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AF - 38007� � �� City of Fridley, Mirm.. 1�1T° � 92 6 BUILDING PERMIT Date: Sept , 9, 1968 p�. $omedale Blders . Builder ..Sa� Addresa 5 217 Wayzata Blvd . �,d�g Sam� _.._.. �. LOCATION OF BUILDING No. 7428 5treet . Concerta Curve _.._. Part of Lot ��10 __ Block 2 Addition or Sub-Div�ision Melodv Manor 3rd Addn. Corner Lot _ Inside Lot X Setback 35 � �_ Sideyard 5�/ 10 � Sewer IIevatian �.— 877 • 09 ._._ � Tc�cx 88(1 RA Top of Footing DESCRIPTION OF BUILDING To be Used sa: Dwelling �t 46' Depth 24 28 Height 2�—. Sq. F't. —1�.5� Cu. Ft —23...120 Garage Front 16� Depth 24� Height l�� Sq. Ft 384 Cu. F't. _.__��+� 7.j+pe of Construction Frame ��_ $18, 000 _ To be Completed SEWER LOCATION - 65� East of Manhole WATER LOC,ATION - 76' East of Ma.nhole In cansideration of the isauance to me of a permit to construct the building described above I agree to do the P�P� work in accorflance with the description above� tiforth and fn compliance with a'11 Provisione of orclinances of the dty oP FrTdley. � � � yl %./� In conafderatton of the payment of a fee oE $ 40.00 � p�t � hereby granted to ��edale Blders . to construct the building or addition as descrlbed above. This rmit is granted upon the exPr�s condition that the P�'�n to whom it is granted and h3a agents, employees an�worltmen, fn all work done in, around aad upon said buildiug, or any part thereof, shall c�nPornz in all respecta to the ordine�ncea of Frldley, Minnesota regardiag location, construct�on, elteration, maintenance, repair and moving of buildinge wituin the dty )imfts and this permit may be revoked at aTMy time upon violatioa of any oY the Provisions of said ordinancee. > �i1�in8 Inspector Clarence Belisle ��oS � I NOTIC� Tl�s psemh d�s net �wr t6s eoe�roeNoe, leuta�a�toa fe� whh�g, plumbteg, ga huNee, aw�� e� wahr. e� sun to � t6a BniWi� lespseter foe ssparals paemHa fer fhsa t�ms. A � 0 APPLIGATION I�OR BfJII.DT-IQG PERMZT CI�.'Y :OF F.RSDLTY, �; MIIdNESO� . OWI�Eg � 5 I�E . . � _BLTIII,DER � : ",;�� '�" .�.�. � � - - ... . , .. �� . ' : ' ; . :• ', :;s: _ . ' ,r.,' � ADDA,^�S$ � � ' .`_�-_..._,;_ __�:1�iL�DRESSi�;�� _ :-�-� � ---�:--- . • ; �-; • . . . . . . . , LOCAT�bN � QF. �, BUZLU�G . - � . . NO.,;f�� : S1`RFET 1��✓�' .�r ,.C��-�t�,'�'-- . ... ��_.._._ e LOT_� � OER _�� D�TTaN : OR StIBD�V.YS3Cfl . _ � � � , � � Q. � � � �CORP3IER LOT_____� _7.L�T�SIDE L __ r___SETBACK ., .•��*�SYDE'�AAD � _ �__. SEWFR E�EVAxION T�P OF FOOT�NG Apn�.ica�aC .attach .ta thia €orm 1�'wo : Certificate,� .building loca�ion.�drawa on thes'e-Cgrtif3.cate8, . . . ,. ' ..DESCR�PTZO,N �OF 93lTLDIN6 of. Surveyr. of . LoC �.ar►d propoeed To Be Used As s � � • - � �- - _^�� : F'ron�� Dapth � . iieight _ �'� �� t f` , ��- . . � / � Q /,% � Square feet.�.,1% Cubic FeeC � • �� /�` / .ravur • i ar✓ -c— � — - ..��.�.- � , Square feet � Cubic Feet „f�` �� Type of Construction_s�ii/�� Eeti,mated Co$C �� To Be Camp The underaigned hereby makes application for a germit for the work herein specified, agreeing to do a11 wosk in st�tict accordance with the City of Fridley Ordiaaaces aad ruling� of the DepartmenC of Buildings, and herebp declares that all the facts aad representations stated in tbis application are true + DATE �� (Schedule of Fee Coets caa be found on the Reverse Side . �,� ✓ ��, -��s� g _. --�,�,� �- ,'-� � � , , � ,___:. ' ��. '. . v BUILDING PER1�fZ�" �EE SC�iED13f.� . . . .. ., . �� SEGTIQ�1 2• Th� Insp.eceor of. Bui.ldings shall; bafore i�rs�ing 'permit� fo;. , the erection of �ay building or�etructure, or for�any gddition to �ny - existing structure os building,-or f�r any �a'�eeration or repa,irs to any ;: existing building or struc�t�.re., up�un applicaticn th�.�efere, require" 'the the payment by Che appli�cant for sueh permit of fees to-.the.amount._;he�ein below seC forth and in the ma.nne= herin provided to-wit: �� _ IInifarm �uildin,� Code; T}�pe ly 2, 6c 4- $1.�'S for eaCh one Choueand cubic feet, er fractiaa thereof, in such cubical conteats. 'Tqpe 3 8� 5- ��1..50:for each one theusand cubic feet. � . �• . F�r the �u�ise ef et�ntirig -fees for building permi�s, the cubical �� eont�ats ef anq buildi�tg or addition t� a��iiorm heig�r throughout by multiplying �the ground area..covered frqm a pQi.nt..sin (6) iaches below �the floc: � line �f the ba"se�ent or the cellar te the average hei�ht of tbe upper surface or Co tl�e aveiage height of-the�roof su�face,of the main gable of a � -pitched roof . . � � � - • � F�r re$airs or altera��.ons to an egistiag structure, th� fee ehall be aC the rate of $3.OB pe� each fivi�-fiunclred dollars ($500.�0) or fraction thereof in the �,oaC ecf all propoeed �ork, ..._. • . .. . ;, � Ia ne case shn1L the .€ee: c�ta�ged fer anq perm3t �as set. �orth� ia Section 2 be legs �.thari $5.A0. - . . . . . ,. . , . ' NSSSD , Caaneetion�� Charge� lissed on: � locatisu- ��rea. 1 oi , 3. � - .. • , _ . ,� � � . �. � ' . , . ... _ � ` , �. V � � -i. � -1 .r a � ._ _�� __. „ � � [ond Rl� �Ald S!Y'IK1//� / .�rs r�t;,� C"►v,e b M�irrpol �,�,�� B7'S-iYr�v°i�� f. t'�fi��bi5 J� , �� E�t'd C I NEE R t t'�IJ G� t f� C. ��°�° _ � sr��c-�o� --- En�C ►ineers � S`u�vec�ors --- ce:�ta,�scat�e o�' s�s�� a� . . , � � e . , .r . a / �i •... � � Yri o�v�.�.apm�r�� NORi'MI � �� - r � . : (rQN�� o Cv ^ �� OENCT6�5 iROt�t�6ENOTES ORA1tdAGE AtsD U?IL1TY EAStiME1d? LOT 14 LOCk Z, 1V�EL.ODY MANO� 3i�D AOCtTtOK ItNaxw c �TY / 14aEdr� c�rf�j'y fl� Nrrs � o M�e and mr+2c¢ ve�r�rstofea� o�'o scswet� �'lP�t �BS �i'4 a�an� d�brd lrs�rl, ari�! o�'N% /ac�fi�ri a�'ml bw,fdrr�s ,1h►�Pan , a�da►/ ris�E�e a��nfs ..�'ax�. �iun ar m t� laiao! As siu-rr�ed 6y m�e 11fi� "°f�J '�'`�'us� A.D�. SU8UR8AN ENGINEE�1NCi. INC. /�nerrs fr sur.�ars -__ - - _ _ SCole: I�s�Q,� gr�� 7� � � � --- - --. � � a�� - — - - -- ¢� - - - — _ . .: .� y � �Ti ?e�' R sr =w— � � � � 0 � 0 � x m � b 0 � � � � z z � H y � � xxz� � � � O � � � z i. � � Q � �—.,-- � �n � w o � � � m � � � Z m �l m � � � Z .�'f O � n � fA M w w R9. � H 'a�d y �w�o� � � � "rJ M C m ►= � M r+ 'a p � � �v�i � o �� $� � � � �� : ' y � : : � . : : .�. : : : y : : : : �,: : : : a � m� x �'��° � � � � � �� o � m 'd � � � � � � � � � � � o w � m Otl � I " P. � � � � � p ]d � � � p' � � � o � � � �� \ �. �ro 0 C' � � � C � :° � w oa W �� "r� y o � y O V� y � � . � �. �: �. � �' : � 8 � �. � � � � � P�p � I M a i�i � � 'nJ" '�J' � � p � � N � ,R�. � � x � � O c�'�'.� o m � H 0 0 � ,ri c R° R° y �� e�o 0 0 � � � � � � a�-► � M M : � � . . �i � � x �d . . o � . . � : : � � : : � : � � � � � � �.�.� �� R° R° � � � � � � � � � � y ��* �, R° P' � ° �� w � � g � � . � � a � � ° p, � : � .. �p � � : o O � . . � o . . . m o : : : � � '�O � 'd � .i .. � �' �' � � A � � � � m � �� "'�� .. �� ° � � � �' a�' : � . . � ° : : 0 0 . . pp . . P : : : . . � . . . . � ' � � �° w W o o w�� w o W�� o �� o g o� o�$ o o g S r� .�.� � �� ► 0 � � �^ ♦• � � I�i � O � x � � � M � � � �� o � � �� U�� a � P7 �a a � M � � � �. � o c m� 9. z 0 � � aa� �0 c�o ►� �°• � rps b��,� y�+ � � � � �� Of�D Cpq �d°°�� b o �:� aa �.�° � pp�� rop � y � ��p tl7 07 � ��b � � �b o�� p��o �a�p .7 M o-'4 �! �� a��. � a�� y : � ti � � � � � � ��o � � �� > „�� D � D r � � m tn 2 m C m � � a � � �s �� O � �o o � �; o. o' � � �� h � 0 � 0.� �� " �i O D 70 � � � � o. � � PP o r p � : O � :i . � : � : � � � . � : � � '�_ � � ►� M ps � i � � "- f�D � N� A � x 7i � � �, �S � 8 � � t � � G� �o n �� p� r'! f° �i i�4 m � a� m � � � ° � � °y � � � � � tNp � O � � :V ' � p 'O �' ,� � 'i� � . � " � � .��, a ° � �: m� �� . . � � ' : ib : : � Q 0 N /d il M il � k K iC i! 8�i 8� 8� 8� g� 8�' tn � N ss �n rfl sn fn � 0 I � g� �� ( I r � � � Q w � �, C � � , � �; � a 0 i A � � a � � � 0 i � � � � D � m � n m v r m * . �o. w � na .. !p X � � I� a � � e �� I o I � i � ' � 1� � � WATtR aASRS uaiwLLs r►rM � ansns SINKS w� ra►rs DRINK. FOUNT. SFIY�IS. �R ��►� u� �� W� � �. �' RANGE ows � oaENnros ,. i A tt�pp� � � �� `j A �� I � � �❑ I I i � � . �a � � s ` � � � � � � � �° �� _ �' f, � -�i, � � � � a � � �. �. � ,� ,� � � � � ro M �� M 0 � p• � � 04 � � � e y � � M� � � s► a � � � �. � � '� � g � �� ► � a e a � � � � � �� , � � °� � � '� � � b � �, � �. �� a� � �o �� a �� . m �� . � � �. �� o �� .. A�x � 3�� \�� HOUSE HEATING TEST RECORD ADDR��S �� -��'�� APT. F OR CI URB @ OCCf1PANT OWNER ,' �+� �'' HEAT LOSS DATE HTG. INST. GAS C0. METER BADG # SOLD BY INSTALLED BY � � - ' � �_ Eleetricoi Work By Gas Line By TYPE OF HEAT GA FA �W STEAM SPACE HTR. UNIT HTR. OTHER � GA�ESIGpFj� � ` CONVERSION MAKE �'-��'� � � �° � %�� MAKE OF BURNER Model �- Model Serioi �_- �� Max. BTU Ruting INPUT ,��. Qs% MAKE OF FURNACE Model CONTROLS � THERb10STAT _��eat Plug Vent Sizs � _� � Valve {�� KIND OF �INER��/ __��_ _. _.___,7F � '' tun�tF Limit �%~ �� DraR Hood e;� � Regulamr Limit Setting � Fi Iters Size Number Fan Setting �� -� Chimney Loeation Inslde � Outaide Pilot Type � Q�imney Construction Pilot Make �' Pilot Model �� Smoke Bomb Wiring ��'�' Pilot Timing �-��— Draft �'�— Test Tag L� L.W. Cut Off r Pressure_ Lighting Inst. ✓ , - , L � �.�-�°� Proasure �F � Pe e� C Date Tested S��" ,� � � Inpuf CFH �G� `� P6rEent �"2 �-� �-o�mpany Testing � Staek Temp. ��`— Percant CO �6� Name of Tester ,,.�� Form 235 SUBJECT R O. City of Fridley � 138 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � CEIPT NO � � COMMUNITY DEVELOPMENT OIV. � � j L -'��-� /i r � � PROTECTIVE INSPECTION SEC. � 1 . � � � /��'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OP APPROVED BY �•---� � �'� sia-5so-3a5o 910-F15 10/8/76 � � JOB ADDRESS �428 Concerto Curve N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �.O 2 Melody Ma.nor 3rd Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Jerrold Nelson 7428 Concerto Curve N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same � � 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASSOFWORK � N� ❑ ADDITION � ALTERATION ❑ REPAIR 0 MOVE ❑ REMOVE 8 DESCRIBE WORK Install fireplace between house and garage 9 CHANtiE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIH CONDITIONING. M3SOI1 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R�- ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIE�. $700 $, rjO 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- �� $7, r,O STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE yS`8.00 � SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT (DATEI HEN P OPERLY VALIDATED THIS IS YOUR PERMIT � � � �� '- �* SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG �NSP - �A E CITY UF FRIDLEY APPLICATION FOR� RCSIDENTI/�L BUILDING PEft�1ITS �NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER' S NAr�E : v2� BUILD�R : ADDRES S : % � ,� � (� }�' ��G� ADDRLS S : ��;� — �= °� `"° TEL. IdO. . NO: . � �� STTt�FT: ��Y7�1�%%.v.� ��/�if/.�r� � � I,OT: f� BLOCK: v� ADDITIOi�: �'JZ� �C�C!''�ci�>-a� CORI�'ER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this foxm Two Certificates of Survey of Lot and pxoposed building location dra�an on these Certificates. DESCRIPTIOZ OF BUILDING To Be Used As: 7"�j-� w Front : Depth : Height : _� Square Feet: Cubic Feet: Fxont: Depth: Height: Sq,uare Feet; Cubic Feet: Type of ConstrucCion: �%��d��'�.c.,� Estimated Cost: $�QD • �To $e Completed: ��Yy'li��-7 � The undersigned hexeby makes applicatinn for a permit for the work herein specif ied, agreeing to do all woxlc in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application axe txue and correct. DATE : CX } '`- � ,� �Gi 7�� • STGI�AT[TFE : tion � (See Reverse Side For Additional Informa .) �, � � � -� °�� /� � � e ��4 j �R � ,a .3"�',�-:'`� � � i BUILDING PERMIT PEE SCHL:llULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing buildi.ng or structure, or for any alteration or repaixs 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: . iVEW CONSTRIICTION: Si,ng],e Family Homes and Garages: $4.00/1000 cubic feet PLAN CHECK: 25 percent of building permit fee. ADDITIONAL INFORA7ATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement ox the cellar to the average heights of the upper surface or to the average- •heighC of the roof surface of the main gable of a pitched roof. � For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five fiundred dollars ($500.00).or fraction thereof in the cost of all proposed work. � In no case shall the fee charged for any permit as set forth in Section 2 be less Chan $7.50. � V�RIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the tiane of application, to allo�o for proper review of the proposed stxucture and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceedin� with the framing. CERTIFICATE OF QCCUPANCY Applica�ion for a Certificate of Occupancy shall be ma.de•ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Gccupancy has been issued. a . � sue�ecT P IT N O. City of Fridley ° 16 3 8 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r ; � ECEIPT NO. � ; L _____ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � . � � � /"��1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""'� � ,�' 612-571-3450 910-F15 / / 9 14/81 JOB ADDRESS �428 Concer'ta Cuxve N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1Q 2 Melody Manor 3rd SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE Jerry Ne].son 7428 Concerto Curve N.E. 786-0199 3 CONTRACTOR MAIL ADORESS Z�P PHONE LICENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Resi.dential 7 CLASS OF WORK ❑ NEW OX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 16' Porch Addition 9 CHANGE OF USE FROM TO STIPULATIONS �� $etote diQging calt 4oce1 utilities TELEPNOPtE-ELECTRIC-G►�s Etc. HEPERATE PERMITS REQUrR�D FOR 1��7t� R�QUIRED 8Y LA� �T��G, P�U1�18�NG AND Sf6�d� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPAfiATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. W_OOCI Fi�ID@ THIS PERMIT BECOMES NULL AND VOID IF WORK 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 APPLICATION Z STALLS GARAGES 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 $2� 880 $1. �,4 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- $38. SO � STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE $9.63 $49.57 GNATUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI WHEN PROPERL VALIDATED THIS IS YOUR PERMIT / ji �/'� �'/ IGNA7UR OWNER�IF�.OWNERB ILDERI IDA ) BLDG INSP A E CITY �F FRIDLCY Effective Aug. 1, 1981 APPLICIITI�'� FOf� RESIDEi�TIII� QU1LDIf�G PE�f�ITTS (tJe��, Alter.�tions, AddiLivns, or Repairs) 011�JER: � �-� /��-�� [3UILDER: -��Z� � -� ' . ADDRESS: ��-� ��'�� ADDRESS: � TEL n10: �� - �! �' � TEL td0: Construction Location - STRI�T NO : �'��d �° � STREET: (�c� �J �' L�2 f`� C, vl„'�' �/� LOT: �� BLOQC: a— ADDITION :�!1 c`°'.�,f� �;1 'a i'r�9 r'�✓��,,/'C.� � "—T Corner Lot: Insii3e Lot: %� SetbacY.: Sideyards: Ap�licant attach to this form two Certificates of Seirvey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOid OF COh�STRUCTIOPd 3 S�s�J c�2�'f� Front: /� Depth: %,�, Height: Square Feet. ,� �j �— Clxbic Feet: Front: Depth: Height: Square� Feet: Cubic Feet: Type of Construction : �� `�� Estimated Cost: $ � ' �'� Zb Be Oor,�pleted: Alt. A Alt. B proposed Drivec�ay Width If New Opening Is Desired: $� S SE� REVERiE SIDE OF SHEET � T'iie undexsigned hereby make� application for a perntit for the �:ork� herein specified, agreeing to co .all worl: ir� strict accordance with the City of I'ridley Ordinances and rulings of �tl1e De�k-�rtment of Buildings, and hereby declares that all the facts and repr�sent.ations stated in this application are true and correct. D.'iT�: ��0�0 �" � SIGN2�TUFtE : StipulaL-ions: �� ,�-c� �.� �� 3 .� 1 ` �� . �� Bi1ILDI•1�iG PERI+�IT F�EE SCHEDULE The Inspector of buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any bxisting building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant f or such permit of fees to the amount herein below set fortfi and in the manner herein provided to-wit: TOTAL VALUATION $1.00 to $500.00 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100, 001 ar�d up FEES $10.00 Minimum Fee $15.00 plus surcharge $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 $�,000 or fraction thereof, to and including $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 $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to arid including $100, 000 $443.00 far the first $100, 000 plus $2.50 for each additional $1,000 or fraction thereof PLAN CI�CR: 25 percent of building pexmit fee DRIV�WAY DEPRESSION ESCROW: Concrete Curb S�reets Only Alternate "A°: Removeal and replacement of curb and gutter only Drineway width plus 6 feet x$13.50 Alternate "B": Reaoval and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 f eet x$15. 75 VERIFICATION OF FOUNDATI�ON Permits for construction will be issued a minimwa of 24 hours fro� the time of application to allow for proper review of the proposed structure and �f the construction site. A Certificate of Suzvey of the lot, shawing the location of the founda tion once it has been constructed will be required before proceeding with.the framing. r � �d ��'e.7 's- �rara . �'C� � � � � � � � � , � �� 0 �'' ' �,�/ �� Oo�/S � y', �O .�.r /� /1b3. so ''. _ A,v,��a-cs��1 = SL/OritJ[� �(�s ��v�2 � i'�0.7,� a �G cJ� � %/iss ��x� ' / 7 S� X �— = 3 S� , -- � � � - i. �� ti � . � < �,� i iI +' I ; 1� , l� � - --_. . . , � . . 1 1 I' ' � 1' � ; . , S . I �—, � ��+ ' _. .._ : � 1 '� G_ _ �--_..__- -�i r � � � * � D rh 1� 7 O � (�D �: � � �• � N � y. � O � � � � � o � � h a� O �• a �• �, � A lD � � � � a a� m `c �- � � � �� Q. ` � '_ O � e •�.r � � �1 � � � �l � � rn z � � m � O z T rn m 4f! �P V 0 � \ _ � D (A .� �. � � � � < Q- Q. � � � o \ c Oq ?' � � v � m -� m r � _n (, � � � � � C1 � \ � (A co � C \ 2 � Z G� c� O .� v � m � c � r p �3 � � o � d � C N Q. O � D �+ � � a�' � fAD 0 � O � o � � r � rn � m � S N m � � I��1 0 � � N � .D �. � � � j n � � � � � Q ,�ti. -�+. fl' fD n> ,.� c� �, _ � rn� �. v' W�'a � � � � � o � a °Q o. � 3 0°`� ��' � �tn�—� � �• � N �� Q � � °: � .� ci m � � � =� �� ma�-^ -�i A � O c Q �+ m�'�'-a m � � y (�p � as� � � o .��+ � O-w � � .-r � � - S r+ � � N �' fD Ci � � � O N O � d a� cD � Q � � _ _. D �_ �i Q O � <`D � p� N � m c�u � � II1 D �� N "� QD ai' D � � o .� �� N � r N � O Z W � c� v � -�-i W C "` � m � --I � a cD Z a, m 2 "O N fD z 0 v � D � .�• 01 �) v O 7 a%�c� = v� � �� D �;� � � m � N � u � � 1� G� G� D -n cD tn N O � Q. :(l � � � � �D j -p. V; tD � � � m � c�"c c� tn d Q�<� m ''� � .�+ � � � Q � > > � a-�'�o — C � � � � � � s�� o � � n � �� .�•.+. � " W � � � fAD � � � � � � N r � i-+ (N cn O O O O O O O O O � m � � � � � � � � o � � "T1�-IZ m C � ° — � a m ,�, azi � � � m � Oq C � N 2 O � n � n n � o p � � � � � ^ m N �- tn m . � r N a�"z� � � o ,� _ 0 a�i N v g � v m � � D � m � n O � -� � m � � z O � � £+.J W C r 0 Z G7 C � m v . O Z .� � � m N n _ m v C r m • .. �- � r � Cn � rn C� N O. W � � o� � � ��•� z� � �� 0 W D � N c�D Z Z � m� m � � z � C � a � � z � r �� mZ � � -�-1 � O� Z � v� a �° �Z O N za vz �v o= Zm Z � �Z -yC 'n �n rn O 3r� N Z Z � v< v "' mZ < '� f� � N O Z � m (� < fD � � L � � C � � F-+ N � � � 0 � � COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existina 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 plastiGPVC 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 current 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 specfications. Yes ( ) No ( ) Yes( ) No( ) Yes ( ) No ( ) When installing a new ventina svstem, the undersigned hereby verifies that it is a listed assembly and meets the cuRent codes and manufacturer's 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 current codes. Yes () No () Appliance Tvae 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 Connecto� Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describel HEATING CO: Signed By: Date :