PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: MAY 24, 1966
=1 , _ t_a
HOMEDALE BUILDERS
N° 8856
Address Address
3017 LYNDALE AVENUE SOUTH
MINNEAPOLIS, MINNESOTA
LOCATION OF BUILDING
No. 7428 street MELODY LNEKIk9a DR lg-E- Para of Lot
Lot 21 Block 4 Addition or sub -Division BODY XQ$,, A'S'H ADDITION
Corner Lot , Inside Lot X setback 35 _ sideyard 10
sewer Elevation _878-5 __._...__._ .____ Elevation _881.5
TOP OF FOOTING
DESCRIPTION OF BUILDING
To be Used as: 24/30
DWELLING Front 40 Depth 27 Height 20 Sq. FL 080 Cu. rt 2�,,,,CQO
GAGE Front 14 Depth 24 Height — 10 Sq. Ft. 336 Cu. Ft.._.1s10
Type of Construction ERM Est Cost _ $17s5-QD-..M_ To be Completed
SEWER LOCATION - 162' N.E. of Manhole
WATER LOCATION - 172' N.E. of Manhole
In consideration of the issuance to me of a permit to at building described above I agree to do
the proposed work in accordance with the description abo a se and in com with Z provisions of
ordiaanoes of the city of Fridley.
In consideration of the payment of a fee of S 25.00 , permit is hereby granted to HOMEDALE
BUILDERS, Me to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any= thereof, shall conform in all respects to the ordinances of
Fridley, MUmesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within
city limits and this permit may be revoked at any time upon violation of any of the provisions of
ordinances. eaYd
WILLIAM H. SANDIN Building InspectOW
NOTICE
1bb permit den cot cam dw eondme0m, 1mla0dbn for wiring, phmbine, ea hestiee, serer or wda. Be era to as
tba Boifdi" bwectw for "pasta pwa fq for thea hams.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY., MINNESOTA
ADDRESS ADDRESS/ ,
LOCATION OF BUILDING
N0. STREET PART OF LOT .i
LOT a*'-/ BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT �V SETBACK 315 SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as; Z
Front Depth Height.
® �
Sq,.Ft. Cu. Ft, 0 0
Front', loe DepthHeight
.46
Sq. Ft. /P Cu. Ft. oli -� O
Type of Construction_, Estimated Cost
s
To be completed
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 representations stated in this application
are true and correct.
DAT �i-r G, (� SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
0
It
1
r� y�jy,y� 6875 Highway No.65 N.E.
Land Planning su,�u,'IG(J'T.Gn ,
• • Minneapolis,
• `.land Surveying ��
:.:Solis Testing "w� ) P�nC' Minn.--SS432 `
;• Civil -Engineering Telophorw 784.-6066`
tMunkipal Engineering Engineers & Surveyors Area Code 614
Mortgage Loan Survey for,reveq
GCA i? • 'j tech = 3 0 t ,:�
Lo -T- 2i BLoct- 4.,
ANELooy. INS ros Nap, 41-1-1-rT�c�vlot
COUNT;' OF A\W0t<A -
.This is a true and correct representation of a survey of the boundaries of the land above described and of the
location of all buildings, if any, thereon, and all visible encroachments, if any, from or an said land. This survey is
made only in connection with a mortgage loan now being placed on the property and no liability is assumed
except to the holder of such mortgage or any other interest acquired by the reason of suih mortgage. It is
understood and agreed no monuments have been placed for the purpose of establishing lot lines or boundary
corners. Dated this IA46day of MV! -V -C 14 A. D. 19,1j_
SUBURBAN ENGINEERING, INC.
L,V2q Enginao o Sury y M
'L'L •_•
by T
_ U -
Application for Power Plants and Heating, Cooling, Ventilation, ReFrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work ..........................
8.00 $
Replacement of Furnace .............................
5.00 $
Repairs & Alterations—up to $500.00 ..................
5.00 $
Repairs & Alterations each add. $500.00 ...............
2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ qw�
each add. 60,000 BTU 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ......... x $1.50 $
Additional Fixtures ............... x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $ J�
ROUGH
FINAL
Dept. of Bldgs. Phone 550-3450
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application pAe true and correct.
Owner
Kind of
Used as
19 (�
To be completed about
Estimated Cost,
d -d
C) Permit
Permit No. No.
�6
DESCRIPTION OF WORK
HEATING or P R PLANTS—Ste Hot Wa �WamAir o
Trade Nam 45� (24� Size No :eO
Capacity S . Ft. E.D.R L�r7j BTU H.P.
Total Connected 7 Rind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R. BTU H.P.
(REMARKS -OVER)
RAY
�N.. WELTER HEATING CO.
_
ByWNNEAPOLIH 7. MINNE®OTA
.3<.O. 42 Business Phone No. 6""4-4 %
City of Fridley, Minn. 6 10966
BUILDING PERMIT �
Date: March 26 1971
Owner: James Dahl Builder Same
Address 7428 MP -Indy Trriyc- N_F.- Address Same _
LOCATION OF BUILDING
No. 7428 Street Melody Drive N.E. _ part of Lot
Lot _ 21 __ Block 4 Addition or Sub -Division . Melody Manor 4th Addition
Corner Lot — Inside Lot X Setback M._ Sideyard 6.9 ' Back 6.4' Front
Sewer Elevation _ _ _ _. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Addn. to Gara>;e Front 81 Depth 24' Height 10' Sq. Ft, 192' Cu, Ft. 1920'
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost _ $1200 - 00 To be Completed EAh-alary, _ 1 A72
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description above forth and in con fiance Ath ail ovisions of
ordinances of the city of Fridley.
v
In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to James Dahl
to construct the building or addition as described above. This permit is granted upon
the eFress condition that the person to whom it is granted and his agents, employees and workmen, in all work
doneFridl, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits and this permit may be revoked at any tune upon violation of any of the provisions of said
ordinances.
4k=&`AdingInspector
CLAItENCE BELISLE
NOTICE:
ihis permit does not cover the construction, Installation for whing, plumbing, gas heating, sower or water. Be sore to see
the Building Inspector for separate permits for these hems.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:7Z /7% F S Dfq BUILDER:
ADDRESS:—'7OK rh re Lv 1) v DR. . . ADDRESS
NO • .`'1 �' g STREET • VO e L
LOT: o % BLOCK: =Z ADDITION: (y� A Mt)n� �l I4ciN
CORNER LOT: INSIDE LOT:_SETBACK; SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
64d', Front: Depth: c,7/ZZ Height: Id
G3
Square Feet: l Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: / Estimated Cost:_��� d
To Be Completed: �- / — 7c--�2-
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: ` % / ' SIGNATURE.
(See Reverse Side For Additional Informat on.)
Land Planning solo Udwit 6875 Highway No. 6S N.E.
Land Surveying• • AIM.
Minneapolis,
Soils Testing 1,ablWWWr AIM. Minn. 55432
Civil Engineering Telephone 784-6066
Municipal Engineering Engineers & Surveyors Area Code 612
Mortgage Loan Survey for Jp,,-�Es D/a.HL_
�rX
0�Inr3� . 04
OQ
�U
Lc) -7 21, BLocw- 4-
-N\ELoDy
MANOR 4T`-'
Orr loN
Cau"T- 01= %Notca�
This is a true and correct representation of a survey of the boundaries of the land above described and of the
location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is
made only in connection with a mortgage loan now being placed on the property and no liability is assumed
except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It is
understood and agreed no monuments have been placed for the purpose of establishing lot lines or boundary
corners. Dated this 1101day of ' e.j A. D. 19_1L.
SUBURBAN ENGINEERING, INC.
M1 Enby e��a, Sur _ '
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
New Fixtures $ 5.00 $
Future Fixtures $ 3.50 $
Old Opening, New Fixture $ 1.50 $
Beer Dispenser $ 4.00 $
Blow Off Basin $ 5.00 $
Catch Basin $ 5.00 $
Rain Water Leader $ 5.00 $
Hydraulic Valve $ 5.00 $
Sump or Receiving Tank $ 5.00 $
Water Treating Appliance $ 7.00 $
Hot Water Heater $ 5.00 $
Gas Range $ 10.00 $
Gas Dryer $ 10.00 $
Back Flow PrevenytiYes No ( )
Type 7 $ 5.00 •$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appliance $
Reinspection Fee $ State Surcharge $ .50
($15.00) TOTAL FEE $ /5"150—
Effective Date May 1, 1988
Job Address �� e / �� � j a 4
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. 4/ L� , 19 470
OWNER
KIND OF BUILDING
USED AS a esl6e'h/ "C' l
TO BE COMPLETED ABOUT �[ �� ?
ESTIMATED COST GO,
OLD - NEW BUILDING PERMIT NO. PERMIT NO. 16
Company &%s C P V ►tib i C .
Signed By ' 3? 8+--'' -
Tel . No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT��
MINIMUM FEE FOR ANY PLUMBING PERMIT I $15.00
PLUS THE $.50 STATE SURCHARGE
m
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W
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X
W
Water
ro
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04
wf�
Heater
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ro
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3
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lec
1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
New Fixtures $ 5.00 $
Future Fixtures $ 3.50 $
Old Opening, New Fixture $ 1.50 $
Beer Dispenser $ 4.00 $
Blow Off Basin $ 5.00 $
Catch Basin $ 5.00 $
Rain Water Leader $ 5.00 $
Hydraulic Valve $ 5.00 $
Sump or Receiving Tank $ 5.00 $
Water Treating Appliance $ 7.00 $
Hot Water Heater $ 5.00 $
Gas Range $ 10.00 $
Gas Dryer $ 10.00 $
Back Flow PrevenytiYes No ( )
Type 7 $ 5.00 •$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appliance $
Reinspection Fee $ State Surcharge $ .50
($15.00) TOTAL FEE $ /5"150—
Effective Date May 1, 1988
Job Address �� e / �� � j a 4
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. 4/ L� , 19 470
OWNER
KIND OF BUILDING
USED AS a esl6e'h/ "C' l
TO BE COMPLETED ABOUT �[ �� ?
ESTIMATED COST GO,
OLD - NEW BUILDING PERMIT NO. PERMIT NO. 16
Company &%s C P V ►tib i C .
Signed By ' 3? 8+--'' -
Tel . No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT��
MINIMUM FEE FOR ANY PLUMBING PERMIT I $15.00
PLUS THE $.50 STATE SURCHARGE
CINOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
May 17, 1999
Steve Price
7428 Melody Drive NE
Fridley, MN 55432
Re: Final inspection at 7428 Melody Drive NE
Contractor: Dependable Indoor Air
Dear Mr. Price:
A mechanical permit was issued on May 6, 1998 for the property located at 7428
Melody Drive NE for a new furnace and air conditioner. According to Section 305(a) of
the 1991 Uniform Mechanical Code a final inspection shall be performed on the
mechanical permit. As of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, we will expire the permit and any inspections on this installation will
require a new permit.
Any questions can be addressed to myself at (612) 572-3603.
Sincerely,
/17 `G,
Bary Riesch
Building Inspector
CITY OF FRIDLEY INSPECTION DIV.
Effective On August 1, 1995
6431 University Ave NE
,r
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —rulings
of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace
$ 30.00
$®• ��
representations stated in this application are true andcorrect.
(Side Vent — Fill Out Back)
�� � 6 ,199A
Gas Piping (Needed with new furnace)
$10.00
$
�cn -
OWNER K:J sL
Gas Range
$10.00
$
BUILDING USED AS
Gas Dryer
$10.00
$
ESTIMATED COST ���J �.00 PERMIT NO.
*Air Conditioning — All Sizes
$ 25.00
_
$00
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
I% of Value of Appliance or Work
$
No. of Heating Units / Circle One (Steam) (Hot Water) arm�Air
Trade Name �Q/'1®/ Size No.
Commercial/Industrial
BTU '"2:3, ® U ® HP EDR
1.25% of Value of Appliance or Work
$
Fuel Total Connected Load
*\44ttJ_� State Surcharge $.50
i
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
REINSPECTION FEE $42.00/Hr
Burner Trade Name
BTU
HEATI
Signe
HP
Size No.
EDR
Approved By ltw Rough—In Date
'Air Conditioners can not be placed in alside yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON
written permission from adjoining propi#ty owner. REPLACEMENT FURNACE
Final Date
21
NEW [ ] CITY OF FRIDLEY
ADDN k4. 6431 University Ave NE, Fridley, MN 55432
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Addre
Legal Description:
Effective 1/1/2002
(763) 5722604 Bldg Insp (�
Owner Name & Address: Skfty\ f r r°C if 7 `l 1zq Wye 10 j y br; Tel. # -765- 7 3S -A 7 y
Contractor. MN LICENSE #
Address: Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length t'
Length
l
Length
DESCRIPTION OF IMPROVEMENT
Width Ar
Wdth &
Height_
Height
Width Hgt/Ground
Sq. Ft V cp-q) 0��
Sq. Ft
Sq. Ft
Construction Type:1 4 L h�� Estimated Cost: $ ®
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: �I _ oZ %- (� APPLICANT: Tel. # 76 �' 7 �S"'�1t� 7
Call (763) 572-3604 for Permit Fees if mailing In application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ ]
TOTAL $ o 0 STIPULATIONS:
MNcheck COMPLIANCE REPORT
Minnesota Energy Code
MNcheck Software Version 3.0
COUNTY: Anoka
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 4-23-2002
COMPLIANCE: PASSES
Required UA = 114
Your Home = 113
0.9% Better Than Code
Permit #
Checked by/Date
Area or Cavity Cont. Glazing/Door
Perimeter R -Value R -Value U -Value UA
CEILINGS
504 38.0 0.0
15
WALLS: Wood Frame, 16" O.C.
436 19.0 4.0
22
BSMT: Conc. 7.0' ht/5.0' bg/7.0' insul
626 10.0 0.0
46
GLAZING: Windows or Doors, Above Grade
58 0.350
20
GLAZING: Windows, Foundation, <= 5.6 ft2
12 0.350
4
DOORS
18 0.320
6
COMPLIANCE STATEMENT: The proposed buildinggn described here is consistent with the building plans,
specifications, and other calculations submitted wit a permit application. The proposed building has been designed
to meet the requirement a Minnesota Ene Code.
Builder/Designer Date �% '7 — ®o�
susJEbT
IT NO.
City of Fridley
32573
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
"I PROTECTIVE INSPECTION SEC.
r
1 . �
.."'S CITY HALL FRIDLEY 55432
NUMBER
REV
DATE'
PAGE OF
APPROVED By
� 612-571-3450
910415
5/8/02
JOB ADDRESS 7428 Melody Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
21
4
Melody Manor 4th Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Steven Price 7428 Melody Drive NE
763-785-2074
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW Ck ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE , ❑ REMOVE
8 DESCRIBE WORK
Construct an 18' x 28' Addition to Dwelling and an 18' x 14' Garage Addition
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
WARN11%
BefOre digging
cell for
all utiI4 location
SEPARATE PERMITS
o02
REQUIRED FOR:
EQuIR4E
® BY LAW
WIRING HEAMNGG������
PJAIMBINd AND SI6t1�
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
ANY TIME AFTER WORK IS COMMENCED. `
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$33 765
$16.88
WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAWGULATING CON-
@
Fire SC $33.77
STRUCTION OR THE PERFORMANCE OF
$482.15
7��
PLAN CHECK FEE
TOTAL FEE
$532.80
AGENT S� OF CTRAR R TAGENT ,DATE,
ONC OAUH ZED
X 1
EN R P ALIDAIK THIS IS V9UR PERMIT�
5 i
,
fA'-\ NATURE 0F OWNER ,,F OWNER BUIL ER, DATE
G iNS� MATE
NEW (] CITY OF FRIDLEY Effective 1/1/2002
ADDN 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: d cr re
Legal Description: [ IJ u' Kor v
Owner Name & Address: 6fieq-eV �r71"ke etc Iub Tel. # 763-7 rY- 2.O "] y
Contractor. MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length 19 Width
'
Height J
Sq. Ft
GARAGE AREA: Length Width
1 `%
Height ,
Sq. Ft Sv2
DECK AREA: Length Width
Hgt/Ground
Sq. Ft
OTHER: %I Le `l
���y F
LtY� �� Gtwr°��a
S� LI
Construction Type: Estimated Cost: $ zZO, 6 ri
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: ? -1 t - O;, APPLICANT: Tel. #
Call (763) 5722604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
E
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined byEngineenng
Agreement Necessary [ ] Not Necessary [ J
TOTAL $ STIPULATIONS:
MNcheck COMPLIANCE REPORT
Minnesota Energy Code
MNcheck Software Version 3.0
COUNTY: Anoka
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 7-16-2002
COMPLIANCE: PASSES
Required UA = 132
Your Home = 124
6.0% Better Than Code
Permit #
Checked by/Date
COMPLIANCE STATEMENT: The proposed building. described here is consistent with the building plans,
specifications, and other calculations submitteda permit application. The proposed building has been designed
to meet the requirements of the Minnesota E gy Code. /
Builder/Designer Date %— b "
Area or
Perimeter
Cavity
R -Value
Cont.
R Value
Glazing/Door
U -Value
UA
CEILINGS
568
38.0
0.0
17
WALLS: Wood Frame, 16" O.C.
564
19.0
4.0
29
BSMT: Cone. 7.0' ht/5.0' bg/7.0' insul
626
10.0
0.0
46
GLAZING: Windows, Foundation, <= 5.6 ft2
12
0.350
4
GLAZING: Windows or Doors, Above Grade
58
0.350
20
DOORS
18
0.320
6
FLOORS: Over Unconditioned Space
64
30.0
0.0
2
COMPLIANCE STATEMENT: The proposed building. described here is consistent with the building plans,
specifications, and other calculations submitteda permit application. The proposed building has been designed
to meet the requirements of the Minnesota E gy Code. /
Builder/Designer Date %— b "
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.00 $
$ 10.00 $
$ 10.00
$ 10.00
$ 25.00
State Surcharge
JOB ADDRESS -7
t;I,F ("tt f
OWNER Sit%�e-N
BUILDING USED AS
ESTIMATED COST
Effective On January 1, 2002
Y1
PERMIT N0.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name Size. No.
BTU HP EDR
$ Fuel Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
TOTAL FEE $ V
J
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
HEATING CO b`J -I'-`'
Signed
FAX #
Approved By Rough -In Date
DATE 11/- D",
TEL #
Final Date5 a 0,5
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VFNT, VENT CONNFCTOR ANn COMMISTION AIR VFRIFI CATION
When re la _ing_an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes( ) No( )
The venting system is plastiGPVC and meets all 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 manufacturers specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes( ) No( )
The exiatingsembustinn air is sized and installed to meet the current codes
and manufacturers specifications. Yes( ) No( )
When .required to install a new rnmhnstean air�it will be sized and installed
to meet the current codes and manufacturers specifications. Yes( ) No( )
When installing a new v _n ingnystpm, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes( ) No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( )No(
)
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
HEATING CO:
Signed By: I Date :