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AF - 37974,� � n City of Fridley, Mirm. BUILI�ING PERMIT Da�; Feb. 21, 1969 � � �S 9 � � pwner; James Glidden B��, Clemron, Inc. pd�re� ,�d�e� 4411 Central Ave . N E N° 10i10 LOCATION OF BUILDING No. 7398 g�t Concerto Curve _ part oP Lot Lot 1 __ Block 3 Addition or Sub-Diviaion Melod3 Manor 2nd Addn Coraer Lot — X 7naide Lot � Setback 35 � Sideyard 17 � 6" Sewer IIevation 870.85 ._ 8Z�_R5 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwell ing ��t 31' Depth �� Height 20' Sq, Ft, 775 �� 15 , 5 00 Garage �Yont 20 � Depth 25 � I�eight 1 �� Sq. Ft _�� Cu. FL _ 5 Q00 'lj�pe of Construction __._ Frame ��, �_ 25 000 To be Completed SEWER LOCATION - 33.6' S. W.of Manhole (25' Lead, WATER LOCATION - 15' N. E. of Sewer n In con�deration of the issuance to me of a perm4t to construct the building described above, I agree to do the proposed work in accordance with the description above set Porth and in co�npliance with all pravlsions oP ordinances of the dty oP Fridley. �,i,�� .- a. 5100.00 Sewer Connectin Char�e Ea consfderatton of fhe payment oP a fee of $ 31. 00 ��t �� Clemron, Inc . to construct the buflding or addition as d�cribed above. Thispe rmit is granted upoa the express condition that the pereon to whom it ie granted and his agents, employees aad worlanen, in all work dane in, around and u�n said huilding, or any part thereof, shall cronform in all respects to the ordinance� oP FridleY, Minnesota regarding location, construction, alteration, meutntenance, repair and moving of bufldinga wlthin the dty limfts and this permit may be revoked at any time upon violation of aay of the Provisions of said ordinanc�. - , Official ..•—_— �-- —�...��:.�'�.L' f :i::f? . - �? NOTIC� 761s psrmit d�s eo� eover ihs eoes�ruetion, iestallaHon Por v+6Pne, plumbine, ea 6eaHa8, awe� er wNsa B� ara to ss� fha Bailding lesp�etor fo� uparat� parmNs for t6� Itfms. " a 6 _' v 1 � �rei APPLICATION FOR BUII.DING PERMIT CITY OF FRIIiLEY, MiNNESOTA OWNER' S NAME s�e e alidden BUILDER Clenaro� � Inc. ADDRESS ADDR�SS�l�.11 Certtral ��v�a . N.E. LOCAT�OAT OF BOILDING N0._ 73� � S�REET--.- Ccaac�r�o PART OF LOT �_ 1 BLOCR 3 ADDITION OR SUBDZVISION M�a 1_� rqat�pY• 2nd Add� GOI2NER LOT�_INSIDE LOT SETBACR 35 � SIDE-YARD_ 1? � 6� SEWER ELEVATION FODNDATIOft ELEVATIQft �BbOVe c�t1Pb Applicant attach to this form Two Certificates of Survey�of Lot and proposed building location drawn on these Certificates. ' DESC1tIPTIOft OF BUII.DIIVG To be used as; S8ID8 as� 73?0 I'�em�ry La�e _ _ �-L-��c-D .D 1%.A� _ Front � / Depth � � fleight o7 U Sq. Ft._ y'y� Cu. Ft._ / S� S� Front a v� Depth �� Aeight�� Sq. Ft. S� (;u, gt. o,j �'fi-� Type of Construction�/�.�y�•,�� Estimated Cost__ �� T�� To be completed The undersigned hereby ma,kea application for a permit for the work herein specified, agreeing to do a11 work in strict accordance with the City of Fridley Ordinances and ruliags of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicati.on "� are true and correct.. DATE 1��brLBr' l9z 19%9 SIGNATURE =� (Schedule of Fee Costs can be found on the Revers Side). � �1 � � ' � I � , , �"`1 - � - - �'1 �, BIIILDII�TG PERMIT FEE SCflEDDLE SEG'TION 2. The Inapector of Buil�inga 'shall, before iaeuing aay permit for the erection of any building or structure, or for any addition to any esistin� building or gtructure, or for any alterations or repairs to any existin� building or etructure, upon application therefore, sequire the paymeat by the applicant for suc�i permit of fees 'to the amount her.ein below-s�t fort�i and in the manner herein provided to-wit: a a a . , � 2_ 1, For any auch permit for the erection of anq fire-proof building, othei than a garage, warehouse, factory or grain �Yevator, or for the erection of any fire-proof addition, for similar occupancy, to any exiatin� building, shall be at the rate of �$1.40 for each one thcueand cuhic feet,�or fraction thereof, in such cubical contents. � . .. . 2,+.2 For any si�ch.permit for the erection of anq fire-proof garage, warehouse, factory or grain elevator, or for the erection of'any fire-proof addition, for similar occupamcy� to any existing building ahall be at the rate�of $1.25 for�each one thousand cubic feet, cl.assified as "fireproof" by Section 502 of the Minneapolis Build3,ng Code. HOIISES 2� 3. For any such permit for the erection of any aoa-fireproof building, other than a garage, warehouso, factory or �rain elevator, or � any non-fireproof addition, for similar occupancys to an� existing building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any suck�permit for tha erection of aay non-fireproof garage, warehouae, factory or �rain elevator,,.or,for the erection of aay non-fire-proof additioa, for�eimilar occupancy, to any exisCing building or for each auch building or addition - ninety cents ($0.90) for each oue thousand cubic feet. or fraction thereof, in the cubical eontents thereof with the minimuui of "$4.00. For the purpose of computing fees for.building permita, the cub�cal contents of any buildiag or additioa to a uniform height throughout by�mul•tiplyi�g the, ground area covered fram a point six.(6) inches below the floor line of..the basement or cellar to the average.hr�fght of the upper.surface or to the average height of the roof surface of the main geble of a pitched roof. • 2_5_ For repaire or �Zterations to an.existing atructure, the fee s?�Pll be at the rate of $3.00 per each Five Auadred Dollara ($500.00) or fractivn thereof in the cost of all�proposed work. 2.6. . In no case shall the fee charged for any permit as set for�h in Saction 2 be less than $4.00. STORM REPAIR DAMAGE EEES: Residential: Estimated Cost of work up to $500.�� -�5.!?� Estimated Coat of work over 54�::..^:'' -s ;�:r,�-, ��0 Co�ercial; Estimated�st of work t�,: �:�, '�.� :'�;:, :.��) _. :;?."� a :�=- —-� Eatimated _�sC Of WOZi: u:,i':�t°°y?i1ZaUi! — 4i1?. � `• -�`L"' R �.= _ a . t lf7rttl f'lgttrtrn� Ca��.t�rrey�ny 3nr15 Tetlarc� (ivrl fr Afirtwrr�o�7/ £n�rrieer�rz� ,��' � ,�.� ?r ' ��i� � . �' 6875-H,�hncrr� ;tt ,vf.. ,��i,trtFi7fltL�.i ?l. ENC INEE�tNG, INC, -�'F��°'J SI�r,;eF.�-60t�t� -- En�ineers � Surve�o�s -- cests�scate o� ti�� 20.0 -,_�' ��. � / ° .� '�_..._�, " d ` . `�_. �.� � � � s�,t�eT �o� - E+� M DEYELnP1�F.i�tT C0. OTE�- � �E/.BB2 �¢l• Be�• l. Elevairions 5i.a.vn nre P�ope�.¢d � w �T�+r .r `-� `�,� 2, Fi��t C1sor sh 2.5 ii. •6�vQ. gr�n+td s „ � / � � � � hoa5¢ Coe►n¢�+-S . / � _ �-f /� �. �`� . �� \ E1�✓• o,r��?r:v.rar� hous� � ,� — � corncr^.s �'83�+� � `� �s� � � , `�� ;-�� +�'� �. ' G � �' • � . �o �, C� �� , G �� '�� \ r \ � .= a � . •` , � � � �� ,, r� ,a N� � �� o EI. � \ �` 8j� �i°� � ¢ � , g � �Zo� , . �� ' �' ��/ � �j�i� b :`" y i/ °� � �£, / � �� s�, �� " �j r� �� 'l�9��,' � �� '��,� ��`� �` �e� 8�8�� o z�EtvoTe� IRoN �' ��' � UENoTE5 Di�AtN�GE � UTILITY T�.A►sEME�tT LOT � BLOCK � MELODY lU'IA►N4R 2''—° ,i4I}D�TION �4nokq Goun}Y – M�ntt¢�eo-}�o�� • I htrefi�C url�i�'y 1%t lh�s rs o lrr�a and ��f �r�a*esentafe�n o�("a si,rv�y �f'1h� d�o�,na�es �'!�r ada,�r aEsrl+6�d /a►nd, mad a�"t'i�r /aatf '�n gi'ol/ baNin9s ,�wt , avd d� riii6ly d�orrli'mtnfs , il'orr�, �i ar en sa�id /and. As wrrr�cd f� rn�t f�s _ d� ' �' a„�r � l A_D �1�. SUB UR�AN ENG/NEERINC'i . lNC. �/T�➢7►NtlS �l' StI/"►21�OPJ SCALE. 1"= 3Q' � p/�� (- � >_.�_—__ _ ''"\ i'� w ^ . r�..,._ �-._. � �- --t. f., �� c�0 ' yll ►�i. � �. � � � � cb0 0 � � x � � � � � � b ��'��i �' ��'� �'s� � O � � r. �'a`, � �C � � � � �. n. �t °-+� � �" � Q � � � y �i; � �. `z o�� n �b � � Py N. � �� .��' A y � �. �. � � Q. h � O Q �. 0 � "`4 n, b y � � � � Q � a� �• � Co' c�� m �• `�' �, y � p � � O � �'` p b � _ °�°��' �p � � � �• t� � � �� ea A C• n �b�°~�',o t� (� C � O t0 � s• � � � � O � � "� O "' —� �' ` � to ~ �� o,Ci � O o '�j �' � � y b �. �„ �,��o�. � � � ,. � � aa � � AJ � � � �o � A� C4 n. A� O � � � _� � � � O � Op p � � e M � � � � � 0�4 0 M m � W � � � "a� �, � � � � �' I I I ICLOBETB � I I I I I URINALB a I Irues � (�' I � I IBASINB � � o � � �' � � � �. � � o � � �� o � � � � � � A . � � I�D 0 � ISINKB � �• � � @(((�� I WASH � G ¢ � � ` � s� TRAYS vi n DRINK a � �is FOUNT. M � � O T "� � ��j O ISNOWERS O O a � �: � 1y a IFLOOR O O �" � DRAINS �q' � � � � �� ICATCH '� � � � BASINS m � yyy�� RAINW. � � � ILDRB. � � � � IMISC. � �'• � FIX. �� yyy OAS M � � A � APPL. � C3A8 " � RAN6E :y ro � � �� > 0 i w �� f� � x �� p n � �9:� � . � a� _ o � � z � �, � � � � �. � ��.,' � � '� � � �. :o M � � � '� �, � � � ti I� � � � �' �' �' � i A N i 3 < � � � � °-�, � � tn y `ry° �, ° p ��:A� aY�a � �OO��i� � � �. s• �•o .�. �, C � �"� ��y„�. o��•�, �� c�o��'� � � �.��',c,� no��, F�'o �, n. F�• A '� �'� Q � o�.�.�.� �, � � � A � � ��'� � �' �� •�� b pb A � � �' S o �, o � � � �: �;' o, � � c� � �_ �' C `ti. �• eti. V� � � � ' � �� J �� , ,�� o � �• � � �, an � A � ��,�. � o �. �� A��-� � � �� $ E;' � n' ° � r« � Fo 0 �� bR'Qy�a �I �, b � �i. � w o � �°. �' r. � � �to'�� A �� o��; ��.��+�p y y� (0 R' 1 • � a�J ��t�"'O �n+. �' `C �+ (0 � ,� � o z � o � � Q � o� o � �o �' c�' (�. m p+ � I I , N I � � � c 0 � � c � � � �' � � � �, O �. a � �. � o � � �' c1 0 � b � � � t° ° a' � � � � � � 'b � � � � � � o � � � � � �. � \ , �� I � �U � O+ l0 �' a � � � � �. a O � � � � � � � � � � � � � \ N � � � � � � O a O � � � � � ; � � � � —�0-,.<3 � p D �I a �: -� � Q o � � o 'o y � O . � 7v � 3 � � � � Q �� Q rt h !� D � n� � _ y � � m� . O 0 �""� � � b � � � O � � A � � � � � � 9'1 Q. � `Z � � � •0 � � , ;� C � � � � Q� �„ `,p, • ' �' M O � ' HOUSE HEATING TEST RECORD ADDRESS �� APT.��j L OR CI UBURB ��` OCCUPANT OWNER �",�� i ��- HEAT LOSS DATE HTG. INST. GAS C0. METER BAD # SOLD BY INSTALLED BY �' Elsetrical Work BY Gas Lins By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER _��C�C� GA ESc�_ _`�•�� CONVERSION MAKE ��- �=� � MAKE OF BURNER Model a?/� � ��1� D �'� � Model Serial .��/ ��"'�� Max. BTU Rattng INPUT �2� �% MAKE OF FURNACE Model NTROLS 7 THERMOSTAT �, `� at$�(ig Venf Sizs � Valve �� c �CIND OF LINER � SI�E NONE Limit � � �' �� _�� Droft Hood ___Z:��f Re9ulamr Limff Ssfting � Filters Size Number Fan Settine l'��'��" C�imney Location Insida e°� Outaide Pilot Type i Chimney Construdion Pilot Make Pilot Model Smoke Bomb ` Wiring �� Pilot Timing Draft �/'' `'�— Test Ta �� e L.W. Cuf Off Qyor Pressuro— Light(ng Inat.�� 9 � � � �/ Preasuro ��' �` �P �n t p D te Teated `�� '� Input CFH �� frerelfe� '' �c �'' - mpany Testing � Staek Temp. �,� Pereent CO �� Name of Teater Form Z35 °�-- SuBJEC7 . c�ty of Fridley . 0 18721 AT THE TOP OF THE TWINS g U I L D I N G P E R M i T r EIPT . , � aa��-� � `y __�__. COMMUNITY DEVELOPMENT DIV. � r � � PROTECTIVE INSPECTION SEC. I i � � /��'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'""� � �'� 612-571-3450 910-F15 10/22/86 � � JOB ADDRESS 7398 Concerto Curve N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 3 Melody Marior ZT1C�. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE �d James and Carole GLidden same � 786-6836 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING ' R-1 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Storage shed - 12' x 12' 9 CHANOEQFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATIN(3, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PEHMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHOfiIZED 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 WOFiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALI.S GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUF;TAX AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT %OO.00 �.'rJO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CNARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LS.00 PLAN CHECK FEE TOTAL FEE 15.50 ATUREOFCONiRACTOR AUTHORIZEDAGENT IDATEI WHE PROPE LY A A HIS IS YOUR PERMIT P � _ �� `Z �� Si � A URE OF OWNERi1F OWNER 8 LDER� IDATEI \ G iNSP �a7E p� �� City of Fridley Effective 4/1/8� ADDN. [ 7 R-1 AKD R-2 pLTER. [ � Building Permit Application Construction Address: %� �� 1. +� �c�� e-� � u � �T' I � �C.. � � �C. � i(1''1 � � �� ii �� 6� "� � Legal Description: I �� ; "—�'�� owner Name & Address : �! ��c�s a. C"c� 20 le �Ls �d�Pr� Tel. � 7�� `��`3� Contractor: Tel. # Address• Attach to this application, a Certificate of Survey of the lot, With the proposed construction draWn on it to scale. DESCRIPTIOP OF IMPROYEI�NT LIVIPG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECR AREA: Length Width Hgt/Ground Sq. Ft. OTH S%.o � r� g � �' G,.. � �% / � �C / Z - Corner Lot I�J Inside Lot [] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ 700 Approx. Completion Date: 10 - v�� °�C� Alt. A Alt B Proposed Drivexay Width If Nex Opening Is Desired: � $ See Back Page for Explanation ZZ -� c Tel . 4 7S1� -�if3'� DATE: I� � � APPLICANT � � CITY IISE ONLY Permit Fee � l��o�� _ Fee Schedule on Reverse Side Plan Check � � 25� of Building Permit Fee State Surcharge $ �� 5.50/$1�000 Valuation SAC Charge $ �u75 per SAC Unit Park Fee $ Fee Determined by Engineering Se�rer Nlain Charge � � �.�� Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS• BIIII.DING PERMIT FEE SCHEDIILE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any add3tion to any existing building or structure, or for any alteration or repair to any existing building or structure, upon applicatio n 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 Valuation �1.00 to �500.00 $501.00 to $2,000.00 $2,001.00 to $25�000.00 $25,001.00 to $50,000.00 $50,001.00 to $100,000.00 �100�001.00 and up Fees $10.00 (Minimum Fee is �15.00) $10.00 for the first �500 plus �1.50 for each additional �100 or fraction thereof, to and including �2,000. $32•50 for the first �2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and ineluding $25,000. �170.50 for the first �25,000 plus �4.50 for each additional $1�000 or fraction thereof, to and including �50,000. $283.00 for the first additional $1 , 000 or including �100,000. $50,000 plus $3.00 for each fractfon thereof, to and ��33.00 for the first $100,000 plus $2.50 for each additional �1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROii (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Drivexay Width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach With 6 inch depth - Driveuay �ridth plus 6 feet times $15.75 VERIFICATION OF FOIINDATION Permits for construction Will be issued a minimum of 2u hours from the time of application to allow for proper revieW of the proposed structure and of the construction site. A Certificate of Survey of the lot, shouing the location of the foundation onee it has been eonstructed xill be required before proceeding With the framing. - � � - - � =� �-.- _ � • ,,, .. � � � . , . ��1 . - . . 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'�. �� toka �Ca�ri}� � �ll�*ts��,�►i�►�a� x; `'g " �y �` - 1 �rtby � � � a � �as �s+�i'�ci iepra� a�'+e �� +�'�1ic Ms.�ti�w�s �'dlir ,�drnrn�►�d lsad,,er�d '� � � ��: �";�k la�alriari 4P4 a� ��, A�v, �ad�V+�tt ,,�i�y'.�sr� rr �ae� /aaat J� snrtieya,r! � m� /l�..—.-.�: � > :+�'=-�-�A—r�'r... � .�., � .�.: a:�� , - d � �� - . : _ , - . . . . _ �.: : ; _ ,s - .r _. . ,_ . � �J�tIR� AN ENGIJYfEQWI� il�fG. Nr t, . .� � . - �i • - , �� ' ,�� - � �?. �_ I 1�^y� � - . . _.r : , . � . r . -�' . ��. - QG' n� � r''��::s$ sawo �"`:.`�::.�,.�.�: , .�`��i`e SS - (�p •�S� o �soah �n � �w.� • iB�,_�� _ - � � C°�o�a!!T^+ Y ii . sue�ecr E RM City of Fridley 2 6 31 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ' � O. � �v _ COMMUNITY DEVELOPMENT DIV. p� r � � � PROTECTIVE INSPECTION SEC. �� J i . i s � � /�"1 � CITY HALL fRIDLE� SS432 NUMBER REV DATE PAGE OF APPROVED BV �----�' ,•� 612-571-3450 9t0-F15 6/23/98 � � JOB ADDRESS 7398 Concerto Curve NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACNED DESCR. 1 3 Melody Manor 2nd Addition SHEET 2 PROPERTV OWNER MAIL ADORES$ IIP PFIONE James/Carol� Glidden 7398 Concerto Curve NE 786-6836 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO. 6 USE OF BUILDING Residenital 7 CLASS OF WORK � NEW ❑ ADDITtON ❑ ALTERATION �7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK • Reroof House & Garage (17 Sq) Tear-off 9 CHAN(3E OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. ti SEPAHATE PERMITS ARE FEOUIRED FOR ELECTRICAL, PLUMBING. NEATING, TYPE OF CONST. OCCUPANCY dROUP OCCUPANCY LOAD VENTILATING OFi AIR CONDITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR, CONSTRUCTION 20NINO S�. FT. CU. FT. AUTHOfi12ED IS NOT COMMENCED WITHIN 80 DAVS, OR IF CONSTRUCTION OR WOHK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWIG. UNITS OFFSTREET PARKING I HEREBY CERTIFV TNAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A pERMIT �1 f4'17 W. ]1 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ��FO.�F% Fire SC �1.4L PLAN CHECK FEE TOTAL E � .1� SIGNATUFEOFCON�RACTORORAUTMOtiIZEDAGENT IDATEI N pp p LIDATED T IS IS VOU PERMIT � -�i�_�__--_ � �3-�� G.' " �-13-�� SiGNATUREOFQWNERi1iOWNERBUILDER� IDATE� �ByAC�, gp qaiE NEW [ ] � Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 ,�� BUILDING PERIVIIT APPLICATION ,�,Ui � � .� �' ConstructionAddress: � � � �' D� � �° s� � � � � �- Legal Description: S , � � �� G� � �Al v �C� �Z� �� %' s Owner Name & Address: ��"ea ��s ,f- � s� ��e � l � c�c�c � Tel. # 7�( —� �.�' h Contractor: MN LICENSE # Address: , Tel. # LIVING 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 Length Width Height Length Width , Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: � e. 1C p p� !/ r�� Estimated Cost: $�� D l� r�% �%l7 � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: —o � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Ft x $ _ $ $ y� �� l• �. �D r $ CITY USE ONLY Fee 5chedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,0(� Valuation $1000 per SAC Unit Tel. # %S�� 3� $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. °B" Above E� $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL STIPULATIONS: $ �%G. `U' >_� �- BUII.DING 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 $50,000 $50,001 to $100,0� $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 fo: `�first $50,000 plus $6.25 for each additional $1,000 or €raction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or Traction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012:25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof IDRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6�nch depth - Driveway width plus 6 feet times $15.75. 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 construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. 1072 Payne Ave. St. Paul, MN 55101 651 /772-2449 GAS WORK ORDER � -�r., .� STANDA�RD �� 4�o W. �ake st. b HEATING � M�� s �8242sss�os & AIR CONDITIONING ` A Blue Do�: Service Co. EQUIPMENT INFORMATION LAST � � r� ��`'� � FIRST �. �r � TYPE ADDRESS `l � �' c� Y1 G� %`�� c� MAKE � CITY A ZIP �,� MODEL 3��j HM PH ` �i'� "' K PH SERIAL Q�'J TECH DATE �' �� WPUT �� , CO2 '� � O2 e� CO NET STACK TEMP % ��o % �� ORSAT TEST RECORD � METERED INPUT .�C� Cfh CHIMNEY TYPE �e LIMIT SEITING % �� ° FLUE SIZE PILOT OUTAGE l sec CONNECTOR SIZE . � TOTAL CHIMNEY INPUT f in. in. btuh � � D � � � O 'D � � o �,• � N. � O ti � � � � o � � � 0 Q� O �a �• o� � A cD a Q' o � m °' N � � � d 1 "4 Q. . � � 0 c � D a � 0 < m fl. � � 0 c 0� s � � N �r N � � � 0 � N J � :L7 m z N � m � O z � m m � � V 0 O � _ � N oq � m Q. 2 � � � � �-' o � 3 � � � °, �. d \ c�u Q. �• � D �+ "� �i c�' � A m 0 � � 0 �- O � N I""' � m = � m �. d oa c� � � � �� 0 � r a� � � � �� -� � vi --� ��,�� A � m � � � a � o Q. � � .+ n► �, _ � � �. f/f W �, lD v, _, � a .� aa � � � o � a � Q, � 3 vo� r►<�°_' � �v� —d � � O y $�� n� Q' �•'� .�+�� C� �D _ � � =t N a� �► � � fl.n"-w � A Q O C � � fl1 m � �� N � � Q- ^� 3 c� a�i � �_« o •�+- s �. � �, o � � — �- ,_,. �. 3 m �- m C� � � � o N Q � N Q' � � Q N � � � � D �_ �o -�,, � < `D � N � m m -�i. � a N' v c�' D � � m � O � �o � O N � r N � O Z � n � D C7 O � a O � 7� Oq D N m N � N � f�D � G� G� D '� � � N y � fA a�i �^�n � � 'p. Cn fD �p �„� c°qu oa m� cn d � Q�<� m �. � �. � c� � Q . � � � �p ,�.� �+ �. � a._�p —c � �; O � � ��d� � � W � o � � c°'i �- �� ..�i�v W C m � � � � cNn o 0 0 0 0 t� �a t�► �a 9 � � �� C W � m � � � a m Z oi m 2 -O � N CD z 0 m v � � Z �, o �" O m �, � _ � � � m = '�c � �- I 2 � � � al n n � O � 7 � 7 �p � ^ N �- fn f�D r N� � Qmz3 v �o� _ �o �� dm 3 �I D � � 0 0 � 0 o a'' m � � 0 n� � � m � � D � m v C� O � � Q � Z77 3 I -_� z O � \ � W C r v z � C � m � � � m N n x m v C r m O z m � � � � � � � �-d (T� TI d1 n . V 3. � — N a W � y r C1 � C � �A�c'�7 Z fD �7 �� W D � N t�u Z z C� rn -° m . � O z � < � D � � z � r \ � � � �Q � mz � �O -�i � O� Z� Z� v .� a� � �� O �/► vz �v o= �- Z rn W Z -�I D � Z °v �� m -N1 � O � 30 �N Z a� Z- vm v� �� n � �N O � Z � d / � m � <' m O � ` v � c � � ►-+ N O O O � d COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furance, the undersigned hereby verfies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastiGPVC and meets all current codes and manufacturer specifications including sizing, �ength, number of elbows and termination. Yes () No () The undersigned also verifles that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina 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 current codes and manufacturer's specifications. Yes( ) No( ) Yes ( ) No ( ) Yes ( ) No ( ) When installing a new ventina system, 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 coRectly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Aaaliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input " Common Vent Type Vent Height Appliance #1 Vent Connector Height ft Length ft Appliance #2 Vent Connector Height ft Length ft Appliance #3 Vent Connector Height ft Length ft _ Diam�;er�_ inches ;�� Diameter '-�� in Type Diameter �in Type Diameter �' ' ��in Type ALTERATIONS• (Describe) � HEATING CO: Signed By: Date : � _ C[ ■ � OF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 23, 2001 Carole Glidden 7398 Concerto Curve NE Fridley, MN 55432 Re: Final Inspection at 7398 Concerto Curve NE Contractor: Standard Heating & Air Cond Co. Dear Ms. Glidden: A mechanical permit was issued on July 6, 2000 for the installation of a gas fumace and air conditioner at your address. According to Section 305(a) of the 1991 Uniform Mechanical Code, a final inspection shall be performed on the mechanical permit. As of this date no inspection has been called for. The permit fee that was paid covers the inspector's time to check to make sure the furnace and air conditioner were installed correctly. We also need to check for the installation of combustion air, vent and connector sizing. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, your permit will expire and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAV��ENSEN Buil i g Inspector DJ/mh a �