AF - 37941�
�
n
City of Fridley, Minn.
BUILDING PERMIT
Da�. SEPTII�ER 8, 1966
�1T�� 9U06
�.�i o -�
Owner: ROGER MARI Builder �ON�_INCORPORATED
Addre�a .._... Address 701 Colunibia Blvd.
Minneapolis, Minnesota 55421
LOCATION OF BUILDING
No. 7341 ____ S�t CONCERTO CURVE .� � Part of Lot
�,� 13 __ gl� 2 Addition or Sub-DiviBfOII .�Y�ANOR.� A7�]�TTTnN'
Coraer Lot M Inside Lot _.. .� Setback ...._._...� � r..._ Sideyard ._.�_� �' ___.�_
Sewer IIevation � ��. � ._ IIevation 8Z1.5
TOP OF F�TING
DESCRIPTION OF BUILDING
To be vsed as:
BESIDENCE �t 44' �p� 25' H��t 20' �. � 1,100 �, � 22L000
�
A�°T. GARAGE Front 20� Depth 22� Iieight 10 Sq. F't. .� '�'� G�. F't. 4,400
Type of Construction - � F�t Cost ._-.�?�..sQQQ...____ To be Completed
WATER LOCATION - 30' North of Man.hole
SEWER LOCATION - 16' North of Manhole
In �tderation of the 3ssuanc+e to me of a germit to cons the buildin des ' above, I agi�ee to do
the proposed work in accordance with the description above f and th all provla�tons of
oralinances of the dty of FrTdley.
�
In consfderation of the payment of a fee of $ 26 .00 , permit fs herebY granted to ��O�a ��•
to construct the building or addition as described above. Thfapermi t ia granted upon
the express condition that theperaon to whom it fs granted and i►ia ageats, employees an� worlQnen, in all work
done in, around snd u�n satd building, or any► part thereof, shall conform itt all reapecta to the ordinance� 04
FridleY� M3nnesota regarrliug locatfon, conatruction, alteration, maiatenance, repafr and mavin� of bufld9uga
witl�in the dty ]imits and this permit may be revoked at aqy ti�ne upon violatfon of any of the provi�ions oE said
ordinanc�s.
CLARERCE BELISLE 8��'�
NOTIC�
'Ihis psrtidt doas not eo�sr t6s coedro�Hoe, testallalloe he whine. P�+�& 6p 6�9, Hw�� er Watsr. B� sun to su
ths Bnlldle8 Inspsetoe te� ssparats pormtls Poe thas t�m�,
- . e;�,r
APPi,ICATION FOR BV�LDING. PERMIT
CITY OF PRIDLEYy MINNESOTA .
a
OWNER'S NAME
ADDRESS ADDRESS
LQCATIOAT OF BIITLDING
N0. �,� y� STREFT ��yl,/'p��,/ �iy,� PART OF LOT
i1(iT /� BLOCK �� ADDIZ'ION OR StTBDIVISION �iY�.
i / i
CO1tNER LOT INSIDE LOT, �/�ETBACR . ��S —b SIDE-YARD /Q — O 9� S' d
SEiaER II,EVATION � FOUNDA'I`IOft ELEVATI�
Applicant aCtach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTIOR dF BU�DING
To be used as:
. . � �
r
Front �/y � Depth o� - Reight
//�
Sq. Ft . Cu. Ft . � �, �-�--�
CG%� , � , � . �C�' �
Front �Q � Depth� �? � Height �
Sq. Ft. �/�J� Cu. Ft. �% �/ �/ �'
Type of Construction_ ��jy�� Estimated Coa _,�%
To be completed
The undersigaed hereby makea applicat�ion.for a permit for the work herein
specified, agreeing to do a11 work in strict a�cordance with the City of
Fridley Ordinances and ruliags of the Department of $uildinga, and hereby
declares that all the facta and represeatat3ona stated in this application
are true and correct.
DATE � gIGN�gg
(Schedule of Fee Coste can be found on the Reverse Sid .
U �
� � �� •�
� � � -� ,�� �
.�
BIIILDIIVG PERMIT FEE SG`HEDtILE
SECTIOP 2. The Inapector of Buildings shall, before iasuing any permit for
the erection of any building or structure, ox for anq addition to anq existiug
building or structure, or fox eny..al�erations or repairs to any eacisting
buildiag or �tructure, upon gpplication therefore� require the payment by the
appl�cant for . su�ch permit of f��s- ta the' �amnoun� i�a�ein below set forth and in
the manner herein provided to-wit;
2.1. For any auch perntii,t ,,for, the., ;e;ecti�on of any fire•proof building,
othei than e garage, warehouse;�facfory or grain elevator, or for the erection
of any £ire-proof addition,,for s�.mi,la;� occup�acy, to any esistin� building,
aha11 b.e at the rate of�$1.GO for each.one thoueand cubic•feet,.or fraction
thereof, in such cubical contents.
_ 2.2, For any auch�perm3t for the erection of any fire-proof gar.age,
�wa�rehouse, factory or 8zain�elevator, or fo� Che erection�vf any fire�groof
addition,.for.similar�_occupancy, fo�any exfstitig building ahall be at the
rate of $1.25 for each one thousand cubic feet, classified as "fireproof"
by Section 502 of the Minneapolis Building Code.
HOIISES �
__.__.
2„3. .For any such � permi� . for. the erection. of any aoa-fireprQof
building, other than a garage, warehouse, factory.or grain elevator, or
any_noa-fireproof �addition, for 'similar occupancy, to any exiating,building -
permit $1.00 for..e�ch one thousand cubic feet. .
, . �.:.� .. .. . . ,-
GARAGES - . ,
2.4. For aay such permit for the erection of any non-fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non-fire-proof
addition, for similar occupancy, �to any esiati�ng buildiag or for each_such
building or addition - ninetq centa ($0.90) for ea.ch one thous.and cubic feet:
or fracefon thereof, in the cubical contents thereof with the minimum o£ $4.00.
For the purpose of computing �ees for building germits,-the cubical contenta
of any bu�L�ldiag or addition to a uaiform height throughout by multiplying the
ground�area covered fr� a point six (6) inches below the floor line of the
basement. or aellgr to�the average b��ght of the upger �urface or to the average
height of the roof surface of the main gable of a pitched roaf.. �
2,_ 5. For repaira or alterat3.�na.to an esi.sting s�ructure, the fee ahall
be at the xate of�$3.00 per'e�ch Fiv��Hundzed Dollare ($$00,00) or frac�ion
thereof in th� cost of a11 propo,sed work. '_ . ,
�..
2.6. Tn no case ehall the fee cliarged for any permit as set forth in
Section 2 be less than�$4.00.
STORM REPAIR. DANIAGE FEES : , � �, � � . • ,
Reaidential ; Eatimated Cos� of wark up to S;4��. f?� - S� e�?�
Estimated Coat of work c--�:.:: `: :•, :., _ �: �! � ;; i ; , :�U
Co�ercial; Estimated-�ost
Estimated_.ost
. �
of tTr.�•:c-�t?.,:-�`� '-�;?`....�� � ;j°:�7
O� �iOiiL OV�3' y:�i:�'.iia1 � yc�.i..- J - 3
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Land Plvnnm9
!� Sur'veyiny
Sn�ls Testm9
c,�,i � tif�,;�,po�
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A�1,naeu� �s 2/,
E N G 1 N E E R I N G, I N C. ����n��°f°
SUnief 4-ti06v
--- En9ineers � SurvecJors
cesrts�icate o� s�s��ve �ot - E�. M DEYELOPMENT C0.
. T
NOTE :- �
1. Eleva4ions 51+ewn ar¢ Prspos¢d
8 �`„� �el. 9�7 � .
2, Firy} C{eor �I. 2.4 f�. ab•vn gr�c�
� � heiag¢ Corn¢rS .
y
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o nFtvo-res IRoN UENoTES DRAINAGE � UTILITy EASEMENT
LOT i3 BLOCK � MELODY MANOR 2'�'—D ADDITi4,i�I
�Anoka Coun}� — Minne�o-}a�
/ hvrby cer�r�'y fYr�i /his es o�ri�e arnd coritcf �rese�ofian o�'a scrretf �1br bnra,sorres �'flr aGo� dsri�r6�d /and, ond
�li� /a�cv/ion o�a// bvildin95 , N�arr , aadd/ risiG�l� axrnvthmdrfs ,��'arx�, �'rnn ar in.�id /and. As survecJed � me f/�s - a(�
9� A v r i I A.D. /9�.
SUB U28q1�1 ENG/NEERING , INC.
6n�eers E Sur'v rs
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` HEAT LOSS CALCULATIONS DEPART,AAENT OF INSPECTIONS ,�.�, �,�
��riN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor ' d How Applied i
Yes—No Yes—No w,. � 9 b.,fi �m � . � " � `.,� � � ,�'; ' a �?, �r �� � � �
Fl.� � _ �" ' ,�=�a�aq,n � Length ���� �Width �' Height �` '° Fl.���'',,� �.;� Room . Length ,,,�' .� Width,,, �" Height , � �
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
�V1dth HeiBht No. ot Llneal f. Ares � Width Relght No. ot Llneal ft Ares
No. ot pane ot,Dane IlBhte ot crack eQ. it. No. ot Dgne o[ Dane IlBhte oi cracB eq. 1G
ys �1� � p.�
,y� ' .�a" ., � . . . �n �{ ' .'J� . �.r�: F�i" � .r' '�r �'� ri�l � '-F~
�° �" ��' _.� -F��k � .
,� �2 � f�` ��-�'' :��`��' ��+�
�
Coef. Beu Coef. Btu
,
Infiltration � �"� ,�°� ,,�� `� � Infiltration � '�;�" '��;i ��" `�' :,�.
Glass ,� ti a;� �^� �� d.�` Glass �`'� �a ° �
Fap. wall `��� +� � ,�a' �,9' Eap. wall - .� `� +���i�
Net e wall - � `
xP• '.'� ° � �'` �� � a ' ��' Net esp. wall � ; � '.
' Int. waU � Int. wall
.
.. -
� a'�' ' r' .. .� . .._ _ __ r.
Ceding �'" �� � '�` � {;�` ."'„ �,�" ,�' , J, Ceifirng �- , � �..�, ,�- aF. ,
�-� _ ,� , �" � , - c� o-� �_ �,
Floor _ � ���`` ' � �°" Floor ��" :t�, `� ,�°' � �'��
1'otal Btu. ' ""` Total Btu. _, �� �a
Reqnired sq. ft. E.D.R. or sq. ias. W.A. Leader area „�' ' Required sq. ft. E.D.R. or aq. ins. WA. Leader area f
Fl.� ,''� " Room � Length � � Width ��= Height !� ��' F7.1._ '� "" 5 Room I Length Width Height �" ,"�,
Windowa and Doora—Cracicage and Area - Windows and Doors—Crackage and Area
Wldth Helght No. ot Lineal it. Area Width Helght No. oL Lfneal tt. Area
No. ot pane ot pane lighta of c�ack eq. tt No. ot pane ot Dane 1lghte of crack ea. [t.
d�3 �i� F
� - �' � `� �� ��"` �' �'� � � �,�� .
, � �;�.- �'4�a :�' �' � �! �� ��. �?
�
Infdtration
Glaaa
Eup. wall
Net eap. �
Int. waU
Ceiling
Floor
Total Btu.
�
+�
�
Required sq. fG E.D.R._ or_ sq. iaa.
IaBpectore notea:
�
Coef. Btu
�,�r r. ;
,� �`° In6ltration
,� "� � � .�'� " Glaaa
� Fap. wall `� ��"�� ;�';
Y �i � '; Net eap. wall
Int. wall
�� Ceiling �,���� � ,�
�� �
:� �
d � Floor
``4 � `�� Total Btu.
�; `
area � Re4uired aq. k. ED.R. or
�
4' .._ ,�.
PET7IZLt FP.e � ......................._._.
APPLICATION FOR MECHANICAL WARM AIR HEATING PERMIT
, � F� N+�,. _ P..z. .-----•----....----
Ddteof zsswccnee--------------•----•--•--•-------•---------•--•-=----•, 196...... LoccLtion..._.........._....-•---------•---......----------•---•-•--•---•---•----------------
.Minneccpoli�s, .1Vlin�t.,--•------------•-----------------•-------•----, 196------
Inspector o f BuiZd,i�c�s
The undersi�n.ed hereby mak.es a.ppLication for cc permii for the in,siallatiorc, alteration or repair of
cc hec�tbng, air eonditiunin� or ventilc�ting system, dez�i,ee ar equ�i�urrcerct, as h�•reire speei�'ied, 2�reeing to do
a�ll. sicch u�ork in Ytricfi ac.aord,c�nee zvith the City Ordincan.ces c�ntl ruli.n�ss of the Department of Inspeetions
and tlae �speei�'i,ec�tions set fcrth in this applicati,on cts a��urured and �'iled in t/�e Drpartn�ent of Inspection,�.
�. s
�4ddre.ss of Ou�cer.--•--...--• ................. .. ... - ----•-- -------...--------
K'ind of Buildin� ................•-•---------•-•-•------•--...------._._......._...Hout occunied..._.._..--------•-•--•-------•-----•--•--------•-•••-
Work to be started----•-•--•--=• ..................................•-, 196.----- Work tn be completed---.........-------------------...-----•, 196------
�_�___�-- - _� _ __ _
_ --- _ _-- _
Estimccied Cost �--•--•-----•-----•---••----•--••---• • •-_.• -_-.-.:-•--••-Old = JPez� �t,iZdin� F-crniit No--------------•--••---- •-•-----------------
DESCRIPiION OF WORK
Nofei Inserf the' word install, add, alter, or ropair, aaording to whieh is fo be done. Under "Remariu," itemize removala, if aery, and
alferations to equipment. , �
Mechdnicnl Warm Air Heating Plants—furnaces
Ma,k,e.---••-------••---•----------------------------------------•---••-----•---------•----•--•--.._..._..--------•Size --•-----•------•--------------------------.._..- -�----•--
Conneetedioad..-----=--••-------•- -----------•------••-• ......:.........••-----•---------------Cc�pcaeit� ........-----•-------------------•----•--•----..
Air Conditioning System: Summer — Winter — Jlll Yecar
.Mcike----.......-•--•----• ...................•--------•-•--._.........._...-•-•--•-•-•----•-•- ._CccpaciLy..--------......_.....-----......-----..Cf m•-------------•-•----------------
..........--•-----•---------------------------••---•--•--•--....-----.._...--=---•---•---------•-•-•--
Veintilating System: JVlccke .......................•----•-•---•--------------..........-•---••Capacity.•-•-------------•-------------- C�71z•------------------------------
•-•---------------------•---------••-•-----......-•--------••---....-•--------.._......._...__.........---•----------------------•------------------•----••------•-------------------•----------------------
E�lanation of work to be done:.-•-------------------------------------•------------- Plana with permit (yes) (no)
._J__- � _ ----_-- -_— - _
Si�ned------------- � --••--------..._..-------...----•------------------------------------
, By---------------------•--------------•-------------- -------...- -----...----------
./ipproved----------•------•----•---•-•--...-•••••---•-••--•--••-•-•••-••-----, 196.----- �Iddress------------------•---------•-------------------•-•--•----------------•--
TelepTwne-•-------------------------------------------•---•------------------
Inspeator.
u-ZO .��e .. . .................•--...._..._...__...-----..._..-••-----...-•---•--......... . ._
�+p,�,r�v'� l���1�-"; � ��� �,*`� � � � �� ��
��1�`'� .� ,�'+�'+'w � �'�'�k, �
` HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTIONS �°`' �� �1INNEAPOLIS� �1.
Weatherstrips A'S'H'V'E' Construction Na II � Insulation
_ II Guide II - -
,. .e. .. . .e. ,. ,. � . — _ _ s, •
�. • ��„�''���, .. �m� ,�`!j� � Width � � Height �" � , . � ��,� > ��� �.�'�' '"" Width ,� �� Height ` ; ,��.
Windowa and Doora—Crackage and Area ' Windows and Doorn—Crackage and Area
Wldth Helght No. of Llneal ft. Area Wldth Helght No. ot Llneal tt. Area
No. o[ Dane ot pane lighte ot crack eq. tt. No. of pane ot pane ll8bte ot crack ep. tt.
c �, �ar�,
t�+' i�' `"� � `�° � -� �' �' �`' �� �� :`� � �S � i \ .:
�B
P
� r.� �r: `�; � ,�r �' � !°
� �i � �y7 �', y.+�^ 6�` �yt . �i� �� '�qi y��
Coef. Btu ` Coef. Btu
In6ltration ,.� '"`� �.�;` �' � Infiltration „�'�" � � "�` _
Glaas �": -.� �,^ � � � w�,
,�' r'
Fsp. wau � � :�' `� �` �
Net e:p. wall �! '�" .�
iat. Wau
Ceilin "F� f'� '' ''
S ;�'=- ;�° �: ,� , ;�►' �,�` :
Floor i �;,�' �� ��
Total Btu. _ _-- _
Required sq. k. E.D.R. or aq. ina. W.A. Leader area
Inepectore notea:
.� �;-�' Glaaa � _;; �'�, �
Eap. wall �,� � .�?' N ��
w '� Net eap. wall ' ��>'
Int. wall
� �,'`°�'. Ceiling �s� $ , ,¢� �' .�r . �r�'�� ��a �
� � �", Floor ' � ;.��, ,�'
,� Tocal Bcu:
Reauired sq. k. E.D.R. or aq. ins. WA. Leader area
. -
Inspectora notea: �
4 - � _ �.
Permit Fee �.....---•--•---•-......_...
APPLICATION FOR MECHANICAL WARM AIR HEATING PERMIT
��
N4�, ,P-�--- ----------------
Dateof iasu,ccnoe.-•---•--.....-•---•-•----•-•-•-•---• ...........:...... 196...... Locutio��............-•--...--•-•---•-••----•--•--•------••------•••--._�..----...---•------
.Minr�empoli�s, .MLnn.,.....---•--• ..............••-----•----•••-----, I96......
Ins�peotor o f Buildings
The und�ersi�ned hereby mak.es a.pplication for a pernzii for the iszstuLlc�.tion, alteration or repair of
cc hca,tin�, air coruiitioning or veniilatin�% syste�n, devue or equ.i�urr�ent, as hereire speci�'ied, 2�reeing to do
a-LI• Aicch z�+ork in xtrirt ac.eord,c�nce zvith the City Ordincince�s arul rulin�s of tlze Departnzen,t of Inspeeiions
and tlae xpec�i fieutiona set fcrth in tha� application as .ccppraz�ed and filed in tlre D«partnaent of Inspeetimt,Y.
Ow►�er
Kin,d of Buildin�.....---•-
.........--•-----•-----...-•----...a4ddreRS of Ou�ner .............•--•--•••-•---.. ._ .... ._..... __.........-------
•••-•-•--••-----------•----•-------Aow occunied••---•--• .............:.....•---•-----------------•-- ----------------------
2
Work,to be started...-•----• ..............................•---------, 196...... Work t�, bc eompleted.._.....-----•-•-----•-------•--------.., I96------
�= �___� _,_ _:, _ � �� _ `_ _, - ---
Estimated Cost �` � .Old = JV'e��atZZirz� � iit No------- -------- _ - - -
DESCRIPTION OF WORK
Notei Inhert fke word inatall, add, alter, m rapair, aao►ding fo whieh i: to be done. Under "Remarks," itemize reerrovals, iF a�y, m�!
alterafions to equipmerM. , ,
..._........�..-----•---•• ....................Mechanicnl Warm Air Heating Plants--F�rnaees ....-------------••----...---------•-----,-----•--------•----•-----
.J[�a,k�e .. ............ ..........•-•-•------._...........-----••-• - -•-----------•-•-----._............_.._...Size ----•-•------------------------- --.._.._..- --------•----------------
• Conneeted load---=---=--------------------•---•----------------•--------=----•------•-,----------------.Ccopcceity
. . ---------------------------------------•----•--------....._�.._
Atr Conditioning System: Summer — Winter —�RlL Yecir----------------_-------•---•-------------•------•---------•-----•--------•---------•---
Mu,ke--------------------•- ..Cc�PaeitzJ•---------•----------- --C'fm•-•-------------------------•----
---•-•----•--•---....._..-•--•--._.....--• ........................ . ----------.....
...----•-• ...................----............---....-----=---•--•-••-----••-=---....._.._............ --•----..._._..----........------••-•--•-----•----•-----•---•--•----------------------------------
Ventilating System: .Ma,ke-•---------------------------•-------._.--•------.......--•--...CaPcLeitiJ•--••-------------•------------- C'frrc•----------------------•------
. ......................•----•-----••-•--------..........-•-•---•--.........----........._...----------...._........_.......---•--------.....------------•--__...._.._...---------------------------...----
ESplanation of work to be done:.---•---•-----•••-•-•••-- --------•----...----•------•- Plaus wlth permit (yes) (no)
-=�- - --- - _. - -
____ �_- � --`- - -
_____ �- - -� _ _.� . - - -- - -�__- - -
•----....._.._---------------------------------------------•,........----....-•-----------•-=-------- •------------------•---•------•---------------------------•------•-----•-----------•----------------
�pproved-•---•----•---••-•----•---• ................•--•---..............----, 196------
Inapeotor.
Si�ned..-•---.....- r -•--------•----------------•-•--------------•------------------------
8�---------------------•-------------------------------•---...------- -------------------
.fl ddress-------------------•----•-----........_..-•-------.._...-----------------
Telephone-•-•-----••-----------•-•-----------------•---------•---------------
azo.��e.. ................................_--•-----•-•------..__.......---•---••----- � -------•--------•--••---••------_.........................--------•----...------........
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1 c�
sua�ecr ' PERMIT N
City of Fridley _ 19 4 5 6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� t
� `L ____ COMMUNITY DEVELOPMENT DIV. �D���
r � � PROTECTIVE INSPECTION SEC. 4
1 = �
� /"�1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�"""� � ,�' 612-571-3450 910-F15 5/11/88 / /
JOB ADDRESS �341 Canc�rto Curve N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ],3 2 Melody M�r 2nd Addition SHEET
2 PROPERTYOWNER MAILADORESS ZIP PHONE
RaX Ma,ki 7341 Concerto Curve N. E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Normandale Services Route #1Z, Isanti 55040 338-1511
4 ARCHITECT OR DESIGNER MAIL ADDHESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
R�eroof Dwelling (20 ScSuares )
9 CHANGE QF USE FROM TO
STIPULATIONS
Roof can be 2nd la,yer but not � 3rd layer. Install ridged galvanizecl
valleys. ,
On ali new mofs or tear-qffs and repiacem�nf roofs,
State Cod� requires that 2 tayers of 15 Ib. felt,
m�pped �og�ther, be installed te a�oint 24 inches
up from ex4erior wall line, or the us� af dth�r
approv�d t�ntlerlayment membrane.
.;k'
y
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBIN(i, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VEIVTII.ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZONINC3 SQ. FT. CU. FT.
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. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION �' STALLS GAqAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $]. � OOO $. �JO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE R CAL LAW REGULATING CON- �S`2S.00
STRUCTIO R THE PERFORMANCE F CO STHUCTION.
� PLAN CHECK FEE TOTAL FEE
� i ,� $25. 50
GNATUREOFCO� TRACTORO A TIIORt2 � AGENT IDA EI ,� ' WHEN PqOPERLV �IDATED THIS IS YOUR PERMIT
SiGNATUREO:OWNER�IFOWNERBUILDERi �DATE� BLDG �NSP � TE��
I�1 [] City of F'ridley EEfective 5/L88
A�N [ ] R-1 AND R-2
AL�R [] Building Permit Apgl ication
construction �ress: � 3 ``� � Co � C � � f � �i� J �t%
Legal Description:
Owner Naane b
Contractor :
Address:
Attach to this appl ication, a Certif icate af Sluvey of the
lat, with the proposoed construction drawn on it to scale.
� �• r• •� • i• �� � ia,
T•�r1G ARE'A: Length Width 8eight
Scj. Ft.
c�,RAGE ARF�Aa Length Width Heic�t 9q. Ft.
DEQt 1�RF,A: Length Width Hgt/Grotmd 9q. It.
�
Gbrner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
�pe of Construction: /�e �o �� h°��o ��e�i F�ttimateol Cost: S_�,,��
Approx. Completion Date: ' 01 C� .,S(� � v�t�S
Proposed Drivcway Width If New Opening Is Desired: S_
wi + 6 ;\
I]ATE : � ��' � APPLICANr: '
CLTY OSE C�Y
Petmit �ee
State Surcharge
SAC CY�atge
Driveway Escraw
Park �ee
Sewer Main Qzarge
7.'OTAL
STIPUI.�IONS:
$ ��. C�G�
S �:?�
�
S
$
S
$ �S. ��
Alt. A Alt. B
S
See Back Page
��
T�.. � �3�5- / ��%
F+ee Schedule on Reverse Side
5.50/51,000 Valuation
5550 per SAC Unit
Al� '�" or A1t. '�° Ab�ve
Ftee Determired by E�girieering
Agreenent Neoessary [ ] Nat Neaessary [ ]
�
�t_il-i��Si�, ' �;�v 4+ a+� `.M:ia��. 1
The Cnief Building Official shall, before issuing permits for the erection of any
building or structure, or for any addition 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 applica� for such permit of fees to the amount
herein belaw set forth and in the maruier herein pravided to-wit:
TO'I'AL VALUE
S1 to $500
5501 to 52,000
S2, 001 to 525, p00
525,001 to $50,000
FEES
$15 (Minim�n Fee is S15 plus surcharge ) �
$15 for first $500 plus $2 for each additional 5100 or fraction
thereaf, to and including 52,000
S45 for f irst S2, 000 plus S9 for each additional S1, 000 or
fraction thereaf, to and including 525,000
$252 for first $25,000 plus $6.50 for eaah additional $1,000 or
fraction thereof, to and including 550,000
550,001 to $100,000 5414.50 for first 550,000 plus �4.50 for each additio�al $1,000
or fraction thereof, tro and including 5100,000
5100,001 t� 5500,000 5639.50 for first $100,000 plus $3.50 for each additional $1,000
or fraction thereof, to and including 5500,000
5500,001 to �1,000,000 52039.50 for the first 5500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including 51,000,000
51,000,001 and up 53539.50 for the first 51,000,000 plus $2 for each additional
51,000 or fraction thereof
D�VE�v D���S?ON FS[_�
(Concrete Curb Streets Only)
Alternate pA": R�nwal and replavement o�' curb and gutter only - Driveway width plus 6
feet times $13.50.
Alternate "B": Reno�val and replaoeme,nt of curb and gutter and install a 3 foot wide
approach with 6 inch clep�th - Driveway width plus 6 feet times 515.75.
/�; M • � • ' �1�:U��� � • �
Permits for construction will be issued a minimum of 24 hours f rom the time of
application to allow for proper review of the proposed structure and of the o�nstruction
site.
A Certif icate of Slirvey of the lat, shawing the location of the foundation once it has
been aonstructed will be required before proceecling with the fr�ning.
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SuB�ECT
City of Fridley
AT THE TOP OF TNE TWINS g U I L D I N G P E R M I T
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� ; y _�_�� COMMUNITY OEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 . �
i---.� �"' �'� CITY HALL FRIDLE� SS132 NUMBER nev
t 763-571-3450 9t 0-F t 5
108 ADDRESS 7341 Concerto Curve NE
t LEGAL �OT NO. BLOCK TRACT OR ADOITION
oesca. 13 2 Melody Manor 2ni
2 PROPERTY OWNER MAIL ADORESS
Raymond Make 7341 Concerto Curve NE
3 CONTRACTOR MAIL ADDRESS
Midwest Roofing 7385 Mark St, Greenfield, MN '
d ARCNITECT OR DESIGNER MAIL ADDRESS
S ENGINEER MAIL ADDRESS
8 USE OF BUILOING
Residential
7 CLASS OF WORK
D�TE V�GE OF
8/15/02 / /
, 32990
,�___
RECEIPT NO.
����
AVPROVEO BY
SEE ATTACMED
SHEET
ZIP PMONE
tIP PMONE LICENSE NO
763-416-4804 20010277
ZIP PMONE LICENSE NO.
ZIP PNONE LICENSE NO
❑ NEW � ADDITION D ALTERATION p REPAIR O MOVE O REMOVE
X
B DESCRIBE WORK
Reroof House & Garage (23 Sq) Tear-off
9 CHANOE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Buiiding Code.
SEPARATE PERMITSARE REOUIRED FOR ELECTFICAL, PLUMBING, MEATING, 'r�v� vv•�.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING
AUTHOR12ED IS NOT COMMENCED WITHIN 80 DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOR A PEH100 OF 120 pAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS
1 NEREBY CERTIFV THAT I MAVE READ AND EXAMINED TNIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yqLUATION
AND ORDINANCES GOVERNING 7NIS TYPE OF WORK WILL BE COMPLIED
WITM WHETHEq SPECIFIED HEREIN OR NOT. THE GRAN?ING OF A PERMIT �2a465
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TNE pEqM17fEE
PROVISIO OF ANY OTMER TE OR LOCAL LAW REGULATING CON- @83.25
STqUCT N F TME PERF A CE OF CONSTRUCTION y�
PLAN CMECK FEE
License
T E OF CON • AACT OA Op�2E0 aGENT IOATE� EN (
S�GN4TUqE O� OWNEA ��� OWNEA BU�LDEpi IDAiE� G� nf. �.Co
SC.
STAILS
GROUP OCCUPAN
CU fT.
OFFSTREET PANKINC
IGARAGES
$1.23
SAC CMARGE
Fire S $Ze47
TOTA�f
5.00 .95
ALIOATED IS YOUR PER�
LOAD
YR�
NEVV ( J CITY OF FRIDLEY Effective 1/1/2002
ADDN �] 6431 University Ave NE, F�idley, MN 55432 (763) 5723604 Bldg Insp
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: I 3 �I � �GrncR,�� Gta'�-�
Legal Description:
Owner Name 8 Address: � � f�' Tel. #�
Contractor. ����� ���^°� MNLICENSE# �-�U�G�'77
� 9�a35� Te�.# �'��'�l�G-�'l%Y
Address: ��g5 ��k J�' ���(�/
LMNG 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.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width � Hg�G�und Sq. Ft
u �
Construction Type: ��`�� �'e""� Estimated Cost: $ � o �����
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$
�..
DATE: � �S � � APPUCANT: Tel. #
Call (763) 572-3604 fo� Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card �umber.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge �
Driveway Escrow � �
Erosion Control � `
Park Fee
Sewer Main Charge
TOTAL
�
$ 3. S
� � y�
$ .��
$
$ -l� �
$
$
$
$
$ '
��
CITY USE ONLY -
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 ( ]
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition 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 $25,000
$25,001 to $50,(�0
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,0�
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,�
$69.25 for first $2,000 plus $14.00 for each additional $1,0�
or fraction thereof, to and including $25,OU0
$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 $50,0� plus $7.00 for each additional
$1,000 or fraction thereof, to and including $�100,000
$993.75 for first $100,0� plus $5.60 for each additional
$1,0(?0 or fraction thereof, to and including $SOO,OQO
$3,233.75 for the first $5(�,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the iust $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
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.
VERIFICATION OF FOUNDATION
A Certifica.te of Survey of the lot, showing the location of the existing
proceeding with the framing. New Houses Onlv
�
foundation will be required before
Building
Inspections
763-572-3604
DATE
SITE ADDRESS �
THIS APPL[CANT IS:
PROPERTY
OW1vERJ
TENANT
CONTRACTOR
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADD ESS
--Ct,�tl/�lc/� TD �GUZf//c.
❑ OWNER a,�QNTRACTOR
ADDRESS: ' % �5
PHONE: 7L. � —%� "
G
Pemut No.:
Received
A
SUBMIT A COPY OF STATE LICENSE # � O�G� /�/%% EXP DATE ��3%�d ��
YOUR STATE ADDRESS: ���f �e �L`' � r" /L//� CITY ��ii[//� STATF/J��d�IP�r�,3
LICENSE WITH PHONE � �_'� � / ,(� _ /_ FAX
APPLICATION 7'` n „ � -1 _ � — �� �
PERMIT TYPE
TYPE OF WORK: � o New
FAMILY ❑ TWO FAMILY O TOWNHOUSE
DETAILED DESCRIPTION OF WORK
�
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE IVOTED. FIXTURES: (WDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
_ BATHTUB GAS PIPING rNi:ir�crn�uc•r•:NSi:) SWIMMING POOL WATER SOFCNER ($35)
_CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($IS)
_ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
_ WATER METER X OTHER �/�h DOh° i( o.�l
Permit Fee
TOTAL DUE
I hereby apply for a bui
conformance with the oc
not a permit but onty an
approved plan in the cas�
SIGNATURE OF APPLICANT
$ �. Number of fixtures @ $10.00 x $10.00 = $
.50 Number of fixtures @ $15.00 x $15.00 = $
$ .� Nurnber of fixtures @ $35.00 x $35.00 = $
State Surchazge = $ .50
� Tota1= $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
mit and 1 ackn wl dge that the information above is complete and accurate; that the work will be in
and co s of t of Fridley and with the Minnesota Construction Codes; that I understand this is
ion for a m' nd ork is not to start without a permit; that the work will be in accordance with the
s � w an a roval of plans.
PRINT NAME�'U�G � �/S� DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977