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AF - 47213,��' ,�- � A G R E E M E N T , This is an agreement dateci June 29, 1965 between the City of Fridley, Sandatrom and Hafner, aewer and water con'tractor, Clemron, Iacorporated, builders, Lance Buoen home owners and accupanta of 7331 Jackaon Street Northeast Fridley, Minnesota, Lot 12, Block 1, Melody Manor 3rd Addition and Suburban Engineering Company, Incorporated, the coneultaat eagineers for the plat of Melody Manors. If ia hereafter understood and agreed that to date the watern�ain on Jackson Street Northeast betweea 73rd Avenue Northeast and Memorq Lane has aot passed a leakage teat; therefore, it is fur,ther agreed that eince the awner of the houae at 7331 Jackaon.Street Northeast wanta to take occupaacq on Wednesday, June 30, 19659 eaid water ancl aewer hookup will be made prior • to fiaal teating providing all partiea above meationed agree to the followings (1) That Sandstrom � Hafner underatands esid '�ookup ie being made and that it is their reaponsibility to ahut off wa�,er service to said house at the stop box prior_to each test or repair. (2) That Clemron, Incorporated, builders, aad the home owaer will hold the City of Fridley., Suburban Engineering, Incorporated and Sandstrom and � Safaer harmlesa of any aad all damages or inconveaience �aused by said � teating or of any repairs that may be deemed aecessarq to fix the water- main and aervices an Jackson Street. This agreement will aot be termiaated uatil auch time ae the watermain paeaes all leakage teste required by.City epecifications. -1- �� .- � . � �gre�eat 7331 Jackeon Street N.E. � 0 n � ��.�..�9 Sandstrom � Hafner � � Clemron. In orvo te Home Owner � ` • �� ,� . -2- 0 � i I ,� "'� � City of Fridley, Minn. BUILDING PERMIT Date: April 4, 1968 p�Er; Clemron, Inc , g�� Sam�, Add�s 701 Colimabia Blvd.. �,d�� Same �o LOCATION OF BUILDING No. 73 Ol _ g�t Ja cks on S t. N. E. part of Lot � 15 __ glock 1 Addition or Sub-Division .._._...�.€�odv Ma,nor 3rd Addn. Coraer Lot , X Ine�tde Lot ._._. Setback 35 � y.._ Sideyard _ Sewer IIevation �_ $68 .53 _ _�1,� Top of Footing DESCRIPTION OF BUILDING � l �� 9650 To be Used as: Dwellin� Front 26 � Depth � Height �.�Q' Sq. F't. _1A1.�-.� C7u. Ft _2.0�2.80 Garage �nt 27 � Depth � 21 � �e1�t 10' �, � 567 �, �, 5670 Type of ConstructionFrame �� _$26,400 _ To be Completed 6 Months SEWER LOCATION - 30' 1Vorth of Manhole WATER LOGATION - 40' North of Ma.nhole In consideration o4 the 3ssuance to me of a permit to co ct building the proposed work fn acc�rdaace with the descriplion abov set rth �in cg ordinances oP the dty of Fridley. �, ns oP In conafderat4on of the payment oE a fee of � 39 . 00 ��t is hereby granted to Clem:�on, nc . to construct the building or addition as descrlbed above. Thia permit is granted up�► the express conditfon that the pereon to whom it fs granted and his agents, employees and worl�nen, in all work. done in, around and upon said building, or anypart thereof, shall conform in all respects to the ordinaaces oP Fridley, M3nnesota regarding location, conatruct�on, alteratiton, maintenance, repair and moving oP buildiuga within the dty limits and this permit may be revoked at any time upon violation of any of the proviaions of sa�d ordinancea �.�� Clarence Belisle NOTICE: T�s peemit does eot eovsr ths eoesnvcNoe, �tion te� �ee. plambing, ea 6eadne, �ra or watsr. B� sun te ns the Bntldhe� lespeetar Por ssparm parmhs f�o� t6as tlfms. � .�• APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, M[NNESOTA OWNER' S NAME� ,/�/�� -� BIIILDER � �=�� annx�ss ,_ ann�ss �,4/ / i�� , LOC� ° OF. OILDIATG �� N0. �%`,?�� .� STREET �;!� ��,_�� ,. PART dg LOT / I� LOT_ ��BLOCR ADDIZ'�ON OR SIIBDIVISI4N .jj��// / / / i CORNER LOT INSIDE LOT SETBACYC ��5�—� SIDE YAR�l j,�-D `��-� SEWER ELEVATION-- �� • �3 FOUNDATION ELEVATI�ft ��%° �� a2 �'h•`�' pplicanC attach to�his form Two Certifieates of Survey of Lot and proposed building Iocation drawn on thea Certificates. -��— -�� . � d �� DESCRIPTIOR OF BOILDING To be used as; � � � ' / � � � i Front �� `� Depth_�'��-D Height �" �' /,'�� Sq. Ft._.._.e'.� Cu. Ft. �� i�i �� / �_ �� Front �� Depth,�2 ,/ fleight � ` Sq. Ft. �..�i� � Cu. Ft., S� 7� p' U' Type of Construction_ _ ��,iy�,��J� „ Estimated Cost ,,�""��". _ ,I�%� �,,�. � �.� To be completed The undersigaed hereby makea applicatioa for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruliags of the Departmeat of Buildin,gs, and hereby declares that all the facts and representations stated in this application are true and correct. DATE L ` � (Schedule of Fee Coate can be found on the Reverse Side). �� 3 q, � � � � � �, �-�� r � � � � S �c c n . - - �: . ,� �, C� BUILDING P��MIT k`EE S�DOLE SECTIOP 2. The Inspector of Buildings shall, before issutng aay permit for the erection of any builc�ing or structure, o� for any addition to any exiating building or etruc�ure, or for any' a�teiatione or repai�s to aay exiating building or structure, upon application Chereiore, require the paya►ent by the applicant for such p�rmit of.fees to the amount herein below Bet.forth.and in the manner herein provided to•wit; 2.1. For any such permit for the erection of any fire»proof building, othei than a garage, warehouse, factory or grain elevator, or for the erecCion of any fire-proof addition, for similar occupaacy, to any eziating building, ahall:bQ at.the rate of $1.40 for each one thousaad cubic feet,..nr fraction thereo£, ia such cubical eontents. 2.2 For any such permit for the erection of any�fire-proof garage, warehous�, factory or grain elevator, or for the erection of any fire»proof addition, for similar occupancy,'to any exiating building ahall be at the rate of $1.25 for each•one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapo�.ia $uildia� Code. HOIISES 2.3. For any such permit for the erection of any non-fireproof building, other than a garage, warehouse, factorg or �rain elevator, or any non-fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. � GARAGES 2.4. For any such permit for tho erection of anq non-fireproof garage, warehouse, factory or gr8in elevator, ot for the erectioa of any noa-fire-proof addition, for similar occupancy,-to any existing bnilding or for each such� building or asldition - ninetq ceats ($0.90) for each one thous.and cubic feet or fraction thersof, in the cubical eontents thereof wlth Che minimum of $4.00. For the purpoae of-computing faea for building perm3ts, the cubical contents of any bu3lding or addition to a uni£orm height throughout by muZtiplying the ground area covered fram a poiat six (6) inches below the floor line of the basement or cellar to the average h��ght of the upper 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 en existing structure, the fee s�tall be at the rate of $3.00 per each Five.Huridred Dollars ($500.00) or fr�cL3�n thereof in the cost of ali proposed work.��` 2.6. In no case sha11 the fee charged for any permit as set forth in. Section 2 be less thau $4.00. STORM REPAIR DAMAGE FEES: Residential; Eatimated Coat of work up to c��'nofl� -$5.�a Estimated Coat ot wor.� c--��: ;:'. -.., �:� � ��, , ,�:0 Coa�ercial; Estimated �st of. �;��?��. r�� c =�4:?^�,�.;,�� ., p� r� � 1 ' •'. . 'y 1'.. '- � Estimated _ .s� of �yo�;� over $>;+:�.o ilU - $�t3.,,,, +�}+y � f�` , t� �v f-- (Qrt� Ptannir� �td7� .�1!/'V21/ 7. Sairs �istin� Crv,l Fi �uipiol �� __ , � �-��hn�,y *e. ,v�. ��n71�O�G'�fS 31, ENC t�IEERlNG, fNC, ��°'� Sll�r_�efQ-60� . �-- �n ineer,� E Su�v�ec�ors —�- 9 ces�t3��,i�ate o� su�s�e �'o: �� 1'1'1 Q�v��t�P1�"��,i1 r_� � w Noa� � w � � � � � � x � a � � � � � '13RD AVE, N,E. � OENOT ES IRbN �=OE�T ES DQAINAGE At�tD VT 11-tT Y�.ASEM�NiT LoT ��B�o�� --�--M��O°Y MAwoa 3ac� Aoo1T10N �NOKA C� T� L� S8J?f@tlF:fl d St/"1ACu ��C � ¢ '"" �la E�'1'�f� �OI�,� ��d�+eby �'� f� Nl� !S O h?/� d�rD aarruf �p� °� a !`� �l , o�r�n�d l�d At � rrx l� �y� !� �('� �r�i�r s, fle►rea� , ardetl ris►b/t �arts ,r�°�y � .�`� � � �.�., � A.n�s�.. SUBuRBAN EH��r�fE�lrrva, Jnrc. � � y,, ,�r�-��,�' �� , �`t�._-,��-t�... �CC��B� `�d r `�� , � } '� �� ,� e� � ' ��' - -- N � m � � a m 0 c�i x N � ro O fpD � � .r � � M y x x � y r � o H � '�' � x x x � � � � O � y � Z �� b � � '��i � B � o $�. � � m � '� � � � M 41 v�i `j '�% y � � � x �''� � Cd (��j o 'a�d ^ � � '*1M C c�o � �, L'q ��pr "C p � � NCO O � � � •" � ��: �� `��y � m � � : ,. � �. y ; • n . � • a . .,� � m : x � �°��° : g o�i � � � � � � � � 0 r � b w M � �` � � �� Q � � � � � � � � � 0 0 r 00 dy C I � o w 05 �''� w � �� M � � � o � c o � � m . � . f�D �D • �: �� : OD S � y n � � � � � � � � � � n O � O �' � � � J� i � � � � � � � � � � x � � � � � �� ° bd �' � � o ` z � �� b� � � � � � x � � o � M aa `D fD x � � O H 0 0° � � � � � � � � ��'� �e�� ' � � � � o o � " o � � � � M ' � ,e� . . � � � x �d . . o � . . � : � � � . . y . � W W 0 0 S � S S ��,�, � � O � � � z 0 � � � �°� ,� � � �'�'� � � � R° R° � � � � � � � � �°��,� iL �°� � �� o� � Q �'� � � � yOd a � ' ° a, ��„ : G � o : : `�' p $ : : O O O o . . . � .° : : : � � W O� O� W O o° � � o g � � � � �6 �� Q VGl �xx+, � � � � i ° N '� � � p � � ,� � �Q I � � ( �9 � �., N/ b b � � S � � m � � y � � �o � � a � � � � w �° �° � 0 o a ao � � � � �'r �' � ° � a � � • Q, v► . � . . w � : : O � . . qO . . C . : : . . . � �° t+� 01 6� O 0 0 o g r� � O � � � a `�° � y �� M �� y �� w �� e o FaSp `� .. � d�� b � ��°° �p�� ppG`4 � � R� �po� ° � N�~Ti � �� n �� m p�'`*� m �aop ��,o ., ��.�m �� a�� 0 � �� o �� \ I�� n D � i � m H 2 m C m �� IO�s � � � � m � � ._ . � '� 'a� � � �' O � v �o O � 0.� o � �� _ � � 3 � � 0 � 0. %0 A � �� i/ � � � � o� � , form BD5 ��' `�� HEAT LOSS CALCULATIONS BUILDIN6 DEPARTMENT �y -� MINN. Weatherstrips a.s•H.V.E. Construction No. Insulation ", Guide Wind Doo s Reference Out. Watl Int. Wall Ceiling Raof Floor Kind How Applied � Y No No 19 � �fl. ��`�{�.Room � Len �,r.� Width �?/ Height � FI. Room � Length Width Height Windows and Doors—Cracka e and Area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area Width Height No. of Lirteal H. Area No. of pane oi pane lights of crack sq. H. No. of pane oi Dana lights of crack sq. ff. _ _�� d � � J /9 � / ?-o � � / // � � � � Coef. Btu ' Infiltration � 8 Glass � c.S`� Z. Exp. wall 3 Net exp. wall ��, Int wall Floor Ceil. � cl `Z / o O GO Total Btu. Required sq. ft. E.D.R. cr sq. ins. W.A. Leader area / FI. � Room I Length Width Height Windows a d Doors—Crackage and Area Widih HeighT No. af Lineal ft.� Area �� No. of pane af pane lights � of crack '� sq.ft. .�� G-� � 3��F,�, I��F� Coef. Btu Infiltration 3 Glass � � Exp. wall 2 2 �( � , Net exp, wall /� � � Int. wall Floor � Ceil. � J� � Total Btu. Required sq. ft. E.D.R, or sq. ins. W.A. Leader area FI. � ,„� Room � Length %.� Width �� Height � Windows and Doors—Crackage and Area �WSdth�Height No�. of Lineal it. : Area No. oi pene � of pane li his ot crack ; sq. fr. /' � �� / i� �-� Infiltration I ; Glass Exp. wall ��„� g i e Net exp. wall Int. wall { Floor i Ceil. / y Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � Btu � � Infiltration Glass Exp. wall Net exp. wall Int. wall Floor Ceil. Total Btu. Required sq. ft. E.Q.R. or sq, ins. W.A. Leader area , f FI. � �� Room � Length � Width Windows and Doors—Crackage and Area I W'P th Haight No. of Lineal ft. Area No. of ene of pana I lighta of crack aq. ft. 3 � 3 to ; 1 3'� � Z 1 -� Infiltration Glass Exp. wall Net exp. wall Int. wall Floor Ceil. Total Btu. Coef. Btu 8 � �� _� ��i � � Coef. Btu i 3 $ Z.� �oo Z/ � /� �'� � FI. � � Room � Length 3 Width J� Height Windows and Doar�—Crackage and Area No. !Width Height No. of Lineal ff. Area of pane I of pane � lighta oi creck sq. ft. �, i.o 3 S.� I�T 3s T�� Infiltra#ion I 3 3 � Glass . Exp. wall � X g / � Net exp. wall Int wall Floor Ceil. � ii% ] ! i/ Total Btu. ' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Coef. Btu � cS'+� /o��—c� o / �o i � �� `� �. � p � : � . � � � Ic N � � � � � a� � p� � m�� z z �� o � � � 4� " � 8 � � � � � � �p�� ° � �O m � °' '" ' `° � � �. • x �d � : p � `ci� : � � �o �'' o � y �. : � ": �� : � a ° � � , en � : � g : � � � : : : � o : : : : : : : : td : : : : : : : : � : : : : 0 0 aa �a oa �" oa oa oa >4 s4 ie � � � � � '� � � � � � � � � � � � � � g g � � � vs �, �s, �, H H y R ' H �° �� 0 � x � D —��i � � �"' m � � _ m C r m 0 i � bd � � � � 0 � � m� p. � ,X, • eP w �N r+ � � "a. a, � y x �+ � �� ° � � O a `� � $ � t �� 8 M � � � � � � O "7 � � � a � �� ' � � a a � I g I WATER � ua�wv.s nnrH rues e�siNs SINKS W,� ranrs DRINK. FOUNT. sHwRS. FLOOR DRAINS CATqi BASINS Atrro w�En GAS APP�. � W WGE GAS OPENINGS ,� • z • � � � � � �. a � � �� ro �� . �� oq�� • ". ��a� � � � �� a �' �. `4 � �r°� � G0 � 7'i fp Ot C W � � p• '�tl � � b � � n � � m 0 �a°d � ro eM � � M � � � w ro ¢� �� o�y��: fyD � (�D y � �A�r °: � � m � O M r"r Q� i�i ►+ �D 5 "� 1 � 3 � f° pA ,.' e �d DC � � 'b ay R� & �°, p � M � �n i+a � � h � '6 � �� O D � n � ; o � � � ', a b�a � o � M � � W ro �p 0 � �° � , � � �� sue�ecr _ PERM City of Fridley . 19157 AT THE TOP OF THE TWINS g U I L D I N G P E R M I i � � � . � `y _.�� COMMUNITY DEVELOPMENT OIV. r � � PROTECTIVE INSPECTION SEC. �� d� � 1 = i l-_-. A ��"��,,, CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV i �� 612-571-3450 910-F15 9/8/87 � � JOB ADDRESS �301 Jacks.on Street 1�.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �.S 1 Melody Manor 3rd Addition SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE George Smith 7301 Jackson Street N.E. 784-�2346 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Durabilt Associates Inc. 4601 Excels.ioz Blvd. 938-9350 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDIN(3 Residential 7 CLASS OF WOHK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 OESCRIBEWORK Construct a 12' x 16� �orch Addition 9 CHANOEqFUSEFROM TO STIPULATIONS Room may not be heated �zith �os.s.il fuels unless room meets State � energy code. . '�'�RNi�� - . Before digginB call lo�,�{ i��#;��;;� ��PNQNE - ELECTRIC - �� , ��f��1�ATE P�RMITS REQUIRED FOR �'��C,��g��p �� l�� lNIR9NG, IH�Al"ING, PLUMBING A�lD SIG�S. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY OROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHOR�ZED IS NOT COMMENCED WITHIN BO 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 TH/1T 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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4�000 S2.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL :THE pEFiM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STAT OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANC OF C�NSTRUCTION. $44. SO . ) PLAN CHECKFEE TOTALFEE � � `� 'GQ � ��. �� "� $11.13 $57.63 �GN TUREOFCONiRACTORORAUTHORIZEDAGENT �DnTE� r WHEN PROPERLY �LIDATED THIS IS YOUR PERMIT r ' - /_ -I � �r ' �� I �� ` / �� SiGNATUREOFOWNER�IFOWNEHBUILDERI �DATEi LDG iNSP � TE NEW [ ] ADDN. [�] pLTER. L 7 Construction Address Legal Description:_ Owner Name & Address Contraetor: Address: City of Fridleq Effective u/1/86 R-1 AND R-2 Building Permit Appl3cation Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROYEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: DECK AREA: OTHER: I�t2�C Zd`� z 3�13,G� ► Corner Lot � Inside Lot [] Ft. Yd. Setback Side Yard Setbaek J�°� Type of Construction: Estimated Cost: $ ,�c Approx. Completion Date: �� J� O� y� �� Length Width Height Sq. Ft. Length . Width Hgt/Ground . Sq. Ft. ^� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ � See Back Page for Explanation DATE: LL" l�� APPLICANT. Tel. ��y�-�--�� - CITY IISE ONLY Permit Fee $ �� Fee Schedule on Reverse Side Plan Check $ � 6�� 25� of Building Permit Fee State Sureharge $ �� $•50/$1,000 Valuation SAC Charge $ �`' $ 525 per SAC Unit Park Fee $ '^ Fee Determined by Engineering Sewer Main Charge $ °' �� Agreement Neeessary [ ] Not Necessary [ ] TOTAL $ STIPOLATIONS: �� . � �� w � �ss�-., �'ux� v�i��Lt . 4ofj� ao� �a,� �c t L u �.� i BIIII.DING PERMIT FEE SCHEDULE The Chiei' Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing buildin� or structure, or for a�y al�eration or repair to any existing building or structure, upon applicatio n therefore, require the payment by the applicaat for sueh permit of fees to the amount, herein below set forth and in the manner herein provided to-wit: Total aaluation $1.00 to $500.00 Fees $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for eaeh additional $100 or fraction thereof, to and ineluding $2,000. $2,001.00 to $25,000.00 $32•50 for the first $2�000 plus $6.00 for eaeh additional $1,000 or fraction thereof, to and ineluding $25,000. $25,001.00 to $50,000.00 �50,001.00 to $100,000.00 $100,001.00 and up $170.50 for the first $25,000 plus $4.50 for eaeh 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 and including $100,000. $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "An: 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 approaeh with 6 inch depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOONDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed strueture and of the construction site. A Certifieate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. . � i -� , L1ft� riOr►n�r� [o� Swtiey�ny ,Snr�s Trstrnq c►,�� ,�,�i En��n�rm� GB73' -H� �ts aE. M4v�,o�aGsi?. ENGINEERING, tNC. ��°�� Sti„r/4-t�/Oi�i -- En9inee .rs � Sur veyors ---- cesrtz�icate o� su:ve �o: �� 111 DEV��.OP1'ri�n'i � i NOR7'H I _ 1z_ I W g �� I6 i `� _� � y c � � � * �pT' I i � Z A IS I � � I PR/UE �� v i .� • O� I Q -� � -� N I �� V � �� ' . 6 �z� _ q� _ - "13a� AVE, N,E. � OENOT ES IQON ---- OENOT ES ORA►NAGE ANO UT 1LtT Y EASf MENT LOT �=$�p�K �� MELOOY MANOR 3RD A�01TtON �NOKA TY I l�irnrby �srl�'y 1M� b�s a o/rue a►+d mr+rttf �r�rtss�ntotan �('o �y �'fbr b�af�ts � i�6ws af�bed land,a,d ��"w�On 9('0l! eudv�s , fh�a, , s►id d! risib�� ear�aorhmartf ,�'ay. �i ir rn.sand /a�d. As s�s�.:� ��!hs �_ ob f d�,.,s� A.O r�,l�.. SUB URBAN EAlG1NEERING , /NC. jncv�s � s�nya�, SCO��: � �4C � �y ` r�- _-� °��` — -:.—�----, - �__.,��------ - _ _ --�__._�_ _ _ _ ._ , _ �•r��h � nn•t�-�� ! ,-�., .. � ._ `;� sue�ecr RMIT NO. c�ty of Fridley �, � � �; 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � � Y r � � � � RECEIPT NO. � `� _.�__ COMMUNITY DEVELOPMENT DW r � � PROTECTIVE INSPECTION SEC. �� . � i l---• � ��;.� CITY HALL FRIDLE� 55432 NUMBEF i1EV DATE PAGE OF APPROVED BY L J\ 612-571-3450 910-F15 8/8/96 / / JOB ADDRESS 7301 Jackson Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1S 1 Melody Manor 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charles Smith 7301 Jackson Street NE 784-2346 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO Midwest Siding & Roofing 3533 Perry Ave N, Crystal, MN 55422 521-3652 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 2��102�� 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 8 DESCRIBE WORK .Reroof House & Gar 9 CHANGE OF USE FROM STIPULATIONS O ADDITtON ❑ ALTERATION � FiEPAIR O MOVE � REMOVE (23 Sq) 2nd Layer TO Roofing can be the 2nd layer but not the 3rd. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OP VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OW 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATI AND ORDINANCES GOVERNING THIS TYPE OF WORK W OCCUPANCYGROUP �OCCUPANCYLOAD SQ. iNITS STALIS ILl BE COMPLIED � 1, 426 WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FE� PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �(+8. SO STRUCTION OR THE PERFOFiMANCE F CONSTRUCTION. � PLAN CHECK FEE License SC $5.00 S NAf RE FC N7RAC70AOR TH0�71ZEDAGENT IDATEi HEN PqOPERLY V ID/ _ S�GNATURE OF OWNEA dF OWNEA BUILDEAi IDAi6 0, nn _ eo � � CU.FT �STREET PARKING GARAGES aTAX $.71 Fire SC $1.43 TOTALFEE $55.64 paTHIS IS YOUR PERMIT � � � NEw ADDN ALTER i] [l [] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Bui�ding Permit Application ConstructionAddress: 'i.�� % � ,. � �.� f, �� -�G � - J I � � � �� Legal Description: Effective 3/1/96 O�vaer Name & Address: � ��. ��- � SL.-� : 7`4 Tel. # � �' ;� - � � Y � Contractor: v°h e � � � s F- � ; ' :� �'�� f �� °A �, MN LICENSE # �� . � � Address: � � 3 3 �'r - -� .�-��-� -� - - Tel. # � �/ -� � S`a� Attach to this application, 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 IlVIPROVEMENT Length Width Height Length Width Height n Width Hgt/Ground li OD c�� - v�,3 S' ,U � � Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yaxd Setbacks Type of Construction: ��c d�� Estimated Cost: $ � � - �� 2� Approx. Completion Date: fCost on Back) Driveway G�rb C�t Width Ne,edexi.: Ft. + 6 Ft = Ft x$ _$ DATE: ��'/ G°f�� APPLICANT: .� �� -� Tel. # ,.� � f -.3 � s � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Gharge TOTAL STIPULATIONS: � S-�� 1 �� . $ '%I $ $ �`.�U $ $ $ $ � ,�� ` CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $900 per SAC Unit $5.� (State Licensed Residential Contractors) Alt. °A" or Alt. "B" Above $450.00 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 applica.tion therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,�1 to $50,000 $50,001 to $100,000 $100,001 to $5(lO,Ot?0 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,�0 plus $12.50 for each additional $1,Q00 or fraction thereof, to and including $25,000 $349.75 for first $Z5,(�0 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,�0 $574.75 for first $50,_� plus $6.25 for ea.ch additional $1,000 or fiaction thereof, to and including $100,000 $887.25 for first $100,�0 plus $5.00 for each additional $1,.000 or fiaction thereof, to and including $500,000 $2887.25 for the first $5�,� plus $4.25 for each additional $1,000 or fiaction thereof, to and including $1,000,000 $5012.25 for the first $1,(�0,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and guiter 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 $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the l�ation of the foundation once it has it has been constructed will be required before proceeding with the framing. `i�< � _ � • ' � SUBJECT .. � i , City of Fridle� 2 8157 AT TME TOP OF THE TIMINS g � I L D I N� P E R M I T r ; � � ECEIP . � • COMMUNITY QEVELOP�iIENT DIV. � � � �V �'�� r � � PROTECTIVE INSPECTION SEC. 1 ; � � � /"'1 � CITY NALL FRIOLEY SS132 NUMBEN pEV OATE VAGE OR AP VED 8Y �""'�� 612-571-3450 910-F15 10/8/98 � � J08 ADDRESS 7301 Jackson Street NE ' t LEGAL �07 NO. BLOCK TRACT OR ADOITION SEE ATTACHED oescR. 15 1 Melod Manor 3rd SHEET 2 PROPERTY OWNER MAIL ADORQS$ ZIP PMONE Charles Smith 3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO Midwest Roofin & Sidin 1 d ARCNITECT 01i DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADDFiESS , IIP PHONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION � R�PAIR O MOVE O REMOVE 8 OESCRIBE WORK Reroof house and ara e 28 S Tear-off 9 CHAN(3E OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for all required inspections - ice & water and final inspection. TVPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE fiEOUIREO FOF ELECTFICAL, PIUMBING. NEATING. VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTpUCT10N 20NINC3 S0. FT CU FT, AUTHORIZEO IS NOT COMMENCED VyITHIN 80 DAYS. OR IF CONSTRUCTION ; OR WORK IS SUSPENDED OR ABANpONEO FOR A PER100 OF 120 DAYS AT " ANY TIME AFTER WOqK IS COMMENCEO ' NO. DWLG. UNI75 OFfSTREET PARKING 1 MEREBY CERTIFV TNAT I NAVE REAO ANp EXAMINED THIS APPLICATION S7ALlS GARAGES AND KNOW TME SAME TO BE TRUE ANO COFiRECT. ALL PqOWSIONS OF �AWS VAlUAT10N SURTAX ANO OiiDINANCES GOVERNING TNIS TYPE OF WpRK WILL �� COMPI,IED WITM WHETHER SPECIFIED HEREIN OR NOT. TME GRANTING OF A PERMIT $2399 $1 . ZO DOES NOT PRESUME TO GIVE AUTMOHITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANV OTMER STATE OR LOCAL LAW REGULATING CON- STqUCTION OR TME PERfORMANCE OF CONSTRUCTION 7�F.75 Fire .SCi 2.�4� P4AN CMECK FEE T07 FEE � Licen C 5 � .35 SiGN4TUAE0�CON:NACTOAOAAUTMOp�ZEOAGENi ippiE� � N O � VALIDA THIS IS VOUR PER IT / �� S�GNOTUAE O� OWNEA��c OWNEp BWIDER� IOATE� ' BlD ��NS� ' � p6tE ��-i� ��a: �w �1�4 CI iY � FR IIILEY � Z - _ � � � � �� [ � � � � l�+ i � a��7�'+ � "� � �i ��1 � ��i ��6�'�V 6'� g �Lrbdrd'f i 6�l`6 C�sl]ti.��fliii �)� .�_ll {:.::t ' JE_ ��' �:Yj•}-- .�-1�1 ii:'�. � �31� P.61� ��V$ �� s ;,. , . � r, _ �,, , � � ,. � . . �� ► �� , . . _. _ . �, ; � -: u • f — � i lU; � I : �.. . � i � �, ='- �- ' �� _� .� � �.-� , � -� _ , �,' �r � �► , 7_.� �1 ,.,�� , � �, ��1� �� l_ � � �� ; � � � . _ , � , _� �1 � . , �, ��.![.: li1_'- _li=:.kk.y 3�. �1t ►-: �- .�l��.. _ i �.:_ � �,= �n.�� f;� 3i :- -r� F� �:c��-_.., � i t5i-�- lu�t .-�.� �.t l � �i ! 2- >Ywc = _- �I 1 � � '-r. y :1�. 1��t 7� ' - •_" ` :'� i,�. •' Ii �"id f!. � '• i ` .lY L,".�: �: .f ?? '!;'yM ' :� ��,�� , +i't: ��°�- �.�,. `.� -,-i 1=l;. � ,1 1' ., 7' .1 r - :.1 � �'� � � _i , ��_:'� r!ltflaliiit� s� �1�1 � �: ` � ��. �� I `�1 �� - - r� ��x� � �� c�a c� �� : � . + � �ti � ,. � �c � � � D��= 1D% �� o �o � �. � y l � �L�� b�J ti��._i _ r - : �. , i � � , r.� - �:�._ - `� �i' h�'i � �.*':: - �.'{�_.� .�. � �,_r. .�.. ,I't3..., _ , � �-� �, - ��. �� , IC�'S?Z'^s .1.�is_ j' :� • � t� : �, �.�:��.,-T. � ,� � � 7S� � � @ r � M..r.r�..�o $ `-� _ � +D � � � �3. �� '-��: F��+�� onR�� .�1 of �ic v�oa tu3�o�i�) ��e� �� 7�� +�++� � ,�L. °�►� OY �. °�° �i�bY� �yRJ1i•W7 �rVi�qiY� � �i�W � � � �Y I ] 1►Ti� l� [ I s�r.��c�s. �� , _ �b -�-�� , �- �� SuB�ECi City of Fridley AT TME TOP OF TME TWINS g U I L D I N G P E R M I T i � � � � ; v __�� COMMUNITY OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � 1 i � � �"'1 � CITY MALL FRIDLEY SS132 NuMBER AEv �----�% ,'� 612-571-3450 910-F15 JOB ADDRESS 7301 Jackson Street NE t LEGAL ��T NO. BLOCK TRACT Oii AODITION oesca. 15 1 Melody Manor 3rd 2 PROPERTY OWNER MAIL AODRES$ Charlie/Sue Smith 7301 Jackson Street NE � CONTRACTOR MAIL AOORESS Renewal By Andersen 350 73 Avenue NE, Fridley 4 ARCFIITECT OR DESIGNER MAIL ADORESS 5 ENGINEER MAIL ADDiiESS 8 USE OF BUILDIN(i Residential 7 CLASS OF WORK O NEW B DESCRIBE WORK Replace 18 windows 9 CHANOE Of USE FROM O ADOITION � ALTERATION TO O�TE 3/16/99 MN 55432 ZIP ZIP / / 29021 RECE—� � /l� / APVqOYEO 8� SEE ATTACHED SMEET PNONE 784-2346 PNONE LICENSE NO 502-4777 20040630 PMONE LICENSE NO. PHONE LICENSE NO � FiEPAIR O MOVE O REMOVE STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 1994 Uniform Building Code. TYPE OF CONST. SEPARATE PERMITS ARE REOUIpEO FOR ELECTRICAI, PLUMBINCa, HEATIN(i, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AN� VOID IF WORK OR CONS7RUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAVS AT ANY TIME AF7EF WORK IS COMMENCED. NO DWLG. UNI I HEREBY CEfiTIFV THAT I MAVE REAO AND EXAMINEO TNIS APPlICA710N ]. AND KNOW TME SAME TO BE TIiUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION AND ORDINANCES GOVERNING TMIS TVPE OF WOfiK WILI BE COMPLIEO WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT �LS,466 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI TNE pERM17fEE PROVISIONS OF ANV OTMEH STATE OR LOCAL LAW REGULA7ING CON• STRUCTION OF TNE PERfORMANCE OF CONSTRUCTION �23].2S SiGN4TUAE OF CON7RAC�Op OA oUTHOAIZEOOGENT IO�TE� � � �o•ie� OGCUPANCYGROUP OCCUPANCY S�. fT CU fT, OFFSTREET PARKING S7A�LS GARAGES SURTAX $7.73 C $5. /SC $15.47 EE 265.45 S Up PE ly �� ,C� O�TE rrEw ADDN ALTER [) L] t�' CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 �-\ � GO �� ConstructionAddress: % �j(��,��S��n f� Legal Description: Owner Name & Address: ("y�,,,� t i �.t �t,t.�. ,-��J-ji �j Tel. #�1 Z- 75�� Z�( Contractor: RENEWAL BY ANDERSEN MN LICENSE # 350 � 73RD AVENUE NE Address: FRIDLEY, MN 55432 Tel. # ( 612 ) 502-4777 mficate of Survey of the LICENSE# 20040630 -- �-..�� Q �o�a�tion drawn on it to scale. - - - _ ��S_CRIPT'ION OF IlVYPROV�NYEN'� LIVING AREA: Length Width Height � Sq. Ft. _ GARAGE AREA: Length Width Height Sq. Ft. DECB AREA: Length Width HgdGround Sq. Ft. OTHER: +Ze�l4.cR- I� l,cair�dDw� Construction Type: Estunated Cost: $ , 5,¢�p� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: APPLICANT: � "�� l,�� Tel. � �/Z --� 'Z8� �xf. !�¢ Permit Fee Fve Surcharge State Surcharge SAC Charge $ 7 �7a 7 . $ 1 �', et,_ 4 7 $ �� 73 $ CITY USE ONLY Fee Schedule on lZeverse Side .(�1 of P�rrnit Valuation (1/tOrh%) $.SO/$1,OQ0 Valuation $1000 per SAC Unit License Surcharge $ 5,�0 $S.QO (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ . Fee Determined by Engineering Sewer Main Charge TOTAL $ $ Z6 . �� Agreement Necessary [ J Not Necessary [] s�ur.�TTONS: j��ol��0� Sin�/� �!��"�`�� .c.� i�r.� G�i�/ /��n�-- ec}•�a G�l /�GC.. �Y'�� 1�� T.</� ��!'�"l�.r.�'�--!'�-� �� . -�/O, q. �, i-, /�9�!-1 �• � . _ � sue�eer c�ty of Fridley AT TME TOP OF THE TWINS g � I L D I N G P E R M I T r � � � ; y __�� COMMUNITV OEVELOPMENT DIV. ! � � PROTECTIVE INSPECTION SEC. � i � � �"'1 � CITY MALL fF10LE� SS132 NUMBEN ��°'� � �'� 612-5��-3a50 s�aF�s lOB ADDRESS �301 Jackson Street NE 1 LEGAL LOT N0. ' BLOCK TRACT OF ADOITION DESCii. ],S 1 Melody Manor 2 PROPERTY OWNER MAIL ADDRESS Charles Smi.th 3 CONTRACTOR MAIL ADORESS Lennander Contracting 11100 Yates Ave N d ARCNITECT OR DESIGNER MAIL ADORESS S ENGINEER MAIL ADDRESS 8 USE OF BUILDING Residential 7 CLASS OF WOF;K OATE 8/17 21P PAGE O: / / PMONE �0— 79 PMONE PHONE '30066 \ a� RECEIPT NO. �� APPROVEO BY SEE ATTACMED SHEET LICENSE NO 2(117513e LICENSE NO. LICENSE NO ❑ NEW ❑ ADDITION ❑ ALTERATION L� REPAIR O MOVE O REMOVE B DESCRIBE WOqK Replace siding 9 CHAN(;E Of USE FROM STIPULATIONS TO Call for building wrap inspection before covering. TYPE OF CONST SEPARATE PERMITS ARE REOUIRED FOR ELECTFICA�, PLUMBING. NEATIN(i, VENTILATING OR AIR CONOITIONING TMIS PEFMIT BECOMES NULL AN� VOID IF WORK Oq CONSTRUCTION IONING AUTMORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANOONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO DWLG. UN I HEfiEBY CERTIfY TMAT I HAVE READ AND EXAMINEO THIS APPLICATION ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION ANO OROINANCES GOVEpNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETMEq SPECIFIED MEREIN Oii NOT. THE GRANTING OF A PERMIT �SOOO OOES NOT PRESUME TO GIVE AU7NORITY TO VIOLA7E OR CANCEL TME pERMIT fEE PROVISIONS OF ANV OTNEH STATE OR LOCAL LAW REGULATING CON- �TRUCTION /OR THE PERFO�ANCE Of CONSTRUCTION ,Q','I S 3_ 25 iNA/UaEOfCON'aACtOAOpaUTMOpiZEDeGENT IUaiE� NAtU�7E O� OWNEp�� OWNEN BU�IDEA� IDATE� OCCUPANCY GROUP OCCUPANCVLOAD SC.FT CU FT. OFFSTREET PARKING STALLS GARAGES SUR7AX 4. 00 SAC CMARGE Fire SC 8.00 Tor FEE 170.25 VALIDA 0 TMIS IS R PE T �/ .� /� � ��J ADDN ALTER � Effective 5/10/99 [ l CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII.DING PERNIIT APPLICATION Construction Address: ��Q � �JaCC � Lega1 Description: _ �v �� o �1 �° �o Owner Name & Address: �,� � ( �' �"� �` ��j Tel. # � �" �°-�-� -r.►--r—��-�e►�a" Contractor: Lev�ha �c��c C'C3u f�x e�r`ng MN LICENSE #'� I�S' (,T ef Address: �%/06� �G �P.S �� '� Tel. � e'�7G-796 �'J Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTIOIV OF IlVIPItOVE�MENT LIVING AREA: Length Width Height Sq. Ft. _ GARAGE AREA: Length Width Height Sq. Ft. _ DECK AREA: Length Width Hgt/Ground Sq. Ft. _ OTHER: � Construction Type: i� k iv�,p��Estimated Cost: $ �, DO'� Uriveway G�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �-�7° jc'°% APPLICANT: �� ;6�� Tel. � � %G %lG'.�� Permit Fee Fire Surcharge State S�rcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 1�.3,�5 $ . DC� $ � $ $ S�� $ $ $ $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (Stat� Licensed Residential Contractors) .,: .. : Alt. "A" or Alt. °B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] $ �S ` r _� BUII..DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 - ' $501 to $2,00(3' $2,001 to $25,000 $25,�1 to $50,000 $50,�1 to $100,(�0 $100,001 to $5�,000 $500,001 to $1,�,000 $1;D00,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including _$2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,(�0 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 $1,000 or fraction thereof, to and including $100,000 $993.75 for first $1.00,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,(�0 $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 0* fraction thPreof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alteavate "B": Re�QVal and replacem�� of cu.*b 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 sixucture and of the construction site. A Certifica.te of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. � -� D m (�p � Z � o � � m ��' � . O � � � � � m o � m � � � A1 � N a o m a �� '� _ cn c�i � � Q o �' � � m � N � � � � c� � � Q � 3- O � � �� m � rr- O D C m -� � Z n � � � � C � � � � � rn D � n m � D � o < � m i � ;, _ D � -� m � Z � Z � � � � � ,n m �\ � c'^ rn v♦ � m � G� m � Z � c � T m m 0 � �� O Z Z �� IO rnl0 � � � � --� � m Z � I� o I�0 �O ;Z C/� _ � a � � Z � � � n 0 N � � o � O A N � � � � o � � � � �. N � n (D 0 0 � O � -i �' D � r � � � m � m � t� tD D D O O 1 c� � N � Q N � �. o ¢, �• � N � � � D u�' � _ � �p � A � (p � N (D O 0• N � � o "' � � � -a O Z D n � � N � 0 a Ic� f» rfl � �� 1� o � C W � m --� � n. m z w (D 2 v � N� m z 0 rn I- .o 7I7 � U7 � Z m � 0 — C � a Z 3 `� � c� • o cQ C � � 2 o � n � � n � o � � � 7 (D n � (D Q � � o m 3 m �' � Z � �' o � - _ 0 � m v � D � �» P a � � � 0 � (D � m � � � m � n O � --I � m � � -� Z O \, �-hJ � � G� G� D � � ii A� v� � cn � m o � a � -°�,�o� m 7 �• p- -�p � •_-► � Z N � � N tD m � 3 � a � � � m �- � � c � � c .' � 7 ,.n.. � '�" � � w � o � � � c � OD � � � m � � � tfl tys t� � O O O O � °o o° o° °o ¢' m � c� c� c�, -� 0 � D � C r= � z � C � m � D � O � � � �s � � �• tn cu m c�ii � �c � c� �' • � � � o Q a � `° m �, . �- � a � � � � y °° m. � �, tn �• � Q A1 Q � S � a`� � m Q � � o .� � � � �' � � N o' � � o c�n � � u� �- v� � - i � � n� �- u, v o- � �_ �- � �`� � " ` A� ,� A� O (7 � �� n J � cp o 0 n � -. � �, � �, � � S � � c�i m � o � �• �: ��sv � o � � �- m �- � n m � `� o �"' o'� a �' � Q N � � � �" i � '.S� rz .� � D m � C7 _ rn � C r rn � O � D � 0 � m � � w � '1 r. a V �t °� n ,� �, N Q � � t � w� C O ' o � � .A Z � �1 --. � � �� w D N � Z Z rn � � m C� � O Z 0 < m � -rt � .'rD � n m y � � A O oz Z � Z � 0 D Q �o g c� rr� o� Z -� � � � Z O ,� Z � Z D � �� -�-1 rn � � � Z o � � � m p � r n Z ai G� < m z � � -� � Z . m � c� � �. < cD � O � L �� ,� c m .7 � �%� :o _,, . �� ; �� s�-�� , CHIlVINEY AND STACK VERIFICATION The undersigned hereby verifies that the.existing chimney or stack: 1. Has been cazefully examined � Yes O No O 2. Is free from rust or deterioration 3. 4. 5. 6 Has no foreign objects lodged within Is securely supported Meets all current Code requirements for size �nd _t�ta.l �TIL'� s�n nect�d -- Has total heating BTU's of All � other BTLT's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: . � YesONoO Yes ( ) No ( ) Yes()No(} � � Yes()IVo() _ - - -Q� `� �� j�1 , 'A,� l � -r�' s � , �� U" � Yes ( ) Nv ( ) Yes ( ) No ( ) List ALTERATIONS Being Done: � HEATING CO: Signed By: Date: ��;� � 9�s � I�s�� P�r# 37 �'. HOUSE HEATING TEST RECORD ADDRESS /� C% I��1 SQ%i s'( ' N� CITY /-/ /G1/eC1 OCCUPANT S f'n j OWNER HEAT LOSS DATE HTG. INST. - - INSTALLEi) RY ,/"° n,��.,�- ELECTRICAL WORK BY /�'%/St3-� TYPE OF HEAT GA ,� FA _ HW _ STEAM SPACE HTR. U1VIT HTR. OTI�R GAS DESIGN MAKE / SERIAL �� J � f'V /\ � MODEL: �� `�� ,'� � INPUT(BTU) � • �� ' . CONTROIS KIND OF LINER SIZE NONE COMPANY TESTING FILTERS SIZE NUMBER NAME OF TESTER PRESSURE �,�� PERCENT CO2 � II �, INPUT CFH �� PERCENT 02 ,�% �� INPiJT �� /1� -- -C:s� (. — __ ✓I, l o CHIlVINEY AND STACS VERIFICATIO The undersigned hereby verifie.s th�at the.existing chimney or stack: %�U� uP.��- � � s� , `� , � �� ,, � -� 1. Has been carefully examined � Yes � No () � 2. Is free from n�st or deterioration 3. 4. Has no foreign objects lodged within Is securely supported Yes � No ( ) Yes (� No ( ) Yes Q� No ( } 5. Meets all current Code requirements for size and total BTU's connected Yes Q� No () 6 Has total heating BTU's of ��! �� `5 All other BT'LT's t�� TOTAL BTU's �� e� �� 7. Has a liner been provided for water heater Yes () No ��(�� 8. Has combustion air been provided for water heater Yes () No � Remarks: . List ALTERATIONS Bein� HEATING CO: Signed By: Date: i � n � � m � w u� Z Z Z c n oi `"" �" m` O ��' -i c� y y rt°r rt 3 � � S` c�D °' � � cNnO�, �'�v�c�o c�u c�u.Q s O-� C ° 2 c�i � ° m � m rn � m � � � v �, � CA °, m= �-' m� fl: �i c> c�u c�, Go �� -i �� v�� c� �� Z• r- � N N cc N � � D rn < � m`° i'o � �� Z � o v� � � c�i � � � � -* � N � �1 � O � '� �' �� :�o c 2 � � � ° � � m � rn o m � v r Cn � D a � � � � � (T� � �., -p Cn �O ""I � N Z N � r � � � ^ C � � m m o m I I I I�I I I I I I I I � � � �� m j � � w w w � -� � � .� -� � � Z cJ, o o cn cn cn o 0 0 0 0 0 0 � � °o � o °o °o o °o . °o °o °o °o ' °o o °o n � � m a�j w H � � � � 0 Z � ° D �� a cn Y Z � Z � rn� � v a D � � � -� m m om °' m '" .D m � Za 1 �» � � � YI � � � � c"'D � � � � a �� ; � � � � "� � � cN � s y „ ZC ) _ �' 'm_ � � mOp � i� C� c�"'u � : � cn o6 C = � �_ V i �� - o � m o - w . � �_ c -�'i � � D v °-' z Z � � v c n n � � � v D -I D � I I�' � � N � �$ �' � � � "I � � m �. 3 =i z 0 P , � � � � V � W � rn � o � � � � _ ��i D ��z°� m N � � m � z 0 � _ � �� 0 0 � � i � � �D T c > > L �' fD i N. i �Q � ' i a � 3 �� L a. �� ; � L � I � �v � � iI O . � � co 3, 'o :� . � 0 � . � m �' � C � � z � 'n � C �7 m � � .-� ^. �. .• � �i u O a r O � v v � � � � �I � � �� 'Il '7l "�l '7l W in �' o ooSo�� .t�wiv�3 v, C �' N :;�::::::::::; � � � Z � � ;�<:::::<;:: �7 �;��: o :::;: -� � �� m � `'`�` O ,��:�.�: m p� ...•O . -� � o D r �:;:� : ° �°:: .. :S Z �♦�� »D 2 � � � x md —�� , � n: w ; �: �p -' , � N � � � (r,) bz N O � N � � � � N < N � m w � � N � V � � ci a 0 z � � r � Z a v a N � �ii m � � � � � FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND CQMBUSTION AIR VERIFICATION When replacina an existina furnace, 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 current 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 existinca 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 specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installina a new ventina svstem, the undersigned hereby verifies that it 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. Yes () 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. No ( ) Yes( ) No( ) Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat App�iance #3 Type BTU Input Fan Assisted or Nat Total Appliances __ __ Tc�al Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Conne�tor 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 : ADDRESS PIN LEGAL DESC PERMTT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 �63) 572-3604 FAX: (763) 571-1287 : 7301 JACKSON ST NE : 113024140020 : MELODY MANOR 3RD ADD : LOT 15 BLOCK 1 : PLUMBING : RESIDENTIAL : ADDITION/ALTERATION PERMIT 1�I�0.�. 2004-004� DATE ISSUED: 04/08/2004 s VALUATION : $ 400.00 NOTE: COMBUSTION AIlZ SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL GAS WATER HEATER # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPEIVINGS) # GAS WATER HEATERS # GAS RANGES # WATER TRMT APPLIANCES APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S MINNEAPOLIS, MN 55408-2173 (612)827-4033 OWNER SMITH CHARLES K& SUSANNE M 7301 JACKSON ST NE FRIDLEY,IVIN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if constntction or work is suspended or abandoned for a period of 120 days at any time atter work is commenced. I hereby certify that I have read and examined this applicarion and know 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 permit does not presume to give authority to violate or cancel the provisions of any other state or local law regula ' cons ction or the performance of construction. Applicant � Date , Bldg 1 # GAS DRYERS 0 # OF NEW FIXTURES 0 PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPEI�TINGS) PLBG FIXTURES (EXIST OPENII�TGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 28069 SEPARATE PERMITS REQUIRED FOR WORK OTI-�R THAN DESCRIBED ABOVE. 0 0 0 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.50 35.50 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 r'AX: ADDRESS : 7301 JACKSON ST NE PIN : 113024140020 LEGAL DESC : MELODY MANOR 3RD ADD : LOT 15 BLOCK 1 571-1Z87 PERNIIT NO.: 2004-00424 DATE ISSiTED: 04/02/200 �''l '�" � � PERNIIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERNIIT ISSUE DATE. INSTALL WATER HEATER # INSPECTIONS APPLICANT AID ELECTRIC CORPORATION 7101 HWY 65 NE FRIDLEY, MN 55432-3302 (763) 571-7267 OWNER SMITH CHARLES K& SUSANNE M 7301 JACKSON ST 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 ordinances governing this type of wor� 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 provisions of any other state or local law regulating construction or the performance of construction. Applicant Date 1 Bldg Insp Date I STATE SURCHARGE, ELEC FLAT ELEC PERMIT FEE - MIN (RESn TOTAL PAID WITH CHECK # 42868 .�i.a cu� i u i uiu�u 1.� i�alvii�niJ i' Vit W V1C11 V 1 riDl( 1 tiH1V L�Jl.K1YSL"1J AtSU V L"' . i�- 0.50 20.00 20.50