Loading...
AF - 37992� � � City of Fridley, Minn. BUILDING PERMIT Date: July 25 , 1968 p�; Homedale Blders. g��, Same Addreas 5217 Wayzata Blvd. �,g�� Same �-s�.i � � a N+� 9846 LOCATION OF BUILDING No. 7412 Street Concerto Curve part of Lot � 14 __ glock 2 — Addition or Sub-Division .� Melody Manor 3rd Addn. Coraer Lot _ 7nside Lot —. x Setback 37 �� Sideyard 10' /5 � Sewer IIevation _ 877 .5 0 _ 88Q .5 0 Top of � Footing DESCRIPTION OF BUILDING To be Used ea: Awelling �t 46' �p� 24 28 g��t 20' �q, �, 1152 �� 23, 040 C�r� Front —LR � Depth ,2�� I�eight �1.� � Sq. Ft � Cu. F't 45 6 0 � op ����� _ Frame �yt, ��u�18, 900 _ To be Completed Oct . 1968 SE WER LOCATION 13' N. E. of Manhole WATER LOCATION 23' N. E. of M�n.hole In canatderatlon of the issuance to me of a permft to conatruct the bwllding described above I a�r¢e to do the proposed work in acc;ordauce with the description above se, forth and compliance with provIsfons oP orrlinanc:es oP the dty oP Fridley. � 0.0 0 Sewer Cd�nnection Charge � Ea consfderation oP the payment of a Pee of $ 40. 00� p�rm�tt 3s hereby granted to Homedale Blders . to construct the buflding or addition as de.scrlbed above. This �ermit is granted upon the express candition that theperson to whom it fs granted end hia agente, employees and worl�en, ffi all work done in, around and upon said building, or anypa� thereof, shall conform in all reapects to the ordinaaces of Fridley� Minnesota regardin� location, conatruction, alteration, maintenance, repair aad moving of buildir�s within the dty limits aad this permit may be revoked at ar�y time upon violation of aay of the provYs�iona eead ordinancea lm C uiiaiaBInspector Clarence Be13�le NOTIC� 71ds psrmh doa aot wrsr t6s eoe�ruetion, imhpatloa M� wiriae, plu�a6tne, ea heaNeg, mru er wat��. B� wn le a� tlro BuiWleB lespsetoe Por aparat� pwmh� Poe t6as Ihm�. � � � ��zc�TtoN ��� �u�,n�c� r�ta ��7:Y 0� F'RS�Y, �SOTA OWNES' S N�lE . BLTxLbER _ _...._.4,_....,—.— y --�---- — . . • . . � �' ADDRESS . _ . ,;,,: . . _ � _�'�DRESS � �I�,���� , _ �::._._.� _ �.. . , . . .. .. . . , � � � LOCA.TTt�N� �}F � B�G�D�T� . - , . : . , ` . .. , ' . ... � d : ., .� � . .. � • _ . :.�. � . ,�. , _ .. . NO ..�a�l LOT.+_��� .. BLOCR; _ r. . . ADDTTION OR SUBDZiRSiUN�c;�;����,�'� •��- , ,.. . , ,. . •%" ! i; : y?i s [ „ ' ., . ' CORP3�R LOT`� �,INSIDE L(3��:�• : :�' �-SE�C�C :. .S�DEif�•D.:%,+,'. �'__.,_ ? �� . SEWFR ET�EVA�ION d �% -.J'!�Q TQP OF FQOTiNG .. . ���oo �1�:, . :..; ,`•,.;.. , Ap, lican� a�ttach to this for�m �io Certificates of Snrvey of Lot aud propoeed building .lo�atioA �drawa =`�n:��i��se� E��tifiEates�. . � � . •�• ;.. . , . , • krZ�E�wt/ � T � . • , o�`.�''I V/'.�' i , G� �a'fAJ� . ;` , .� , . . . � � � nESr�►.ar�ra�� �o� �.s�.aa�c���. � �: . . . . � > . r : . . . . . • . . -' , ;-- , s ' � To sa Usea' •Aei s ` - � •, .. s . • . . • . , � . . - 7 . • . � ... . ^ J� � � iA:'.' � __r___ FroDC Depth �Height��_� . .. ��. � . S. �^ feet •�v � G,ubic Feet• �_��, � � s�� �_._._......,.-- --- : •,. y �',�i �� � _ __ e � n...,�t, � � � Aai oht d � Type of Conatruct To Be Cample . ° "; .. .: . � 1 : . . . ,. Square feet�____,�� � . . : .Cub3c �eeC�,: �..r�. ,r � � a ' ���r� timated, Cost• � �,.,:..�� �� ,� �, ;� �' -- �" ft / SA � V The undersigned hereby makes applicaCiou for a permit for the work l�ereia specified, agreeing to do all work in strict accordance �ith the City of Fridley Ordinaaces aad rulings of Che DepartmenC of Buildings, and here�q declares thati all the facts and representatioas stated in this application are true and correct. DATE _ � �'� � SIGNATURE_��"�� - ---- � � � � Schedule of Fee Costs caa be found on the Beverse Side�. ��. �� �,� c�� �,�5 ��,G�SC� / �a � v �""� . , � � _ _ � / \ v � � �. � � ��.�:::: � BUILDING PERMZT FEE S ,CHEDULE SE�TION 2, The Inepector of Buil�tiags sha11, before•=issuirig pe�ibnits for • the•erection df �ny building or atructure, or for anq �dditian �,� any axisting atr�c�ure or building, or far any altera�ian or;repair§°to any existiag building or etx'uctaire,�t upou' .�gpl�catian th�re�ore, require the the payffient by the applicant for sueh permit of t�e5 to the amount herein •below set fortb and in the mauner herin provided to-wit; ._ . _. --___�.. .. . .. , � . . • A••t ,.. . . Uni_, form �tuildia� Ccde: Type��l, 2; '� 4-. �l..75��for each -oae thoiseand cubic ieet, er irac,tioa thereof; in such cu�i�cal contenta. Type 3� 5• $1.50 for each one theusand cubic £eet. � '° � �' F�r ti�e �ur�oge ef c . � ' �7t' � ': . . tmiputiag� fees for•. b�ild.ing perinite, the: cubical conteats of any building or °additiioa t• a u�niform hei'ght t'hrou�hout by multipi�ing the ground area coverec�: ,f��r, a point six (6) inches below the flor�: line �# Che basement or the cellar Ce the average height of tbe ug�er surface or to the average height of the roof surface of the main gab],e of a p3tched roof. ' • � ..F�r regairs os alterations to ari e�is�3ng sCtucture, Lbe�-fee�ehall ba at the� � rate.of`�$3.40'��p�r each five hundr�d:doliars ($500.�0) or fraction thereof icti �the _cosC �f e].1 proposed �vork._. ' � � In no c�se ahaxl th� fee :charged "i'air anq �peraiit�'as set forth ia Sectioa 2 be less�th�n $S.AQ.,. . NSSSD ��nneeti��n Char.g�e�:based aa locatiaa,- �,�ea 1 or �. , . . , , . i:: . ' ' . .. ,, if,�. , .. : . ' ' � ' • .. ' , •.• .. �t: . . � . .. .; . , .'::i:• � .. , ' � . �. e. � � � . " . . . . .. ..,� r' ::.. . . . • , '• � � • � . . , ,. � k�. -. . ' • - ,:.:: : a s: - . ' � � ' _ •a': .,. ! �, — � r c � ,' - . :. 4 ,� a .. . � > _ , a , e-i, � �r� � , � ''- �. . .c � , � r , �.�,, � _ � . . . . , .. . � . . , - a I r . . . � �."`.'< �'^ 7 .. � � . . . . �. � � -.f x��. f ' � �' Y � �a)d �YHIIl�/ � �%�'.%� �' � � '. a !ad :Gf+r"1�.i� � � J',�� �� �s'�r� ENGtNEERINC3, INC. "� . ` � r,►o, b Ak.�e�piar/ sikiri ��ii � E�y� -- En�ineers � ; �; �-. Sur �erfors --- y �,� � _� � ces�lt�'��a�s �►�. s s ,Q �.: � ' f�t fJ���ri'k��' � � �. s,���._� , ,ea��:��ow � � � ����, � , � : �� / 3 /1/. �', � /� ,a� .a�o,� � � �j l�Uyl.`` E� � , 8�7,5'U ,`� d�� �ooT�N� �/���Po� $'�C7,so �I'� ,- ; w ,���;�e ,,� � � e� T�� ,✓ � � • � x� �� . i f 0�3 i � 1�-;r.,, ' /�s� Gv ¢�!a L � I'. . , � . / � �:� � / �� . / � ,� . � � � - ; � � ' .. . ' , l. � ^ ��� i � " . '�• Lb'( ,l4 . , . .. . , , . /, �" � . � . �� • _ `� . ° ' • f . � . F . . . . . .. � � . . , ' . �. : . .. � , - .. , �� • : r .. . � � s�. � � . . . �. ��.� . ., . . � � � � . • - �.. . . . . . . 'f / i . . . . . ' . . .... . � ; #.. '� � . .. •. ' .. �'��. . . .. .. �..' . . - , ,,�'� `���j�t,. ' 0 5 � ��-'��� � . � _ (,� , . � . .. � . .,,.,;Y..��. ' �" " . . � . � �% , . . . . � . . . . . . ' _ DE1iQTE S:: IRON �._..., � � _ 4 —_ CE1�10'iE s pilA1MA6E 11lID Vt i lIT Y E J►it.trKltT '�.;, lo� ia. � bt.ocK �� t�+���as�r M�aoR 3RO Aoo�Y►oM :� �`� ,�; �l�r�by ` �i#es s e �r a�►ar�rr�c� nr�rs�ol�r�kir� �'a �.�Nr�1�iiMwr��r �r +A�r�►+i�,�r�t.;� �.:u �� �'1lic �idi� �'�, �, �aQ► ril+�ir es�arovr�i�dc , y�'�y. �w ir «r�r/ � As ,�w+�d�:,�r� �.�,..:�:� : � . �'�..� A.Q l�ii' R ,`� ��� �� ��, �._^ � + ,t",..'!� � `+ - Sta k: 1~� 40 i�,r .�,,ao.�.,,,,.. - - --- __ ,. --- ---� F_- - — �. ��.._ -.. . � -. .k �s- .. . —�� . �' -i� ,�. ,+�- ,... �.„ __� - , ��� :k� - -- � _ .. .. . . . 't`� :» .x.. ���I �- �..! '�-��J . . - -. .. - r��� �S�'+ �� 1 . � � .. . � � - . . .�- � ��� � � , " � - . M, '. - ' � - � - � ��. � ,yd . . � . , . , ; . � ia* y� 1 pi7 ' � J�` .t ., . . . ... .� .,� � $ �� k , � . + .. .... � _ a,,.. . . ..,- . . . . .. .. . . � . .. . . . .x':. , a...n:9�. � A. '3i., .:t�>:` , s i iu. ri'S.'w'!T.,3��b H � � � � � �k` w� � � � p° � � � x � M y x z � h�o r � � ��� x x z � � � � o � � � � � � � � � � �� ' �n � � � � � m � � � Z � "� I� _ � � � D � � M � n „H,� pd � a � � x � a w �g �d � e � � �n� � m °�' � C9 t�p,, 'c� o �1 � Nc0 0 1� � y • � C�D � � : m �y: �� y � . m . . � : : � �: . . . N : : : p, : : : : a � I I I m � � � � x � ,e � o � � � � 8 � ��-� M =o � 0 r b�.dy y � x c° � y I w � �' w �p �� � M � ^�' y O � �o � � � � A �D � �: `�. � � � � • �, � � � � $ � � o � � � � ro � � `�• fD � � o � Z z I � � � � � � � � � � � � �] n ; , � d �� '�° �d .� � o � � � � � � �, a �, � � M' W � o � � o z �� �� � V `a . , ro � � � � °x � O Pi t� t� � � ,c"'. a 0 0 � �,�n ;� � e� r� � � x� ° ,� �� H " � � � � � 0 � x ]' y � � R° y � � � � �� 0 0 � � �' �d � � � wwoo � � o 0 � � � � O � A � � � � � 0 04 �' m �, z 0 � � � � � ro � � � �'�� �� R° R^ � � � � � � o � � y � t* p, R° � � � � � � � � n � � � O � a,�� �yo a, ��„ : G •- o. � O � . . � O .° : : : � M/ ����5 y 01 � �'y'��K � � R� � v, y a�.�� � m o " � w �' R° �' 0 � �y � 0 y �y I F � � � � � � a � � � �. � . . � . . �•C°: : p o . . Q : . : W O� 0� W O W O� O� O � os000 o�go� �,�,�,�.�, �� O � � y G v � � �' � � � n ta p ►! �. w O � � O ~ y �° a � c� �' .� g �. � � � � � � � � � � ��� � _.�r, ��� A aa� � MH�'p ���� � y � � y �� p� � a d o�p�. !� � b�a � � �, �b � ���j''o � p."! �—~'`� M y f�.y ,�y W d �x�' b n�'�'w ��yb � py�� � �°'op �+m �,y ���m b � �� �� �� � ���� ��� ��o ��� fD �. m � � `�'rB�� D "'' D r � m y _ m C m �� ��is � � x � m � � �.r � � � 'v. � � � O A � ao o � � p � d O = �� � �� � �h �� 0.:� � ; �� � � Q �3i D � � � � D � 0. � � � � �y � r d � : � � . � . ~ . � : � r �: r, � � � � � `i: � � � � � � � �J ,� i± � w x 8� �� C � �, n �� � � � � � � g � �' p. ,� � � � �e r+ 7d O tp �y � � � � p b °� O w � O � O � � fA � � � � tD : � � .. � � � � � . . � : : � 0 0 91 a4 p4 M?0 b! iC K iC i{ g ay g,��, g'S�'' g�n" � 8' $�' $► y sn b► sn �► tn -" 0 � Q � I �" � 0 a x 0 i �d i � � � � � x 0 i � � r D � m H n m v � m * ° � � I� " p� � '� �r . w w � � m �' sA � � �i i � � a � � I � � I �� � ❑❑ I I � H Q � � a a. � � � � �, � �� � O � cy, � a � • WATER f1G6lTS uaiw�s NTM � swsiae SINKS WA41 TPAYS ORINK. FOUNT. 511VYR4. ��� GTCH e�tNs �wro ww� ows �. � RANGE � OPENII�KiS a . ' E • � �� a � � I � a. o. �, � �' ��y � O "- , O � ���� � �� °� � ���� � a� ���� m ���� ���� �. �� ���o � ��� M ���m �a � �� ���� �.�� � ��v� � m � � � 3� � a � R � � �'� C: � � � 0 �l � ��'+7 �. � �R \ V � � �' n �' �°, � �- � ° � �� M � 0 � � � �.. �. � M b � �. PP trot � p � • � : °x : � . m : M : o . a � : � . �� � • O Z��1 � � � � � � 4� 9N �'� p czo � w� c�'o � x x �� o W � � 4� y � � � � :� � � � m 5' � � 5e � � � � � o � � �i p' y • � � � � � x �i � : O � � � � � b a o � � �.: � `":,g":� a ° � � , ru � ' ' bd m : �. �y . �: : a Q : � : . . OG � . . . . : : : : tA : : : : : : : : � : : : : N 0 � �4 id N � N �! k N i! id � � � � � � � � � � � � � �� � � � � g � � �.� ��� ►� H H ��-1 o° � � � o � � ! \ 'J � D � r � m � 2 m C r m .K. . �a. w � •• pd �r w R, � v�, x ^� � V � m �� � � �r p� � � i �� �� 8M yi � � y� � ��� fyD fp' !� tn ►�'4 M � a °g b� �y � � CL � W 0�4. c�a � w O � g a�. � Q � �° �� g � G N O� t90 � � f'd WATER aosers uaiwus e�ni TUBS ewsin� SINKS W�, ranrs ORINK. FOUNT. sHwRS. FL000. DRAINS UTCH BASiNS �o W� GAS APPL Gti5 RANGE GAS OPENINGS �. Z. � � P n � � �. � � � � m � � � � o� m � � � � O lD �� w ��0��� ��o� � � � � ����a � ��y� �� b � �-� G ���� � o��.m � p � m o 00 �c,oa �'�,o �! ���w ��� � � �� ��@� �m �� �� � m �oo �aa' �• fD � x �o he � I ��� A 0 � � � � �d �' A � � aM R� & �°n � M � �, �i � � W -� � o' � � �� ei" * � �' � '9 o. a b � ;�r � M � � � � ]''d,. �O �° m � � � � � � � � 0 � N � � � �J'1 � � , HOUSE HEATING TEST RECORD ADDRES�� �����`— �� - APT. F�OOR CI RB � OCCUP�IT OWNER t - HEAT i.OSS DATE HTG. INST. GAS C0. METER BAD SOLD BY INSTALLED BY Electrical Work By Gaa Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GA ESI � CONVERSION MAKE - MAKE OF BURNER Model � �� Model Serial � �--�° � Max. BTU Rating INPUT /��-�-�� MAKE OF FURNACE Modsl C NTROLS � THERMOSTAT ��� Heat Plug Vent Size Valve KIND OF UNER SI� NONF Limit �"� Droh Hood Regulator Limit SeMing � � Filters Size Number Fan Setting �-S��°��� Chtmney Loeation Inside � Outaide Pilot Type Chtmney Construction Pilot Muke � �� Pilot Model Smoke Bomb Wiring Pilot Timing ������ Draft � Test Tap � L.W. Cut Off D or Presaure_ Lightirtg Inst. �� Proasure �� � Per n�0 �� e � Da Tsated - °�" �' � Input CFH�'� Pe��"P� mpany Testing - Staek Temp. Percent CO , �t � Name of Tsater Form 235 � � �v ,` � � � 1 � � r � � �� � �� ���o R � � � �� o � � � m .. ��w � p �� ^ �p � 4;� 'd s �� o ffi : �� � � : �� _ : : �� : � � �: � � ._: : :� � � � � � �►. ,� � o � ��s� � � ° �� � � , � � � $ G1 m o � � � � ,A I � � � 1 � � � � � �� � � �. � o � � � � � � O r � �� M � w �w �� � � o� �o �� � :- �� �: � $ � m � ���� � �a�� o o $ � � � �� ��� x � � � � ����� ��$ o� m. � �: �� . : �� : : o � . . �. : : � : : � . . . � �.+ o0 0 0 g88g a �°a � O ;� � � �. .� 0 m � 0 !: � �� O. � �� � � g � �� ► � � ��� �� ��� �� ��� �� ����� a�� o � � .� � � � : � �,�� �� ��: � ��: � � �:::� . . . . � �.���o 88g�8 � ��� m M � O � � �+ �� � � ���� ��� N � ���N� �a�'�� ►°�. A, �� �� �� � ��:� ��� � ��� : gg: : _ s:�.: : � �. �° � � � o gsg8� � � � � � �.� � ��.�� � fD � M � � MM p' A � d°� � ��s$ b ���� oa�'� � ��� �. � b �;�m � �� o��� a��,o �a�p tr � �� �'m �� � a � �,� � � � ►°� ��� � o � � A p' � � A � � � � � z m C �n � M� C' � � � � � �� , �' � �. �_ � N � �.�� � W � � � D . � � � � � �� SUBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � � � COMMUNITY DEVELOPMENT DIV. � ��: ------� r � � pROTECTIVE INSPECTION SEC. � _ �"'1 � CITY HALL FRIDLEV 55432 NunnBER pEV oaTE �""'� � ,'� 612-571-34b0 910-F15 7/2g JOB ADDRESS 7412 Concerto Curve NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION oesca. 14 2 Melody Manor 3rd Addition 2 PROPERTY OWNER MAILADDRESS illiam Heid 7412 Concerto Curve NE 3 CONTRACTOR MAIL ADDRESS Same � 4 ARCHITECT OR DESIGNER MAIL AODRESS 5 ENGINEER MAIL ADDRESS 8 USE OF BUILDING Residential ZIP ZIP PAGE OF � � � I� APPROVED BV 7 SEE ATTACHED SHEET PHONE 78 3--05 89 PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. 7 CLASSOFWORK � NEW ❑ ADDITION O ALTERATION �] REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroo� House & Garage (23 Squares) Tear-o�� 9 CHANGEOFUSEFROM ro STIPULATIONS Undexlayment must comply with the State Building Code. Propide adequate attic ventilatian, �rov�-.de smoke detectors as per TJBC 121Q adjacent to all sleeping areas and in basement. TYPE OF CO� SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTIIATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTtON OR WORK IS SUSPENDED Oii ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. I HEfiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $l�Z/�2 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEf;M1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- $3]_aQO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TUR F CONTRACTOR R" Opl2 AGENT IOATEI � � �-z� � 'UREOFOWN R��fOWNERBU�LDEIii IDATEI OCCUPANCY GROUP OCCUPANCYLOAD SO. FT. CU. FT. OFFSTREET PARKING STALLS IGARAGES VALIDA $.62 AC CHARGE Fire SC $1.24 OTAI.FEE $32,86 � THIS IS YOUR PERMIT �� � �� 1vEW ADDN ALTFtR [] Il �� Construction Address: Lega1 Description: Owner Name & Address: Coatractor: Address: Effective 5/26/93 CITY OF FRiDLEY SINGI.E FAMII.Y AND DUPLEXES R-1 AND R-2 Building Permit Application LMNG AREA: I.eugth GARAGE AR�A: Length DECK AREA: Length � :� Tel. # ��50�89 MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the propos� construction drawu on it to scale. DESCRIPTIUN OF IIUIPROVEMENT Rlic�h Hgticnound Tel. #� Sq. F� �. Ft. �. F� Corner Lot [ j Inside Lot {] Ft_ Yd Se�back �Type of Constcuction: Approx. Completion l�ate: Side Yard Setbacks Estimated Cost: � `'�''�� � (Cast � Back) Driveway Curb C.'ut Width Needal: Ft. + 6 Ft = Ft x$ _$ � � ` � � DATE: l��l %� APPLICANT: ��� Tel. # �c��OS�' Permit Fea Fire Surcharge State Suurcharge 5AC Charge License Surcharge Drivevvay F.scrow Erosion Control Park Fee Sewer Main Charge � �1 C� $ /. � $ �v�- $ $ $ $ $ $ +1. M. ' � .�I_ Fee Schedule on Reverse Side .001 of Permit Valuation (1/li�th%) $.so��i,aoo v��aoo $750 pe.r SAC Unit $5.00 {State Lic�sed Residetrtial Contiractors) Ait. "A" or Alt. "B" Above Cons�vation Plan Review $45U.(K) Fee D�ermined by Engineering Agreement Necessary j] Not N�sary [] TOTAL $ ��' � �' STIPULATIONS: BUII,DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the ere�tion of any building or structure, or for any addition to any existing bnilding or strucdire, or for any alteration or repair to any existing building or structure, upon application therefore, require the pay�nent by the applicant for such permit of fee.s to the amount herein l�low set forth and in the manner herein provided to-wit TOTAL VALUE $1 to $S00 $SOl to �$2,� $2,001 to $25,0� $75;001 to $50,000 • . $50,001 to $1(�,000 $lIX?,001 to $500,0� $500,001 to $1,000,� . $1,000,001 and up FEF.S $15 (Minimum Fee is $15 plus surcharge) $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $45 for first $2,000 plus $9 for each additional $1;000 or fraction th�eof, to and including $25,000 $2.52 for first- $25,OD0 pl�s $6.Sa for each additional $1,OOQ or fraction thereof, to and including $50,000 - $414.50 for first $50,000 plus $4.50 for each additional $1,000 or frac�ion thereof, to _ aad including $100,0� $639.50 for first $1�,OUQ plus $3.50 for each additional $1,�0 or fradion th�eof, to and including $500,(m0 $2039.50 for the first $500,000 plus $3 for each addifronal $1,000 or fraction thereof, to and iacluding $1,(m0,� $3539.50 for i�Ce first $1,0�,000 plus $Z for �ch additional $1,000 or fraction �thereof � DRIVEWAY DEPRESSION ESCROW (Concrete (;�ufi Sixe�ls 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 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for const�ucbioa will 1� 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 locdtion of the foundation once it has it has been constructed will be required before proce�ding with the framing. O � � m m � � �. C � � m m c � w � � c 0 � su tQ � � � O � C � 0 "rl X C m 0 D v v � � � � � � � � � � � � � n m � o z j � � f�A N N (D (D � � n � � a � � � � v T � 1 "'1 � ? v O � �' O �� 2 2 i 7o a� W� u, �� ='• � � c�°u � � � ° � �'• a° � �' � � 'U (D (D '—'• N � N � N � � � -� � �� � N. W � N � < I I cQ �� 7 m Z � � m D cQ Q. m GA '"' A1 � -�p � � � W � m � - � �l -°o m � � '�' � o � � � c � � a � m .-. � � 0 D m v � � Z o m `m v a � � � C / (� � � 7 � � m (� � � ' m r "n � Z � o w a p' � V m (1n w� � � 0 �'I � � � r C � W z � �T1 X C �11 m � m � I � I I I I I I ( I I I ( I~ O � �r� �t��tfltfltfltfl4nt�tfl � O O O v O V V�I V Ul :A �1 ° o 0 0 0 0 0 0 0 0 0 0 0 ° o 0 0 0 0 0 0 0 0 0 0 0 � � r C � W Z L� C) O � � � Z � N 3 � m a n 0 � � �. � ` �D m � 3 -� Z O \ t ��a s; � c Q. 3 � C � m a a N O � 3 m -�. � � � � D� �--I m -� O � � � � D 0 v � m � � � � � � � V �. A N a W � I �J w � � � � O ,°a, � < � Z � �p � � � N � � � Z z � m � m n � O z v < � � � < m O � � � � � w � � � � W 10/15/1999 15:50 � ���1� 6128616361 TO: Ron Julkowski / � Re: 7492 Concerto Cv Frid/ey, MN Phone F�x Phone 6�2,579-9287 I CC: BLANCHARD PAGE 01 Date 10/15/99 ' Number of pages including cover sheet 4 FROM: 8/ancharol Engineering 6936 Washbum Ave. S. Rich�eld, MN 55423 (m) 961-0770j Phone 861-6361 Fax Phone 869-6361 10/15/1999 15:50 � 6128616361 7 �/ � BLANCHARD c.r� c.v�r.,v,� � ,�s.y ....1, 1 here8y Ce�Wy that this ptan was prepered by m6 or u[bet my �rod su,�ctvision and that I am a t�uly Regi�ered Protvsgbnai Er�ineer under tt1-r l�wS o� Ih8 Sti�9 OF Mk1119Sptt3. �L�r�.�..i � i�i�� oate /d C� Re�. nw_ ,�� B �/t..�,�E,,,�',�,,,� ����� � PAGE 02 � � � � � �%G �rt�poo�t�✓/� '�G�yc��p ,kw/ wL g'�/ 63�G� 10/15/1999 15:50 6128616361 � F BLANCHARD 7 � T�/I�uA4�I I�es T' B�ivM� Is/ �CLa� ��/�.s'yZ�OoS�� Jl �- D�/ k,, �e�rx �L L`��.L` Z�/,�, Co.di'r'� � �� � x.�� k. _.__ � �s �2� � �������� PAGE 03 /�/��//p 9 �3 � i. � . � f/ 2�4 � � a r� Z z �. �4 a`. 1 �' • �(o. 9/ � * � . �� '""".. r �sr- c.�. i x.�� �-�ss ��. ����� - .- .� 2� �d/�E�t�'.✓r' �.w Fic�- •!rl�y�•� ,��, � Z; �y�s� _ �.r�� ��- � t.:� C� �s ? � � �z �. e�'r' � �' <! !/ ♦♦ 9L�+ � /Or � �jRr,�,, � ..��v. �' i+r�rsr � /e. 3 - : dit,, v:� s . r� s.,� e�.�vc.w..� t.mt�. P,�� ?.G�.. ' f d� i- . r ��.. �% I . .Gti� C.o3�C �C�►��Ciii �(zXy _�,%X�i�)C� C�.�z)� s e �s'. ��-��C29s�X S"� Y X ��� � � � ,. iv r KC►z �/o. i C/L1�J s' � ��� �'' ��. 4�. d�?, p L � ?,�y��. Y' a �• I G 3, vs� GdG�tZ�" �36 ��t.c u� �-N�s,r �c�v+�. s�. C� 1 �xY �°�� �3� 2•`f - �: 2 k- >� � �r �.- . � . d4. y) C�t,� v,�a6,.� /1s�r- �, � t�fXG �J d -�(��J lo,�, � vs� C?) 2xY �r�~ w n.e � i...�� -+��+���.�����^�� � � ��O ( ����i, '6 1�.,�`� ��i�� �_ -. n� s �s i.� --- 10/15/1999 15:50 6128616361 BLANCHARD PAGE 94 F , � �i�4►� l�t�rrrs.. !.✓�•6�,` s.��-r,r�•✓t ----- 'i ` �`r�,r�a �,s,� S'.o+� N�Q- " G� �a, 3` c✓/ G i.✓� G� C•�c•� E,�,r� �.��.c <s) / 7Y`�- �:y ��✓� 7� r� r�.v< .� 6�'.� t�,�r ;. `°�$ �� � �19'04 } a. v yo) • o- �iL Z ���O.O��o) `� 0.�8 � L x o. o�t�-) = d. 3 a 0.37 �r� � �. y` i �yf i U O. o� � � � J. ..,L d. �c O°.ob h o.og N �. ,3�i ,� � �� � . y �'•�� � � o.do e. 30 �"i �Z /,r�,� �°�! � Z 91 'r`�i�- s�i�. /� f � � � � � !.7 �Y � 2 0 �Fa'/� . 9� G'�1�G ��i1� Lo.*► • �y x isr.�,c� �.�; . �ib r�! ��i ¢ 0��. � -�.�� �i�f •s.. l�' si�.ac � we��,r y=�� � 1 C4 LrX.o� � � � o.�� � c- ��-:.� 'r't� � �.�Yif��) `= St��- � ��� C Ya) «� �oe 1°� �-rx�- �s �� �y)c�'� ._ � �lk. � �x.��� o /�s�v�cd 2� ��..`� �. / s!' �s � Z I�f� � - �- y isn�a c.,x, � 1 a�, � iVtlJ!{:� . City of Fridley AT THE TOP OF TNE TWINS � � I L D I N� P E R M I T r � � ; `y _ COMMUNITY DEVELOPMENT DIV. f � � PR07ECTIVE INSPECTION SEC. � _ �'�'1 � CITY NALL FRIDLE� SS132 NUAIBEP �----�: ,.� 612-571-3460 s�aFis JOB ADORESS `��� � /'n��• ��`�e � �& t LEGAL �OT NO. BLOCK TRACT OR AODITION DESCR. j(} 2 Melody 2�, P`iiOPERTY OWNEii MAIL AODRES� GTA�'��ia✓!r J �� ��lZ �r2t.�� �vrs 3 CONTRACTOR MAIL ADORESS �l�C/l ��C ��lS��e� Owner a ARCHITECT OR OESIGNER MAIL AODRESS 5 ENGINEE MAIL ADORESS �s �/ ����� 8 USE OF BUILDING Residential 7 CLASS OF WORK NEV DATE VAGE O: 12/3/99 / / Manor 3rd Addition 21P �� 0565 � RECEIPT NO. � er /���� SEE ATTACMEO SMEET PHONE � �/Z ��o�° PHONE LICENSE NO PMONE IICENSE NO. Ph10NE LICENSE NO O NEW � AODITION � ALTERATION p REPAIii p MOVE O REMOVE B DESCRIB� WOFK . �� a �� •��. ; g��� , ��l � ��,:�� � 9 CHANGE OF SE FROM ' �� r TO STIPULATIONS � See notations on plan. Call for building rarap inspection before covering. Underlaym.ent must comply with the State Building Code. Install smoke detectors to meet the State Building Code; in each sleepinbg room and on each level of the house. �``t ` ������� Before ci�ggir�; v;�4f f�s a11 uti�ity !ocations 454-O�OZ p'����`� ����t�TS ����RED BY LA� ����'�„ HCATIf��, F'L�g U� E� �C1R . � Ai�� SI�S. SEPARATE PERMI7S ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. VENTILATING OR AIR CONDITIONING. THIS PEiiM1T BECOMES NULL AND VOID IF WORK OR CONSTRUCTtON 20NIN(3 AUTHORIZED IS NOT COMMENCED V111THIN 80 DAYB, OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONEO FOR A PERIOO OF 120 DAYS AT ANV TIME AfTER WORK IS COMMENCED NO DWIG. UNITS 1 HEiiEBV CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 ANO KNOW TME SAME TO BE TRUE ANO CORREC7. ALL PROVISIONS pF LAWS yqLUATION ANO ORDINANCES GOVERNING THIS TVPE OF WQqK WILL BE COMPLIED WITH WHE7HER SPECIF�ED HEREIN OR NOT. TME GRANTING Of A PERMIT �9S �OOO DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL THE pERMIT FEE PpOVISIONS OF ANV OTNER STATE OR IOCAI LAW REGUTATING CON- STRUC710N OR TH ERfORMA C OF RUCTION $958 ,�S / PI,AN CMECK FEE �� � 4TUNE 0� C • OA OA oU�M0�7i2ED OGENt 1DAfE� EN P OPI S�GN4TUFE O� OWNEA��� OWNEABWIDEAi IOAi�i Bl �NSP � � � � a r-- � � SO. S7ALlS CU FT. iffSTREET PARKING IGARAGES IURTAX $47.50 AC CMARGE Fire SC $95.00 OTAL F E $ 1.25 iS iS rOUp PEpMir � ��-7� Q`TE LOAO r�w � � ADDN ALTER Effective 5110/99 I l CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 ,,,p ,&; BUII..DING PERMIT APPLICATION �� a-�`� s Construction Address: %��j Z ��� �-�a �r� ,�/'� Legal Description: �wner Nau Contractor: Address: Tel. # �� ��S 4u'9 MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRII'TION OF IlV�ROVEMENT �� ; �cr'� LIVING AREA: Length � Width 2�� Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AI�.EA: Length Width Hgt/Ground Sq. Ft. �T,��: G � �uP Z. ����� �Y'�ID t?�� �' ��SS� �%�R� EtJ•'�aerJS S' G 1�-�-G-� b�� Construction Type: �' �,-.�.� Estimated Cost: $� v� , pqp —� Driveway G�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ . DATE: � Rl - APPLICANT: �G� �� �,� ,��}� P� Tel. #� - � � � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ ��,�� Fee Schedule on Reverse Side $ � � .001 of Permit Valuation (1/lOth%) $ � � $.50/$1,� Valuation $ $1050 per SAC Unit $ �`� $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.� Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ � �� � �� 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 $5(� $501 to $2,Q00 $2,001 to $25,�0 $25,001 to $50,(�0 $50,(}O1 to $100,000 $100,001 to $500,000 $500,001 to $1,�O,Q00 $1,000,001 and up FEES $23.50 $23 .50 for first $500 plus $3 .OS for each additional $100 or fraction thereof, to and includi.ng $2,000 $69.25 for first $2,0� plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,Q00 or fraction thereof, to and including $100,0(}0 $993.75 for first $100,000 plus $5.60 for each additional $1,(�0 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,�0,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�rb Streets Only) � Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construcrion site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the frami.ng. 19i94/1999 a7:28 6128616361 BLAMCHARD PAGE 01 MNCheCk COMPLZANCE REPORT Minnesota �nergy Code MNcheck Saftware Jersion 2.p Min�esota Department a� Public ServiCe 1-�12,296-5175 1-800-657-3710 COL�J'TY: Hennepin STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: DATE: 10-$-1999 �ATE OF' PLANS : TTTL,E : GOMPLYANCE: PA5$�S Requir�d UA = 482 YQUr Home = 365 Single Family Ferm3t # Checked y Dat� �r�a or Insul Sh�ath Glazing/Door ___,______�______,_ ___w_____^ Perimeter R-Value R�value U-Value U,�, ------------------------------ CFTLINGS: Raised Truss 1156 38,0 0.0 + ^�Zg wALLS: W�od Frame, 16" O.C. 2664 19.0 2,4 I3� GLAZING� WindqFts or poors 321 0.350 112 DOVRS 42 0.350 15 B5MT: 8.0� k�t/7.0� bg/8.p' insul. 1184 1Q.0 72 HVAC EFFIGIENCY: Furnace, 95,0 AFi7E COMp�,�ANCE STATEMENT: The propos�ed building design represent�d in these dGCUment� is consistent wi�h the btzilding plana, sp�cif�.�atione, and othex' calculations submitt�d with the permit applicatian. The propo$ed buildin,g has been designed to m��t th� xequirements of �h� Minr�e�ata Energy Cocl�. Buiider/Designer ../ .� �,[� � . Date����T_ 10,+'a4r'1999 07:28 6128616361 �' { CATEt;nRY^ 2 } BLANCHARD PAGE 02 .� � NEW HOME Fzk:�,z7 IN$pECTION ENERGX CH�CKLI�T �c�uv�a�r zc�rr : [ ] Exterior foundat�o� w�ll insu].atzoz� installed: kt - [ J Slab-on-grade insulatit��. ir,st�lled: R- � i L�ucts i.n slabs have R-5 insulatiQn bottcrn and si�es P�NE�'F.ATIt�NS : [ l Win�ow and d�ar fzames sealed � l�'zame� wali �pzr�ings into attic sealed [; Other joXn.ts in wall sealed [ i D•r�ppPd ceilin� aa�r-blocked [ ] �'1umk�ing penetratipr�s se���ci [ ] Extexior w«lls behind tub a�� 3hower sealed [ ] PJ.umbing vent stack seale� L ] Chimr_�y flues sealed at cei].ing i 1 Pexi�,eters of all grills azxd xeg�sters sealed to vapoz b�rrier [ ; ��e�trical service sealed E 3 Rec�ssed ligY:t fixruxes s�aJ.cd [ ] w�re pez�etra�ion5 into attic sealea � ] �'elp�hone, cable T'J p�n.eC�r�t i.oz�� sealed � � F'an� sea�.ed w�.er� v�pc�� barrizr p�n�trated OPTIOAAL (CATEGORY 1} . } k'ouz�dation rim joist s�alec� 3iY'�l�rxt [ ) Upper s Cory k��r�d j ox st s seal�d ai�x��.gk�� _ ] Geili:�g poly sealed t� tc�p af a.�teri�r partition walls [ J E�e��xi.cal bc�xes se«led to va�or barrier : ] �'ax.: k�ousings air sealed 10f04f1999 07:2b 6128616361 BLANCHARD PAGE 03 NEW HOM� FIELD INSPECTiON ENERGY CHECKLTST PA3E 2 { �ATEGORY 2 ) I NSUZ,ATI p1V : [ ] Vapar barrier installed [ j Interior foundatioz� wall: ( ) tlapor baxrier installed ! ) InSUZa�ion installed: R- ( ) Moisture k,arrier iriSta�lAd [ ] Attic insulation ins�alled: P. - [) At'Cic card posted with proof of bags inata?led [ ] F�oax ineulation inetalled: R- i ] Wall insulation ir�stalled: ( } R-19 ( ) R-21 ( ) R- WIND WASH BARRI�RS: [: Wind waah barriez installed a� atti� edge ( � averhangs (cantilevered fLoors and baX windows)have wind wash �arriers MEGHANICAL• [ ] Ducts running outeic�e conditioned space sealed and insulat�d w�th minimum of R-8 ( J Returns in same space as furnace aealed [ J �iucta ir� unheated spaces I] Water heater has pipe insulation ar h�at tra�s installed [ l Furnace AFUE: [ � Cen�ral Air S�ER: �pT IOATAL i CATE�',pRY 1 j [ l A�1 exterior joints in building enveJ.�pe epaled [ ] Residential mechanical ventilation sy�tem installect (Mandatory if one or more item in �hia column is checked? ----1�TCTES Tp FIET,D (Building Department Use Only) -----..______________..____ n O � C -�i Z D � � x � r W m 'v O < v m v � m � C n � n � 0 Z w 0 D v Z v D � r m � D n � � � Z < m z � z � O O z � n � � v m � � rn � c --I � S D �° r � � m m � � . \J � � < � D � �rr,m � � O .o -i fp Q+ 2 cy. N � � c � � o z m -h v �O� � c o o m = � D' v v � _� 01 D uv � � m � Z � � � z m 0 �� � � w � W � -I � ai ai � � �2 c o�i, eni � � � rn d d w 3 9 �°� °' � � � O � m c� c�u � �. � p -n ��� c° c�i c�i m� m y p�o -yo �. c � � � � � 7 � 1 � �. c�n � � � ' r �n y � � � cn � � � c� Z m � � � � v � � � m � � �°— � � -n � � � � c c � � m a ,-. m y � z 0 I I I( I I I I I I I I� � r C � W Z � � C � m � � z O � t� F� t� �y �.tA t�► t� t�! tfi �f t�fl � CJ� O O O V p V �I �t �I C7f A�I m O O O G O p C O O O O O O O O O O O p O O O O O O O O O � � v C � � z � �� ,` y W Q �. a w � o. C c� � 0 0, � D N 1 �� (o -� z m z � � ! � � � � � � �-/ � • � 5 � � � l �� � i� �� I � i � � c � a - m N co' � . Q 3 . � N . � � : � N c'�D . � . � .� .� 0 � 0 � d -o m � � 0 � � m � 0 � � � m �' L � n : a�eQ :�(8 pau6ig �O� JNIl�d3H aqw�sea :SNOIlbRl3l�d ad�(1 ui �a�aweiQ �} y�6ua� }� �y6iaH �o}�auuo� �uan E# a�uei�ddy ad�(1 ui �a�aweiQ � y�6ua� }� �y6iaH �o��auuo� �uan Z# a�uei�ddy ad�(1 w �a�aweia � y}6ua� }} �y6iaH �o}�auuo� �uan �# a�uei�ddy say�ui �a�aweia �y6iaH }uan ad/�l �uan uowwo� �ndu� n}8 �e�ol sa�uei�ddy le�ol �eN �o pa�sissy ue� �ndul f118 ad�l £# �uei�ddy �eN �o pa�sissy ue� �ndu� �g ad�(1 Z# �uei�ddy �eN �o pa�sissy ue� �ndul f118 ad/�l �# a�uei�ddy uo�;euuo�u� �o;aauuo�;uan pue;uan uowwo��az�g pue a 1 a�uei� d () oN () saA �sapo� �ua�n� �ad se �(�a;e�edas pa�uan pue �uan uowwo� ay� wo�} panowa� uaaq sey a�uei�dde ue �a}�e �(��a�o� pa��e�sui pue paz�s s�o�auuo� �uan pue �uan uowwo� ay� s� () oN () sa� �sa�uei�dde }}e�p �e�n�eu pue pa�sisse ue� �o� sa�qel 6w�uan a�ewn� �e��ua� � tio6a�e� yWy�-y�y apn��ui saop siyl �suoi�e���ads s,�a�n�e�nuew pue sapo� }ua�n� ay; s�aaw pue �(�qwasse pa�si� e si }� �ey� sa�uan I(qa�ay pau6is�apun ay� `wa;s s u�;uan nnau e u���e}su� uayM ( ) oN ( ) SaA ( ) oN ( ) SeJI •suoi�e���ads s,�a�n�e�nuew pue sapo� �ua.�n� ay� �aaw ol pape}sui pue paz�s aq ��w► }� ��e uo�snqwoa nnau e ��e�su� o} pa�mba� uayM •suoi�e���ads s,�a�n��e�nuew pue sapo� �ua�n� ay} �aaw o� pa��e�sui pue paz�s si �ie uo�;snqwo� ui;sixa a� () oN () sa� �sa�uei�dde }}e�p �em�eu pue pa�sisse ue� �o� sa�qel Bui�uan a�ewn� �e�}ua� � �Go6a�e� yWy�-y�y apn��ui saop si41, �suoi�e���ads s,�a�n}�e�nuew pue sapo� �ua.�n� ay} s}aaw pue �(�qwasse pa�si� e si �iun }uawa�e�da� ay� �ey} sa�uan os�e pau6is�apun ayl O oN O sa� �uoi�eui�,wa� pue snnoq�a �o �aqwnu 'y;6ua� '6uizis 6uipn��ui suoi�e��i�ads �a�n}�e�nuew pue sapo� �ua�n� ��e s�aaw pue �nd�i�se�d si wa�s/�s 6ui�uan ayl () oN () sa� �pa�mba� a�aynn paddo�sa�� pue pa}�oddns /��a�n�as si pue `suoi}�ru�sqo `uoi�e�oua�ap `�sru wo�} aa�} si pue pauiwexa uaaq sey 6wluan ay} �ey} sa�uan �(qa�ay pau6is�apun ay� 'a�ue�n; ui;sixa ue u��e� aa ua� N011�1�I�Ia3A aIV NOI1Sf18W0� aNV 2101�3NN0� 1N3A 1N3A NOWWO� DEC-14-1999 �8�17 FROM � � r�n �� /F 1 � ..► � p � � � et7D �. � � � � � � O � O� H � o � � y Z ''� � � � A � o� � �� � � V y Q Cr $ C o fD o �, � T t� � � � O � � '+D s� � y � .� a: � o `� ? �� � � � � � c � .. � y v � � �°' a I � v c � � v � � °r � rn -n � � � � i � �. � � � � � �C�.. a (� c � rn � z � 0 � � CITY OF FRIDLEY ►� o � � O e'i � \ tCA �a, �� �= si �D 0 O x O � O/ b � � „ � m � S � w � � 1 � � � �, v� --� � C• 6�D � � � � C ���� � � °� o�. H�R� � c�, a ,,. �� o � a Q � • � O � 3 �. �, �3:� � N OI .. �a f�/1 � w � � _�.�z' �� o � cs °: � � �c � � c�aA-� .+�o 0 ��'��' ���� � � � . r�r u°'> � �N a � °fr.� ��.�r^ rt � � � � � � Q � ��� � y � �; � r � ps � Qi. � C � � � (D � °, a � N _� a�' b � h c�a � o .« �a �N (,�"`„ � � Z y� n �°1+% � � +� D 1 C� a O � � � y t�s � � TO � � �C e�3 � r 0 � 132065415�22 a�i o�i �—' c v�i N � NF y Q � �� � � � � �,��tAU •�•-.•► �p p�p �D Ol fh 01 +J °'` �+ �D � •�•► f�ZD � � � � r� � �'1 ''' � � ��=cgc°i 01 � �, 4�1 � � � � � Q � i c� �` � �a � �� W � � W �� ts► � � 0 0 0 � � � � � t�a � � � (ov �t 0' °1 ^� � coco �oo�z --1 C . • � -i m O c�� � �o.' � Q � �. � �` � e� �� �� � o� � C �� � � � � � y � C �. 1 �i = O � n � � rt �. O1 � ci � Q o � � � � � N cr. o N Q- fn A � � � 3 o am � o wl��y � 1_ � . � � m � v � � � 4 � � �► tya � O .� � � � � � � � v 0 � � � � -a � � I `.,` / � �} � .�� w C � v_ � c� c 0 f' . 4��/05 � O W � � � � � � � � 4 � � �31 �7 O� C'i N Q. W "� �--� �C C�+ ;e C O� �r � a 4 � Z � � � N, �G p� m w A � N � � z� mm � � -v�a D d � � r �a �o � � �O �� O� Z �� v •v a� n� ��� o� z� �� �� �� �2 D� 0 � a 4 � �r y O z m � A < � � � � � u.+ O � � Buildi.n;g I�LUMBING P�rn��.rro.: �DZ Ix�p�ctions ItESIDENT�.AY. APP`LICATIUN �v�ct �y: 76�-572-3604 �Y'a"'Y' OF FItI])LEY n 0� 763-50�-4977 FAX EFFEGTNE 1-1-08 �ATE 1/I� G „y, �.�a�9' YOUR &-MAIL A17DTi�3S �+C.l�"G r. ' � t��/'YI iC / � � /%7 311E ADUR�SB �la/ %�—L��'' n �+��t+ r �s+ � �r. � � �/ �.S"�✓ �� THIS Al�FLICANT I9; � OV�R�F�k OGONTRAGI'�R PROFERTY xa�: . ' �ix � , �� ADDRESS: 7�I � ` sM f1�n � �.�-� J�'CITY � � ' -�J� STATE ��� �� �xo�: '7�' 3 c^.s"�'S' CQNTRACPOR rran�: ST�IVIlT A COF1r OF g,1,A'1'E I.ICEN3E N 67� DAT'E YOI1Ct STA1E - - Y�CENSTi. FtONb AI+1D STA'fE BQIVD � B� CiATE CEkiffiCATE OF ariri]�ESS: C!7 Y S'rn�rE ZIP INSUltANC� rttbN'� �n�c � ��, �p� �I( SiNGLE �'A1rIILY O'1°WO FAMII.Y O T+DWNHOCISE TYPE OF'W�RK: � T'�W �3'R�PT�0.CEMENT dETAII.Eb XIESCR1PT101�T OF V6rORK a r" � PER MS 16B.6�i5 ti�e permit fee is a mi�i�om oi 515.00 ar 5"/0 oP the tutat caat np to 5500.00, wi�ichev� is greater, for the� intprav�, in.�atlation or replac�n��t of a residcd►tial fixture, excluding the fixpu�s_ (This ghould reflect otily d�e oost of lmbot ) Labor c� w�r �Q4 = 515.00, Labor aost bet�ween �.300 to $500 ° c.ost of' lsbor x.�5 = plus .50 sutcharge UR FQI� pRQj$C75 W�RE LABQR PJCCF�DR 5500, FE�S ARE �AA9F.D ON f10,00 PER PlX1i1RE, E7CCSPT WFiERE NQTBb. �'DL1Vlt�s: (Q+IriTCA7'E TCYI'AL NUMBffit oF �nCH HE[.ow�. N�NUM F�¢ 515.50. BATH S�lL.AV Ff.00►li riRAIN9 $}iOW�Et _ WATER P7PWG BA7i�'[U� GIRS PT�NWQ (N�D CI'CY 1JC) _ SVYIIaA�ANG POOL WA7'E12. 30F'19J� {$35) —�,p�,q �rpg�t KlTCt�N S11VK WA1ER C[ASET � BACKCLOW PRBV. (S15} bLSHOVASt�R LAIYNb�t'Y TRAY ,� V�IATER HEA7'�R (S33) FtfRlRlt�0AT10N _'WATER MErE� _ 07�R . . ,o. L. .. . • ;. e•,., �;: . p�n�t F�e a�,- c� N� of Fuch�ro� (t�, S1p.00 x�YO.� _$ e .50 Num6� of $xqu+es (a3 �15.00 x SiS.dU °� TOTpY, DUE $�. '�4 OR N�rtnber of Sxt�es (e� �33.00 x 535.00 =$ Stete Surcharge � $ .50 �[1'hd $15.50 $15.5� Tofal � $ 'TH1S TS AN APPLiCA"C10N FOR A PfiRA+�T NUT vAL(p tINTIL PR��44SED I heneby apply for a p}umbu�� per�nit and I aclanowl�tige that the inform�ian above is complete and scctvate; that the work will be in c�formar►ce wit� die o�s aad oodes of the �ity of Fridley �d witb dte Mlnnesom Cor�struction C�od�s; d� i understand ibis is n�, a pennit but only an sppli�tion for a permit and wark is not to start without a permit an site; d�t the wosk will be in accardanae with the approved plan � the c�ci of al work � ' r�wiaw and approvai af plans. SIGNATURtE OF APPi.[�nNy' /� PR�TT NAt� �i Il�a.�'f ��G� riATE I�� I� 0�3 APPROVLri BY DATE , - �'ity of F�°lrlley 41l'Y7 �g'�o g9d� �s�`l H�eilding In�p�ctione Depart�tent Q9/1v �31 V�i1l►eiTS�� I'lV�llB �� FTI�$�1, MN 55432 763-572-3604 FAX: 763-502-A977 W�6£�OL�6800Z/6/Zl �a3�a 1./6:a6�d 89ZZ08LZ69:wa� . .