AF - 37985�
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City of Fridley, Minn..
BUILDING PERMIT
Date: Se�t. 9, 1968
����� ��
N� 9924
pwner; ,�omedal,e Bu ders g�� Sa�g_ _..
pd� 5217 Wayzata Blvd. �,d�� Same
LOCATION OF BUILDING
No. ��........ 8treet ..— Concerto Curve � .�.._, p� of Lot
� 15 __ glock 2 Adclition or Sub-Divisicn _��� Me�ody Manor 3rd Addn.
Corner Lot — Inaide Lot X Setback 35 �—____ Sideyard ._ 12
5ewer Elevatian _____ 873 .74 _ 876 .74
Top of Footing
DESCRIPTION OF BUILDING
To � v�a as:
Dwelling �t 36� Dep� 40� g��t 20� Sq, �, 1210 �, �, 2r4 200
Garage Front 20' Depth z4 � Ke�ght 1 �� sq. F't. 480 �, �, 4800
Type of Construction Frame ��, �_��00 _ To be Completed Dec . 1968
SEWER LOCATION - 39' S. W. of Manhole
WATER LOCATIOIQ - 29' S. W. of Manhole
In cansideration of the issuance to me of a permit to construct the building described above I agr�e to do
the proposed work in accordance with the description above set �orth and in compliance wlth provisions oP
ordinances of the dty of Fridley. %� �� �� a_�"
In consfderation of the payment of a fee of $ 45 .00 .� ��t � hereby gi�anted to Homedale B�ders .
to construct the building or addition as described above. This �rmit ia granted uPon
the express condition that the person to whom it is granted and liia agents� emPloyees and workmen, 3n all work
daae i�►, around aad u�n said buildiug, or aay part thereof, ahall conform in all respects to the ordinauc� oE
Fridley� Minaesota location, construction, alteration, maintenance� r+epair and mev3ng oE buildinga
within the dty ]imits� permit may be revoked at er�y time upon violation oP aay of the Provisiona of seid
ordinaac.ea.
� _ B �.�..�_1'
Buildin8 InsPector
Clarence Belisle
NOTICEs
76b psrroN d�s not eovsr �hs eonsnueN�, hatalWioa toe wiring, ph�m6tee, �a hsMiae, saine ee wnsr. B� sun to ss�
tlro Buildieg I�or for ssparm parmhs for fhas tf�.
a.� ��
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Gr�xf S�►re+f�n�
So►ls &si�ry
C"�+erl F. M+miic�pro!
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�NG1i�EERING►� INC. ��°'°
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-- En9ineer�s � Sur veclors ---
c��t�scate �� �s��rr�e �o: � �'Y�'i � D�V"�,�,�P'�1�.11i'
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� CEN07ES IRON �hENCT ES ORAt1+tAGE � AWp U? 1LIT Y EASEMEt�1T
LOT ��• BLOCK Z� IVIELOCY MANOR 3RD A001TtON
A�KA C N�'�f
/�y ctrfr�y flrot Nus n o lrt�e �d mv�'tc� r�senf�ian a�'a sa`ratf �fl�.► 6au9►rdari�s !/r a�berer ai�vrb►d lar�d, �d
o�('lY,C /uot�vn a�ial/ bra�l�vl�s , l�ut�n ,�cid/ nsiddt �w�orli�n�-tts , r�'aa�/. %►em ar a� �aid !m'fd. AS s�'rL't�d 6� rn�' /ftrs �- dN�
�'_ e'�_______ a.v.�. SUBU�BAN fN�lNEERING. l�iC.
F.�rretrs fi� Sw`�`e�'sr}
Scale :1r s �Q,�� �� � '� �-�___-�,��. .�� .� . � �, _,
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APFLICAT:tON FOR BU7LDT_N(; PERMZT
CITY �0� E'B1D���'; MIF�N�SOTA. �
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„OWNEB' S Nl�1+� J;;, _ ,,;rBt1iLDEA � �1'
A4DDA�SS. �-��—,� y ._..�:.:_. --� r �1DARES$���.:4�� �.4��'
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. .. . :. �.:�r ,. ..�.... ,. . � ..
,_. . LOGATTON•: tl�. BtJILDII�jG _ • . , • � '�
., • � {
N0._s�� S�ET,�., .��._.�_._���'�f�l- �-��--
.. BLOCK_ � ADDTT�d%T; ,b�:. SUBD�?4TiSIdN ,�,��,� �.�
L.OT��,.� — -. ..���.,._.�.� . ..
,: . . . _. . . .
1�: 1 r
_ : � coxr�.R` _ sin� �r.ar r�`s��A�x�:�,si��� . 1� �.._.
5E[�R ELEVATION TOP OF FOOTiNG ,.
�Ap�J.iaant .a��ach tp� thia �qxm.,Two Ce��4,ficat�s uf: Snrvep of•jLot and proposed
bui�ding 1QCatioa .drawa,;on.,f�ese;,Certifi�Gatea�,� Y, ._ _. , _
. . �, f t � . �_ ., ;, ;DESC�,�TION OF B'�JILDII�G � .. , . � . . � �
. . ��_ t. , , .•:: . .. �r . � • .
To Be Uaed Ast . �� ' � �
0
..���' ,;G,r Frpnt �: � _ Depth_. ii4ight _�
_. � ��r,-;�; . � . .. �� � � _ � ��-.e�0'
5auare €eeC � .Cubic•,Feet
Square feet�g�'' . Cubic FeeC �'"�v"
���J t�d
Type of Conetructioa�, 7i ;�'�� ��i�, Estimated � Cost,�!��,��
To Be Campleted �"
The undersigned hereby makea applicatioa for a permit for the work herein
specifiecl, agreeing to do all work in stricC accordance with the City of
Fridley Ordiaaaces and rulittgs of the Depar�ene of Buildings, and hereby
declares thae all the facts and represeatations stated in tvia application
are true and correct.
DATE °� �l� ,_SIGNATIIRE �.�°��,� '��
_� _ ..�._�.
(Schedule of Fee Costs cen be fouad an the 8everse Side). �
,e..e� ` /��� °O ' � �ll s. S, F_
P,�-� .
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� BUILDING PERMIT FEE SCHEDULE
SECTION 2. Th�-'Inepector of Buildings shall, be�ore issuing permits' for
the erection of :�ay building or structure�,. �or•.,€pr :any addiCion to an�
existing er�"u�ttire o� bui�ding; 't�f fAr any alteration ojr. repairs to a�ip
exiseing building or structure, upan applicatin�,,�th�.refose, r�quire the
the paymeat by the appl3ca�s� for sueh"pe'rmit of L�es to the $mount herein
bel�,w set forth and ie the manner herin provided to-w�tt:
��...,'�"•.�•: . � . . . _ . � - .
-IIri��uildi'n� Code; a~ Type 1, 2, 6 4-,.$1.75 for each one •Chousand cub3c
feet, er fxactip� t��eof, . in su�h cubical. �contente�. Tqpe 3 6 5- $1.50 for
_eaeh aae Cheusaad cubic feet. � �
-,. �. .. . ..
F.�r the parpose �ef 'computiag #ees fo= building�.per.mite, th�e, cubica].
ernatenCS ef anq by�;lding��or- ac�ditivn �e� �a �u�iform he3ght througho�t by
multiplying the grouad area cavered fr�.a �oint.eis (6)..�ric•hes �elow the floo-
line af the basement oz.the cellar te the av+erage height of the upper surface
or to Che avera.�e heitght of the roof surface of the main gabYe of a
pitched roof . . •� • . � ", . . • � °
- Fer repaire Qr a,l;te�ratfons to an ex�.s'tiin� ��tiu�tuxe�,�. the s�f�e'`"shat� `be at the
�xate of'$3.06 per each five hundred dollars ($500.40) or fraction thereof
ia ehe cost of all Propcsed work. .
. • .. . . .. �a
Is �o case ahal�. 'th�e fee,.ctiarged for`anq perm�tt .as. sat._��orch� �ia �Section 2 be
leas than $S.AO. '
NSSSD C�nnection Charges based oa lecgtiron- Area'1 or 2. ,
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HOUSE HEATING TEST RECORD
ADDRESS ���J' �" ��c'-��� APT. F OR CI S RB �
OCCUE�►NT OWNER � � � �
HF/►�T LOSS DATE HTG. INST. GAS C0. METER BADG °
SOLD BY INSTALLED BY
Eleetrical Work By Gaa Lins By
TYPE OF HEAT GA FA �W STEAM SPACE HTR. UNIT HTR. OTHER
J�!� j`� Gl�DES�I % � � CONYERSION
MAKE ��� L1� �� � MAKE OF BURNER
Model __��,�� �f'"f/�.� �� Model
Serial -5 -����'�-� � Max. BTU Rating
INPUT ,�� ��� MAKE OF FURNACE
Model
CQNTROLS �
THERMOSTAT ��/L41eat Plug Vsnt Size
Valve ��� KIND OF LINER IZ �� NONE
Limit ��— �� f�� ���_ Draft Hood Regulamr
Limtt Ssriing �� Filters Size Number
Fan Setting —���i /-? —l�� Chimney Location Inslde � Outaide
Pilot Ty� (�(mney Construdion
Pilot Make � �
Pilot Model / � Smoke Bomb Wiring
Pilot Timing ��� Draft /% /� Test Tag ��
L.W. Cut Off f, � `�� � or Pressure— Lighting Inst. ��
Prossure �� Pe eent 0 � Date Tsatsd ^- �
Input CFH �/"�,� P�E�i�' ''�/�ompany Testing
Staek Temp. -� Peresnt CO , � d� Name of Teater -
Form 235
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srAiE aF MINNESOTA DEPARTI'�NT OF HEJILTH ���. —"lJ� �
ABANDONED IiEU. RECORD
i. ��rice OF w[�� �� , � / MINNESOTA UNIQUE MELL N0.
tounty Name ���--1v (ieeve blank if not knmm)
TamaMp Naam mmsMp 1lumba� Rgng6 Mumber Sectlon Na. Fraetion 4. MELL DEPTH (eompleted) Oaie sesled
N E k 4 of �
Fridley 301� Sr 24W �� 11 SW SW N 19ft� 5-21-91
Numerical 5treet Ad�ress and Ctty of Yell Loeallon or Dlatance trom Road 5. ORILLIPI6 METHOD (1f known)
/ Intersection., 1C7 caele toot 40 Rerene )[] oriren lq] uug
( � �
7408 �bncerto Curve, Fridley, Mn 55432 � H0��0Y R0d �7"�� �7 eo�a 1 NA
��y-eaact 1 ation of wel l ���rY b� Jettad 90 Pmro� Auge�
� (t, ion yrid rith •X•) � Slcatch map of relt loution g. QgSTRUCTIONS
N /�J Yeil obatrueted 0 7ea �] 80
- t__ ._._� /p c��� � ��� Obstruetlons removed � ras [] Mo If abstructlons cnnnot be
� � � � � r�oved, contact !�H
W _' ' � � � yu u s C betorc sasllny.
� - _ ° ' : ' I _ ; _ rE �� 7. USE
- , • � • � - - � y .a, / — - 1[� �mastie 4� MonitoMng � Heat Loop
..� .._... _.,.. .... _ I C C� N['� P� fiU �Ir�igatlon 5� Public 90 indust�y
� � S� 1 30 Test Mall bj] Nunicipal 1� Co�ercial
�-- 1 .it. —� 7[JA1� Coaditloning 11[]
2. PR�PERTT OWNER'S H0.RE Natling Addnss tf dlffemnt than 8. CASIN6(S)
property addreas indlcaLed a�vs 10 Black 40 Threeded 7C1
�Galr. 5� Wided
Mark Sticak Same �j]Plasttc 6psc����e,: se�ei
Haaoxess ov 1� tn, co 19 rt.
3. FORMATtON l�G COLOR FORMATIOl1 FROM TO
If not knawn. indlcate farmatlon log from ner re11 0� nearAy wall. tn. to ft.
NA 9. scrt�en
p s��ea �i t r� _ rt. u rc.
— (tf �o.m�
❑ Open Hola fron _ ft. to ft.
1VA
10. STATIC MATER LEYE�
1 7 ft. � belor ❑ aeora 5/21/9
tand surfaee Date Heesurod
il. YELLHEAD CONPLETION
1� Pitless Adapta� � Found BuMed
208asemenL offset � 1' above arade
30 Wall P1t
16. REMARKS. ELEVATI011, SOURCE OF OATA - CASINGS REMOVED. CASINGS PERFORATED. ETC.
12. GR IMG INFORNATI08
I[�Neat Ceaent 2[] 8entoMte �
Sand point Grout material #1 rrom�w1g rt. ��. yds
Possibly driven for grass irrigation --
13. NFJ�R�ST SOURCES OF CONTAMINATION
�.Ufeet S hcrettioe�•G• �,.p7Ilq type
Yell disinfeeted befo►e sea11ng1 []�ea
14. PUMP � Removed �Nat Present
• Type: 1[1 Su�anlble 3� L,S. Turbine 5� Reciprocating
20 Jet � 4� Centrlfugal 6�
• 15. EXISTIH6 YE�IS (Ptasa� skateh loeatlom oP abandoned a�d
activa we11a in r�aa�ka sectlon or on back.)
Other unusad wil(s) on property7 � 1'ea �] 80
Abandoned: [] Permanent � T�nporary � pot sealed
17. WATER IIELL COMTRACTORS CERTtFICATIOA
This well aas sesled under my Jurlsdietion and this report
is true to the 6est of my knowisdge and betief.
Lleensee BusJnass Name Ltcense tlo.
, rott Drillin Services� Inc 02303
� Address 681. Birch t Lino Lakes, Mn 550 4
Stgned - - o-c � Dete � a•! /� �l'�
Brad Bar�tt pau 5-21-91
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COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacin� an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all cuRent codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's 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 manufacturers specifications.
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacture�'s specifications.
Yes ( ) No ( )
Yes( ) No( )
Yes( ) No( )
When installins� a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specfications. 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 current codes. Yes () No ()
Appliance Type 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 Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
PERNIIT NO.: 2004-01729 ���
DATE ISSi7ED: 10/OS/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 7408 CONCERTO CRV NE
PIN : 113024130075
LEGAL DESC : MELODY MANOR 3RD ADD
: LOT 15 BLOCK 2
PERNIIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSLTE DATE. INSTALL A SAVERS
SWITCH.
# INSPECTIONS 1
APPLICANT ELEC PERNIIT FEE - NII1�T (RESn 20.00
HUNT ELECTRIC CORPORATION STATE SURCHARGE, ELEC FLAT 0.50
2300 TERRITORIAL RD TOTAL 20.50
ST PAUL, MN 55114- PAID WITH CHECK # 118132
OWNER
REDMOND JOHN D& NANCY J
7408 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 know the same to be true and correct. All
provisions of laws and oidinances governing this type of work
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 provisio of any er state or local law
regulating constru 'on or the erfo ce of construction.
Applicant Date
Bldg Ins Dat�°` l
SEPARATE PERNIITS RE D FOR WORK OTHER THAN DESCRIBED ABOVE.