AF - 37953�
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City of Fridley, Minn. 1�T° 9 6 4 9
BUILDING PERMIT
DB�: April 4, %S�SR 1968
p�r; Charles Rosick g��r Clemron, Inc. .._
pddr� p,ddress 701 Columbia Blvd .
LOCATION OF BUILDING
No. 7361 g�t Concerto Curve �� part of Lot
� 1� _ Block 2 Addition or Sub-Division _—. M�o�v�anor ,�$ Addn .
Corner Lot _ Ins�tde Lot X Setback 35 �._._._ Sideyard �
Sewer IIevation ____-869 .54 ,_---• — 872.�
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
�e�.�.iag, Front 26 � Depth 35 � 6" Height ?� ` Sci. Ft. �.� (�. F't �7_2�
Garage �nt 27 � Depth 21 � 9�� I�eight 10' �� 594 �� 5940
Type of Conatruction Frame �� �{ _ 24 _000 __ To be Completed
��
SEWER LOCATION - 29' South of Manhole
WATER LOCATION - 17' South of Manhole
In consideration of the issuanoe to me of a permft to c ct building desc33b almve to do
the proposed work fn accordance wlth the description above set fo and in com Haa all ons oP
ordinanc�es of the dty oP Fridley.
$100.00 Sewer Connection Charge
In consfderation of tt►e payment of a fee of $ 37 . 00 ��t is hereby granted to Clemron, Inc .
to conatruct the building or addition as described above. Tt�is rmit is granted nPon
the express c�n�]itiou that theperson to whom it is granted and li3e agea�►ts. emPloyees an�worl�en, fn all work
dane in, around and upon safd building, or anypart thereof, sl�all conform 3n all respects to the ordinance� of
Fridley� Minaesota regardiag locatton, constructton, alteration, maintenance, repair and movlug of buildin$a
wlthiu the dty ]imits and this permit may be revoked at any time upon violation oE any the provisiona of said
o�dinancea '
� ,
Clarence Belisle
NOTIC�
� 't6b psemtt d� not eorar t6s eeestwcHee, iestallaNee Mr �riring, phimbtne, ga huHne, ssvre� e� w�tsr. 8� am to a�
t6a Bnildio8 lespeeto� fo� aparat� parmha foe �hess h�ms.
s, 1 , _
� , �
APPLICATION FOR BUILDING FEFI�IIT
Ci�'Y OF FItIDLEY, MII�iESOTA
L�GA1".LON OF BpZI,,DING
No.�,/ � Stseet ��/� -. � ��rt of Lot�_
LoC �;��' Block �. Addition or Subdivision � ,� ,_..� � � ,
G
' .: , a . , w, o
Corner Lot �Inside Loe Setback �,S -�-�� .Side Y ' ,�� �•��
SEWER ELE9ATION • � __.__ FOUIODATION ELE9ATION �% .�y .
Appli�aCta��o this form Two C�rtificates of Survey of Lot aad proposed buiZd-
iag locaCion drawn on these CertiE cates. ,
`�,,� _ �7 � �°- � �. `� � .
DESCRIPTION OF BU�LDING
To b used as: �' �
� I Fsvnt �� �� ��i•ih : ,�.��'�,� fleight f -
.. Sq. Ft .q'� .,� Cu . Ft .• _.C�.�� �' G
� •f ��
' � FronC �r% � � Dzpth � � Aeight �/
Sq. Ft. ���-- Cu. Ft. � f�% �
Typg of Ccnstructioa ������ Estimated Coat�� ��� _
To be
The undersigned hereby makes appZication Eor a pernait for the work herein specified,
agree�ing to do all work ia strict accordauce with the Citq of Fridl�y Ordinances and
rulin�a of the Department of Buildia�s, and hereby.declares that a11 the facte �.nd
repreaentatiaas stated in Chis applfcation are true and correct. �
�Schedule of Fee Casta can be found on the Reverae Side).
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BU�DING PERi�:T FEE SCAEDULE
Section 2. The Inspeotvr of Buildia�s sh�ll, before iesuisg any pea�mi.t for
the erectioa of any buildiag or etructure, or for any addition eo aay e�3at-
in� building or strucCure, or for any alterations or repaire to any existiag
buildin� or seructure, upon application therefor, sequire the payment by the
appl3canC for such permit of fees ta Ehe amount hereia below set fortu ar..d
in the m�nner herein p�co�vi�led to-wit:
2.1. Eor aay such permit for the erection o.i a�y fire-pronf buildin;, other
than a gaxage� warehouse, factory or grain elevator, or for the erection of
saq fire-proof addition, for simi.lar occupancy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet, or fractioa
thereof, in such cubical conteate.
2.2. For any such permie foY'th� erection of any fire-proof garage, warehouse,_
factory o�r,gra3n elevator, or for the erection of any fire-proof ecHIiCiota'
for simitar aceupancy, to any exietiag buildi�ag shall'be at the rate of $1.25
€or each.one ti�ousand cubic £eet, classified as "fireproof" by Section SG2 of
the M�lnneapolia Buildiag Code.
HOUSES
2.3. For anq such permit for the erection of any non-firepsoof bui�d��r!.� ��`l�ea
t&an a SaraSe, warehouse, factory or grain elevator, or any noa-fizep.c�:��
addition, for similar occupaacq, to any esisting buildin� - pera�,t $�..Q� �or
each one thousaad cubic fe�t.
GAR___�__AGE3
Z.`4. , For aaq auch permit for the erecti�-� �: a�r;;� r..�r����s.?���,,� ga�a�e,
warehouse, factory or grain elevatox-, �=- ::�'.= �.`-:t, -�=�::��;.�cr� c��� �n� riaa�f�:xe»rao� -
additioa, -€or--s3milar occupancy, to �-;,; e���b ,.�: : ir� i�,:; .,`;;�:�o oz for each such
_ . - - �build3ng or addition - ninety ce*_+�:- ;;,t; .,~�,`3; ��:^.r �:z.;:� ,��e thcc�sand c�m� feet
or fraction thereof, ia �he cut��:.G�. �.d�<�.�c:.r.`:. �;1P:��es erith a minimtmn of $4,�Q..•
For the purpose of computiag Eeea f-�:r ?�4; _..;,iz.;; ppr�;,I �.s, the cubical coatenta
of aaq buildiag or addition to � a un�fc,�::-�.� �:�•�.;;:_t ti�����:.�;hout by multiply�.ag the .
ground area covered from a poinC siu (6) i:ar_ �As be� :f�a-t?�e floor line o�E .�he
basemeat or cellar to the average height of ��:•� �:��d�er sa..�iace or to the �
average height of the roof surface of the maiu �;�ule, of a p�tched roof.
2.5. For repaira or alteratioas to an exiating structure, the fee shall be
a the rate of $3.00 per each Five Huadred Dollars ($500.00) or fraction
thereof in the cost of all proposed work.
2_.b._ Tn ao case shall the fee..char�ed,.for_�ny pern��.�g Bst forth in
Section 2 be lesa.thaa $4,pp,
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ENGINEERING� INC, �'�n��°f°
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� � En9ineers � Surveyors
ce:rti.�icate o� su��eT �o= -��- M DEYELOP]WiF.NT CQ.
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O DENOTES IRoN UENoTE5 DRAINAGE '� UTILITY EASEMENT
L4 T � 5 BLO CK 2 MELODY IviANOR 2'''� ADD I T IO�I
�Anoka Coun�� - (�flinn¢�o-�'a�
/ hereby urfi�y flwf �his is o fi�e aad carrrcf �e�resenfot�an o�'o su-retf �'fl�t bavndo�es �l'�/�e abe►r d�rr:lasd �drd, ond
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SUBJECT PER
City of Fridley 6 312
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
� � RECEIPT NO.
� ; v _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. 3� y O
i i �
' ����1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�"'"'� � ��� 612-571-3450 910-F15
7/31/8l � �
JOB ADDRESS '7361 Concerto Curve N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ],rJ 2 Melody Manor 2nd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
C:harles Kasick 7361 Concerto Curve N.E. 786-2345
3 CONTRACTOR MAILADDRESS 21P PHONE LICENSENO.
Dolphin Pool & Patio 8832 - 7th Avenue North 542-9000
4 ARCHITECTORDESIGNER MAILADDRES$ ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
8 USE OF BUILDING
RPS 1CIETlt].3�.
7 CLASS OF WORK
I� NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
��i Construct a 16' x 34' SSurrimming Pool
9 CHANGEOFUSEFROM TO
STIPULATIONS
See sti,pulations in letter da.ted Jul.y 30, 1�81 by Enviro�mnental Officer.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PEiiMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMiT BECOMES NULL AND VOID IF WOf;K OR CONSTRUCTION ZONING 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 EXAMINED THIS APPLtCATION 1 STALIS 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 �`Fj/ OOQ �3. QO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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- 36.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �
PLAN CHECK FEE TOTAL FEE
$39.00
SIGNATUREOFCONTRACTORORAUTHOiiIZEDAGENT (DATE) 4Y .- -,'`�' HEN PROPERL LIDATED THIS IS YOUR PERMIT
.� � �- i � a�
SiGNATURE OF OWNER IIF OWNER BUILDERi IOATEI '� - BLDG I DATE
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ENGIf�DEERING� INC. ���°f°
� SIG,x� �,COe6
—� En ineer� � SurvecJnrs —
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O �£NOTES IRON UENOTES DRAINAGE `i► UTILITY FASEMENT
LO T i s DLO CK 2 MELOI)Y M�OR 2�D ADD I i I O�I
CAnoiCq Cioun7� — M�nntflo�'q'
/ bn�rby wli�'y lJbf �us �s o lyua and mmcf �epresrnfat�an o�'o sw�r�y �'t}t b�mdo+��s q�'/f r a�berr a�cr6ud /�d, a►�d
flYn laafi�ar� c�('aN drnNr�s ,lhitr� , oad d/ risi6�lt aav�oorhmaiis ,�!'o•�, %nrri ar �n savd /and. As .wrveyed 6tJ mt Nrs - a9�
t Agri I �.D/��. SUBURBAN fNG/NEER/NG. /NC.
S 6r SK!ts�ar's��
�'J�i�L..E. i��s 3a� + � �i;r .� ���lL V
--v
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CITY 0� FRIpLCY
A('PLIC/ITIO�J FOft R�SIDEidTI/F� QUILDIt1G PEf2r�iTTS
(tde�•r, AlteraL-ions, Additions, or Repairs)
a«rr�R: �/���-'� �4SIC,(C
ADDRES S: 7,36 I CON .. �D U/��
TEL �d0: ��� - a?.35�5
QUI LQER : ���� ��C �°' pA��
; �,
nooRCSS: �3a 7'`'� �v� No
TEL td0: ��a7 � �O�
Consi:ruciion Location
STR�ET NO: /J d � &TREET: ��N�/�r °� �//P��
LOT: . I S BLOCK: � ADnITION: ��C�Dy /�J��rZ a��/��J�OlY
Corner Lot: ' Inside Lot: x SetbacY.: Sideyards:
Ap�licant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOid OF COPISTP.UCTION
�3�-' P90 �
ront: Depth : H eight:
.3 �" O��'t Squa�e. Feet: C.l.ibic Feet;
�ront: Depth: Height:
Square• Feet: Cubic I'eet:
�� �OO� /
Type of Construction : � N�� (�N�� L^' (��� 5��� Estimai:ed Cost: $ C� 00'0. �-4
Zb $e Cbr,�pleted: .��/" � / 19a 7
Alt. A Alt. B
Proposed Driveway Width If New Openinq Is Desired: $� $
, SE� Rc,VERSE SIDE OF SHEET .
�Rie undexsiuned hereby ma}:e� application for a permit fcr the work� herein specified,
agreeing to do ,all work in s'trict accordance Frith the City of I'ridley Ordiiiances and
ruling� of tlle Department of Buildings, and hereby declares that all the iacts and
represent�-�tions stated ;n this application are �,rue and correct.
D.'�T�: 7 3Q " p� SIGNIITUF�E : �
� T'
StipulaL-ions: �
�—��,e r�>�--2� �
� �
� ����� � _ IL'°' ; ����
� �
��� .�- �'•,
�,�, _ �� -�-. � �
�
� � �. Q � �'' .�1� ^' ��� a
�^
�
. �u��ni<<�G t'�'Rt�1T r-e� sc�ir_�u�� � .
S1;C'PIOt•7 2. �'z'li� 7n•.:��ect-ar_ of 13ui1din�J :::hriJ.l, bcfor.r. �. �sui�ig Z�ennits for Clie crec'L•ion
af .�.»y l�u�.]_�l:ii��� ar :�t:ruct:urc, or. fox any adcii.4i��n L•o a►iy cr.i:;tinc� }�uilclincJ or �tzucLur_e,
. ci�' f.�r. r,�iy a1L•c_�ratio�� or. r.c��air.s to •any c�:i..Linc�{ }�u�_).di,�ig or st-�ucturc, u��c,n ar>��li_cation
�ihcr.:ior.c, rcquarc Ui� Pa}�menL• }�y t]ie a��p7.ic:ant: for. such ��cr.mi.t- of tees to tl�� �nount
}ICX'tS111 bcJ.cn•� set ior.tli ancl i.�i tlic �nannc�: hcrcin providcci to-�•::iL-: •
I•7L•'1•� CON�:TI:UCTIOIJ: Singl.e 1'ami1.y Ilomes and G�r.ac{es: y4.00/1,000 cubic �fect..
PLT:2� CIII:G;: 25 percerit: o,f buS.lciing pe�.-mit fee.
UitI:VEI;Al' DEL'P1:SSIOI•l: (Cpncretc C�irb Si:reets Only) � �' �
• A]-te.rnat:e A: liemoval and replaccment oi concrete curb and
`. � qutL•er only; Driveway �•�idth plus� 6 feet• x$13.50
Alternate II: Removal and rep�acem�•nt of concrete curb and
. gutter and in�tall a 3 foot wide approach caitjh �'
' ,. 6�nch clepth; Drive��ay ���idth �plus 6 ieet x$1�..75
• . ADDI �" I O�/�L I NFOR��1�T I ON �
For the puri�se of computing tees far_ building permits, L-he cubica2 contents of any
build�.ng or addi�ion, is detexmi.ned by rnultiplyii�ig ihe qround area covered from a
, poi.nt sir. (6) inches below the iloor ].ine o£ the basement or tha cellar to the
average heights of ihe •upper surface or to the average height of the roof. surf:ace
of the main gable of a pitched roof. �
For repai.rs or a].teratioas to an existang structure, the fee shall be at the rate
of $3.00 rex �ach five hundred dollars �� ($500.00) ar fraction tllE.'lt'.0�. ,].11 the cost
oi all proposed work. . , • • �
• � , � ` . -.
In •no aase sha�.l the fee charged fc�r any pPxinit as set %rth i.n Sectian 2 be less
than $?.50 plus $.50 staL-e surcharge. � '
� VERI F I CATIO�! OF FOU��(nI1TI0fd
0
NOTE: �Permits �or construcL-ion caill be .issued a minimtun af 24 hours from Uie time
�f application to a7.locv for proper revie�v of the proposed structure and oi ihe .
construction site. � T .
A Certificate of Sunrey of the lot, sho�aing the location �f the foundation once it
has been constnicted ti*ill be required before proceeding with the iraming.
�F$TIFICl�TE �F OCCUPAf��CY
APplication i'or a Certificate oi-' Occupancy sh�ll be madQ ten (10) c3ays prior to the
use or occug3ncy oi any siructure for which a L�uilding permit has been issued; and
said structure shall. iiot l�e usec3 or. occupied �itil a Ceri:ificate of Occui�ancy has
bcen i,ssued.
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1981
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Dolphin Pool & Patio
883 2- 7th Avenue North
Golden Valley, MN 55427
TELEPHONE ( 612)571-3450
Re: Swi�ing Pool Construction at 7361 Concerto Curve N.E.
Dear Sirs:
This letter is to make clear this department's requirements for the swi�ing
pool construction at the above address.
1. As indicated, two (2) ski�uaers a,pproved by the National Sanitation
Foundation will be provided.
2. As indicated, two (2) i.nlets of approved design for fresh and/or
repurified water will be provided.
3. As indicated, a main drain of approv� construction will be provided.
4. The filter and pump sha.11 be approned by the N.S.F. and be of
suff icient capacity to provide a minimtmm turnover of at least two (2 )
times in 24 hours. This department recomme�ds a turnover rate of
6 - 8 hours.
5. A deck of at least three (3) feet wide, mea.sured fraan the pool waters
edge, shall be provided which extends caanpletely around all private
residential pools. Above ground �rivate residential pools may be
provided with decking of a minimum size of 4 feet by 4 feet at pool
entxy points and provided that such decking has the approval of the
City .
6. The divirig area will be acceptable provided there is no overhead
ob struction.
7. Fencing or other effective means including but not limited tA walls
or buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swi�uing pools.
Fencing shall meet the following criteria:
(a) The fencing shall prevent the entrance of children and be without
ha.nd or foot holds that would enable a person to cliinb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self-latching gates capable of
being locked.
(c) 5elf-closing and self-latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
8. An automatic chlorinator should be provided with a suitable test kit.
9. All electrical and pl�mmbing installations shall be inspected and
approved by the City Inspection Department.
�
d
Dolphin Pool & Patio
July 30, 1981
Re: 7361 Concerto Curve N.E.
Page 2
10. All overhead electrical lines must be a minimum of 10 feet horizontally
from the pool surface, and 18 feet straight line distance from the
waters edge. An alternative is to bury said lines.
11. The pool fill spout must be protected by a vacuum breaker or air-gapped.
12. Suitable safety equipment to include but not limited to a ring buoy
and mpe that is 1� times the pool diameter, and shepherds cmok pole
must be provided and maintained with the pool at all times.
Furthennore, these and any other requirc�aents must meet the pr��ie�it�is
the Fridley City Code, Section 115, S�aimming Pools. The building p
approved contingent on final inspections and approval by the City.
If any questions or problems arise from this letter, please feel free to
contact me at 571-3450.
Sincerely,
S N J. OLSON, R S.
Environmental Officer
SJO/mh
CC: Mr. Charles Kasick
7361 Concert� Curve N.E.
� � ���� ��;����
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8832 Seventh Avenue north, aolden Val�ey, Mft 55427 •(612) 542-9000
EQUIPMENT SPECIFICATIONS
�
�.
NATIONAL
SY� POd.
DA�E 7'34'�I �NSnruTs
Customer �1K� L
Address / N �
City State � Zip_�� _
Phone Home Office
Submitted By:
POOL DATA:
Pool Size & Shape �6x�� � Turnover Rate! ,Hours
Surface Area Sq. Ft. Rate of Flow d�..GPM
Capacity �,_Gallon$ Perimeter /O,�J—•-Lin.Ft.
PIPING DATA:
Suction ��
Returns
Manifold Y
. .
LINER STYLE
COPING STYLE
BOTTOM MAT�;RIAL
FILTER
PUN� & MOT OR
��E�IMMERS
��IR.FLOW INLETS
CHLORINATOR
POOL HEATER
POOL STEPS
LADDER
ANCHOR CUPS
� DIVING BOARD
SLIDE
POOL LIGHT
MAINTENANCE KIT
VACUUM KIT
AUTO POOL CLEANE
WINTER COVER
SOLAR COVER
CHEMICAL KIT
DECK WORK
DECK BRACES
CONCRETE FOOTING
FENCING
ELECTRICAL
OTHERS
•#
�
SCHARGE
CHEONS � o
......__.—_
t��x �
KIT
BRUSH
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by��+ '
December 18, 2000
Jackie Kasick
7361 Concerto Curve
Fridley MN 55432
RE: Chair Lift - Elevator ID# 00-06831 PT00-28R
Residence: Kasick, Jackie Residence
7361 Concerto Curve
Fridley 55432
Dear Sir/Madam:
Minnesota Statutes Chapter 16B provides that the Department of Administration, Building
Codes and Standards Division, Elevator Safety Section, inspect and approve elevators and
manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the
Elevator Safety Section recently inspected your residence and determined it meets
requirements of the Minnesota Elevator Safety Code.
NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for
Elevators and Escalators does not necessarily assure compliance with the
Americans With Disabilities Act of 1990.
Sincerely,
BUILDING CODES AND STANDARDS
�� . � � �
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`�=� -� . einke
State Elevator Inspector
bjr/rkr (CE-2)
c: Julkowski, Ronald, BO, City of Fridley
Tri State Lifts
ElFormCE2R
Building Codes and Standards Division, 408 Metro Square Building, 121 7th Place East, St. Paul, MN 55101-2181
Voice: 651.296.4639; Fax: 651.297.1973; TTY: 1.800.627.3529 and ask for 296.9929
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When realacing an existing furance, the undersigned hereby verifies that the
veriting has been examined and is free from rust, deterioration, obstructions,
and is securely suppo�ted and firestopped where required. Yes (� No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
specfications including sizing, length, number of elbows and termination. Yes () No Q�)
The undersigned also verifies that the replacement unit is a listed assembly
and meets the cuRent codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existing combustion air is sized and installed to meet the cuRent codes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
to meet the cuRent codes and manufacturers specifications.
Yes � No ( )
Yes � No ( )
Yes (� No ( )
When installing a new venting svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes (� No ()
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 cuRent codes. Yes (�j No ()
Aapiiance Tvpe and Size/Common Vent and Vent Connector Information
Appliance #1 Type U�� �c �P BTU Input 66���� Fan Assisted or Nat �
Appliance #2 Type �� e� ea er BTU Input a aoo Fan Assisted or Nat it/�tf
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances � Total Btu Input �°� °O `'
l ��
Common Vent Type C��SS !� Vent Height � Diameter � inches
�r
Appliance #1 Vent Connector Height �ft Length l�2 ft Diameter � in Type C��u C
Appliance #2 Vent Connector Height Z ft Length Z ft Diameter �—in Type c(afs �
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS• (Describe)
HEATING CO: ��rC'co l� t° 1` �'i �rq 7`���'�
Signed By: Date : S/ � �Z
_
_
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
August 23, 2002
Ms. Jackie Kasick
7361 Concerto Ciuve NE
Fridley, MN 55432
Re: Final Inspection at 7361 Concerto C�rve NE
Contractor: Pierce Refrigeration
Dear Ms. Kasick:
A mechanical permit was issued on May 8, 2002 to install a fumace and air conditioner at
your address. The final inspection conducted on May 30, 2002 noted the following
conections:
1. Size vent connector and common vent per GAMA tables.
2. Provide listed chimney cap.
3. Fire stop where common vent passes throuigh floor.
We need to reinspect to verify the corrections were completed. To set up the reinspection
or to have any questions answered, please contact the Building Inspection Division at (763)
572-3604.
DJ/mh
3uilding
:nspections
163-572-3604
�A� ���� �
ITE ADDRESS _
'FiIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
C1 �
��P/ -G�ee��
O OWNER �l
NAN1E: �'���e
Annt�ss: � 3 !c
PHONE: %�0 3 ' 7
NAME: • ,
STATE LICENSE # '
PROPERTY TYPE I �S]NGLE FAbID.Y/NE
❑ TWO FAMII.Y/NEW
PERNIIT TYPE � �DTtTON
❑ BASENIENT FWISH
❑ DECK
�E oF woRx:
�ESCRIBE �ORK BE]NG DONE:
3IZE OF
iROOFING
�TJMBER OF SQUARES O�
sARAGES
'ROPOSED SIZE:
?ROPOSID HEJGHT:
3IDIIVG
� Vinyl
7 Aluminum
� Other
VVINDOR'S
1�1 EXISTIIJG OPENINGS ❑Yes ONo
�R FOR NEW OPENTNGS-DESCRIBE STZE OF
�PENING CHANGES &
TYPE OF VdII�TDOW TO BE INSTALLED
Q.
OUR E-MAII. ADDRESS
_ __ __.
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" O SII?ING
❑ SWIlVIMING
. ❑ DITION
eam x�vtoD�..n
— rv
LENGTH
❑ HOUSE ONLY
�OUSE & GARAGE
❑ ATfACf�D GARAGE
� DEfACI�D GAR.AGE
❑SoffR
❑ Trim
O Fascia
IACATION OF WII�IDOWS
NUMBER OF
❑ �WS
❑ DRAIN TII E
❑ OTHER
Permit No.:
R���ea. By:
Daxe Rec'd:
HEIGHT
��3
Ft
BASENIENT REMODELING SUBMIT:
1. Existing Fl�r Plan
2. Proposed 800r plan
3. List of strucwral memUers to be used
FOR NEW CONSTRUCTIOAi INCLUDING DECKS,
ADDITIOAIS. & POItCHES SUBHDT:
1. Site Plen/Survey showing ffie existing str�cmres
aad proposed project
2. Two sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATIOAT, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING 'I`I� 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Dne
$ � 3,� S See Back Page for Fee Schedule
$ �T— 65% of Building Pemut Fee
$ �� j� (.0005) times the total job valuation – Minimum $.50
$ /^�� .001 x Permit Valuation (1/10%)
$ $5.00 (Sta.te 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 navable to: Citv of Fridlev Attach
THIS IS AN APPLICATTOAi FOR A PERMTf NOT VALID UNTIL PR�ESSED
I hereby apply for a building pemut and I aclmowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances an cpd of the i of Fridley and with the Minnesota Eonstruction Codes; that I understand this is not a
pemut but only an cation for e�mlt an work ' not to start without a permit; that the work will be in accordance with the approved
plan in the case of and p of plans.
SIGNATURE OF APPLIC - PRINT NAIvlE�tc (G� �`Il. aG�� DATE I/ �� d�
� / /
3
Page 2- Building Residential Applica.tion
BUII�DING PEI�MIT FEE SCHEDT�.E
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any a.ddition to any existing building or structure, or for any alteration or repair
to any existing buildi.ng or structure, upon applica.tion therefore, require the payment by the
applican.t for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
TOTAL VALUE FEES
$1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 fa�r each additional $100 or fraction, to and
includi.ng $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 pins $14 for each additional$1;000 or fraetion, to and
includin $$25,000
$25,001 to $50,000 $39125 foi 1�` $25,0�0 plus $10.10 for each additional $1,000 or fi�action,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1� $50,000 plus $7 for each additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1� $100,000 plus $5.60 for each additional$1,000 or fi-a.ction to
and including $SOO,Q00
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fraction to and includin $1,000,000
$1,000,001 and up $5,608.75 foi the 1$1,000,000 plus $3.15 for each additional $1,000 or
fraction
VERIFICATION OF FOUNDATION
Permits for consiruction will be issued a m;n;mum of 24 hours from the time of applica.tion to
allow for proper review of proposed structure and of the constxuction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Depariment
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977