PRE 2010 DOCSData:
City of Fridley, Minn.
BUILDING PERMIT
AUGUST 30, 1965
N° 8418
Owner: Builder HOMEDALE BUILDERS
Address Address 3017 Lyndale Avenue South
Minneapolis, Minnesota
W1.
LOCATION OF BUILDING
7493 Street MELODY DRIVE N.E. Part of Lot
. Block
Lot 2 —
Corner Lot _
Sewer Elevation
5
Inside Lot — X
Addition or Sub -Division MELODY MANOR, 4th ADDITION
— Setback 35' Sideyard 14' & 10'
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
DWELLING Front 42 Depth 24/26 Height 20 Sq. Ft. 1, 048 Cu. Ft. 20, 960
ATT. GARIGE Front 14 Depth 24 Height 10 Sq. Ft. 336 Cu. Ft. 3,360
Type of Construction FUME Fast. cost — $17, 00P'00--- To be Completed 11/15/65
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 set orth and in compliance with a'll provisi of
ordinances of the city of Fridley. a Y — A le
0
In consideration of the payment of a fee of $ 25.00 , permit is hereby granted to HOMEDALE
BUILDERS 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 part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
ALLEN G. JENSEN
NOTICE:
ffib peewit does not ewer the construction, halaliation for vArhM phanbing, gas henthm sewer or water. Be runs to we
tis Building Inspector for separate permhr for these Items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S
ADDRESS ADDRESS
acv//�L i :..r•=
LOCATIO14 OF BUILDING
Street Part of Lot
LOT R ADDITION OR SUBDIVISIO
Corner Lot Inside, LEST � Setback Side -Yard
__
.SEWER ELEVATWX 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:
e
FrontDept . b Height >,P
67 f Sq. Ft. / -* Cu. Ft._
—Front ®Depth>�geight / t -
Sq. Ft. Cu. Ft._
Type of Constructionrid
—_ Estimated Cost /�®�®
To be completed_ ae?�—'% ,�— lam'
The undersigned hereby makes application for a'permit for the wgrk 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.
DATF,�_p�5 /4 tS SIGNATURE ��✓��
(Schedu a of Fee Costs can be found on the Reverse Side).
s . . 0
SUBJECT
PERMIT NO.
City of Fridley
2327 9
AT THE TOP OF THE TWINS
B U I L D I N G PERMIT
Ir?
RECEIPT NO.
`y --------COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATEPAGE
P OF
APPROVED BY
612-571-3450
910-F15
4/11/95
JOB ADDRESS 7493 Melody Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
5
Melody Manor
4 Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mary Ann Hoffman 7493 Melody Drive
NE 780-5911
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
R & B Associates 16132 Xenia St NW, Andover, MN 55304 323-9203 20020127
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW Cj ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 14' Addition to Dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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 I 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
014,326
$7.16
WITH WHETHER S E IFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRES M TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF OTHER STATE OR LOCAL LAW REGULATING CON-
$162.00
Fire SC $14.33
STRU ION OR T PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
License SC $5.00
TOTAL FEE
$188.49
SiGNATUFtE-Ot CONT RACTOR.OI AUTHORIZED AGENT (DATES
WHEN PAOPE Y VALI THIS IS YOURS PERMIT
_ /` I!
BLD NSP DAT
SIGNATURE OF OWNER of OWNER BUiLDERi iDATEi
NEW
ADDN
ALTER
Construction Address: t`t
Legal Description: LJ
Owner Name & Address:
Contractor: ` e
Address: �1�� �P/►i ao. �.. .� V�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Lei AJ6�u, e� �! ✓� F�,��� - AV-/
We -
T�
Tel. # i
MN LICENSE #
Tel. #
Effective 1/ 1/95
_t;cl I
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft. '
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [q -""Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $�
Approx. Completion Date: j - q S % L/ 26
(Cost on Back)
Driveway Curb Cut -Width Needed: - Ft. + 6 Ft = Ft x $ _ $
DATE: (4 -"D APPLICANT: t; -W Tel. #
162,
JcZ CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ /`/, 33 .001 of Permit Valuation (1 / 10th %)
State Surcharge $ :�7, $.50/$1,000 Valuation
SAC Charge $ $850 per SAC Unit
License Surcharge $ $5.00 (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 $ Agreement Necessary (j Not Necessary
TOTAL
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
Rate
$ 20.00
$10.00
$10.00
$10.00
$10.00
JOB
J
.Effective On January. 1, 1995
.
ZG .
The undersigned hereby makes application fora. permit for the work herein
TOTAL specified'agreeing to do all work in strict accordance with the:City Codes ar
rulings of the Building Division, and hereby d0clares that.all.the facts and
$ representations stated in this application are true a�n correct.-
-1995.,
$
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of App lance orWork j $ ®a o d
Commercial/Industrial a '��
I% of Value of Appliance or Work
State Surcharge x.. 60
TOTAL FEE $„36, -,I(L
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed In a side yard without
written permission from adjoining property owner.
OWNER %�l- Yjr✓1.:
BUILDING USED AS
ESTIMATED.00ST 5600, ® PERMIT NO.
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
HEATING COMPANY
Signed By Tel No, 1664
Approved B Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VER-IFlcATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
The undersigned hereby verifies that the existing chimney or stack:
L-
Has. been carefully examined
Yes ()
No
(
)
2.-
Is free'froni.rust.or deterioration
Yes
O
No..
(
)
3.
Has no foreign objects lodged within
Yes
O
No
O .
4.
FIs securely supported
Yes (}
No
O.. .
5.
Meets all current Code requirements for size
and total BTU's connected
Yes (
)
-No
(
)
b
. Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes ()
No
(
)
8.
Has combustion air been provided for water heater
Yes ()
No
(
)
Remarks:
HEATING CO:
Signed By:
Date:
suejECT
ERMIT NO.
City of Fridley
2 6 6 8 9
AT THE TOP OF THE TWINS
BUILDING PER M
`
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
--------
- PROTECTIVE INSPECTION SEC.
r �
1 . �
NUMBER
REVDATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
__J
/19/98I
JOB ADDRESS 7493 Welod Drive
1 LEGALLOT
NO,
BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR.
2
5 IMelddyManor, 4th Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mary Ann Hoffman 780-5911
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Grand Exteriors 9601 West 16th St. St Louis P919-5091 Pending
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
O NEW ❑ ADDITION O ALTERATION S] REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for inspection of building wrap before covering.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS 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
$4290
$2.15
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$99.75
Fire SC $4.29
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
�'--'3„m`
License SC $5.00
$111.19
SIGNATURE OF CONTRACTOR ORAUTHORIZEDA IDATEI
WHEN ALIDATED THIS IS YO R PERMIT
[p/P/R�OPER
b G INSP GATE
SIGNATURE OF OWNER OF OWNERBULLDERI IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 2
Effective 1/1/98
�1 V"
Legal Description:Cj ,
Owner Name &Address: Tel. #_ _��(j ' 57 f /
Contractor:C�'c,4 /� L �s� r'�s� S' MN LICENSE # Pe yD S
Address: 2-2 f S Tel. #
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:
Length
Length
DESCRIPTION OF IlAPROVEMENT
Width
Width
Height
Height
Sq. Ft.
Sq. Ft.
t
Construction Type: "o J Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: G atl� �� ,%6 Tel. # 9 - S®f/
CITY USE ONLY
Permit Fee $ c'/, 75 Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ c� $5.00 (State Licensed Residential Contractors) P��o
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ ► l
STIPULATIONS:
i
SuBjECT
City of Fridley
772678
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
• _____ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIOLEY 55432
L 612-571-3450
910-F15
8/18/98
JOB ADDRESS
7493 Mel dy Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
5
1 Melody Manor,
4th Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mary Ann Hoffman
780-5911
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Grand Exteriors 9601 W 16th St. St Louis Pk MN 55426
919-5097
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION JaK REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (22 S 2nd Layer
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Roofing can be 2nd layer but not 3rd.
SEPARATE PERMITS ARE REQUIRED 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
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
$1378
`
$.09
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIO R THE P RFORMANCE OF CONSTRUCTION
$45.75
Fire SI; $1.38
PLAN CHECK FEE
TOTA EE
Licens$5.00/.82
SIGNATURE CFCONT ORORAUTHORIZEDAGENT )DATE)
EN ROP
BLgrU INSP
ALIDAT D IS IS YOUR PER T
qA E
-- SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:7W3 M-&z�ve/ L-)ve2-
Legal
Description:
Owner Nair.
Contractor:
Effective 1/1/98
Tel. #—,2
MN LICENSE #
Address: &n/ 4tj• /& 015 d. Tel. # - 179-50 Z
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 Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Lengthdth Hgt/G/�ound Sq. Ft.
OTHER: ��? iLJ 6 ( 4 a
Cl/
Construction Type: % Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: �eAPPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.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 [ ]
PLUMBING
RESIDENTIAL APPLICATION
City of Fridley
!Tber
d
12fate Rbedived
NTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT.
-
Sri
DATE , /0' YOUR E-MAIL ADDRESS
SITE ADDRESS `y of 4 3 fKE1-0 b y b "e—
THE APPLICANT IS: (CIRCLE ONE) OWNER ONTRACTOR
NAME MA&v AAln) I-} d FFe►+,4n%
PROPERTY OWNER/
ADDRESS /;g -40b16 IL
TENANT
y
CITY FA + b i- E v STATE /A J ZIP
PHONE # '-7( 3 ` Vd 9 i f
NAME 1�,2,4'p OL,ER�+erc�2 10ZL4^d,,J6 ®aD C. LICENSE#
ADDRESS / (o C U Lf A),- 1/W 1 O
CONTRACTOR
CITY F?—)LE y STATE It ZIP Z
PHONE# -163 5`71 - do.PP0 FAX# `r&3 X73 Y
PERMIT TYPE
_SINGLE FAMILY TWO FAMILY TOWNHOUSE
TYPE OF WORK
❑ NEW tX- REPLACEMENT
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FIXTURES: (INDICATE TOTAL NUMBER OF EACH)
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15)
DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION
WATER METER OTHER
Permit Fee $ 3S 0 U MINIMUM: $15.00 or 5% of cost of the improvement -whichever is
Plan Review $ greater on work less than $300
Surcharge $ .50
TOTAL DUE $ 3 6-- s® Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT - NOT VALID UNTIL PROCESSED
1 hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with
the ordinances and odes of the City of Fridley and with the Minnesota Construction Codes; that 1 understand this is not a permit but only an
application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which
requires review and approval of plans.
el
�A k, r R `t`°I F
NAME OF APPLICANT DATE
Please type or print
SIGNATURE OF APPLICANT
CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT
6431 UNIVESr1Y AVENUE NE, FRIDLEY, MN 55432
(763)572-3604
n Y
%TI OF FRIDLEY INSPECTION DUSION - l
Effective On January 1, 1999
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND
HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
,� I
JOB ADDRESS 77qZ
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
in this application are true and correct.
Also Replacement Furnace $ 30.00
$
representations stated
(Side Vent —Fill Out Back)
Gas Piping (Needed with new furnace, $10.00
$
but not replacement)
OWNER
Gas Range. $10.00
$
BUILDING USED AS
Gas Dryer $10.00
$
ESTIMATEDCOSTfla®®, 01) PERMIT NO. l
*Air Conditioning — All Sizes $ 25.00
$
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK
1% of Value of Appliance or Work
$
No. of Heating Units � Circle One (Steam) (Hot Water) (Warm Air
Ph;;zn Size No.
Trade Name
Commercial/Industrial
BTU 160 HP EDR
1.25% of Value of Appliance or Work
$
Fuel Total Connected Load
State Surcharge
$ .50
Bumer Trade Name Size No.
BTU HP EDR
TOTAL FEE
$ • �®
ANDEPWN HEATING & AIR GOND
HEATING COMPANY 43347 Cantral Avenue N.E.
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
x:01 mbia HeiclhtS. ASN 554 1
No.
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
Signed By, _ Tel ���-�
PLUS THE $.50 STATE SURCHARGE
:� \
REINSPECTION FEE $42.00/Hr
Approved 4Rough—In Date Final Date � Z
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (Ii)�'No ( j
2. Is free from rust or deterioration Yes (O"No ( )
3. Has no foreign objects. lodged within Yes (ONo ( )
4. Is securely supported Yes (LNo (. )
5. Meets all current Code requirements for size
and total BTU's connected Yes (PNo ( )
6 Has total heating BTU's of Yb j D0
All other BTU's
TOTAL BTU's -701 a®
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 Being Done:
HEATING CO:
Signed By:
Date:
ANDERSON HEA71NG & AM COW
4347 Central Avenin N.F.
i - lb —ou
i
I
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
November 9, 2001
Mary Ann Hoffman
7493 Melody Drive
Fridley, MN 55432
Re: Final Inspection at 7493 Melody Drive
Contractor: Anderson Heating & Air Conditioning
Dear Ms. Hoffman:
A mechanical permit was issued on August 18, 2000, to install a furnace at your address.
According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be
conducted on the mechanical 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 Mechanical Code. We will keep your permit open for another 30 days and if we
do not hear from you within this time to set up the inspection, we will expire the permit and no
further action will be. taken.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
Building -
BUILDING
`j ��
Permit No.: -Q/q
Inspections
RESIDENTIAL APPLICATION
'' . o� I
Received By:
763-572-3604
CITY OF FRIDLEY
_
Date Rec'd:
i
.' —
$
DATE V YOUR E-MAIL ADDRESS
.001 x Permit Valuation (1/10%)
SITE ADDRESS
$
�/
THIS APPLICANT IS: ❑ O XONTRACTOR
$5.00 (State Licensed Residential Contractors)
PROPERTY OWNER/
NAME: Rif,,
ADDRESS: CITY
STAT -- �
TENANT
PHONE:
Erosion Control
CONTRACTOR
NAME:
$450 Conservation Plan Review
SUBMIT A COPY OF
STATE LICE SE # EXP DATE
Determined by Engineering
YOUR STATE LICENSE
ADDRESS: CITY
(a— STA
WITH APPLICATION
PHONE — FAX
$
PROPERTY TYPE
SINGLE FAMII.Y/NEW CONSTRI ON SIZE
❑ O FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
ECK ❑ SIDING ❑ OTHER.
❑ SWIMMING POOL
TYPE OF WORK:�'
❑ ADDITION
r❑ MAINTENANCE/REPAIR 11 REMODE
DESCRIBE WORK BEING DONE: U,< r
4
SIZE OF IMPROVEMENT LENGTH QDTH
HEIGHT S . Ft.
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES e ATTACHED GARAGE
PROPOSED SIZE: 'ACHED GARAGE /_
PROPOSED HEIGHT:
��T: /
1.
2.
3.
Existing Floor Plan
Proposed floor plan
List of structural members to be used
`- p
SIDIIVG C�
FOR NEW CONSTRUCTION INCLUDING DECKS,
Vr
❑ Vinyl s[]Soffit(/
ADDITIONS.
&PORCHES SUBMIT:
13 Aluminum �! ❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia
A
2.
and proposed project.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
AIi.L aA 3 a AnD ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
SING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $._ , Qr�, OCCUPANCY TYPE
Permit Fee
$
`j ��
See Back Page for Fee Schedule
Plan Review
$
'' . o� I
65% of Building Permit Fee
Surcharge
$
_
(.0005) tunes the total job valuation — Minimum $.50
Fire Surcharge
$
a
.001 x Permit Valuation (1/10%)
License Surcharge
$
1500
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
Erosion Control
$
/
$450 Conservation Plan Review
Park Fee
$LieFee
Determined by Engineering
Sewer Main Charge
$
�
Agreement necessary ( ) Non Necessary ( )
Total Due
$
17
Make checks payable to: City of Fridley Attach Stipulations
I hereby apply for a building pern
conformance with the ordinances an
permit but only an application for a
plan in the case of all worire
SIGNATURE OF APPLICANT
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
acknowledge that the information above is
f the City of Fridley and with the Minnesota
dwork is not to start without a peTit; that
w and approval of plans. (�
and accurate; that the work will be in
ion Codes; that I understand this is not a
will be in accordance with the approved
i FC - sU
I_2