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PRE 2010 DOCS7--P-C City of Fridley, XHnn. 8048 BUILDING PERMIT Date: June 28, 1965 Owner: John Johnson Builder Clemro% Inc. Address 3�8 Memory Lane Adm 701 Columbia Blvd. LOCATION OF BUILDING No. 7387 street Nemory Lane Part of Lot Lot _ Block Addition or Sub.Division NelodY Mex10T, 3rd. Add. Cormer Lot _ Inside Lot X Setback __._ Sideyard Sewer Elevation _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Stele Dwe] ling Front Depth Height Sq. Ft. Cu. Ft. Att, Gauge Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fr -W0 Est. Cost$21,000.0 _ To be Completed New Dwelling, Att. Garage In consideration of the issuance to me of a permit to co ct buildin cri agree to do the proposed work in accordance with the description abovpr set f and ce wi , provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $-L6 . 00 permit is hereby granted to Ronald C. Johnson Clemron, Inc. to construct the building or addition as described above. This permit is granted upon Ile express condition that the person to whom it is granted and his agents, employees and workonen, in sII work. ELd rounand upon said buildingor any part thereof,shainnesota location,ction, alterat, tcity limits permit may be revoked at any tone upas violation of any of the provisions of said Allen Jensen Building Luvedw NOTICE rob permit don not carer the construction, Installation top wkbm plumbing, gas boding, sewer or water. Be ars to see the BdMing fimpe ter for separate psrmNs for these Nene. APPLICATION FOR BUILDINGG PERMIT CITY OF FRIDLV, MINNESOTA ZVI ADDRESS _-.ADDRESS LOCATION OF BUILDING LOT ____&�� ADDITION OR SUBDIVISION Corner Lot Inside LOT _t/Seiback Sid of Lot______y SEWER Ok ELkViTidN Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be u d as; ront_.Depth S -toq Height Sq. Ft. Cu. Ft. --T i Front_,'® 7jS Depth , �® Height Sq. Ft. 2 Cu. Ft.: le, Type of Construction_ Estimated Cost 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 Cityof 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 corrs". SIGNATURE / (Schedule of Fee Costs can be found on the Reverse Sid II M]MGASCO, 53-84-S-915.51 Ci -j of F�iaiey Applictstlan for PDarnbing and Gas Ml','ng Per m.jt Dept. of Bldga. Phone SOO-3490 DESCRIPTION OF WOM'. Numboar. Kind snd LocrSion of Fixtures p V O; .., Number Fixtures ................ 1 3� Future Fixture Opening ............ x $1.50 $ _. New Fixture Old Opening.......... ✓� 8� N S� � °< i W 7i � e 7 . e N WATE4 MTA. GAS (l[C ase Electric Watar Heater .............. a $2,00 $ AS FITTING FEES: NO. RRTE TOTAL 1st 3 Fixtures ............ • • • • • • 1 x $2.00 2.00 Additional Fixtures ................ x S .75 $ Gas Range to 199.000 BTU ........... x 55.00 1 t ;d d h_ Futuze Conaoctiou C7.-nin.,Is °7 Sever . 4i-aw Fixture, Old finings Ccz--pool C] PARTIAL RATE SCHEDULE LUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $ _. New Fixture Old Opening.......... x $1.50 $_._� Catch Basin .................... x $3.25 $ Water Beater 'Up to 99,000 BTU).... x $3.00 $ New Ground Run Old Bldg......... x ; 25 3 Electric Watar Heater .............. a $2,00 $ AS FITTING FEES: NO. RRTE TOTAL 1st 3 Fixtures ............ • • • • • • 1 x $2.00 2.00 Additional Fixtures ................ x S .75 $ Gas Range to 199.000 BTU ........... x 55.00 $ 1 7387 Memo= ga. ne City of Fridley: . The undersigned hereby snakes application for a permit for the- work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn –R -7h . 19._ Owner tia .ns forell , Kind of Building Frame Used as To be completed about 1-15-76 Estimated Cost. $ 10.00 Old—NM Building Permit No. Permit Ko.% Signed.y—��_ By MINNMARPp -- Business Phone No ROUGH FINAL c/7 e Ci ` -77 AIRS & ALTERATIONS—Refer to Code .50 State Surcharge ° Description .................. ................... -$ $ coral. FEE 2 .50 • Class `°A" Surcharge .50¢, City of Fridley SUBJECT P ®13602 AT THE,TOP OF THE TWINS • � i` BUILDING -PERMIT CEIPT NO COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. { � NUMBER REV. DATE PAGE OF APPROVED BY i1 L A.� CITY HALL FRIDLEY 55432 ._•- 812-580-3450 910-F15 6/23/76 JOB ADDRESS 7387 Memory Lane 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. ll 4 Melody Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Hans Florell 7387 Memory Lane N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Minnetonka Pool Company 10820 Wayzata Blvd Minnetonka 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. SAME 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING 7 CLASS OF WORK ❑ NEW7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install 16 x 32 swimming pool 9 CHANGE OF USE FROM TO STIPULATIONS 1. See letter dated 6/23/76 SEPERATE PERMITS REQUIRED FOR IfflRING, HEATING; PLUMBING AND SIGN& SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. steel & Vin yl THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,800 2,90 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- $36.00 STRUCTIO E PERFORMANCE OF CONST R CTION. PLAN CHECK FEE TOTAL FEE /�✓� / 1!� $38.90 ,1IGNATURE OF CONT OR AUTHORIZEDAGE T (DATEI EN PROPERLY VALIDATED THIS ISYOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) 01, APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : /Th�/�S �LO°GL BUILDER: ADDRESS: 3<F% 425 & e4CV . ADDRESS:_/cAp" 171 . NO:. 73k-7 STREET :_ e) /C L- A) . LOT: l BLOCK: ADDITION: 01LO O V /�i ff ZJ 0 �-- 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: / X j o0 cU t4ccow3l Wit,�ri �'`'�� Front: Depth: y Height: Square Feet: _!5"/2__ Cubic Feet: 3 Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ 5"�m o . To Be Completed: J 0 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict 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: 6 r-9 Z-^ -7 6 SIGNATURE: G , 6116 (See Reverse Side For Additional Information.) I "01, /07 7 3 k7 i,87S 31(ja 1,1 ENGINEERING, INC. ftivlllcct,.5 Sur Veyof '6 c w tiitfii ca to survey fox. E w T11 OEVELOPMEn . N 0 OF -NOTES t90V4----0EN0TV-S OVWNAGIL AND UTILITY EASEMENT LOT —L—BLOCK ME -L00`( MANOR 3RD Aook-rtoN ANOKA COUNTY y"W! "mofime"', --v jr w7 sald i'arfff A5 vr,}ed me thls `bq 10" Scale. 1 -40 Ply r t1 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 June 23, 1976 Mr. Thomas Wahl Minnetonka Pools 10820 Wayzata Blvd. Minnetonka, MN 55343 TELEPHONE ( 812)571-3450 Be:- Swimming Pool Construction at 7387 Memory Lane. Dear Mr. Wahl: This letter is to reiterate my conversation with you on June 22, 1976 and to make clear this departments requirements for the swimming pool construction at the above address. 1. As discussed, one (1) skimmer approved by the National Sanitation Foundation will be provided. 2. As discussed, three (3) inlet of approved design for fresh and/or repurified water 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 3 feet wide, measured from the pool water's edge shall be provided which extends completely around all private residential pools; provided that above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the Health Authority. 5. A fence or other suitable barrier., a minimum of six (6) feet high, that affords no external hand or foot holds and which is impenetrable by toddlers, must be provided around the entire perimeter of the pool. All gates and other accesses shall be equipped with self-closing and self -latching devices which are capable of being locked. 6. An automatic chlorinator should be provided with a suitable test kit. 7. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 8. All electrical lines must be 10-20 feet or more away from the pool surface. 9. ,The pool fill spout must be airgapped or protected by a vacumn breaker. 10. Suitable safety equipment to include but not limited to a ring buoy and rope that is 1�times the pool diamerer,and shepards crook pole must be provided and maintained with the pool at all times. r- q Y page 2 Mr. Thomas Wahl June 23, 1976 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 by the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450, ext. 170. Sincerely, .'- SJO/bak c. c. Hans Florell 7387 Memory Lane 55432 All-� Ar /k- � ' 7 3 k7 4 t ENGINEERING, INC. cem-cificate of su:m%ireur fox- E*-tTl 0EVEOP-MVIT-CCS 0lZ;MNNGlP_ XMD UTUTY S 0 F-MENT LOT 'R L 3 C X 'MCLSOY 'MANOR Sano Aum tom c3UNTY J 10**':/ J k"�.Worwrsjidi'vad A �j J., fA _.STEEL AWS —Al PERM. SAFETY i RADE V —'7--X-B4ACES ON f'O' SPACIAF6 24 -FILTER, %11.P PUMP »•DNecEs - 1500 6.qt.— 512 Sa. FT, I - SKIMMER -ip'v! Typr a 8*3-- FOX17E COPING ONLY D16 TYPE CONCQETE- D163' ' SANDA.MPE" A WEAVER R N, 700 At PID SAND INSTALLATION TO BE IN ACCORDANCE WITH FOX POOL, CORP, fiECOMMENORTAONS. 32'-0" -. "m I am I Dmmn UN=oTk.s=mw9mF"m Rftm as — FMM a" 0 -in Ax D ..6" J= Dm A 1= "aw" GLMU *" van" a cmmom STAW OIL CW VATI2-9-73 Immm m DATA JAWYM Max I WALS WA41 h�X AJS 1-'::L OAC. �--- N*OH [M1VOoHO] KJ o od @o 10820 Wayzata Blvd, Minnetonka, Minn. 55343/612.546-3281 The following specifications are issued in compliance with all �/�/.Old ✓ health and construction codes stipulated. All equipment specified herein is NSF approved. The proposed private swimming pool is to be constructed at 7 31R7 j41LJ. located in The following specifications include only the installation of one _ACl inyl liner swimming pool and shall not be construed to include any additional structure or shelter hereafter referred to or implied. Fence requirements are to be done by the owner as shown on the drawing. Any and all changes to these specifications must be approved by Minnetonka Pools and the department of public health, prior to construction. ..These specifications do not include operational permit fees or inspection fees. S C'at� yc� Tio w� 'V. ' i�/�✓c'G�S� DISTRIBUTOR OF FOX POOLS / STRONGEST NAME IN POOLS LOCATION: Zhe pool is to be located as shown on detail print. The filter and heater are to be on the grade of the pool in the location indicated. The existing building and terrace shall be .the determining source of placing and elevation. POOII The construction of the pool wall is of 14 gauge copper bearing steel, with 2 oz. of copper bearing galvanized per sq. ft. as manufactured by FOX Pools with a 21, mason sand bottom. The steel wall_ erection shall be accomplished as directed by Installation Manual, issued by FOX pools. The pool design shall follow specifically the configuration as shown on drawing. Vain drain to be 2" deeper for proper flow or water while filtering. The transition as shown on plan. GROUNDING AND HOQK-UPI The steel panels, the steel concrete reinforcing, the deck reinforcing, ladders and any other miscellaneous metal fixture within 10 feet of the pool perimeter will be grounded to conform with State Electrical Code. See print cross section for con- nection details. The filtration pump shall be wired to a minimum of 100 AMP circuit, 230 volts utilizing a circuit breaker and onepull switch. All mechanical electric components are to be installed to kinnesota State Code. These specifications are not to in- clude any service to filter area. GENERAL INSPECTION REMARKS The completed pool shall be inspected to assure that the entire filter system is free of leaks, the tank is clean and disinfected and proper safety precautions are implemented by the owner. The specifications do riot cover decks, however, supervision to assure proper installation of ladders is provided. These specifications omit sanitary sewer, bath and wading areas. Minnetonka Pools, Inc. shall maintain temporary con- struction fencing to warn passers-by of the excavation and equipment. It shall be the owners responsibility to furnish necessary additional safety equipment. There are not port- able water sources included in these specifications or in the pool area. These specification shall supercede any and all former specifications published with regard to this pool by this company. Minnetonka Pools 0 RECIPROCAL PLUMBING: All piping shall be located as to meet state code. The skimmer and return lines are to be 12" black plastic 80 lb. test pipe. The main drain is to be 1l" 80 lb. test black pipe. All joints that are buried are to be nylon or FVC double clamped and caulked. External manifolds of 12" galvanized steel and copper gate valves shall make the control manifold as shown on print. The pool tank fittings are to Cycolac. The returns are Cycolac'eyeball type restrictors l" inside dimension. Fed returns are to be placed to obtain maximum surface circulation. The returns shall be connected in pairs to the return manifold as shown in print. The main drain shall be cycolac 7-3/4 inches round, hooked to a 12" common manifold 'by a 1j" line. Piping and drain location to be laid according to State Code. automatic skimmers NSF approved, shall be located as to give proper circulation. Skimmers are to be installed as indicated. Suction lines inside skimmer are to accept vacuum hose for bottom cleaning. FILTER AND PUNPe One pump and.,filter combination shall be as manuf ured by �q sR-HY446 omp Each nk shall e 24 rhes n dia eter an al have 3.142 s ft. of filter media. Each pump motor is i P. d capable of 84 GPN: which will facilitate 22,600 gal s of treated water ach 6 hours. DISINFECTANT: Chlorinator, Erosion. ADDITIONAL SAFETY EOUIPMENTi The pool equipment shall include the following items: One test kit containing accurate tests for chlorine residual, PH test, alkalinity content and acid demand. The vacuum 4s -tem shall cons-! ;.' of one vacuum hose, one vacuum sweep, and one collapsable pole. The cleaning equipment shall be one wall brush and one leaf and debris rake. The pool shall be equipped with one - two tread stainless steel ladder and one 3 tread SS ladder be placed as indicated on location print. The ladders shall be removable to facilitate cleaning. The safety rope shall be placed at the transition point from shallow to deep and consist of 2" nylon rope and 5 floats. A schematic showing operation, backwash, balance and priming shall be posted near filter area. The schematic shall be labeled as to each gate valve and show sequence of operation fcr normal backwash and cleaning use. THE STRONGEST NAME IN POOLS K� fll_\Y_AL aWdl e e ff?Yvl 01v%��nN�}1n LLK o o M,I' loot, 51 0L CS'1WIITPfIM 0 o e z cw, Ll vua w(t 6sDW0l LOO Uiscg@_4 I aw l 0 0 o 1 (K_ o c IV I C�o�ttT11.�. I nf@nl a-a�_dd uuag '4-RkWO-1 �-aii a Q o6 �01 c11 iI-@1 J bow Voux LOO pv@Msb InW_myNb. AAk.44iil4C.oA. dITICi(r, �li�t�'„ c21��iMKe;fl�nFir�i{1ca (o ' o ✓ n_ 0�1'_o"�G� OO �o;ol'L.TRo_11�, Non -Corrosive Throughout For strength and beauty, the Cycolac filter tank is wound with more than 17 miles of fiberglass ribbon, im- pregnated with resin, creating a filter tank that is virtually indestructible and completely non -corrosive. The entire filter assembly—tank, pump and valve—is designed so that pool water never contacts metal parts. UL Approved for Pool Use The revolutionary pump and motor used in all Fox filters are the first permanently wired in -ground resi- dential pool pump and motor to earn Underwriters' Laboratories listing, THE SPACE AGE SWIMMING POOL FILTER A totally non -corrosive filtration system utilizing giant Filter tanks for greater efficiency. achieved only after long and rigo- rous testing. Non -Staining Because water never touches metal filter parts, staining of pool liners and pool water is completely eliminated. Economical Operation Fox High Velocity Sand Filters are designed for efficient operation at minimum electrical operating costs, resulting in both effective and eco- nomical operation. Proper Circulation Assured All Fox filters are equipped with large 1'/Z" influent and effluent lines to assure maximum flow rates, thor- ough circulation, and truly effective filtering. Six -Stage Fox -a -Matic Multipart Valve This unique valve design, housed in a rugged molded Cycolac body, offers easy -to -operate lever action. The design assures exceptionally low pressure drop with maximum efficient filtration. Includes built-in sight glass for convenient backwash viewing. Single Media Required The Fox filter requires a single .45 to .55 mm silica sand base for media. THE CAREFREE FILTER ... for carefree pool ownership This unique Fox filter body is fabricated of strong durable Cyco- lac, then covered with more than 17 miles of fiberglass filament, im- pregnated with resin and wound perfectly to the shape of the filter body. This is the same process used in the production of rocket nose cones, rocket motor cases, and jet airplane gas tanks. The Fox High -Velocity Filter is a permanent media sand filter—corrosion-free, virtually indestructible. Designed and manufactured for quiet, economical opera- tion, it produces crystal clear pool water effortlessly. A Fox High -Velocity Filter, matched to pool capacity, is standard equipment with every Fox Pool. FULLY AUTOMATIC j VALVE OPTIONAL For completely carefree pool maintenance, install a Fox Automatic Valve that knows when to backwash itself and does it auto- matically. Fully corrosion -free. CLEAR VIEWING LID This "Lexan" viewing lid and sight glass lets you see what's happening inside your pool filter at any time, and the pressure gauge in the lid signals you when it's time to backwash. Removal of the lid permits easy servicing, and a high pressure twist lock holds the lid firmly in place. CORROSION -FREE INTERIOR, TOO The vital internal components of the Fox filter are completely rust free and are un- affected by wear. This unit is designed for balanced flow that results in longer and more complete filtration, as well as more effective cleaning in the backwash cycle. MULTI -PORT VALVE Like the filter tank, the Fox Multi -Port valve is totally impervious to rust and features a heavy-duty Cycolac body and cover. An easy -to -operate fingertip control handle provides fast and easy selection of posi- tions for filter, backwash, waste, rinse, closed, or circulate. T the fi Iter pump that won't corrode, won't stain Like the filter tank, the Fox filter pump is totally rust -free and immune to the effects of all types of water and normal pool chemicals. This assures a constant supply of pure clear water in your pool, an absolute end to staining caused by metal corrosion, and longer filter life because metal parts are never exposed to water. Fox High -Velocity Filters feature the first permanently wired in -ground residential pool pump and motor to earn Underwriters' Laboratories listing, achieved only after long and rigorous testing. The possibility of electrical leakage to pool water has been eliminated in this unique filtration system. Fox filter pumps are available in four models, ranging from 1/2 HP through 11/2 HP, selected and sized to match O the capacity of each Fox pool. R plus tease inipo "ant ciil l QJ • A long-lasting high performance impeller, with a unique safety design, is the heart of the pump. O All exterior parts are made of high strength thermoplastic tested and proved for pool filter pump performance. O Yoke and hand knob provide quick and easy removal of the cover and the large strainer basket. O Large capacity strainer means this system requires less frequent cleaning. O Leakproof operation is assured by the use of reusable "O" rings. O An oversized industrial seal and stainless steel metal parts provide This cross-section of the Fox filter pump life for the entire pump system. shows how the motor shaft and frame (red) are fully shielded from the water O The high-powered long life G.E. motor is specifically designed for (blue) by a non-conductive barrier of high - swimming pools and includes "burn -out" protection. strength polycarbonate thermoplastic. Fox Multi -Port Valve Operates with Fingertip Control The Fox Multi -Port Valve supplied as standard equipment with all Fox High -Velocity Sand Filters is a unique six -position filter control valve combining outstanding hydraulic and mechanical character- istics and piping versatility with a rugged non- corrosive body constructed of heavy-duty Cycolac. The valve is controlled through an easy -to -operate lever -action handle. ® The efficient design of the Fox Multi -Port Valve assures low pressure drop and positive sealing in all positions. ® Automatic self-cleaning design prevents clogging or sticking. (9 Control handle rotates on a non-metallic bearing. There is no need to shut down the pump to operate the valve. FOX HIGH -VELOCITY SAND FILTER SPECIFICATIONS MEMBER Sand Pomp THE STRONGEST NAME IN POOLS Average Actual FOter INSTITUTE Peal Fester Fdter Media Motor Fox -A -Matic FAter Ternover Average Model POOL Volume Tank Area .40 to .55 Assembly Mnitiport In Backwash No. Type—Sae—Shape (Gallons) Diameter (Sq Ft) on (LBS.) (H.P.) Valve Sae (GPM Hors (GPM) 24" tank 1 1224 Rect. 7,870 2.92 1/2 HP 1 1228 Rect. 9,450 3.50 F3-224 II 1632 Rect. 500 24" 300 11/2 ' 45 ��$_. /f50 6.30 11 1732 Ova 17,014 I 1527 Oval 10,670 3.95 II 1636 Rect. 18,940 5.74 24" tank III 1836 Rect. 22,800 6.91 3/4 HP II 1736 Oval 18,530 5.62 F3-225 II 2235 Kidney 20,450 24" 3.14 300 % 11/2' 55 6.20 63 II 2235 Pear 20,980 6.36 III 2142 Roman 25,450 7.71 IV 2040 Rect. 29,730 7.62 24" tank II Lazy -L 24,600 6.30 1 HP III 2141 Oval 28,620 7.34 F3-226 III 2541 Kidney 28,630 24" 3.14 300 1 11/2' 65 7.34 70 III 2541 Pear 29,330 7.52 24" tank F3-227 IV 2440 Rect. 35,090 24" 3.14 300 1% 11/2' 75 7.80 85 1% HP 30" tank F3-228 V 2448 Rect. 42,360 30" 4.91 500 11/2 1%11 89 7.93 90 11/2 HP i 1 MEMBER NA THE STRONGEST NAME IN POOLS APPROVED MUM PW INSTITUTE York R.D. 5, Pa. 17402 Form #pF18-21C-1 Litho in U.S.A. • ' 53-84-879001 of p7idloy • Applivatlon for Plu�t•�=:7:3 �dc ��� � il;�l�� PeT�:�ii •• • • .73877 Dopt. of IIldps. 'Photo S.�J.3SS0 ' DESCRIPTI011 0: 4'101t2': I.an® �i3Oz, •umy,= and Locraoa of Fixtures ' City of Fridley; �' Z 5 � r : I t j •'ir�i $ iS ■ o .. ' � :' u 0 A w WAT[l MTS. ens r:cc. ' it for rk The undersigned hereby mskes'ap?.ict`a co.da::ce with tt:e C'tt7 o0:d:r ` 3 o I . s . 3 • _ : o I w 3 t u i specified, 3,,. Being to do all work . hereby declares that 2A the _in is• ' I1 and ruling of the D,;pa:trne:)t of IIui1W'ags. and are true ar+d corre.-t' Es:r and represcrtatlons stated in L':i: applicaLon l� I ns• al p ol. ea er�•idley, L:ian 7-20-76 Hans F'lorell - Owner 3:d -"" frame Kind of Building Goarts::d with res. • Fu:a.•o C -Z reua t`j4C..'r.;a u.crer C3 Uscd as s New Fl::ture. old 0P;nub%p C,czzpco! I] 7-27-76 To be completed about Estimated Cost, $ 10 00' PARTIAL RATE SCHEDULE - TOTAL Old --N Suilding Permit No. Z O� LL'tii8111C FIXTJ?E RATES: NO. RATE _ Signc � Number Fixtures ..... • • • •'• • • • • • • ---.-•-- X S'-•00, S MINNEGASCO gy Future llxture Opening . • • • • •'• • • • • X .50 S , ..----- �--- $1 Buain= T'hure No • New Fixture Old OyrninK..•• • • •'• • • • ----- x 31.50 i....-»- — • x53.25 $ . Catch basin .................... r-- . Yater I[eater 'UP to 99.000 BTU) • • • • S.3-00 --- x 53.00 S ROUOIi, - Neo+ Ground Run Old Bldg.:. • : • •'• • ----- x .1.25 S-------- S �3=77�' S2•00 TOTAL FIYAI, �— �—•- . 11.S T'1TTING FEES: N 0. R� ' • Ist3Fixtures ••••�•••••••••"" __'+'�" 1►d�tU4nj1 Fixtures ..:............ ------- G:s R=ze to 199.00 BTU .............------- x $5.00 5..�.--•— .50 State Surcharga o..?t:�3 k 11L.:iRATIONS—P.�fat to Cods .pe;crly.lon 700 • Torre. FT:.r: 5.--=--_ CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 7 7 RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the Furnace Shell and Duct Work, Burner - �® `� O city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $ that all the facts and representations stated in this application are true and correct. 2 ,1991 Gas Piping (Needed with new furnace) $ 10.00 $ n e- Fla re (i OWNER ��-he/'r Gas Range $10.00 $ / � BUILDING USED AS Gas Dryer $ 10.00 $ e ESTIMATED COST 2y, S_� PERMIT NO. l �� *Air Conditioning -All Sizes $10.00 $ 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 Wate (Warm Air) Trade Name _�jQ Size No. Commercial/Industrial BTU HP EDR 1 % of Value of Appliance or Work $ Fuel S . Total Connected Load State Surcharge $ .50_ Burner Trade Name Size No. p S� BTU HP EDR TOTAL FEE $ 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. HEATING C06ANY Signed By I]& Tel No. q75=33® % ry r v Approved By _ Rough -In Date Final DateAL4 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (ef No ( ) 2. Is free from rust or deterioration Yes (,/j No ( ) 3. Has no foreign objects lodged within Yes ( ) No (vr 4. Is securely supported Yes No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (.�j� No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date q'Z�1?2-- 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 All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On August 1, 1995 JOB ADDRESS���� State Surcharge x.50 TOTAL FEES MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU HP EDR HEATING COMPANY hM°'P Signed By _E a - . ; Te_ J No. (612. S-2-C45D Approved By Rough -In Date Final Date FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNACE The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and $ 30.00 $ representations stated in this application are true and correct. /1�7 167 ,1991 $10.00 $ l7ztl � 79Y -573T � � OWNER $ 10.00 $ BUILDING USED AS <`� $10.00 $ ESTIMATED COST PERMIT NO. - O.$25.00 $25.00$ 12ESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name EdU e:X CU Size No. BTU a9 -0n o - HP EDR $ Fuel Total Connected Load State Surcharge x.50 TOTAL FEES MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU HP EDR HEATING COMPANY hM°'P Signed By _E a - . ; Te_ J No. (612. S-2-C45D Approved By Rough -In Date Final Date FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Yes () No ( ) Yes ( ) No ( ) 11 SUBJE& IT NO. City of Fridley 28276.== AT THE TOP OF THE TWINS ?• BUILDING PERMIT t `NO. : COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. � 1 . � NUMB. TREv DATE PAGE OF APP EO BY i "';•� CITY HALL FRIDLEY 55432 -_-.A 1 612-571-3450 910-F15 10 15198 JOB ADDRESS 7387 Mem v Laine I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kitt Florell 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Citywide Home Imp. 1005 W Broadway - - 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 O NEW ❑ ADDITION O ALTERATION Wx REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house and garage (23 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1971 .98 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $62.25 Fire SC $1.97 PLAN CHECK FEE TOTAL FEE Licens C $5.00 $70.20/ SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI ENZPMPERIIATED THI IS OUR PERMIT S,GNATURE OF OWNEROF OWNER BUILDER, IOATEI BLDG 1,SR - QAtE 11 NEW (1 l�,Bjl� ADDN (( CITY OF FRIDLEY ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: T Owner Name & Address: Contractor: �� Address: / ` k i Effective 8/l/95 MN LICENSE # 7zfL.�. 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 Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot (] Ft. Yd Setback Side Yard Setbacks 23 Type of Construction: 1�/Estimated Cost: $ Approx. Completion Date: %% /- 71 9 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 F = Ft x $ _ $ DATE: APPLICANT: Tel. # Permit Fee $ laz— Fire Surcharge $__1_,92_ State Surcharge $ �9c SAC Charge $ License Surcharge $ 5-106 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS* ill--, 4 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / 10th %) $.50/$1,000 Valuation $850 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 [ ] COMBUSTION AIR VERI CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2001 A31 University Ave NE .ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING. VENTILATION, '63-572.3604 REFRIGERATION AND AIR CONDIITIONING SYSTEMS AND DEVICES JOB ADDRESS -7 38-4 I"16rrty RATE SCHEDULE OWNER C^ TL 2 F_L C1 iLc �L- tesidential Rate TOTAL 1A C Furnace Shell and Duct Work, Burner - c BUILDING USED AS O Also Replacement Furnace $ 30.00 $— Q.—/ ci , (Side Vent - Fill Out Back) ESTIMATED COST t1000 PERMIT NO. Gas Piping (Needed with new furnace, $10.00 $ but not replacement) DEvif mn OF FURNACK AND O BURNER Gas Range $10.00 $ No. of Heating UniIs 1 Circle One (Steam) (Hot Water) (Warm Air Gas Dryer $10.00 $ Trade Name G_40yR''%0Li ze No. BTU_$,$,, o 04_ HP EDR 'Air Conditioning • All Sizes $ 25.00 $ Fuel Nei - G ,"S S Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR :ommercial/Industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work In strict accordance with the City Cods an State Surcharge S .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE 50 $.3o representations stated in this application are true and correct. DATE "c -7 - O,S li1NIdMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING �ES ra` ���s �Ga AQ tEFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 M.US THE .SO STATE SURCHARGE Signed KVTEL # 6(?_- t $ MINSPECTION FEE $47.00/Hr ' Air Conditioners can not be placed in a side yard without ApprovedBy Rough-in Date Final Data written permission from adjoining property owner. COMBUSTION AIR VERI Mar 07 03 02:48p p®3 .MRR-07 2003 11:50 FROM CITY OF FRIDLEY TO 6127242018 P.03/03 THE WOW MUST BF SUM IN MEN REPLACING FUEL. BURNING APPUANCES OR THE APPLICATION WILL BE RETURNED When the undersigned hereby verifees that the venting has been emn tied and Is free from rust, deterioration. obstructions, and is securely supported and fbwtopped where required. Yes No( The venting system is plastIdPVC and meets all current codes and nrdrwradurer spedications includiM sizing, length, number of elbows and termination. Yesj No( The undersigned also vertWm that the replacement unit is a listed assembly and meats the current nodes and manutaaturees speo+tications. This does include AGA-GAAAA Category 1 Central Furnace Venting Tables forum asdftd and nak rW draftapplances. Yes/)No( ThuIs sized and installed to most the current codes t` and manufactuWs spec fireitions. Yes ( N When requited to ' will be srZed and installed to mast the current codes and manufacturer's specifications Yes No ( 'When frtdmwnn 2 riffiaganting somm I the undersigned herby verfies that it is a fisted assembly and meets the moment codes and manufacturers spa tcations. This does include AGA -LAMA Cale" I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No Is the common vent sold vent connectors sized and inste ed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes 0 /No ( )' AI>>tlancu PIType , :; -� _ BTU Input ^a Fan Assisted o a Appft" #2Type BTU input_ Fan Assisted or Nat Appflanoe *i Type BTU input. Fan Assisted or Not Totral Applances Total EW Input,,,M Commron Vent Tye Vent Height Diameter App kPce #1 Vent Connector HeW _ft Length ft Diameter _____in Type Applranca 02 Vent Connector Helght ft t ength ft Diametet__,_­in Type Appliance m Vont Connector Height ft t ength ft Diameter�ln Type HEATING CO: �C-S1-0Cw i%AL G : •�'2 Signed %r Date: 7 — 0 7 TOTAL P.03 CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 May 18, 2004 Ms. Cathryn Florell 7387 Memory Lane NE Fridley, MN 55432 Re: Final Inspection at 7387 Memory Lane NE Contractor: Residential Heating & AC Dear Ms. Florell: A mechanical permit was issued on March 10, 2003 to install a furnace 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 the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and the permit will be expired. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES F� TOW $35.00 $__ $10.00 $ $10.00 $ $10.00 $ *Air Conditioning - All Sizes $25.00 $ `5"` O 1-C-^ r'-0 yc )-5A e C 6 Z14 Z -Tu c3 SC -r-- 2 All Other Repairs or Alterations (List on Back) 11/1, of Value -0f Appliance or Work $ Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater. on work less than $500.00 Commercial/IndustriaAns utional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/IndustriaVInstitutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/1-IOUR - JOB ADDRESS_ -735-J M, (,Tnn � Air Owner C Building Used As H 6 ^'t C - ESTIMATED COST Z6 0 0 PERMIT NO t # of Heating Un _ 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 $ and rulings of the Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. $ .50 $ *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Tel # 6 o Z- 7Zy-1$qf FAX # (a i Z • i Z'-(- Zs91 Date_ 6 Approved by Rough -in Date__ Final Date ----From: 6517484220 Pa&e: 2/3 Date: 6/14/2010 1:11:19 PM Building BUILDING Permit No.: (,� 0 Inspections 1763-572-3604 RESIDENTIAL APPLICATION _ Received By:o e 763-502-4977 FAX CITY OF FRIDLEY�ea' N 1 n in EFFECTIVE 1-1-2010 DATE YOUR E-MAIL ADDRESS SITE ADDRE S 3 Q 2 1 ,&' A. C` THIS APPLICANT IS: DOWNER wed RACTOR _._,..._ PROPERTY OWNER/ NAME: TENANT ADDRESS::,:, 77 i* (rix9Z 4 A//� �G[ rnr_ jr-�1 tJ L L Si STATE P PHONE:-�6,� 7 Hz '�� CONTRACTOR NAME -__/= SUBMIT A COPY OF 0 YOUR STATE LICENSE STATE LICENSE N 2 EXP DATE / G AND CERTiE7CATE OF ADDRESS: /L."'y Gu�tC.r/G-?c !�� .S� u77� CDyy2b,Gj / STATEfiPS'__ t/ZSr INSURANCE PHONE G -f FAX PROPERTY TYPE O SINGLE FAMILY/NEW CONSTRUCTION SIZE D TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE D ADDITION D GARAGEISHED D WINDOWS D BASEMENT F941SH D ROOF D DRAIN TILE D DECK D SIDING G PSL O97 tR +� LSO l� TYPE OF WORK: O NEW HOME CONSTRUCTION Q ADDITION D MAINTENANCE/REPAIR O REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMW LENGTH WIDTH HEIGHT S FT ROOFING © HOUSE ONLY NUMBER OF SQUARES D HOUSE & GARAGE BASIIVI>3NNT RF MODELING SL19Mrr_ I. Existing Floor Plan PROPOSED SIZE: D ATrACHEDGARAG6 13 DETACHED GARAGE 2. Proposedfloorplan 3. List of structural members to be used PROPOSED HEIGHT: SMEWC FOR NEW CONSTRUCTION INCLUDING DECKS, D Vinyl pSaffit AMMONS, & PORCHES SLU MIT: O Aluminum O Trim I Site Plen/Sun V showing the existing structures D Otber D Fascia and ect of Ponshtrction 2. Two sets plans IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS 3. EneW Calculations FOR WINDOWS -PROVIDE U -VALUE AND OR FOR NEW OPENINGS-DFSCRME SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WRJDOW► TO BE INSTALLED NUMBER OF WINDOWS •, rr+r+v raa�r+ aewra� vl� rAL#4JJ%l<JL1V1N01 A%oJUV"1n%v AtM %.Vali VP LlliiVli A1VlJ MAliniKlALn72 �jSING THE 1997 U.RC FEE SCHEDULE) TOTAL JOB VALUATION $ � 0 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $.001 times the total job valuation Surcharge $ '-9 ' .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Detertnined by Engineering Sewer Main Charge $ _ Agreement necessary ( ) Non Necessary ( ) Total Due S ik— _ f'A Makin rhnrlra nownhle in- Vihr of 3Mdlav Afioah CHnn1e10nn 1 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which reclukee4s review and approval of plans. � , SIGNATURE OF APPWCANT �%�"A9j die PRINT NAME / /J`d &Aff � n /"///— DATE. 41!:00040