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AF - 47450� � �� Date: Jun.e 6= 1�68 : r:s,.T:i:��;�w;�'j �,•.•�, � � City of Fridley, Minn. BUILDING PERMIT Builder �omedale Bldrs . Addreas Addresa 521,3 Wayzata Blvd. LOCATION OF BUILDING No. �� Street Jackaon St. N.E. � ,._._... p� of Lot N° �a��.� ��rsz Lot ��__.__.....___ Block ? Addition or Sub-Divisian ....�...Me1ad'� �^^�" '�rd. Corner Lot _ X Inside Lot —. Setback ._..�`�t —_ Sideyard � � 9-5 Sewer IIevation —��1 . � � — ..8� - �.�-� Q ��nx -�-- Top Of Foot;n� DESCRIPTION OF BUILDING To be vsea as: I7wellin,� Front �'4�. Depth 0 20 Height 20 gq, r-t, 1210 Cu, Ft, _.._ C�.�� Front �.Q....— Depth �..� fTeight .��_ Sq. Ft —Q.�Q. Cu. F't. Z�pe of Constructfon Frame ��, �� 26 OOQ�QQ�'o be Completed Octobe� 1968 ` SEWE'R LOCgTION - 188' N. of Manhole WATER LOCgTION - 200' N. of Manhole In considerat3on of the issuance to me of a germit to construct the building described almve I agree to do the proposed work in acc�rdance with the deacrlption above set forth and in compliance wlth afl provisfona of ordinanc�a oP the dty of FridleY• s �I ,r7 _!,� �� . Ail ,� ` In consfderatton of the payment of a fee of $�`1..9�.—, permit is hereby granted to NomP�?a.l a Bld�s . to construct the buflding or addition as descrlbed above. Thispe rmit is grantc� upon the expr�s c�nditlon that the person to whom it is granted and his agettts, employees and workmen, in all work daae in, around end upon said building, or anypart thereof, st►all coffiorm in all reaPecte tfl the orainances oE Fridley, Minnesota regarding la�tion, conatruction, alteratton, maiatenance, repair and moving of bufldings withiu the dty limits aad this perrmft may be revoked at any time upon violation of aay of the Provisiona of eaid ordinancea. � NOTICE: 'Ihb peemtt doss aof eevsr ths coestrncNee, �est+Datioa io� wirieg, plumbtng, ea heaHeg, nw�� ee wNsr. B� wn 10 ss� tlro Bnildiu0 laspeetor Por ssparata parmhs fo� fhem h�ms. /, APPLICAT�QP1 E;OR BL#II.D?IQ� ��P�RI+�T . . .; t •_ CZ�`i' OF FRtDLEii, I�I$1�SOTA � �, . i� A ':%�✓. _%% �' � �� ,�' � ,��, .��, , ,,/�.� �.�.:�_ ..�� t/�� i� �10._..�L,.��S��T . .. . • � • . ....�. _ � � . � - ai LaT�� B�ocR _: . :.��"'afiD�T�o� Q� Sui�;�vis�� _ ,. . e�r� CORY3FR LaT�I1�SIDE LOT ,r„r,SETHACK�SIDE1�AFtD�.,,,,�°_�_,,,_,_,_ SET�R ET�EV.ATION�� OP,,,OF FOQT�}Q�,�,�_ . . .. , . q ' •�•4 et" a'n• c�,.. Ap�licaae attach, zo. this, fo}m �'w�p Cert�.fi,c�tes,�tif, ��irvey:.p� �,At ,�}uc� ,Rropoaed buildiag loca�ion draw� .pu.Ft�ies� .Cext3,ficatei�.: :�_, .,� . �;.,.�,r.� � , . . . . . v . "nii.� � . , . . DESCR7LPTION � OF Bi1ILDING � �� , . � . . To Be ; Us�d As t . . . . . . • �;.,,� . .. . . . . � . .. .. � � �� Front,_,_ �� Deptii � � Beight�;,� � � . . - : Sc�w�;e, feeC ;;��. ��Cub3�c Te�t ,;.. . _��,� Front � � Depth � � � Aeight � � � Squase Type of Conatruction To Be C�ple �.i r�.�r�{:-:' � feet�,_,� ' Cubic FeeC� ��' � ,,,,_ ��stimated Cast �� _ .� �- i The undersigned hereby makea applicatioa for a permit for the work herein sgecified, agreeiag to do all work in strict accordance with the City aE Fridlep Ordinances and rulings of the Department of Buildings, and hereby declares that all Che facts and represeatations stated in tbia applicatioa are true and aorrect. � �� DATE _ _ . � '°� `'_ Tl _SIGNATURE /'y��i _ _,� ' .. _ (Schedule of Fee Costs caa be found on the Reverse Side), � `� -e�o \�-��..�'.P-�,.�� / '�S � f`� � _ -�, > _ .,.,.: , • a . :r� . . . . r , r,, . • ... .. . .. ,. . �. . ...._. � . _ - � BUILD�NC, .PERMIT FEE SCHEDULE - . . _._. , , . a ., '4; - - SEG'�ON.�2. � � �-The_-Inapec�or `�of Bui�l�dings shall,. .b�fore i•as_nia� -p,ermit� for r � tt�e erection of +�ny building or structare, or for any addition to any � �ex�.ating structure or builditig, or• fsr any aLt�,ration or. •repairs to any exis•Cing bu•ildi�g,or sts�e�cture� upan application tk�refore, require the the payment by the applicat�t for st�e� permit nf �zes to th� amount hereia below set forth and in the m�nnei '%erin provid�d�Co-w�t; ,, -.,: Y� � !� . '•/. �-� Uni_,_, foxm �uilding Code: � Tppe 1, 2, &.4- $1, T5 �for - each one thousand cubic feee. �r fYaceion t�ereof, ia suc� �ub�.ca1 contQat�.. ��ipe �3 8�� 5- $1.50 for . ' a:�ac� one theusa�d. �bic £eet. . . .. . � . . . . . .... � • � �,. - .. , w.. • .� _ . . .'"�':l��r the Pu�ose Qf aqmputittg fees �a� buildiag permite, the cubical conteAts ef �ny buiidYirig or addition C�:a u�a�.fozm height throughout by •- �. m�ltiply�.�g �t�e ground area c�qered fram a point siu (6) inchea below the floo� � line •f the �e�aene �or �tihe cel�.ar te the average he3ght of the upper surface � •• .. or te the� au�rage.,hgatght og the roo� surface of the main gable of a � pitched � �oof . . • . .': ., . , .-For _repairs or alee��tians tQ an �fsting structure, -.-Ci�e :��e ahal�.:bs at the . •' rate:oE $3.00 per..�ach fixe hundred dallars ($500.00) or fraction thereof � in the � cost af a�� pi�og�eed work ' � • . . . .. ": ., . • .;, • � �� , . � �� . ..; - . � •�'Ia no c�se;:$ha�_�, the.�ee:♦�j�a��Qd��#or ��inq _p��m3C as set.�:�£cu�h. in Section 2 be leas thaa $5'.AO. � � . . . . � .. . •- .. . . 1 � _ •�• • . NSSSD C�nnect3.oa Cbargee based a�a. locatien- Area 1 or� ,2. . ..,.... . , _ . .. - , . .� /� - . - ^ i ., � � . . `. � . � . . P a�r . . � "`� o a '7✓ '� 9 � �� 3 .. x. � . . . � � o _ A d� �'� '� .5 .: �5 �� { ^P�: � . � ' . - . . �� . � t �P) �4k �'Y"V� 4 � 5� . `� �� Latd Su�eyrit� sats ks�+ny Ciri! b A�lu�crpio/ . . � . . �;.�`%,' t •,x. .M_�'�� , . . . �. � .. . t °��. a x . _ . , q � � r -� . - � . . . � � . . . . . � y- r � �� ' F . . . . � . . . �.: . �.' ' � � kiP � ��fi a., �. � ._ ' �� .1 Y ' �1 • �? �� '� "� �M'_ �� ' . 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ROOR DRAINS UTCH A BASINS � nuro WASHER � GAS APPL � GAS � RANGE GAS i OPENINGS �1 ♦ I 2 � � � �� > A $ h � � ]❑ � I � � � � Ol Q� M �A I � a a� �� °��a � � °°� °a y � 0 � ��o � �' �° � b ��°�.� bd b ��b b � o � ��' �p � �' o � � o p �' '�, o � � � w � a�� o��: ��ry � �� o �� o � ro � 3 `� � `Q � � � � �' d �' A � � wM �r°x &� p � �. � � � � �� i � � � ` : � � � �� o � � � � � w x i � m � � � .�' _ � HOUSE HEATING TEST RECORD ADDRESS �� ° APT. F 0 R 1TY � URB OCCUPANT OWNER ' � � HEAT LOSS DATE HTG. INST. GAS CO. METER BAD SOLD BY INSTALLED BY � � Elsetrical Work By �' Gaa Lfns By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS D IGN i' CONVERSION MAKE � - MAKE�OF BURNER Model -� l�. ��f :�``��_ Model Seriol �� -� Max. BTU RaTing INPUT �� MAKE OF FURNACE Model CONTROLS THERMOSTAT �Heat Plug Valve .�- � � Limit �'°-'� � `� Limft Setfing �� Fan Setfing �� `�� Pilot Type Pilot Maka Pilot Model ` Pilot Timing -�/=�'�-- c-¢ Vent Size � KIND OF UNER � ' NONE Drah Hood Reguleror Filters Size Number Chim�ey Locatio� Inside L� Outside G'h(mnay Construction Smoke Bomb Wiring --- � �''� Draft �� Test Tag f� L.W. Cut Off D or Pressure_ Lighting Inst. � Prossure _�� . Psr �� ct CO f � e �t�Tested - �-'� � ' � Input CFH % � � Per�eAt��c�� '�wnr Testir,e '_ Staek Temp. � Percent CO �� Name of Tester ( Form 235 R Y+ ^ _ r% i a V� FRIDLEY CIVIC CENTER • 8431 UNIVEHSITY AVE. N.E.. FRIDLEY, MINNESOTA 55432 • PHONE (812) 571-3450 t�ay 25, 1984 Nr. R. D. Thomasso 7498 Jackson Street N.E. Fridley� NA1 55432 Ae: SWimming Pool Construetion at 7498 Jackson Street N.E. Dear Mr. Thomasso: This letter is to make clear this department's requirements for the aWimming pool construction at the above address. 1. As indicated, one (1) akimmer approved by the National Sanitation Foundation xill be pravided. 2. As indicated, one (1) inlet of approved design for fresh and/or repurified xater Will be provided. 3. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least tWO (2) times in 24 hours. This department recommends a turnover rate of 6- 8 hours. 4. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided Which extends completely around all private residential pools. Above ground private residential pools may be provided With deeking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such deeking has the approval of the City. 5. Fencing or other effective means including but not limited to saalls or buildings� aceeptable to the City, shall be provided to positively control all aoeess to public and private residential swimming pools. Fencing shall meet the following criteria: (a) The fencing shall prevent the entranee of ehildren and be Without hand or foot holds tbat Would enable a person to elimb over it. (b) The fencing�ahall be at least 6 feet high and entranees shall be equipped �rith self-closing and selP-latching gates capable of being loeked. (e) 3elf-closing and self-latching devices shall be plaeed at the top of the gate or otherurise inaceessible to small childrea. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than Pour inches. R `, w Mr. R. D. Thomasso Nay 25, 1984 Re: 7498 Jackson Street N.E. Page 2 6. An automatic chloriaator should be provided With a auitable test kit. 7. All electrYcal and plumbing iastallations ahall be inspected and approved by the City Inspection Departmeat. 8. Al1 overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface, and 18 feet airaight liae distance from the Waters edge. An alternative is to bury said lines. 9. The pool fill spout must be protected by a vacuum breaker or air-gapped. 10. Suitable safety equipment to inelude but not limited to a ring buoy and rope that is 1-1/2 times the pool diameter aad shepherds crook pole must be provided and maintained vith the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115� SWimming Pools. The building permit is approved contingent on final inspections and approval of the City. If any questions or problems arise from this letter� please feel free to eontact me at 571-3450. Sineerely� y ' . ST EN J. OLSON, R. S. Environmental OPficer SJO/mh F ' s� ._ _. .._ . � � __� . _ __ ....., . - . ,_, � w � j CNA� L��/tr �C-�.e� ---�-1---------�- - � ------------ - -- � � � , - ,�`/� _.._....�. � � �< _ � � U � � � � - ,� � - �= p� 2� � � P . � � A\ +c �� l.'� �' � =� OV �rw O ^ • � � -, 1 � � G 0 0 a E c . s • z� � � n.� N � *a � w c a — � , �� =�i i� /.? 7� Z � �80�iE : _ + GRoaNO %'oo t , � Z �= i,v GR•"J.� g _ / � � V _ � � y � X T c v O ` c � a � � � -�, � ,,, c � � n � � r 0 7 �� C; i� �T 1 , ._�� ( � � � o= —S� . . '° �'.� � � � I 1 � � I O I S� � �A OvV � <�p �s � ( � p v�• 't '` }= 1 S 1 •T � 4 t ♦ ' I '. \ t 1 v� ; � Yri � � .+k' d � .�:� � � � �1 �''�'i I �:: �i� , � ► I t �� ' ... � � �'� � i �� _ �, 1 n 3 E �' 1 L� 1 � i � �, 1 �r � � ,— f I I � �--�, � sue�ECr PER City of Fridley 17 51 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � � � � � 1 v__�� COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � � � i•-_-� ��"" �,� CITY HALL FRIDLEY 55432 NUMBER REV. i 612-571-3450 9� 0-F15 108 ADDRESS �498 Jackson St. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. ]. 2 Melody Manor 3rd 2 PROPERTY OWNER MAIL ADDRESS R. D. Thaanasson 7498 Jac:kson St. N.E. Fridley 3 CONTRACTOR MAILADDRESS Owner 4 ARCHITECTORDESIGNER MAILADDRESS 5 ENGINEER MAIL ADDRESS 8 USE OF BUILDING residential 7 CLASS OF WORK �7 NEW ❑ ADDITION ❑ ALTERATION S DESCRIBE WORK Inqround 12� X 28� foot swi�rmning.pool 9 CHANGE pF USE FROM ro DATE 5/29/84 ZIP 55432 ZIP ZIP R E C EIPT"t�6. r� o �a PAGE OF APPROVED BV � � SEE ATTACHED SHEET PHONE 784-3080 PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. ❑ REPAIR ❑ MOVE O REMOVE STIPULATIONS See stipulations on letter dated May� 25, 1984 �roin Environmental Officer. TYPE OF CO SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. S'tC��. 1 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WOFiK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT jt—: ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �SIGNATURE OF CONTRACTOR OR AUTHOR12ED AGENT IDATEI � , D. QC cirnietiieo nc nwuca iiF nWNER 9lJILDERI IDATEI ST. OCCUPANCY GROUP OCCUPANCYLOAD in 1 SO. FT. CU. FT. UNITS OFFSTREET PARKING STALLS GARAGES SURTAX $2,000.00 �1.00 SAC CHARGE 532.50 ,FEE TOTALFEE 33.50 VALI ED THIS IS YOUR PERMIT � � ��...�y� . in�co nATE N� [d� Citq of Fridley Effective 4/1/8u ADDN. I J R-1 AAD R-2 {�I,TER. � � Building Permit Application Construction Address: Legal Description 7�C�f1 �' ST J/�cK s�� iMr-e�,.eC �vo L �� ''l � �v.v S`sv3 2 � - - ° 3oS�0 Owner Name & Address: �� z'"'�� SS°...� �� CI FfCKSv.c� �j. �+!�, � Tel. #�� yP ContracLor: pd ° L sT°R e .� Tel .# — Address: � � G' S �L�rNF LI9ING AREA: i QARAGE ARE6: DECg AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, t�ith the proposed construction draWn on it to scale. DESCaIPTI09 OF Il�lPBOYSMENT Length Length _ Length �� Width Height _ S9. Ft. Width _ �eight Sq. Ft. _ Width _..._ Hgt/Grouad Sq. Ft. __ � �� ,,,�. Qo�- � �Z ' k z �'' � _ ` Ft. Yd. Setbaek Side Yard Setbaek Corner Lot Lv1 Inside Lot L] �� - � Type of Construction: � �� r� Estimated Cost: $� � � �"' � Approx. Completion Date: �G� / � ��/ Alt. A Alt B Proposed DriveWay Width If New Opening Is Desired: - $ � See Back Page for Explanation DATE: �-2 `/ - &`/ APPLICANT: /1 � D � Tel. # ?gy- 308�0 Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sever Main Charge TOTAL STIPULATIONS: CITY IISE ONLY $ �� •_�� Fee Sehedule on Reverse Side $ 25$ of Building Permit Fee � �� $.50/�1,000 Valuation � $u25 Per SAC Unit $ � Fee Determined by Engineering $� Agreement Necessary [ ] Not Necessary [ ] $ �� . SZ� � �� / �� , �— ,l � i i,�.—.2.• � _ � —,� J� � � i� � �� /� ,-� � l��z....�, . � �� A, y� �� h w . `.° _ �- BIIII.DIiKi PBRI�IT FEE SCHSDIILE The Chief Building Offieial shall, before issuing permits for the erection of any building or structure, or Por any addition to any existing building or structure, or for any �ieration or repair to any euisting building or structure, upon application thereFore, require the payment by the applieant for sueh permit oP fees to the amount herein belo� set forth and in the manaer herein provided to-Wit: Total �aluation �1.00 to �500.00 �501.00 to $2,000.00 �2�001.00 to $25,000.00 �25,001.00 to $50,000.00 Feea i $10.00 (Minimum Fee is $15.00) $10.00 for the first �500 plus $1.50 for each additional �100 or fraction thereof, to and ineluding �2�000. $32•50 for the first $2,000 plus $6.00 for each additional �1,000 or Praetion thereof, to and including �25,000. $170.50 for the first additional �1,000 or inaluding $50,000. �25,000 plus $�1.50 for each fraetion thereof, to and $50,001.00 to $100,000.00 $283.00 for the first $50,000 plua $3.00 for eaeh additional $1,000 or fraction thereof, to and including �100,000. �100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEfiAY DEPBESSION ESCROpii (Concrete Curb Streets Oaly) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replaeement of curb and gutter and install a 3 foot wide approach With 6 ineh depth - DriveWay width plus 6 feet times $15.75 YERIFICATION OF FOIINDATIOA 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 coastruction site. A Certificate of Survey of the lot, shoWing the loeation of the foundation onee it has been eonstrueted Will be required before proeeeding with the framing. � . �� land v�o�� tad.�.�y��y s�s �� c�,� �,�,�� E� � ��875' -lVi�ir� +�L�f AtE. �� M.a►�Jis)t. ENGINEERING, INC. �°'° sr�� -co� — En ineers � " Su�veyors — � cest�i�scate o� �st:ve �o: E� M t�V��4PMENi CQ , .. . . � . �� v b `�. � ' MELO��( 99.� � 61 � I I ��T � � � � . � , ( , ,�; � 61 �� o�z�vE. . ��o ) W W �C F�- � ►lai3 0 � i /. 1 Z 0 � Y � a � � � NORiM 0 � � DENOTES IRON =-DENOTES DRAINA6E AND UTItITY EAiEMENT LOT �+ BIOCK Z• MELODY MANOR 3RD ADD1Ti0N ' � AMOKA C01lNT ' / l4r+ed y c�rfi�'y A►�o� Aya es o bzrr and aorutc,f nprrs�otan'('a sur.�y �'A�e da�r+�l�r'ets �!k �d+,r A�v+�bd la�d, md q�'IYx lrraAan �('�0 E�s , fhvern , nds►/ nsiMt e��s , r,!'ay .� ir n tad �a�d. As sw�rryed � mr /JI� —_�b�r/ � , �—� �.�'�. SUBUQBAN fNG/NEERING, INC. ' E1�� s� �� r ; . . � Stale•. 1 • 40 Iy �� -c�,.. . _ „� �.�.�_�. _ . �.�.- � _,.�-.�.�._.._-___ _--- - • . � � � � o A � s `�1 K .iS - - - � _ � _ _ _ _ _ - - - � T - -w . � `1, :� � ,� � • � a - "' � �- °� ; 2� � . ; � I � e i � R� •c �� , y c . R i� 0 oa �• o �� r � � ti � U G 0 0 GNA►••� L rNrr �f- w�a ---- � y' � /,7 ��! 2 � � �980UE =� � � = GRoaNO J oo � I c� Z �i �•✓ G�t•M�.o 1_ � , � � V� _ � s � x e �, o � C � a � 40 C� � a � � � Y 3-^ _ � � _ � f � ( ► ` OL I - -11 ; o `n.J S I �. ; r i I ' I. ' O� � s � � ,o Z T • ,• o o � ' TQ / e r � R ��' � A co . -L .� A t ', � s -= sT � x I v `.. �� ,�' I � �� '. t.� �, ..,.�. d .�.,� I � � . `�� ; L1',�11 ( I ' -�� f , ; I � ��.� ` '' � ; -,�, . '" „� �:� ' i .� , , i � c-ra % �. , 6t � ' m 3 .' �„� � .'`�l•E r c � , �, , � � � � I �'� ' i � i � I I I � sue�ecr PER City of Fridley 6 2 5 6�1 ' , AT THE TOP OF TNE TWINS g U I L D I N G P E R M I T qEC NO. r i� � COMMUNITY DEVELOPMENT DIV. �� ^ tV ��•�� r � �. PROTECTIVE INSPECTION SEC. 1 ` � � /'�'1 � CITY HALL FRIDLE� SSA32 NUMBER REV DATE PAGE OF APPROVED BY �""'� � �'' 612-571-3450 910-F15 6/16/98 � � JOB ADDRESS 7498 Jackson Street NE 1 LEGAL LOT NO. 6LOCK TRACT OR ADDITION SEE ATTACNED DESCR. I. 2 Melody Ma.nor 3rd SFIEET 2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE Lori Lynch 7498 Jackson Street NE 786-2882 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Siding & Roofing 1897J Gladstone Blvd, Maple Grove MN 55311 4 ARCHITECT OR DESIGNER MAIL AOORESS ZIP PFIONE LICENSE NO. 416-4804 20010277 5 ENGINEER MAILADDRESS 21P PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION C� REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (28 Sq) Tear-off 9 CHANdEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE fiEQUIRED FOR ELECTRICAL, PLUMBING, HEATIN(i, VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO POH A PERIOO OF 12p DAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2,335 �1.16 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PRO NS Of ANY OTHER STATE OR IOCAL LAW REGULATING CON- RUCT N OR THE PERFORMAN E OF CONSTRUCTION. �]�F.%S Fire SC �L.33 PLAN CNECK FEE TOTAL FEE � � '�G` g � �License SC $5.00 $83.24 S�GNATUFEOFCON'AACTOAOApUTMOA�ZEDAGENT iDnrE� WHEN PROPEHL ALIDATED THIS IS YOUR PERMIT s v � � SiGNATUREOFOWNEF1�iFOWNERBU�LDER1 �DATEI BL G �NSD q4TE �w � [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �� (� �� ConstructionAddress: �7 � � �R �' �°S�/� �77�- �� Legal Description: Owner Name & Address: �o ✓� /� � `f,!/�- �'7� Tel. # �� ' oZ ��''a Contractor:��i%i�Gu�S 1' , - 5 i "ri�f'�t � � (�a o � 'h � MN LICENSE # �D/Oa 7 7 Address: l � %1 �' (4 la�es��e i��r�� %,� %� �r-�� Tel. # yl6 ` %�� LIVING AREA: GARAGE AREA: DECB AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. �2�s� ��/crsci %t.�-vF� , l��S� � �� Driveway Curb Cut Width Needed: � Estimated Cost: $ :��— ' -'"�� ..3 � (Fee Schedule on Back) Ft. + 6 Ft = Ft x$ _$ DATE: � `%G � l�� APPLICANT: � v J Tel. # `� 1 /- � � �..� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL ST'IPULATIONS: $ �`� �S $ �� $ j. l �v $ $ �-�� $ $ $ $ $ c� 3: � CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / l Oth %) $.50/$1,000 Valuation $1000 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 [ ] BUII..DING PERNIIT 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 $2,000 $2,001 to $25,000 $25,001 to $50,000 $50, 001 to $100, 000 $100,001 to $500,000 $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 $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1, �0 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Altemate "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 $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. * _. D r� "t m n � O �a ?: 0 � o � o � 3 � Q o o m � 'a tQ c�i v a. �° � m � � Q i � �� m Q � 0 � � � � D � O Z � Z � rn � m � � m z � m � 0 z m � � � -� '� < Q. o�o 0 � m � I � v � m � m O � m � l � � v_� cfl � � m z � t.1111 i � � U'o �► O � D � r tn c rn � � �- .� .. � - = ao 00 c � m Z � � � � m � � � .m � P�'i 7� _ d � � C� � � � � � � S D a � �9 I � � v � � ECt � 0 � � m z 0 -' o � � � � °, ci � m `° a O• � �� m� 0 0 � D � n o x � � m � m ,� °. � D� � f� � � f� � � o = � o o N � � � O Z D � � � � ��o �D a - � �. ��_ � m � c� C � � � � � � � n � � � o � 7 � � � Q � .=iF o m =- � � o = �o � � ��, Q � �� D 0 � � ��. � � I D i� � A�1 A�t D � N v, v, v, � � a 77 � � � ¢t m � � �Q-$��, m m � � � � m . ��m�� 3 � � � � � � a. 3! � �v � � � 3� � m � �o m o m � � �' v� � �� - I cfl � tfl � � ,cNi� o 0 0 ,"' �S � � �' g � � � � � � � o � � m � � v 0 � � � � m � � -i � � � c 6 � c m v � : �. • . : .. [� �2..�� m � N � � �,o�m � � � � � � � c � Q a� n- �° �- c. � ° m � v o � ? � °--' 3 � o � � a� � o m � Q � v � � �� m �. A .,/� 7 �' .n-► � \� � n � m � r► g O O \� � � � � �� m � � A O � .� ,� -� s �• � ^• � � m � m n '� O N � � � am � � � VI � � � � r�i N _ v C � 0 � g � rn � � N � � � . ' Q' j � w m � � z O a z � � �� N � Z Z m �' m � Z v � � O .0 Z C m� � O Z � �. Z � � v � �' -� � �� z� v �o z= z� � Z �� O N C D Z v � v !� � � m� y O � Z �� M � l'd O � 7 N � �l � jr I� / / � / r ♦ / / J �T e � � �i � �� a .. l/ - , � ��95 iV�f `8�4�leH ��qwnjo;� ��•� c�nu��tl f��lUe� Li�£tr �� 3 �!lLL1i�H N0��9�f� ��a :,�g ��5 •0..7 ji.�%ll�l.d�il --� __ ., c�� :auoQ uiag S1�i0I.L�'2I�.L'Id 1siZ ( ) o��(n) sa� � � O j�j�� Sa� � :sX.z�uzag .I2�L�L[ Ia�EM IO� pApiAO.IC� II�Q .ITB IIOT�SiI(lIIIO� SLj; •g .za��a� ia��m io� papcno.zd uaaq iautt ��H ' L QGiCi Q, S�ILLg 'I�ZOZ s�f1,I,g Iaq;o i� �� 3o S�fLLS ��I i�o� �H - () oI1�('i ) sa� --- pal�auao� s�fLI.g-I�o� pu� -- azis ao3 s�uautannbai apo� �uaun� �� s�aay� ( ) oi�i�('�) �� paaioddns �tam�as sI � () ol��) Sa� utq;jnc� pa�poi :s��afqo uSzaio3 ou seg () oN� ) sa� uor�v�oua�ap io �stu uio� aaz� sI 9 'S .,� '£ 'Z i) ol�I� ) Sa� pamtuexa �nn�a.z�� uaaq s�g • i :��s io �aumiq� �m�sixa aq� �� sat,�. ,uan �qaiat� pau�is.�apun aq,L I�tOI,L�'�I3I?I�A S��'ZS QNi`' 1�� 0 ., -r .._..--...,..,...�--�..; ........,-._-._... . ... .�_,r...4,,.`:w : .... ..,�..�--c�---- .-, -.- ,..�.,..,.- �.��.-.,,_ -;;-..,--+cvd.. , �- v.. -e ,f-i-,..we...,.�3t.,y;._,.---d . , _ . - . ___._ . ;.ai-r �-tia ' HOUSE HEATING TEST RECORD `� A ry,,�t �g` �- �J �� A�� `° ��!�A' eADDRESS � � �� r�" ; '�W'�, "---'�- ��` APT. FLOOR CITY SUBURB'�r �� OCCUPANT OWNE� h-1'W`�% �� f � G�- HEAT LOSS DATE HTG. INST��,� �� ' ,r ^ ; SOLD Bl(- �•��.fle� INSTALLED�BY� �-�°�'��`� �%r��,.%'��`; ��.�' ��'�'� Elsctrieal Work By Gas Line By �� *''"� �� J TYPE AF HEAT GA FA HW STEAM 3PACE HTR. UNIT HTR. OTHER ��'� GAS DESIGN MAKE �'��-��'�°-�� i� � MAKE OF BURNER _ Model f` °�,a''> >+�'`a` y� s P� Modsl . 5eriol `�� `` i°��'a r°'' �� f� Max. BTU Rating _ 'INPUT �a��-'--`�� MAKE OF FURNACE Model CONVERSION `''' t _. , ,�p d CONTROLS ��, �;�' `" THERMOST� �`` � Heot Plug Vsnt Size P .c Vatve i�''<"��`°d KIND OF LINER _�'!' -�� ''�" SI�Z�� `9a� NDNE Limif �� Drah Hood ' �_ ` �' 9 r�'.� „ � �.�.� ��f � Ra ular Limit SeHieg ��a. Filtsrs Siss��`,� �_��"'�''`'� Mumber �� Fan Setting ��^ �� Chimnsy Loeation Insids�0utside Pilot TYpe .��-� CJ�imney Construetion y� '''� "`�� " � �� _-'? a^°' Pilot Mnks "�-'��"�"- �-� Pi1ot Model ��1'9 � Smoks Bomb � Wiri�g �'`�°` Pilot Timing ��`,?�` Draft �� Tsst Tap a�� L.W. Cut Off �� Door Pressure °'s' Lightiny Inat. �`'�� < � r �y., Pcessure °o � ;� Peresnt CO � Date Teatsd �� `� -$ � Input CFM �� °�`-� Percent 02 3� _ Companr Tssting �_��.�._��r� Ar�� `� ,�. s.�` �� ' �„-_, 2 ��,,- ° Stock Tsmp. ,� � ", Peresnt CO �b � Name of Tester �� ='-%' �� '"? "' � -'' ��- Form��23�5- w'� � _ CIIYOF FRiDLEY FRIDLEY MUMCIPAL CENTER • 6431 iJNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 11, 2002 L. Lynch 7498 Jackson Street NE Fridley, MN 55432 Re: Final Inspection at 7498 Jackson Street NE Conuactor: Anderson Heating & Air Conditioning Dear Mr. Lynch: A mechanical permit was issued on August 30, 2�0, to install a fumace and new liner at your address. According to the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the work authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspection to make sure the work was completed according to the Code. We will keep your permit open for another 30 days and if we do not hear &om you within this tune to set up the inspection, we will mark the permit "no inspection called for" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/ls NEVV [ J ADDN [ ] ALTER [ ] Construction Address: �" C�?�� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION Effectivve 1/1/2001 (763) 572-3604 Bldg Insp Legal Description: Owner Name & Address �-� c' �0 r Sc� �1 C�� P 2, Te�. #��3 �� - � 9 s'� Contractor. � p �1�„ ', SS�,n�� -2f ; C� �S �_ �t'�n� . MN LICENSE#_(�-ao�ac�8s Address %�5 � f� i(' 1 C ir�0� d�.t� �[ N•� I� U Tel. #�(0 3-%�'C� - fZ']�f�' .��i��o ��? Ss3�o� �voc� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LNING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft. Construction Type: ;1� �S � G�� Estimated Cost: $� �`�Jo O Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: ol � 0/ APPLICANT i�„ ��Gi �,f' ` P�� Tel. #�LO �� C�'oc'v�� 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 $/Sr�• � Fee Schedule on Reverse Side $ �, s'b .001 of Perrriit Valuation (1/10th%) $� . �' Sl $.50/$1;000 Valuation $ � $1150 per SAC Unit $ �B-O $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 [ ] $ ��.� � \�� BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $5� $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,(}O1 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 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 $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.� for each additional $1,(�0 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROW � {�oncrete C•arb �treets �r1y) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv �ui�d�g ��spe.�io�ns 763-572-36a4 763�502-�4977 FAX 3� AAAIt&SS � �us nx��.�c.ea�x zs: ��ta1P'�ll�7l'i� +0►W1N�! ��T�A.lri'�' CONTRaCTOR $v�ei�'�c�r,� cci�x o� �ro�rx sra,�s z�c�rs�, �ao�.�n c�.�cE►a�.OF r�vvsu�vc� �'�'wR1�I�' 7'X�k: �rnE oF waRx: DETAII EU DESCii1 {3 n1N1vER From: 7635193932 Page: 1/3 Date: 4/5/20101:05:35 PM . PLL1�$�3� . . l�S�E�Y�i, .A►Fl�'�CA.'x'�t7�T �ITY �k" �.�DI#�X Yf?URF-M,�4II. ADDRESS �ort�: ? b3 - 7 (07 - 33 `�2.. pe�itt T�TO.:,_,_ �teceived ]ay:, Date R�c'd: � �` �� " �� 0 �VAA�: �� Pf77 " !"CDOT�E�,n J@.Y47 � . 4!7 S7A'C� LICFIITSE i� �� 3�l (- Plr� , � nn�a� /a - 31- !O srars soxn � fa3 � 7S 5 ��,�� Annxt�.�: 1�153� �Z� k v� I�i p crt�_ f�t�.� r�'� s�A�� '�4 �� zor� 7� 3 - �' ( � -�9 a.� _ �nx _ ? � � �- SSJr'�7 � 343 � P.A,NTIE.Y C]'�'WUkAMILY CI'1'VWNHUIiSk: d 1�EEiW o� woz� �• a ia _... __ .. ..... . ._ _.. _ . .. .._.. _. _ ..... .. _._...._... PER MS 168.665 the �t fee is a minima�aa� o�' 5►15.00 or 5% of tk�e ta� cuat up t� $600.00, whichevar is gr�r, fur the improvement, installatiozc or rcplacem�c at o� a reside�atiai �ix�e, eocclading t#ee fixd,ms. (Tl�is sbouid �egect amly, ihe cost of labor ) Labot cost uuxc�rar �300 �$15_00. J abor oo� bdween S3Q0 to $500 = c�st af labor _ �c ,OS =�,�, �lus .50 stack�axge OR FOR �fiCJJFCTS W�RE LABUR EXC�EDS S30V, FESS ARE HA.S�I7 (7N $10.OU �t k�U�tb, �C��' wF�R� 1vOT�D. PbC7uxES: (�ICA't� TO'CAL. N[T►�IDER OF �ACH 1B�LOv�. MiNIMlJ1K Fk� SiS.30- BA1B SIIVR/IAV FLOOR ARAIIVS SHOW� WA'1'�it PIPING ^ HA7HiUB QA,3 �'�k�1G (�C�A CFFY LiC) 3WIMIrIENG POOL � WATER SOETNER ($35} CL07�S WASI�R _ KITCHE�i SAVR � w,A'ATR, Ci.t►S�t BACiCFLOW PxIEV. (SIS) _DISHWASYIEit _,L.A�U��L7f '1'lLA,X ATBR HEATER ($3� F�it IRRICrATfOl�i �WA7.FR M£�iER _ O'1�EB� Fes 'i'�'T.A,IJ DUT PERNi1T FEE Nuiaabc� o�£iMtu�s dlt Nnnaber of �ixtures �iv.w x a,�u.uu=a S15.00 _ x ��5_p0 � $ $35.00 x $35.E}0 = $ Shate Surcharge = � �iwt��tani T�i_� '�S IS AN .AJPk'�,�[CA�Ot�r �o�t ,A P�NQ't'-�iv'r �At� ut�TII. rROCBSS�n I herebY aPPIY for a plumbiin�$ pe�nait aad � aeiauawledge that the infarmation above Ls com�lete and �ccurate: t,hat the work will be iva conf.o�rn�nce w�tlz 1�ae ozdivaEa�ce.s aud co�s o�t�e C�ty oif �ridley and with the M'uu�esota Construction Codes; that I understand ttus �s �uot a�,az�it but oz�l,y en applecatton for a permit wark is ttvY ta Start wi'thout a�rem�air crfuu site; t�at �ite wu,r�C w�1k be in� accvlydaace w�ith tf�e app�oved plxri in th�e af ail worlyv�ii�reqnir�.s reyiew artd s�sprovai of pl�s. 31GNA,T(l� f!� A,PFROVEA BX Ciity o� k't�id�y Bu��.di�ug �nsp�ect�ons �epartment 6431 Ur�iveisity Avenue NE, Fridley, M1�T 55432 763-572-36U4 FAX: 763-502-4977 0