openings
26265
RECE� �PT NO
3�0 �
APPROVED BV
SEE ATTACNEO
SHEET
PMONE
�1%-�Z1�
PHONE LICENSE NO.
rk, MN 55426
PNONE LICENSE NO.
PNONE LICENSE NO.
❑ ADDITION O ALTERATION �7 REPAIR ❑ MOVE � REMOVE
TO
9 CHAN(iE OF USE FROM
STIPULATIONS
TVPE OF CONSr
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. U�
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED @
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT y��7 s OOO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEqMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �112.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ei eu r.WF(:K F
SIGNATURE OF LONiRACTOA OP AUTNOR�2ED AGENT IOATEI -�
i�GNATU�iEOFOWNERUFOWNERBU�LOERi IDATE� ��
.�
DCCUPANCY CaROUP
Sa. FT.
OFFS
STAILS
Inv.Fee
$112.25
OCCUPANCVLOAD
CU. FT.
f PARKING
$3.50
1C CHARGE
Fire SC $6.00
�TAL FEE
$234.00
THIS IS VQU����
�
JUN-16-'02 TUE 13:49 [D:
Prepaid Plaa Check S
Estimated Cost $
Reeeipt #
TEL N0:
CITY OF FR�LEY
R-3, COD�IIViERCIAL & �VllUS
BUILDING PERMYT APPLICA7CY�
#185 P01
Effective 1/1/98
• ; -r (p �
� _��� �1
N `� ��
Cbnstruction Address 7 310 � o��e�'�'p c.� ��� �
�1 7 3 � cJ C: � n c,� �'o G :� � � e - - - - - - -
Owner & Addzess �.�c.� �- �¢ � Id Y�o c�� bl# �71 �' ��
o��cn�R & �x�ss �J e�) : kQ ., W , �..� � 1� � Ca . � , �. � � 9 - b�3�
Architect Re9.# F3�gineer "��� Reg.#
BUILDYIVG CONSTRUCTION
'I'YPE OF FbRK t� New t� �a�.��.on t� ,p,lt�ti� -�5�� w��do� re �)o c,e �-.e, �•�'�
�
2 iC �g �;�, o�p'� t� ��. S
�
OFC. AREA: Length � Width Height _ Sq. Ft.
WHSE �,RFA; L,ength Width Height Sq. Ft .
C!I'F�3t ARFA; Length Width Height Sq. Ft.
APPLICANT � Tel #� 33 � b�n Date �- 1� .. 4�
`V'AiUATION
Sq. Ft. x$ Cv�t/Sq. Ft. = Valuatian $ � )
Sq. Ft. x S Cost/sq. Ft. = valuation S D= S �0 04 0
�
sq . Ft . x$ cost/sq. Ft .= valuatian $ ) Tt7►r�w vAU7E
�
Building Use CbnsGruction 'I�P� ���Y �
Air C�ditioQV.ng [] Yes L] No Fire Protecti� Provided [] Yea [) No
Perfvrmance Band ,Amornit $ See Reverse for Sc.Y�dule Receiv�d Ll Yes q No
�t F� s / /�. ��� �
Plan ct�eck s % � ��
Fi.re 51.u�charge $ �'�`
State SurcY�arge $ r'�j . � �'
SAC Cha�se S
F3rosion Qontrol $
Park Fee $
S�ec . Assessm�nts $
Driveway Escrc�++�r $
T�0►I71L � L ���
$
f,
See Fee Schedule aa� R,�ve1^5e Side
In F�t,cess of Prepaid Amount - See Reverse Side
.001 x Fermit Valuation (1/lOth %)
$.50/$1,000 valuatio� (See Sched. far > $1 Million)
$1000 per SAC LMit (Plans to Nb�1CC for detezmisiation)
$450.00 �nsezvatio� Plan Re�ri�v
Fee Detexmined BY �gineerin�
Agreement Necessary [) Not Neces�y L�
f�t x $13.50/foot
�, .�
ATTAG� STIPULATYONS
' �� � SuB�ECT . � ,
City of Fridley 30382 �
AT THE TOP OF TME TWINS � �� L D I N G P E R M I T
r
� � COMMUNITY OEVEIOPM�NT OIV. RECE���
r j y � PROTECTIVE INSPECTION SEC. ��
1 . ; ��
i.-_. i�'��,'j CITV HALL FRIOLEY SS132 NUMBHA pEV OATE PAGE OF AVPROVED BY
t �� 612-571-3460 9t0-Ft5 10/12/99 / /
JOB ADDRESS �310 Concerto Curve
t LEGAI �OT NO. BLOCK � TRACT OR AODITION SEE ATTACMED
DESCR. lO � Melody Manor 2nd Addition SNEET
2 PROPERTY OWNEFi MAIL AOOR�S$ ZIP PNONE
Richard A Hansen 717-0216
3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Owner
4 ARCNITECT OR DESIGNER MAIL ADORESS ZIP PMONE IICENSE NO
5 ENGINEER MAII ADDRESS ZIP PNONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION O ALTERATION x� REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Reroo ouse and ara e 22 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS �
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIqEO FOFi ELECTRICAL, P�UMBING, HEATING, �PE OF CONS7. OCCUPANCv GROUP OCCUPANCr LOAD
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING SQ. fT CU FT
AUTHORIZED IS NOT COMMENCED VyITMIN 80 OAYS. OR IF CONSTpUCTION
OR WORK IS SUSPENOEO OR ABANDONEO FOFi A PER100 OF 120 DAYS A7
ANY TIME Af7ER WORK IS COMMENCEO. NO DWIG. UNITS OFFSTREET PARKING
I MEREBY CERTIFV THAT I HAVE READ AND EXAMIN�D THIS APPLICA710N S7ALLS GAFAGES
ANO KNOW THE SAME TO 8E TRUE AND CORREC7. ALL PROVISIONS OF LAWS yq�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WpRK WILL QE COMPUED
WITH WHE7HER SPECIFIEO HEREIN OR NOT. TNE GRANTING OF A PERMIT $1923 . 96
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI TME pERMIT FEE SAC CMARGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PEFfORMANCE OF CONSTRUC7ION ,�O9.25 Fir .SC, �..92
PLAN CNECK FE TOT FEE
�GNATUpE OF CON" ACTOA R AUTMOpIZED AGENT �OarE� � EN RO VALI A THIS 53VOUR PERMIT
/0-13-
�GNO UAE O� O N A di BU4 � IOAiE� � Bl �NSo � qcrE
� .. ,
r�w � �
ADDN
ALTER
Effective 5/10/99
I l CITY OF FRIDLEY
[] SINGLE FA1V�Y AND DUPLEXES R-1 AND R 2
BUII..DING PERNIIT APPLICATION
�� ����
�
Construction Address: ��/ G� �G//,%� /P�� C � ���c��e �' �%`%�
Legal Description: _ ,�►��/�,L� )(
Owner Name & Address: �i e.�aQ� ��%���/ 7�10 C�i/I1t_�i"o C� Tel. #'�C 7- Da/�
Contractor:
�.� ' ����'2- MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. #
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height 5q. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type:
Driveway C�rb Ciit Width Needed:
u
Estimated Cost: $ f �,3
Ft. + 6 Ft = Ft x$
—$
DATE: � l� - APPLICANT: � . Tel. # ��� ��/�
Permit Fee
Fire Surcharge
State S�rcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
5TIPLTL,ATIONS:
$ ����
$ �
$
$
$
$
$
$
$
� � . C.�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$S.QO (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
a, . . �
BUII..DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addirion to any existing building or structure, or for any alteration or repair to any existing 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
$501 to $2,000
$2,001 to $25,(�0
$25,OOlto $50,000
$50,001 to $100,�0
$100,001 to $5(10,000
$500,�1 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,OQ0 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,(300
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
Alterna.te "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 FOUNDATION
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 construcrion site.
A Certificate of Sbrvey of the lot, showing the locadon of the foundation once it has it has been constructed will
be required before proCeeding with the framing.
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, NIN 55432
572-36U4 l+'AX:
: 7310 CONCERTO CRV NE
: 113024130034
: MELODY MANOR 2ND ADD
: LOT 10 BLOCK 3
: ELECTRICAL
: RESIDENTIAL
: ADDITION/ALTERATION
571-1287
PERMIT NO.: 2004-01130
DATE IS5UED: 07/19/2004
VALUATION .
NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERNIIT ISSUE DATE. INSTALL BOILER.
# INSPECTIONS 1
APPLICANT
ROBBINSDALE ELECTRIC CO
3754 W BROADWAY
ROBBINSDALE, MN 55422
OWNER
BIOMARA HANSON
7310 CONCERTO CRV NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and l�ow the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construcrion.
Applicant Date
Bldg Insp Date.
ELEC PERMIT FEE - MIN (RESn
STATE SURCHARGE, ELEC FLAT
TOTAL
PAID WITH CHECK # 10234
J�YAKA1� Y�KMII� Kr;(lU1K�ll r�Ult WUKK U'1't1�K "1'HAN llr;SC;RiBED ABOVE.
20.00
0.50
20.50
-���a�v
ADDRESS
PIN
LEGAL DESC
PERMTT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 iJNIVERSITY AVENUE NE
FRIDLEY, MN 55432
5%'L-36U4 1+'AX:
: 7310 CONCERTO CRV NE
: 113024130034
: MELODY MANOR 2ND ADD
: LOT 10 BLOCK 3
: HEATING
: RESIDENTIAL
: ADDITION/ALTERATION
571-12if7
�-�-----=�o: ,.�
PERNIIT N�2004-01311� �-
���
DATE ISSUED: 08/12/2004
VALUATION : $ 3,141.00
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL A FURNACE (HOT WATER, WELL MCLAIN, 105,000 BTUS)
# A/C U1�TITS 0 VALUE OF APPL OR WORK 0
#FURNACES
# GAS RANGES
APPLICANT
FLARE HEATING & AIR CONDITIONII�TG
9303 PLYMOUTH AVE N
GOLDEN VALLEY, MN 55427-
(763)542-1166
OWNER
RICHARD HANSEN
7310 CONCERTO CRV NE
FRIDLEY, MN 55432
1 # GAS DRYERS
0 VALUE (FOR MINIMUM CALC)
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or consttuction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and laiow the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
re ' g constru�rion or the performance of construction.
Applican Date .
: ,: ,,�,.�,�% 1 �, .��f�
HEATING PERNIIT MINIMUIVI FEE
FURNACE SHELL/DUCT WORK
GAS RANGE FEE
GAS DRYER FEE
AIR CONDITIOI�TING FEE
HEATING REPAIRS/ALTERATIONS
STATE SURCHARGE, MECH FLAT
TOTAL
PAID WITH CHECK # 45367
SEPARATE PERNIITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
0
3141
0.00
35.00
0.00
0.00
0.00
0.00
0.50
35.50
�
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JUL-�-20H4 10�0$ FROM C]TY � FR3DLEY TQ SA23101 P.03.�05
�ILL IlV ���PLEiELY Ft�R REPLAC�NI�AIi' F��6 ���4�1N� �PP�.lA�4�E �E��!!�S
C�dA�%�{y �{V�o y�{y� �;�NN��TQR �!R!� E�E2M��l�i'!4N �!!3 bERt�lCr�Tig�d
When re I' 'stin fumace�, the wKtersigned herepy ��rifr� tt�t tf'�e
ventin� has heen examined and i� fr� irQCn r��t, �t�riar�ti�, obstr�acti�r�s,
and is securetY �PP�ned �nci �ir��tAp�►d wt�r� r��ired. Y� � No ()
The venting system is piastic/PVC ��I m�t� al! �t�rr�nt ssdes and mandaf�cterrer
specifications in�ludin� sizinc�, len�th, numtaer pf et�vvs and x�rmin�ti�, V�s �} {yo ���
The und�rsigne� �(so verifies that the repla�ment unit i� � li�t�l �rn�ly
and meets the ciarrrent cx�des and manufa�ur��'s s��ifi�ti�ns_ This �
indud8 AGA GAl1AA Getegary 1 Central F�am�c� Ventin� T2rbl� far fan
assisted ar►d n�tural dr�ft �ti�n�.
ihe air is sized � i�,stalteci tg m�t tt� ��r�t ��s
and manufactiue�'s specifications.
l�lhen required to �nstall a netinr cor�n6ustian air. it witl foe si�ec! �� i�t�It�d
to meet the curr�eM codes and manufacturers sp�ifi�tian�_
Yes �� I�s ( )
Yes � No ( )
Y� ((i}� 6�l0 ( ?
When �nstalii�a a e�w ventinq systeree tF�e undersigreed her�by v�riii�s that
it is a Gsted assembty and meet� tt1� �a`r�nt ��� �nd anar��#�ct��'s
specifications. ihis daes include AGA-GAIW� Categcry I�ntrat F�sma�
�/enting °Cables for fan assisted and natur�l c�€t �li�r��s. Ves �j/ Pdo ()
Is the common verrt and vent c:ont�eCtors sized arui ir�t�ll�d �n�tty ��r
an apptiance has been �mov�i fr�m tF� c-�mmen vent and vented
separateiY as t�et cu�ent c�des. --- - Y��� l� �)
At��liance Tvoe and 5izelCommnn Vent and Veeet Conne�t9r I�fgr�ti�tt
Appliance #1 Type ra'�l �' BTU lnput �� F�r� A�ai�t� sr 6�t �
Appliance #2 iype :�,,��� BTtJ ln�ut ��,�.d. Fan e�i�ted of tyat
APFliance !t3 Typ� BTl1 In�t Fara Assisfed or ldat
Totai Apptian� T�t�i! Bt�a ln��at
Common Vent Ty� -� 101 '-- Vent Heit�ht �_ pi�m�t�r � incf�es
Appliance #1 Ver�t Connector Height ft Length ft Di�►rn�t�r tn Tyy� __
Appl'iance #2 Vert Connector Height ft Ler�gth ft �i��ier in Type
Appliance #3 Ver►t Connect�r F�I�i�ht ft L�ngth ft L�i��teter in Tppe
AL�RATlONS: i�esc�ibel
• � 1/ � / . � /'u�v;�� /
. i��� / _��� Y%: � _ /
� ��
Building PLUMBING Permit No ���'�'�
I'nspections RESIDENTIAL APPLICATION Izecei�ed By: �
763-572-3604 CITY OF FRIDLEY vate xec'c1� ,�
763-502-4977 FAX EFFECTIVE 1-1-09
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: '�9 OWNER OCONTRACTOR
PROPERTY NAMH• ' � L
OWNER/ pDDRESS: ;�� �
TENANT ' CiTY L sTA�:�.��.� 5` �.
PHONE: � C � "' � / J —' f? � I �
CONTRACTOR NAME:
SUBMTf A COPY OF STATE LICENSE #
YOUR STATE EXP DATE
LICENSE, BOND AND STATE BOND # EXP DATE
CERTIFICATE OF ,qDDRESS: CITY STATE ZIP
INSURANCE
PHONE pq}{
PERMIT TYPE �GLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK: � NEW ❑ 1tEPLACEMENT
DETAILED DESCRiPTION OF WORK �� ,9�- _ 1 J� �,�, �j�,��.,�
—�—
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 $300 =$I5.00. Labor cost between $300 to $500 = cqst of labor x.OS = plus .50 surcharge
OR
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. F[XTURES: (INDICATE TOTAL
NUMBER OF EACH BELOVI�. MINIMUM FEE $15.50.
_ BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPMG
_ BATHTUB _ GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFCNER ($3�)
_ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
_ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($351 FOR IRRIGATION
_ WATER METER OTHER
� � � ¢ ,��� �� � x � �` �
�t� � ��, � f.. � _ � � ,�� � ��� � �
. . �. .... .. , . ,�. .,. ,. . r -
, � .. ,..,., ����,� ._ _. � . =.,. .. �. _. . _
, .....,. ,
Permit Fee $ , Number of fixtures @$10.00 x$10.00 =$
Surchar e .50 Number of fixtures @$15.00 x$15.00 =$
TOTAL DUE $ 5. Number of fixtures @$35.00 x$35.00 =$
State Surcharge = $ .50
INIMLJM $I5.50) (MINIMUM $I5.50) Tota.1= $
THIS IS AN APPLICAT[ON FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and 1 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 on site; that the work will be in accordance
with the approved plan in e of�Cll work which requires review and appr al of plans.
SIGNATURE OF APPLICANT
� �/'[ -�I bI/�� PRINT NAME `� (� � ����, �� ���
�
, � �; ,� . �. ,. �. _ ����� ��€�� �� �
ww.��` __, . _,.... u� __._���. � ,�
�� �
_ .�,. �� _.. _ _...._ _ � , .�.. .,, _ ... . .., . , .. _� ...: ._.. , .. �<.._ _� .. :. . .. .
�..���.. � �Yi.'�._. k
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977