PRE 2010 DOCS'1
SUBJECT
Pt RM IT
City of Fridley
715 2
AT THE TOP OF THE TWINS
B U I L I N G P E R I
I
COMMUNITY DEVELOPMENT DIV.
r ° PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
A R VE B
j J \ 612-571-3450
910-1715
5/19/83
JOB ADDRESS 6410 Starlite Circle N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2A
1
Doty Wellner SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
J. A. Menkveld & Assoc. Inc. 540 Greenhaven Road 421-9060
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP SE NO.
Before digging
6 USE OF BUILDING TELEPHONE - ELECTRIC - GA3 Etc.
RE= Residential
7 CLASS OF WORK 4&W
❑ NEW ❑ ADDITION El ALTERATION El REPAIR ❑
X
8 DESCRIBE WORK
Construct a 24' x 22' Double Unit and a 22' x 22' Garage
SEPERATE PERMITS REQUIRED , `j:
9 CHANGE OF USE FROM HEATING PTLUMBING AND Si�NS,
STIPULATIONS Provide sod in the front and side yards. Provide a hard surface
driveway. Provide City with copy of verifying survey.
Sewer Location: 101 South of Water
WATER LOCATION: 91.5' NW of MH Satellite & Starlite & 96.5 West of Hydrant
DRIVEWAY DEPRESSION: N/A
RT; Paid Park Fee of $406.25 W OTY OF FMOL" DINS NOT GUARAWR TIS
ACCUPACV OF UTILITY LOCATIONS AND 1 LEVATION&
THIS oAJA IS FOR IWO&MATION PURPOSES ONLY AND
PERWNz' IJP ..It amou451 wow TMi 600"ATI M
ON THE SM
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Wood Frame
VENTILATING OR AIR CONDITIONING.
THIS PERMIT 'BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
1452
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
$ 62,750
$31.38
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE 9R, CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISION OF N OT ER STAT"R LOCAL LAW G LATING CON -
$322.00
$425.00
TIO O T E RMANC F4CONSECTI
PLAN CHECK FEE
TOTALFEE
$80.50
$858.88
IGNAUREO O OR(DATE)
s WHEN PROPER ALIDAT THIS IS YOUR PERAMIT
•QlA
5 iY • (
BLDA�DG )NSP
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
'1
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATION -FOR RESIDENTIAL BUILDI;JG PERMITS
(Near. Alterations. Additions, or Repairs)
OWNER: BUILDER: �_ M Fc A J'14 L)0L 0 C,
ADDP.ESS: ADDRESS:_ _�L16- �l
TEL 110: TEL NO: 4-L i ® 1'®G fJ
o
Construction Location
• STPMT NO: STREET:
LOT: �� su=: � � ADDITION:rU. ,4j
Corner Lot: Inside Lot: Setback.: Sideyards:
Ap?licant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOR OF MI-ISTRUCTION
1= Front:
SgZar�eeet: � �
cnk-
n� Front:
Square Feet:
Depth: Height:
Cubic Feet:
lepth= Height:
Cubic reet:
n e of 0Dr.5truct10ns s Estimated Cost: 14WO .04
'!b Be tbr..pleted: o
Alt. A Alt. B
Proposed Driveway Width If New Opening is Desired: U
SEE MVERSE SIDE OF SHEET
Me undersigned hereby snakes application for a permit for the :fork herein specified,
agreeing to cb ,all work ir, strict accordance with the City of Fridley Ordinances and
rulings of the DeIMItment of Buildings, and hereby declares t� t all se facts and
representations stated in this application arerue,and co:rkctl.
3X1TE: <— 17"t 7> SIGNATUI£:
Stipulations:
Qcq-f1.-�rT
P.C.
'S
T��P'&aL c -mi
S43
pit. I
tip ►�o
40 (Ir -
0.
I PLC -C, k.3
BUILDING PERMIT FEE SCHEDULE
The Inspector of buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any
•xisting building or structure, or for any alteration or repairs
to any existing building or structure, upon application therefore,
require the payment by the applicant for such permit of tees to the
amount herein below set forth and in the manner herein provided to -wit:
Mix VALUATION FEES
=1.00 to $500.00 $10.00 Xinim= Fee $15.00 plus surcharge
$S01 to $2,000 $10.00 for the first $S00 plus $1.50 for each
additional :100 or fraction thereof, to and
Including $2,000
$2,001 to $25,000 $32.SO for the first $2,000 plus $6.00 for each
additional $1.000 or fraction thereof, to and
Including $25,000
$25,001 to $50,000 $170.50 for -the first $25,000 plus $4.50 for
each additional $1,000 or fraction thereof, to
and including $50,000
00,001 to $100,000 $283.00 for the first $50,000 plus $3.00 for
each additional $1,000 or fraction thereof, to
and including $100,000
$100,001 and up $443.00 for the first $100,000 plus $2.50 for
each additional $1,000 or fraction thereof
PLAN CHECK: 25 percent of building permit fee
DRIVEWAY DEPRESSION ESCROW: Concrete Club Streets Only
Alternate "A": Resaovial and replacement of curb.and gutter only
Driveway width plus 6 feet s $13.SO
Alternate "B": Reaoval and -replacement of curb and gutter and install a 3 foot
vide approach with 6 inch depth
• Driveway width plus 6 feet x $15.75
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, sharing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
t
IQX Pl-,Od--
47—)e
Gq /0, 1%,
pwua
2. Ono,
C), CYJ
ISO IN
TNM CITE/ OF
OIRECTORATE o0
OF °d o
MEMORANDUM
PUBLIC WORKS
FRI L Y
DATE A st 17 1983
MvMO NO 83-57
u�u 5
FROM D.P.W. Planning -Bill Debl on ti
&-
TO
ACTION
INFO.
SUBJECT
AIR CONDIT �NG UPIITS AT
6400, 64102 6412 Starlight Circle
Bill Sandia
Darrel Clark
X
John Flora
X
I have determined that the units as proposed at the above addresses would
emit noise levels in violation of the city's noise ordinance. The developer
has supplied the city with a letter promising to muffle or relocate the units
if they became a problem after installation. Since it has been determined
that they would violate provisions of the noise ordinance and relocation is
not feasible (the wiring and slabs are already in place), I have informed the
developers that the units must be properly muffled. The developed has
verbally agreed to muffle the units immediately after installation. I am
obtaining literature from a noise expert on how to properly muffle these
units. Any other assisstance that you can offer to resolve this situation
would be greatly appreciated.
WSD/kh
Engineering
Sewer
Water
Parks
StreetS
Maintenance
MEMORANDUM
TO:
Barb Dacy, Community Development Director PW93-179
FROM:
Scott Erickson, Asst Public Works Director�4
DATE:
May 12, 1993
SUBJECT:
6420 - 6422 Starlite Circle
On May 5, 1993, 1 performed a Meld inspection of the above referenced property to verify
potential drainage problems relative to this site and the neighboring property to the south. It
appears that the rear lots of 6420--7,6422. grain to the neighboring property and pond on the back
of this lot. With minimal grading, the drainage from this area could be routed to the street via
a small grassed swale. If you have any questions regarding this information, let me know.
SE:cz
2KK
ri
CaYOF
MDLEY
j
Community Development Department
u PLANNING DIVISION
City of Fridley
DATE: March 21, 1994
TO: William Burns, City Manager
FROM: Barbara Dacy, Community Development Director
SUBJECT: Drainage Complaint at 6410 - 6412 Starlite
Circle N.E.
On March 3, 1994, Mr. Levi Powell at 6410 Starlite Circle N.E.
reported that his basement was flooded. He said that his
basement has never been flooded in the 11 years that he has lived
there. Later the same day, Gary Wellner, who owns the unit at
6412 Starlite Circle N.E., spoke to Gary Ford regarding the same
problem.
On Friday, March 4, 1994, 1 inspected the property and met with
Mr. Powell and Mr. Wellner. Runoff between 6412 Starlite Circle
N.E. and 6422 Starlite Circle N.E. had backed -up because snow had
been piled at the point where the water flows into the cul-de-
sac. Gary Ford a-nd Scott Erickson also inspected the property
earlier that afternoon. Wellner contends that the City was
negligent in approving the permit because the twin home was
constructed at a higher elevation than originally contemplated.
Further, a concrete sidewalk in between the south side of the
building and the lot line helped to block the storm water on
Bauer's lot and forced the water onto Wellner's property.
Bauer Construction submitted a drainage plan at the time of
permit issuance which indicated that the runoff on the property
would be directed in between 6422 Starlite Circle N.E. and the
lot line. Staff's position and the City Attorney has agreed that
this is the plan that the developer submitted in conformance with
the variance action and the developer is responsible for insuring
that the runoff is discharging from the property as planned.
Scott Erickson has also identified options for resolving the
drainage problem.
Drainage Complaint; 6410 - 6412 Starlite Circle N.E.
March 21, 1994
Page 2
The City Attorney has determined that the City has not incurred
any liability for issuing the building permit. I recently
contacted Bauer and established Thursday, March 24, 1994 to meet
Wellner and attempt to resolve the drainage problem. I will
advise you about the results of their meeting.
BD/dn
M-94-130
cc: John Flora
Scott Erickson
SUBJECT
P
of Fridley
28380
7Citt THE TWINS
BUILDING
PERMIT
r
RECEIPT
' COMMUNITY DEVELOPMENT DIV.
�------_
INSPECTION SEC.
r � PROTECTIVE
1 � �
i �r---1;'� CITY HALL FRIDLEY 85432
NUMBEN
REV
DATE
PAGE OF
APPROVED BY
----
1 612-571-3450
s� _F15
10/22/98
JOB ADDRESS
6410 Starlite Circle NE
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2A 1
1 Doty Wellner
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Levy T. and Stella D. Powell
572-9416
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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 ❑ ADDITION ❑ ALTERATION Rx REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 15 S 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 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
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
$1285
$.64
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
43.00
Fire,$C `N 1.28
PLAN CHECK FE
TOTA EE
.92
SIGNAi E OF CONTRACTOR OR AUTHOP41ftO AGENT iDATE,
EN R P
ft -NS
V LIDA E THIS IS OUR PERMIT
O�
J/Z>
SSG AT, qE OF OWNER ,iF OWNER BU LDERi iDATE,
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
CP�iCq
ConstructionAddress:
Legal Description:
)<Owner Name & Address: Tel. # 5 7C7- g�f
Contractor- LICENSE#
ON Z/
Address Onff'onwe'451V
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
GARAGE AREA: Length Width Height
DECK AREA: Le Wi th Hgt/Ground
X
OTHER: �� �� Ttie
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: Q'55, Estimated Cost: $ �� 144_
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE://z APPLICANT: 4_.,m —Tel. # 5 .A q VZ
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ "413,0()
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ �o
$.50/$1,000 Valuation
SAC Charge
$
$1000 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 [ ] Not Necessary [ ]
TOTAL
$
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
TOTAL VALUE FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,00,000
$1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
SUBJECT"PERMIT
NO.
City of Fridley
33118
AT THE TOP OF THE TWINS
BUILDING
PERMIT
Ir
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
a: ___ -__ PROTECTIVE INSPECTION SEC.
r
E
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55/32
j 763-571-3450
910-F15
9/26/02
JOB ADDRESS 6410 Starlite Circle NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2A
1
Doty Wellner
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Stella Powell 6410 Starlite Circle NE
763-572-9416
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Master Remodeling Inc 32 Tenth Ave S, Hopkins, MN
55343 952-932-9311 20012916
d 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
REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace 4 windows and 1 patio door within existing
openings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms
and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building
Code.
"M� 'o CI-On Cards
Will B8 M81119d
To Nomeowner To pa.,
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
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
@
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,700
`1'1.35
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-
$83.25
Fire SC $2.70
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
License
C $5.0
$ .30
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
01�4EN ROP VALIDATE THIS IS YOUR PERMIT
F—_2
SIGNATURE OF OWNER,IF OWNER BUILDER, IDATEI
RLCZ
INSP nATE 'ZE�m
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: (a 40 544VL /; /i f C"2 w F -
Legal Description:
Owner Name & Address: 15A -e IIA &W Z'� Tei. # 7&3 5-7 z
Contractor: 1EMTER REMODELING, E!' MN LICENSE #
Address: sota 55343 Tel. #
Z952)132-0391
ITER1EMAOIl�ELUNTO, Ls ; ;_;AUM MINMplication, a Certificate of Survey of the
E2 TenthAvenue &-,,- � � lot, with the proposed construction drawn on it to scale.
Hopldne, Minnesota 5,7V
(952) 932®93q � DESCRIPTION OF IMPROVEMENT
MK LIC. 20012910
LIVING AREA: Length Width Height - Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER:
Construct' n Type: eL Estimated Cost: $ 2 -7 ®•
ON
Driveway Curb Cut Width Needed: Ft. + 6 Ft t x = $
�r�
DATE: - Z "� Z -APPLICANT: Tel.
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 $ • 3 STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for suc� permit of fees to the amount herein
below set forth and in the manner herein provided to -wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 - $993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1;000,000 $3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses 0nly
CITY OF FRIDLEY PERMIT N�2004-0081
6431 UNIVERSITY AVENUE NE —�
FRIDLEY, MN 55432 DATE ISSUED: 06/02/2004
572-36U4 YAX: (763):-)71-1257
ADDRESS : 6410 STARLITE CIR NE
PIN : 153024410074
LEGAL DESC : DOTY WELLNER ADD
: LOT 2A BLOCK 1
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 400.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER
HEATER.
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0
# NEW FIXTURES (EXIST OPENINGS)
# GAS DRYERS
# OF NEW FIXTURES
APPLICANT
NORBLOM PLUMBING CO
2905 GARFIELD AVE S
MINNEAPOLIS, MN 55408-2173
(612) 827-4033
CSI1010 X1:7
POWELL STELLA V & LEVY
6410 STARLITE CIR NE
FRIDLEY, MN 55432
0 # GAS WATER HEATERS 1
0 # GAS RANGES 0
0 # WATER TRMT APPLIANCES 0
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
AbblicBRt/*� Date
Bldg
PLBG PERMIT MINIMUM FEE
0.00
PLBG FIXTURES (NEW OPENINGS)
0.00
PLBG FIXTURES (EXIST OPENINGS)
0.00
WATER TREATMENT APPLIANCE
0.00
WATER HEATER - ELEC
0.00
WATER HEATER - GAS
35.00
GAS RANGE FEE
0.00
GAS DRYER FEE
0.00
PLBG REPAIR/ALTERATIONS
0.00
STATE SURCHARGE, PLBG FLAT
0.50
TOTAL
35.50
PAID WITH CHECK # 28353
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
;ITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004
431 University Ave NE fir?
`ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT n
763) 572-3604, FAX (763) 571-1287 \"
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
'LUMBING FIXTURE RATES:
Jew Fixtures
)Id Opening, New Fixture
Seer Dispenser
)low Off Basin
,atch Basin
lain Water Leader
>ump/Receiving Tank
Nater Treating Appliance
Nater Heater -Electric
Nater Heater - Gas'''
Sas Range*"
NO. RATE TOTAL JOB ADDRESS 6&'V -Ale, aS 0-W AAAr
$10.00
The undersigned hereby makes application for a permit for the work herein
.....S
ower
$10.00
Wash
Tray
:al?ttt>:::>:::::::
.".........................Dr
Floor
'm
Auto.
:Y'>:•:::.x"::<:::<::>
Washer
:::
Gas
Ran e
:::::
%}�#SRr :....
Water Heater
..........Unna
as E lec
Basement.1-1-111-11 _>>
r
Floo 1
Floor 2
Floor 3
Floor 4
'LUMBING FIXTURE RATES:
Jew Fixtures
)Id Opening, New Fixture
Seer Dispenser
)low Off Basin
,atch Basin
lain Water Leader
>ump/Receiving Tank
Nater Treating Appliance
Nater Heater -Electric
Nater Heater - Gas'''
Sas Range*"
NO. RATE TOTAL JOB ADDRESS 6&'V -Ale, aS 0-W AAAr
$10.00
The undersigned hereby makes application for a permit for the work herein
$10.00
specified agreeing to do all work in strict accordance with the city codes
$10.00
and rulings of the Building Division, and hereby declares that all the facts
$10.00
and representations stated in this annlirntinn arp true and correct.
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
Sas Dryer"" $10.00
3ack Flow Preventer Required ( )Yes () No
Type $15.00
Reinspection Fee $50.00/Hr
%LL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
$ 6b
POWELL, LEVY
6410 STARLITE CIRCLE NORTHEAST
FRIDLEY, MN 55432
(763)572-9416
OWNER
BUILDING USED AS kA/St J e.Y►Ge—
r , 20 D'
ESTIMATED COST q� PERMIT NO.00 ��-11
00�!
PLUMBING COMPANY O Y `OWV
SIGNED BY TEL N0. (&(2)827-1103-?
Approved
(o(2)S2%-`10.-
Approved By Rough -In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST
OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN,COMPLETELYFOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existind furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes O No(
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes O No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes ( ) No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( ) No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes O No( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This. does include AGA-GAMA Category I Central 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 O No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input Fan Assisted or Nat
Appliance #2 Type
BTU Input Fan Assisted or Nat
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
CITY OF FRIDLEY BUILDING INSPEGTION
6431 University Ave NE
Fridley, MN 554;32
763-572.3604 FAX 763-571-1287
RATE SCHEDULE
Repidential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
boos -6)�3 ?
Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
COs ADDRESS r �4`/D 57 Z �%1- 14F
Fee Tot Cr„e �A�L-L_
Owner T
$35,00 $ Building Used As IJI.CC��
$10.00 $ ES` 1MATF-D COST / 400 - 00 PERMIT NO
$10.00 $ DESCRIPTION OF FURNACE AND BURNER
Gas Dryer $10.00 $
*Air Conditioning- All Sizes $25.00
ef-✓uzIGo- 3'rMA,6X�
j All Other Repairs or Alterations (List on Back)
196 of Value of Appliance or Work $
Minimum Fee $15.00 for Residential or 5% of cost of
improvement %vilichever is greater on work less than $500.00
Commercial/ Ind ustria V lnstitutiona l
1.25% of Value of Appliance or Work (List on Back) $
Minimum --Foo $35.00 for CommerclaVIndustrisVinstitutional
State Surcharge $__j-5_0
TOTAL FEE
REINSPECTION FEE $50.00/HOUR
*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
0 of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected toad
Burner Trade Name
BTU
Size No -
HP IP 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.
HEATING 00 River City Shep"E Iii-tal, Inc.
suita 3Squ Main St. .
Signed Frid1C}f, MN 35432. Tel �
(763) 754-2199 Fax (763) 754-29
08
FAX # Date
Approved by Rough -in Date Final Date
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
Effective On January 1, 2002
JOB ADDRESS
OWNER 1..i.1iyl cJ Po- W JJ
Rate TOTAL
BUILDING USED AS
$ 30.00 $
ESTIMATED COST Uy®.� PERMIT N0.
$ 10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00 $
No. of Heating nits_ Circle One (Steam) (Hot Water) (rm
$ 10.00 $ Trade Name nits
#A Size No.—S'9 DL-A®Lf S— (0 Y
BTU eco ) HP EDR
$ 25.00 $ Fuel N .Gr. Total Connected Load
State Surcharge
TOTAL FEE
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.
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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEATING CO
Approved By/1y� Rough -In Date
DATE a
TEL # I(p-'� - 02b2--
<�pc
Final Date G `�
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
When re la _ing an_wasting 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 plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes No( )
The axis ing cnmh s inn air is sized and installed to meet the current codes
and manufacturer's specifications. YesNo ( )
When required to install a naw cnmhistinn aOr. ,it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes (? No( )
When ins ailing a new wanting system, the undersigned hereby verifies that �\
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes ) 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 kNo ( )
Appliance Type and Size/Gammen Vant and V _n .nnn _star Inform ion
Appliance #1 Type BTU Input Fan Assisted or Nat at
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 CC
Signed By: