AF - 38028�
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Caty of Fridley, inn
BUILDING PERMIT
Date: Dec . 1, 1967
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p�r; �pr _ Curt s Radbough Builder Clemron.. Inc .
Ad� _ Address 701 Columbia Blvd.
LOCATION OF BUILDING
No. 74'4'9 Street � Concerto Curve � � p� of Lot
Lot ._._Z __ Block 3 Addition or Sub-Divlsian ._ Melody Manor 3rd
Coraer Lot _ Inside Lot r. gSetback 35 �—_ Sideyard 10' & 12'
Sewer IIevatian � 881 48 _�$�� 884 .48
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling �t 38' �p� 25 � Height ?�� gq, �, 95A ��
Garage �}ont 2A � Depth 24 ° FTeight 1�� Sq. Ft. Cu. Fk
Type of Construction Fr�e �, �_$ 23 , 800 �� To be Completed
SEWER LOCATION - Opposite Ma.nhole
WATER LOCATION - 12.5' East of Manhole
In cansideration oP the isauance to me of a pertnit to
the P�P�ed work in accordance with the description abo�
ordinances of the dty oP Fridley. o
00.
�' building descrlbed
8nd iII CotriAliBnCe '
Charge
' agree to do
�provisfone of
Ea consfderation of tbe payment of a fee of $ � 36 .00 ���t ��by �� � Clemron, Inc .
to construct the buflding or addition as described above. This rmit is granted upon
the express condition that the pereon to whom it is gi�a.nted and his agents� employees an�worl�nen, in all work.
done in, around and u�n said building, or anypart thereof, shall cronform in all respect� to the ordinances of
Fridley, B�innesota regardfig lacation, construcl3on, alteration, maintenance,_ repair and movin� 04 buildings
within the dty lim�its and this permit may be revoked at aTMYf �time up,o�;�ia,hoa oY any of�the Provfsiona of said
ordinancea M I C/ 7 ;�
Official
Buiiding
Gasterland
NOTIC�
'Ihb psrmb does eo� esvsr t6s coes�rucHoe, IestaUaHa+ foe wiring, phimbtng, 6n hsaNag, ssvin� e� wats�. 8� sun to a�
t6a Bnitdieg lespsetar fo� separai� pa� fer fhs� iffms.
- , _ �
APPLICATIOR FOR BtJILDING PERMIT
CITY QF FRIDLE°Y, MINNESOTA
OWNER' S NAME �� � :. /1��•.✓.� ; BUILDER �/ _� �'
,
ADDRESS ADDRESS �/�/ � �i
�OCATION bF BUILDING
��� ��
N0. ���/Cl S7.'REET ,✓�/1.-"./��%'�-�1' .s/i��.�.�'�� PART OF i0T
LOT � BLOCK_� ADDITION OR SDBbIVISION / � a���2�� .
/ r /
CORNER LOT IN�]�E LOT A/ 3ETBACR .�-S �-C� SIDE-YA1FD ,/� / 9� i�-�
SEWER ELEVATION � �' % � �� � FOUNDATION ELE VATI014 �� � o ,`��'
App ic�ant attacf� to�orm Two Certificatea of Survey o� Lot and propoaed
building location drawa on these Certificates.
`��.� /�2. S , � � �Z `� .�
DESCRIPTIOft OF BDILDING
To be used as;
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���C D��� Front ,�� D Depth 1�Height ��� �-�
- G� ,� �;)
Sq. Ft. !� _� Cu. Ft. /`✓ � rj
�'� Front ,�� , Depth .�� Heigh� � 6
� Sq. Ft. ��� Cu. Ft. ��„ � ��ti' � ��
Type of Construction ���?_/ Estimated Cost �� �D� �__
To be comp2eted
7.'he undersigned hereby makea application for a permit for the work hezein
specified, a�reeing to do all work in strict accordance with the City of
Fridley Ordinancea and rulings of the Department of Buildinga, and hereby
declares that all the facts and repreeentations stated in this application
are true and correct.
DATE �D G� SIGNATiIRE ��
(Schedule of Fee Coste can be found on the Reverse Side}.
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BIIILDIlJG PEItMIT FEE SGHEDIILE
SEG°1'ION 2. The Inapector of Buildin�s. shall, before issuing aay permit for
the erect�on of any building or aeructu�e� or for any addition to any existiug
building or etructure, or for any alterations or repairs to any existing
building or structure, upon application therefore, require tlae payment by the
applicant for s�sh permit of fees to the amount.herein below set forth and in
the manner herein provided to-wit;
2„ 1. For any auch permit for the erection of any fire•proof building,
other than a gara�e, warehouae, factory �r grain ele�va�or, or for the erection
of any fire-proof addition, �or s�m3las occupancy, to any exieting building,
shall be at the rate of $l..40_for each oae thousand cubic feet, or fraction
thereof, in auch cubical contents.
2.2 For any auch permit fa� the erection of aay fire-proof garage,
warehouse, factory�or grain elevator, ar for the erection of any fire•prvaf
addition, for similar Qccupancy, to any egisting build�ing shall be at the
rate of.$1•,25 for each�one thousand cubic €eet, claesified as "fireproof"
by Sect3on 502 of the Minneapolis 8uilding Code...
HOIISES
2.3. For any auch permit for the erectioa o.f any non-fireproof
building, other than a garage, warehouse, factorq or grain elevator, or
any noa-fiseproof addition, for s�Uuilar occupaacy, to any eacisting bu�lding..�
perm�tt $1.00 for each one thousand cubic feet.
GAR.AGES
2.4. For any such permit for tha erection of anq non-ffreproof garage,
warehouse, factorq or grain elevator, or for�the erection of any noa-fire-proof
addition, for �imilar occupancy, to any esisting buflding or for each such �
building or addition • ninety cents ($0.90) for ea.ch one thousand cubic feet
or fraction thereof, in the cubical contents the'reof with the minimum of $4.00.
For the purpose ot computing feea for building peranita,�the cubical contents
of aay bu3lding or addition to a uaiform height throughout by multiplying the
ground area covered from a point sis (6) inches beZow the floor line of the
basement or cellar to the average h�fght of the upger aurface or to the average
height of the roof surface of the main gable of a pitched roof.
2.5. For repairs or alterations to an e�iating etructur�, the fee ah�ll
be at the rate of $3.00 per each Five Sundred Dollara ($SOOfOD) or fracazon .
thereof in the cost of all proposed work..� ��
2.6. In no case 8haI1 the fee charged for any permit as set forth in
Sectio 2n be lesa than $4.00.
STORM REPAIR DAMAGE FEES:
Resfdential : Estimated Cost of work up to SSC�. i!� �- S5 e�?�
Estimated CosC of work ove� `,':,�_,,._�;,! �' v°':0
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Co�aercial; Estimated �st of �a��•�:'u'� 't;; "�>>^�:� ��� �. �_r:_,�
Estimated , _ �t of w��i�c ov-r:r �,:.�r:+":.U�! - ,Zf).
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SUBJECT
City of Fridley � 14096
AT THE TOP OF THE TWINS g U I L D I N G P E R I T •
� � RECEIPT NO.
� ; L __�_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIdE INSPECTION SEC.
' i '
l---. A �'��1,� CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
� � � � , 612-560-3450
910-F15 .5/20/77 � �
108 ADDRESS �449 Concerto Curve N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 3 Melody Manor 3rd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Curtis Ra.debaugh. 7449 Concerto Curve N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
G.D.I. Builders Inc. 71 - 66th [�Ta N.E. 566-8288
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICEIdSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 24' x 2Q' Addition o Dwelli.n
9 CHANGEQFUSEFROM TO
STIPULATIONS provide copy of truss design. Supply energy calculations by June 6th.
IH�RHIHG
S�PERA�TEE pERM�TS �E(�lIREO f�i WrRn�G, ELEPNONE�nEIECTRIC -�GAS Etc.
HEATING, P�lJIIABING AN0 S�GIVS. °` REQUIRED BY i�4
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATINO, NPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOpd Fi1II1
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTAUCTION 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—�. �SO 9 600
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIPIED HEREIN OR NOT. THE GRANTING OF A PERMIT �`�.3� OOS �`6.SO
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � y�`3S.4O
PLAN CHECK FEE TOTAL FEE
$44.90
Si N REOFCONTRA OR ur EDA T IDaT WHEN PRO ERLY VALtDATED THIS IS YOUFi PERMIT
,! �� , "- � 'lp �—
o�
NATURE OF OWN ER BUILDE ATEI /C' BLOG INSP pATE
CITY �F FRIDLEY
APPLICATION.FOR RESIDENTIAL BUILDING PER��ITS
�NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: �!.[ At-T% � �Ei3A L1 G h/ BUILDER: � . %� .Z� _ �s_e .o /�v � „��
Address : � c%�� �,���rfl�,��ya �� y� �ddress : �- � /U,I�
Tel. No.: ��������'�
No.: Street:
LOT: � BLOCK: � ADDITION: ���� y. �,�A,� � �
CORNER LOT: INSIDE LOT: "� S,?,TBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lofc and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
� /t�,� Front: � Depth: �O Height: /�
Square Feet: �_ Cubic Feet: , Q70Q
Front: Depth: Height:
5quare Feet: Cubic Feet:
Type of Construction: l (►�� �/�%/l,A�Q, Estimated Cost: $��Q.�_ pd
�■
�o Be Completed: l� �a us �/� Oa �
-�- Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representatio s ated in t's plication
are true and correct. See reverse side for dd' ional i.n rmatio . �
DATE: � � �% / SIGNATURE:
Stipulations:
��-•�t �%oa x ��,�,
�� �
�.- , � 3 a�o 8 �
�� �
�� `�
�' �;�� � G�� �r
,� �' � ,,� , _
P��-
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.�
�3�,ya
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j�� 9 �
�
BUILDItJG PER��IIT FEt SGh(EDULE
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 building or structure,
or-for any alteration or repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such p�rmit of fees to the amaunt
h�rein below set forth and in the manner herein provided to-wit: �
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (ConcYete Curb Streets Only) '
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$15.40
-ADDITIONAL INFOR�1ATION
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplyinq the ground area covered from a
point six (6) inches below the floor line of the basement or th� cellar to the
average heights of the upper surface or to the average height of the roof surface
of the rdain 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 hundred dollars ($500.00) or fraction thereof in the cqst
of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
- VERIFICATIO� OF FOUNDATION
NOTE: Permits for construction will be issued a minimtun 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 been constructed will be required before proceeding with the framing.
CtRTIFICATE OF OCGUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building pezmit has been issued; and
said st�ucture shall not be used or occupied until a Certificate of Occupancy has
been issued.
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�- EXTER70R E1:VELOPE AVE�:AGE " " CO'�;;"itTAT70;�
/� .� � `
- ----- �
_ OWNER �_7_`- C� --- � �--�---� P-��-------�--
d -�
�-
S1TE ADDRESS
CONTRACTOR ---��-•%�l L--!���-- nATE _-��ZZ'�Ir%-- PHONE --------------
Determine working square footage of each. ��� ���2
1. Total e�osed wall area .... _, sq. ft. x .17 L
-- �--�'— -- - ° - - —!�'� ��►7
2. Total roof/ceiling area ... sq. ft. a .05
- � - - -- - -��� �
Tota] exposed wall area ahove f]oor =_ ��� __
a. Total wall window area . . ��C�l�F'�. . . . _ _9� _ __
b. Total door area . . . . . . . . . . .
. .i��. . _.�''�_
c. Tota] sliding glass door area . . _�� __
d. Total fireplace wall area . . . . . . . . . /,�j�j� _
e. Total wal] framing arc�a (avc�ra�e l(1%). ... �� __
f. Total net wall area above floor. ......___�'�_ _
g. Total rim joist area . . . . . . . . . . . . ___���____
Total exposed foundation area = __ �d�
h. Total foundation �.�indo�a orea , . . . . . . . _ ��_
i. Tota? net f oundat i on area above €rade ..._ _��_ _
netermine "U" value of each wall s��ment.
a . _ � X ��U,� _.�_��_— - --�6. �.?
b . �� X „U �� -._�t/'� _ --�,y-�
c. X "U" r6� _ ��
d .—_--!�'/-�_--- X ,�t��� - - �� -- - -�"'1�_
e . 8/ X "U" ./O =
f . S"� X „U„ . d�% _ _- � �
� •--�'.—�-- x „U,� .�m� - _ ,�,�
„„
t, . a x u = i�v .
���/��_ _ r� _w °���
1.— I �� }� n 1J n rw°�r� —-�'�.T
---,i�-r+��i----
3 . . . . . . . . . . . . . . . . . . . . Tota1. . . = Il�I���
C�'�.� ���0�
f
�
.�
f
lf item �l3 is the same as, or less than item 4d1; you havc met rhe intent
of SBC 6006 (c)2.
� ,
Total exposed roof/ceiling area = � ���
j. Total skyl ight area . . . . . . . • . • • _____ /��JI�'+�__
k. Total roof/cei]ing framin�; area . . . . . ____ ��r_.________
]. Total net insulated roof/ceiling . . . • _�_ _�f��- .�--
Determine "U" value for each roof/ceiling segrnent.
j . I�O�-� X 'r11 n .— ��'��-- -- ���t� �.
k. %lg }{ ��U�� I ��s'� _ ___%.�Z
1 � x nu�� �a� _ l�.96
.
4 . . . . . . . . . . . . . . . . . . . Total . . . . = I d�+�I�
If total of �64 is the same as, or less than ��2, yov have tr�et the intent
of SBC 6006(c)1.
Alternate Building Envelope Design
' To utilize the total envelope system method, the values established
by the sian of items �13 and �E4 shall not be greater than the sum of
i tems ,�il and ��2.
1. �'.�� d � + 2. ��i%r0� __- ��
3. .�s�� �� _ + 4. ��r %8 _ _ .���o�+ �/
�/1��� ����
DESIGN GONSULTANTS
�01 �3RO AVE N0.
�R�OKLYN PARK, MN.
55���
€!�'4.e�:�'�,ti�� si o� • ,',,,: -.. • �.. , .� . . .
�.
�. y "�
r �
1
TY3'7C�L L:�1.1, E,? CT1n1:
1� Interior Air Film
2, Interior k':�llboard
3. Insulation
4. Exterior `����'�t��ins
5. Exterior Siding
6, E�terior Air FiJm
Total
STUD & HEAPrR AREA
/� Total Area No. 1
Less Insulation "R"
� Plvs 3 z" Sof tc.T�od
_: '_------------'-� � � �_� .
�— ------- ,. _,, �
�: �. +i� ri �
j,:Y i
! r 1. L�: Cn L CJ'� I: ��-o I J � -_--U_'`J
� Ir., . .
��'":1.��j�n?':as. �� n: ,
�I_ � s
_ r.,,,�' '?: - ��,��.r���.� �� . 1' �.
_. �. � („
� �1= �� .��A' � -�
, � �, I � _n .
s ,• -c-;-- ' is
�• I• �� . A � .. ` �
....�L �
:�,,,,,,�:t�la:� � � � , ���• . � ..�,
:-; t �. L I(�� • l� � • •7 • j
�,� U • .�� ��D C
� l�.\ � • ' i. _ -• '�-�.
i I�i '�' � r �" • �'%•
� i. .� .
�' �1—�� ° ' �
i
�
.,% �
0
?��: /C`-%IT?rG
�cac f low
up
Total
RIM JOIST AREA
1. Interior Air Film
?, Insulation
3 . 1'�" Saf twood
4. Exterior Sheath�ng
5. Eaterior Sidin�
6. Exterior Air Film
Total
FOLT`_�DqT?p1' 1;AT,L AREA
��R�,
� ��
__.1—� '��
-�^� � �
• --�'-'��-� � = U
� � �� R
/�
____�����_._ � O�P_
� .�
�� 3s 1 = i
R
�,5� U = � �O
1 � �+
_,�1, o 0
.—f%'���
--�.t�C�
���� 1_-,
, � �:
-i� Gl � l� _ , 05-�
1 , Interior Air Film ____� ��
2. Insulation r—
3. Insulation (Block) _��_a`"� 1 =
4. Exterior Air Film �_ _�>�_ R
Toia1 . �e I�_ U = ��%Co/
ROOF/CEILING_AFEA
1, Interior Air Fi]m
2, Interior ��allt���r�
3. Insulation
4. Exterior Air Film
(�ti�l)
Total
�Cv�
, 5��
!-��`'��
o� _
(e„�� � ,0��
(31
��o�
—�-S'7a
�o,o 0
--`�DI � -
�,�8' U - - f0 3
i
,..
- ws
vu1LLL1fVt, '1'U (k) FACTORS F'ROM (ASHRAE MqIJUAL)
OF TYpICALLY USED PRODUCTS
Interior Air Film (Walls)
Exteric�r Air Fi1M (Walls)
Interior Air Film (Vent�d Ceilin�)
Exteri�r Air Film (Vented Ceilin�)
Interior llir Film (rlon Venteci)
Extcrior Air Film (Non Vented)
1/4" Plywood Panel
3/8" Plywood Panel
1�2" Fiberboard Sheathing '
25X32" Fiberboard Buil� Rite Shg.
Aluminum Siding
w/Backer
w/Hacker 8 Fo;led
1/2 x 8 Lap Siding �Wood)
7/16 x 12 Hardboard Siding
AshEC�tos Sidin�s 1/4 Lapped
Stucco (Brown � Finish Coat)
Built-up Itocfs �
Plus Insl .
3/9" Gypsum Hoards
1�2" Gypsum Boards
5I8" Gypsum Boards
3��+" Wood Subfloor or. Sheathing
1�2" Plywood Sheathing�, � '
1�2" Particle Board "`
�-
8" Concrete Block,(S � G Reg.)
12" Concrete BTock (S E G Reg.)
, 8" Light 4?eight'
12" I,i�ht Weight . .
(R
0.
O.I7
. 61
0.61
0.61
0.17
0. 31
0.47
1.32
2.06
0.61
1.82
2.96
0. 81
0.67
0.21
0. 33
0.32
0.45
0.56
� 0.94
. .. .. �0.62
' 0. 66
'��'� ���.� ��
(� ,. Q,�,�uet�:�
�" �
V - r
�
Fill.ed
Vermiculite
�. ... 1.11 1.93
• 1.28 3.15
� , 2.18 5.03
. 2.48 ' S. 82
Insulation - 3��1/2" Ffiberglass . 11.00'
All other insulation materials must be
19.00'=
. verified (R factor)
��, � � �. �
All Windows �� Note; (U) x area sq, ft.
(w/storms 1 to 4" space)
Removal doubie glazing (RDG) •56
Thea�mo or wQlded 3/16" a.ir spaee ��g
�/EI'� �;�a 4�� '�� �
1��" air space T5B
(Other windows sp�cifieally tested can use better ratin --
1 3/4 ' �')
Solid core door '
w/storm, wood '
Per����st�;cL� �tr�i,,lwL. � ,
Sl�ding Glass Do�r, woad�"�--'�J`�'" %4SR . ,
- _.� . , metal o :
N� �n -. F��e , �; � _ . ,. ,
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APR-04-2903 12�13 FROM CITY OF FRIIILEY
TO 6513651332 P.02/02
'rHE BaOW MUST B� F[LLED BN Wh1EN REPLACiNC FIJEL BURNb11G APPLIANC�S OR TH�
APPLIC�4TtdN IMLL BE R�TURN�D
' CAIL".Md� t�IUT� <�Rt"!' �A.�!!�!��;�5"�R dRd CCf1�Rl1�T1�I� I.L1R VFRIFtCATi01�
WI'ten tt�e wld�rsigned her9eby vefifies that the
ven�g has been �xarnb�ed and is free ffrom rus� detedar��on, obstructions,
and is sec.�rety suppo� �rtd �restopped wher� requi�d. Yes () No �)
�1'►e ventfng �ystem is piastic/PVC and rneets q11 current cades and manu#a�r
spe 'aficaticns inctuding s�ing� length, number af elbauvs and t�rmfia�on. Yes (} Na ()
The undersigned atso vetifies th2it the replaaemertt ut�it is a listed assembfy
�nd me�ts �e current cades and manufacturers specifications, This does
md�ude AGA-GAMA Cat�gory I Central Fumace Ver�ting Tabl� �€or fan
assiste.� and natural draf# �ppAanr.es.
The " is si¢ed �nd instaqed to meet the curren# c�des
and ma»ufad�urers sp�c�tior�s.
VVhen t�qtlir�d t0 insF�n �;�w �e�yL�sc,=,r„it Wil( b8 3iz@d Snd fistalted
to meet #�e current codes �nd manu#adurec's spea�ic�tions.
When , the under5igl'�1 h8reby veri�es that
it is a�s�ed assembly �d meets the aarrent c�des and manufac�urer"s
spec�c�tlons. `t�is does inc�ud� ACiA4GARAA Ga#egary t Centraj Fumace
Ver�g Tables for i�m assisted and natur�l drafi appliances_
Is the c�ommon vent and vent conraec�or� sized and 'mstalled c�rrectly after
�n �ppfiance has be�ri removed from tri� c�mmon v�nt and verited
sepa�ai�ly as per c�t codes_
Y�{ ) No( )
Yes ( ) Ne ( )
Yes ( ) fdo ( )
Yes ( ) No ( )
Yes( )No( )
i � � . � -l•:� , t � �� � � �i ii • � a!i . f � ' fl . i i ��.r E i 1� u� : r • �
Appli�nc� #17ype BTU input Fan Assisted �r Nat
�►pplian+r� #2 Type BTU Input Fan Assi�ted or Nat
Appli�nce #3 Typ� BTU Input Fan Assisted or Nat
To#a1 Appliances Tot�l Btu Input
Common V�ntType ver�t Neight,,,,,,� Diameter___ inches
AppGance �i Ver►t C�r►nedor Height ft Length ft D[ameter in Type
Appl'�artc� #2 Vent �onneator Hei�ht ft Length ft Diameter in Type �
Appliance #3 V�rrt Corv��or Heigh# ft Length f� Diameter �in Type �
1�: I�• � 11�r �;• �i� =
HEATIN� CO:
Signed BY D�ata : . ,�,..,.
TOTRL P.02
_
_
CIIYOF
FRlDLE,Y
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
Apri16, 2004
Mr. Keith Sparks
7449 Concerto Curve NE
Fridley, MN 55432
Re: Final Inspection at 7449 Concerto Ctirve NE, Fridley
Contractor: H P Pipeworks
Dear Mr. Sparks:
A plumbing germit was issued on Decsmber 1, 2003 to install a water heater at your address.
According to the State Plumbing Code, a final inspection shall be conducted on the work
authorized by this permit. As of this date the inspection has not been requested.
The permit fee that was paid covers the inspection to make sure the work is completed according
to the Codes. We will keep your permit open for another 30 days and if we do not hear from
you within this time to set up the inspection, the pernut will be marked "no inspection called for
by homeowner after notification" and expire the permit.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
0
. CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 7449 CONCERTO CRV NE
PIN : 113024140028
LEGAL DESC : MELODY MANOR 3RD ADD
: LOT 2 BLOCK 3
PERMIT TYPE : BUII.,DING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING
VALUATION : $ 4,538.00
NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE.
PERMIT NO.: 2004-00011
DATE ISSLTED: Ol/06/2004 ��
REROOF HOUSE & GARAGE (24 SQ) TEAR-OFF; RESIDE NORTH SIDE OF HOUSE & GARAGE
IS APPLICANT A CONTRACTOR? 1
APPLICANT
SELA ROOFING & REMODELING INC (1050
4100 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416-4727
(612)823-8046
OWNER
SPARKS KEITH C& TERESA I
7449 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 consiruction
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 lrnow the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a pemut does not presume to give authority to
violate or cancel the provisions o any other state or local law
regulating cons ctio r the ormance of construct�n.
Applicant G Date 1• 6`o �
Bldg Ins�%f����YGc; Date/� -G�
BUII.,DING PERMIT FEE
FIRE SURCHARGE
STATESURCHARGE,VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 16138
SEPARATE PERMITS REQUIRED FOR WORK O'TI�R THAN DESCRIBED ABOVE.
111.25
4.54
2.27
5.00
123.06
NEW [J
ADDN [J
ALTER [ ]
Construction Address:
Effective 1/1/2001
CITY OF FRIDLEY (763)
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Legal Description:
Owner Name & Address: �t: �i'�r �r��t/��S Tel. # i'�3 - �/ � %
,
Contractor: �c� A e„r,�,�,r� ���••�,•�����T�,� MN LICENSE #
Address: 4100 EXCELSIOR BLVD. Tel. # �/2 ' Z�d •? 7 i f
. LO I RK, N 5 1�
_ Attach i� �����cation, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Wdth Height
Length Width Height
HgUGround
Sq. Ft.
Sq. Ft.
Sq. Ft.
� _ � 7/%�
/� s I �%�d
Construction Type: C�� d 1" S, �,� .<P,r-� Estimated Cost: $
SI�P �la�,k 5 C�/c•�� �
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: _ / - �`G `� APPLICANT: Tel. #_ �/Z� Z�o • �77/
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
�Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ l/ � as� Fee Schedule on Reverse Side
$ � �- .001 of Permit Valuation (1/10th%)
$ v� _�'� $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ , � $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
ri r �