PRE 2010 DOCSCity of Fridley, -Minn.
BUILDING PERMIT N®
!!6J3
Date: WO
Owner: Builder ---.--
Address Address
LQ O ILD11'�1G
No. S' P of jV
Lot
Lot Block Addition or SMid
'
Corner Lot __ Inside Lot Setback � Sideyard - - 04r&&
Sewer Elevation Foundation Elevation
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 forth and in compliance with a& provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of _: ,_ , permit is hereby granted to—
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.
-o*-. A
Building Inspector
NOTICE:
'lids permit does not cover the construction, installation for whins, plumbing, gad 'heating, sewer or water. Be sure to we
the Building law"Oor for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name 'v- W Builder L
Address 3'0 6 -1) 1) JL Address .
LOCATION OF BUILDING
No. Street Part of Lot
Lot Block_ ^_Addition or Subdi ision I tl 10 0A W d J a ""Cx
v �
Corner Lot Inside Lot-_x—setback- Side -Yard d
5 �
SEWER. ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To b u ed as• r r >
Front Depth -=Height
(f Sq. Ft. Cu. Ft.
f
i Front cqr 'dl- Depth• -•-Height a
Sq. Ft.� Cu. Ft. 1�9
Type of Cons tructiocl�'1 Estiffiated Co6 U(�"� -
To be Completed ` -15- a_
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and 'correct.
DATE 6— SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
4L
J
BUILDING PERMIT FEE SCHEDULE
Section 2. The Inspector of Buildings shall, before issuing any permit for
the erection of any building or structure, or for any addition to any exist-
ing building or s-tructure, or for any'alierations or repairs to any existing
building or structure, upon application therefor; 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;
2.1. For any such permit for�the erection of any, fire -proof building, other
than a garage, warehouse, factory or grain elevator, or for the erection of
any fire -proof addition, for similar occupancy, to any existing building
shall be at the rate of..$1,40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2 For any such permit"for the erection of any.fire-proof garage, warehouse,
factory or grain elevator, or for the erection of any fire -proof addition,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feet, classified'as ;'fireproof" by Section 502 of
the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof building other
than a garage, warehouse, factory or grain elevator,.or any'non-fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erection of any non -fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non -fireproof
addition, for similar occupancy, to any existing building or for each such
building or addition - ninety cents ($0.90)'for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with a minimum of $4.00.
For the purpose of computing fees for building permits, the cubical contents
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point six (6) inches below the floor line of the
basement or cellar to the average height of the upper surface'or.to the
average height of the roof surface of the main gable of a pitched roof.
?.5. For repairs or alterations to an existing structure, the fee shall be
at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof in the cost of all proposed worst.
2.6. In no case shall the fee charged for any permit as set forth in
Section 2 be less than $4.00.
k
City of Fridley
Application for Plumbing and Gas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
• Future Connection Openings I Connected with
New Fixture, Old Openings Sewer
Cesspool F1
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
3 U
TOTAL
Number Fixtures ............... '.......
C/ x $1.50
in
3
o
x 1.20
a
p?
O8
,
QZ
V ad
<
U�'
m
�U'
Z
2
�f O
`
R
N
WATER HTR.
GAS
ELEC.
Base
$
'
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures ..........................
x $1.50
$
Additional Fixtures ....................
x .50
$
1st
x 2.00
$
2nd
3rd
4th
• Future Connection Openings I Connected with
New Fixture, Old Openings Sewer
Cesspool F1
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ............... '.......
C/ x $1.50
$-1'5-00
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ...... .....................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......Z
x 2.00
$
'
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures ..........................
x $1.50
$
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE4$
Dept. of Bldgs. Phone SII 4-7470
City of Fridley:
The undersigned hereby makes 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 facl
and representations stated in this application are true and correct.
Fridley, Minn
Owner - 1A r
Kind of Building
A r A . n AA
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No- /, H Permit No.
Signe
By
Business Phon No- /� - 3 `7 'T -T
ROUGH 9 P 10 >1, '1"
FINAL
42 2M
City of Fridley, Minn..
ING PERMIT
Date: _ December 16, 1970
Owner: Kenneth W. Johnson Builder
Same
Address 7430 Tempo Terrace N.E. Address Same
LOCATION OF BUILDING
N 10918
No. 7430 Street Tempo Terrace Part of Lot
Lot _ 3 __ Block 5 Addition or Sub -Division Melody Manor 2nd Addition
Corner Lot _ Inside Lot X Setback __ Sideyard
Sewer Elevation
To be Used as:
Foundation Elevation
DESCRIPTION OF BUILDING
Eirgglace_ Front ___
Depth
Height
Sq. Ft.
Cu. Ft.
Front
Depth
Height
Sq. Ft.
Cu. Ft.
Type of Construction Brick
Est. Cost _.
$800.00
---To be Completed
Dec. 25, 1970
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 se forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 6.00 , permit is hereby granted to Kenneth Johnson
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 andmoving of buildffigs
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
� In,,�ector
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to tee
the Building Inspector for separate permhs for thus items,
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: --e ti GJ ,/0ht7Sa" BUILDER:
f 3 ® ,e �a T arr��� /V,
ADDRESS:oth ADDRESS:
NO •. 7 V 3 d STREET • / e ,tee 5B—
LOT: BLOCK: ADDITION:_ J'w ia�
CORNER LOT: INSIDE LOT:� SSETBACK: 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:
1 V�,� q c�_Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: 13;-1 cEstimated Cost:
To Be Completed: for ea-r`s�Nr�s
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE:* SIGNATURE:— k)
(See Reverse Side For Additional Information.)
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs to any existing
building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount hereinbelow set forth and in
the manner herein provided to -wit:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic r
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average.=
height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: 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 Certified Survey of the lot,.showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE..OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
APPLICATION FOR HEATING OR POWER PLANT AND SPECIAL DEVICE PERMIT
PARTIAL RATE SCHEDULE Dept, of Bldg .
_,..ems T
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ......................... 8.00 $
Replacement of Furnace ............................. 4.00 $
Repairs & Alterations—up to $500.00 ...........' .. _ ... 4.00 $
Repairs & Alterations each add. $500.00 ............... 2.00 $--
MECH._
MECH. WARM AIR
Furnace Shell & Duct 'Work to 120,000 BTU ........... 8.00 $���
each add. 60,000 BTU ........................ 1.00 $
Replacement of Furnace ............................ 4.00 $
Repairs & Alterations—up to $500.00 ................. 4.00 $
Repairs & Alterations each add. $500.00 .............. 2.00 $ _
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $ _
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.00 $
OIL BURNER—to 3 gal. per hour ........................ 4.00 $
over 3 gal. per hours—See Fee Schedule _
G14S BURNER .......................................... <vM. $ �
GAS PIPING (Up to 5 Fixtures) .........................--t-.21T $ �
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
REMARKS:
!8
See Fee Schedule
$
TOTAL FEE $ Z56 5-o
undersigned hereby makes
!spe agreeing to do all work in
d of the Department of Bu
lication f permit for the work herein
ct acco a with the Village Ordinances
sgs, and ereby declares that all the facts
ration are true and correct.
Minn f , 18
185—
1 •I 2M-5-58
Business Phone No ,04 � � ��
Kind of Building -
Used as
195—
To be completed about
Estimated Cost, $
g
Old ew. Building Permit No. -�_
_
DESCRIPTION OF WORK
="
HEATING or OWER PLAN to Hot Water,arm Air o
_
Trade Nam Size No a__>_
TU
Capacity66L Sq. . D.R BTU-
Total Connected Loa 7 / Kind of Fu
Total
o
BURNER — Trade Name Size No -----.--
—_-._Capacity
Capacity— Sq. Ft. E.D. BTU
H. P.
1 •I 2M-5-58
Business Phone No ,04 � � ��
D•S6 s
! HEAT, LOSS CALCULATIONS D EPARTMENT OF BUILDINGS
VE.
Weatherstrips A.S. ..
Guide Construction No.
W idows Doors Reference Out. Wall I Int. Wall I Ceiling Roof Floor I Kind
7
MINNEAPOLIS. MINN.
Insulation
How A- plied
Yes --No = Y esu No 19�
,r' FU �° _. ,
Room! Length 14 Width Heiaht ��� II FI.I :i'-�� Room I Length
Win ows and Doors—Crackage and Area
`l
Width Height No. of Lineal f . Area
No* of pane of pane lige is of crack sq. ft.
llS C_ U U�
Exp. wall'
Coef.
Coef.
Btu
Infiltration"
W$S$1Y
V"
Glass
Floor �v
-�
�11
�!, .�
Exp. wall
Net exp. wall
�7
W�'�
F1.1 Room i Leneth //
Net exp. wall
Height n "
d C,,
Int. wall
Floor
e_
Ceiling,
.
Floor .4--
r
-i ota! Btu. I I � c� '" d',
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
r
F1.1 /14"/ 4"/ Room I Leneth %' Width,/,//,y Heiaht
Windows and Doors—Crackage and Area
`l
Width Height No. of Lineal ft. Area
No. of pane of pane llghte of crack sq. ft.
llS C_ U U�
Exp. wall'
Coef.
Coef.1
Btu
Infiltration
W$S$1Y
V"
Glass
Floor �v
-�
�11
�!, .�
Exp. wall
Net exp. wall
X-' //
W�'�
F1.1 Room i Leneth //
Net exp. wall_;
Height n "
Ceiling
Int. wall
Floor
e_
Ceiling
.
Floor -
r
Total Btu. I t d t-� Y
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
A FI.1 i e Rrvxn 11.snoth ^ /% `, Welth J i 14p;aht f
Windows and Doors—Crackage and Area
`l
Width Height No. of Lineal ft. Area
No. of pane of pane lightof crack eq. ft.
llS C_ U U�
Exp. wall'
Coef.
Btu
Infiltration
/iL
W$S$1Y
r -
-S- C'
Floor �v
Exp. wall s
�11
Total Btu."
Exp. wall
Net exp. wall
X-' //
W�'�
F1.1 Room i Leneth //
Int. wall
Height n "
Ceiling
Int. wall
Floor
e_
Ceiling
.
Total Btu.
sq. ft. E.D.R. or sq. ins. W.A. Leader area
Width ! , Height
Windows and Doors—Crackage and Area
`l
Width Height No. of Lineal ft. Area
No. of pane of pane llghte of crack sq. ft.
e
Exp. wall'
Coef.
Btu
Infiltration
Int. wall
Glass`
r -
Z ; "2.
Floor �v
Exp. walla
Total Btu."
Exp. wall
Net exp. wall
,
J --
-Int.
F1.1 Room i Leneth //
Int. wall
Height n "
Ceiling d 3
Int. wall
FloorAa_� _
Ceiling
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI Room f Length Width" Height .y
Windows and Doors—Crackage and Area
Width Height No. of Ltneal ft. Area
No. of Dane of pane llghte of crack efl. ft.
,EI A I I I I
Infiltration
`l
Glass
e
Exp. wall'
Net exp. wall
Coef.
-!7
Int. wall
Ceiling
r -
Z ; "2.
Floor �v
Total Btu."
Exp. wall
-''Net
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
J
F1.1 Room i Leneth //
Width ea'
Height n "
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
e
Coef.
Btu
Infiltration
r -
Glass
Exp. wall
-''Net
exp. wall
Int. wall
Ceiling
Floor
Total Btu.
ft. E.D.R. or sq. ins. W.A. Leader area
7 9 ' • ' 7
I>'56ry
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS .. MINNEAPOLIS• MIM.
Weatherstrips A.S. V.E. Construction No. Insulation
Guide'
'ndows —NI rs Reference Out. Wall Int. Wall Ceiling Roof Floor-- I Kind How. `A 'lied
eso , e —No 19__
F1.1 Room I Length Width f I-. Height F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width
Height
No. of
Lineal f . Area
No. of Dane
of pane
lights
of crack sq. ft.
4.
-1 r
Exp. wall
®®
Int. wall
Btu
Infiltration SI
Glass �y I S
Exp. wall
Net exp. wall IV7 Yo 12 o
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length Width Height
Windows and Doors—,Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
-Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length ^ ^ Width Height
Windows and Doors—Crackage and Area
Width HeightNo. of Lineal ft. Area
No. ofpane of pane li hts of crack sq. ft.
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ifis. W.A. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
City of Fridley, Minn. 1.38. ,
6431 University Ave. N. E., Minneapolis, Minn. 55432
BU"ING PERMIT
Date; _ A r l 21v 1972
per: -Kenneth Johnson Builder F • Worwa
.Address 2.430 Tempo_Ter_rar..e N E. _ Address 3332 -M 16th A,�ue sSouth
24o 74-40 Street - Tempe Terrace N.E. __ _ _ part of Lot
Lot I Block 5 Addition or Sub -Division —Me22dY--MgnQr 2nd Addition_ .
Corner Lot Inside Lot - R Setback Sideyard _
Sewer IIevation _
To be Used as:
Foundation Elevation
DESCRIPTION OF BUILDING
2 -s ta= addition Front 16' Depth 16Height 20' Sq. Ft. 256' Cu. pt 5s,120
Front Depth Height Sq. Ft. _. Cu. Ft.
Type of Construction Frame Est. Cost $8=510 To be Completed July 1, 1972
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 forth and in compliance with all provisions of
Ordinances of the city of Fridley.
4.26 tate Surcharge
In consideration of the payment of a fee of in -00 , permit is hereby grantedto K_e ne John on
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
city limits and ibis permit may be revoked at any time upon violation of any of the provisions of said
Inspector
CT AE M E BELIST F
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items. p-
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:
6r c.'•?Js✓�!
J C� ,11 �• f �' BUILDER: ,
•���
�n
ADDRESS:
ADDRES S : 3
.7 -7
NO:. 0
STREET:
Y_?,07 40® ;—e ell -l' e-
'el,
LOT: `�
BLOCK •
-ir ADDITION • ,4'1 e- " P y Ai Wv� t
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.
To Be Used As:
DESCRIPTION OF BUILDING
i
Front: Depth: /4" Height: 09-0
Square Feet: _6_Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: rl.~ e -
To Be Completed: °?—f 7 2 -
Estimated Cost: $
r
The undersigned hereby makes application for a permit for the work herein
i specified, agreeing to do all work in sttict 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.
41
DATE: " r 7 SIGNATURE• ;/�-
(See Reverse Side For Additional Information.)
4-
E ,
BUILDING PERMIT FEI SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs 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 U
the manner herein provided to -wit:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.55 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average
height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: 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.
V
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
Land Planning 6875-,g9hwy *Cs NE.
Land Surveying Minneapolls3 p,
Soils TeSMq ENGINEERING, I N C. O1nne--o`7
Civil & Muniapal Sllnm 4-6066
E,7&riny Engineers Surveyors
Mortgage Loan Survey for Jol-m
Y
L
&5 is a 1rce and
if &7 fliertan, arld Of
hviy pbced w the Proper
such mori9a9e. lfls and
,
7
s'
Gy jr
Ail
• �dl 11
I:
Pjjl ',, °►1' �h � �
n'
P � Dt•
n
red represenfafian ofa: survey of 1he bow dames al'the land obne &5c ibed and #"Ae /aah n of all bvildinys,
le enazaachmerrfs,'an[J, )Crom or on -w,d(k d. Thasurvey is mode mg n uvnneetron with v more lawn naw
and no hikhy is ats med excepf to &e holder o`swh mi joye or aa ollrer in&01 at�,uei by MOW
cad and agreed m rmnranents fmre been ped fw /he Purpose r�'es a6hAy /ohms or Owwers.
dad °� l aC. �=j� ;� A� i9 SUBURBAN ENG/NEERING , INC.
_,
6a9imeers rally Survegor5
dor Power PlImb aw H ngK Ye R. 1 a Md
Air COR oning Sydem and Devices
PARTIAL RATE SCHEDULE
GRAVIFTY WARM AIR: RATZ TOTAL
Furnace Shell & Duct Work ................ .. $10.00 $
Replacement of Furnace ...... ........ 6.00 $
Repairs & Alterations—up to $500.00 600 $
Repairs & Alterations each add. $500.00 3.00 $— _.
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ........
$10.00
$
each add. 60.000 BTU ....................
3.00
;
Replacement of Furnace . ..
6.00
$
Repairs & Alterations—up to $500.00
6.00
$
Repairs & Alterations each add. $500.00 .... ..
3.00
$
STEAM or HOT WATER SYSTEM
$
Gas Range to 199,000
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00
$.
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
10.00
$
Each add. 200 sq. ft. EDR Steam
3.00
$ _�
Each add. 320 sq. ft. IDR Hot Water
3.00
$,
OIL BURNER—to 3 gal. per hour
6,00
$ —
over 3 gal. per hour—See Fee Schedule
ROUGH
-FINAL� -- °� (SURCHARGE $_.50)
Dept. of Bldgs. Phone 3360-34110
City of Ffldley:
The undersigned hereby makes application for a permit for the work ;herein
specified, agreeing to do all work in strict accordance with the City Ordinance:
and ruling of the Department of Buildings, and hereby declares that an. the facts
and representations stated in this application are true and correct.
Fridley, Minn `��/f/�.� y`�
?-7-
l /
Kind of Building .� /1✓f /���P
Used as---_..ice--
To be completed about
Estimated Cost,
Old—New. Building Permit No. Permit No. 15-1 7�
HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No
Trade Name Sine No-Z�
Capacity- I —°� Sq. Ft. E.D.R BTU g p.
Total Connected Load , Kind of Fuet
BURNER — Trade Na.ne Size No
Capadty Sq. FL E.D R- BTU
BIF.
(REMARKS-OVKR)
" oo
GASB (up to 193,0x0 BTU)
g.
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures .. . .....
x$ 200
$ 2 OJ
Additional Fixtures
x .98
$
Gas Range to 199,000
x$ S.00
$
AIR C014DMONIXG
FAN HEATING SYSTEM
See Fee schedule
V ITILATING SYSTEM
ALTERATIONS & REPAIRS
TOTAL FEE$
ROUGH
-FINAL� -- °� (SURCHARGE $_.50)
Dept. of Bldgs. Phone 3360-34110
City of Ffldley:
The undersigned hereby makes application for a permit for the work ;herein
specified, agreeing to do all work in strict accordance with the City Ordinance:
and ruling of the Department of Buildings, and hereby declares that an. the facts
and representations stated in this application are true and correct.
Fridley, Minn `��/f/�.� y`�
?-7-
l /
Kind of Building .� /1✓f /���P
Used as---_..ice--
To be completed about
Estimated Cost,
Old—New. Building Permit No. Permit No. 15-1 7�
HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No
Trade Name Sine No-Z�
Capacity- I —°� Sq. Ft. E.D.R BTU g p.
Total Connected Load , Kind of Fuet
BURNER — Trade Na.ne Size No
Capadty Sq. FL E.D R- BTU
BIF.
(REMARKS-OVKR)
'
HOU-SE HEATIIIC T=r RECOV)
ADDRL SS
V
�_.-C
gnpc>e 0 APT. FLOOR
CITY
SUBURB
OCCUPANT E2A— `Z
.��OIMER
IIGIT LOSS DATE IITC. INST.
SaLa BY _ _
I?lCr.\LLEO By
Giac:crlcaJ. Bark Dy
Cas Linc D.
TfPL OF HEAT: GA FA
tltl STEAM Shcc IITR.
UNIT IITR.•
OTHER '
' CAS DESICPi
CONVCRSIQ:I
vj,xz LC.w�--j
I -L KLP OF. BUMMER
S..iaL q� VA -6''•
-'- \ Max. UTU Rating;
INFUT a 0�
Fd1I:E OF FUMMACE
HOUCI •
CONTROLS '
ZIIERho�i.�:: ' .itcat Plug, Vent Size
Ysl.vc K=ND OF Li247.IL SIZZ NONZ r
Lizcit Draft flood rcj;ul ator
Limit Setting Filtcra I Si=c �,IP�C. Numbcr Zts
C.>
Fan ScttinZ• ,C) Chimney Location: 'Ic�.:idc Outaidc
Pilot Typc CU=cy Construction
.Pilot Make'
Pilot Mcdcl Smokc Bomb Wirinc
Pilo c ZLMLng _ �,� Draft Tca t Taj;
L.ii.• Cut OEE Door Prcaaurc LiBlitiiiC Inst.
• 1'
Prcasurc Z.,C) A4Crccnc colC125 Date Tca tcda -
Input CFF{ Fcrcecst a,-7106 Caispany Tca ting _
Stack Tczsp. • C • Pcrccnt CO Hamm of Tca ter
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
I-OTAI-41--i-ti
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Sumer -
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% of Value of Appliance or Work
-Z -/5Z_
Effective On January 1, I Mi
JOB ADDRESS W3o 1� o T`e t r
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
$ 20.00 $ L0 .�Qo representations stated In this application are true and correct.
/-7 •�Q�
$10.00 $I®XD'.�
OWNER `Ise
$10.00 $
BUILDING USED AS
$10.00 $
ESTIMATED COST 4/OO ® > 0 c) PERMIT NO. :'✓� �,
$10.00
State Surcharge
TOTAL FEE
$so
MINIMUM FEE FOR ANY HEATING/COOLINGNENTItATION
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.
< V 4
w i.
No. of Heating Units : Circle One (Steam) (Hot Water) (Warm Air)
Trade Name„ Lf-m4� i< Size No.
BTU_ SO oo o HP EDR
Fuel N ik % Total Connected Load
Bumer Trade Name Size No.
BTU HP EDR
HEATING COMPANY
Signed
Tel No. 53(o-0667
f
Approved B n Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
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 Yes ( ) No ( )
8. Has combustion air been provided for wafter heater Yes ( ) No ( )
Remarks:
HEATING CO:
Signed By:
Date:
ME
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
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% of Value of Appliance or Work
Rate
TOTAL
$ 20.00
$ LO.o6
$10.00
$2f3o
$ 10.00
$
$10.00
$
$10.00
$10.(0
State Surcharge
TOTAL FEE
$so
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.
,co
Z75z
Effective On January 1,199y
JOB ADDRESS -7 7 3C>rem_ �-r °"'e ° "
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.
1-171 qQI
OWNER E//fe J1) fj.5
BUILDING USED AS
ESTIMATED COST '# qOO O -O 0 PERMIT NO. //,-? 6 0
No. of Heating Units : Circle One (Steam) (Hot Water) (Warm Air)
Trade Name LfAw,4 x � 2 I y ' Q Size No.
BTU- %0 000 HP EDA
Fuel N 47" Total Connected Load
Sumer Trade Name Size No.
BTU HP EDR
HEATING COMPANY M 2c4ray �- 4`e- CONd
Signed By Tel No. 53(o ^066 %
Approved By Rough -In Date Final Date.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
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 ( )
S. 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 limen been provided for water heater
8. Has combustion air been provided for water heater
Remarks:
t
Yes ( ) No ( )
Yes No
HEATING CO: /�r�S/� %�P��"�✓ dd✓�i�. v1� `dc
Signed By:
Date:
SUBJECT
ERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT C
11 -�-� .�
` 6
1 ,
�
RE EIPT NO.
• COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
�
r1
1 �
�®S
1 ; )
NUMBER
REV
DATEPAGE
OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
5/31/95
JOB ADDRESS 7430 Tempo Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
3
5
I Melody Manor 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kenneth Johnson 7430 Tempo Terrace NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Ideal Construction Inc 12621 Tyler Circle Blaine MN
757-3101 4240
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Porch Window Replacement
9 CHANGE OF USE FROM TO
STIPULATIONS
If bedroom windows are replaced, windows
must meet the State
Building Code requirements of 5.7 sq ft of clear openable area.
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
SQ. 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
I
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
@
$4,000
$2.00
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-
$63.00
Fire SC $4.00
STR CTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$74.00
SIGNATURE OF CONTRACTOR OR ORIZED AGENT (DATE)
Vy N
LDG )NSP
Y V ATED THIS IS YOUR PERMIT
4.
ri-4 T I
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
NEW ( J Effective 1/ 1/95
ADDN (J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: .3 C9 /V 72,17 n ¢
Legal Description:
Owner Name & Address: x -e'. -1-1 �r (���n sre�,! �5� Tel. #
Contractor: / e _ MN LICENSE # V0
Address: fa sae 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:
Comer Lot [ J Inside Lot b4 Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $'If y 4,30
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: �Y�� _ � � / ` Tel. # 7,5- 2- Sia
CITY USE ONLY
Permit Fee $ u Fee Schedule on Reverse Side
Fire Surcharge $ 49 ce> .001 of Permit Valuation (1/10th%)
State Surcharge $ 6) $.50/$1,000 Valuation
SAC Charge $ $850 per SAC Unit
License Surcharge $ S,00 $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:r�b""gid`'
BUILIANG PERMIT FEL' SCHEDULE
The C:liic:f* Building Official shall, tore 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 firth and in the manner herein provided to -wit:
TOTAL VAL11G FEES
$1 to $500 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for fust $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000 -
$2,001 to $25,000 $45 for fust $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
$25;001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1;000
or fraction thereof, to. and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $450 for each additional
.$1,000 or fraction thereof, to and including $100,000
$ iomo l to $500,000 $63950 for fust'$100,000 plus --$3.50 for each additional.
$1,000 or fraction thereof, to and including •$500,000
$500,001 to $1,000,000, ' $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 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
S13-50.
Alternate "13": 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 issueda 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.
J
SUBJECT
PERMIT NO.
City ®f Fridley
(T(
26163
AT THE TOP OF THE TWINS
BUILDING PERM
i
RECEI T NO.
_ COMMUNITY DEVELOPMENT DIV.®
v PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-1715
6/8/98
JOB ADDRESS 7430 Tempo Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
1 Melody Manor 2nd Addition
SHEET
2 PROPERTY OWNER MAILADDRES.5 ZIP
PHONE
Kenneth Johnson 7430 Tempo Terrace NE
786-1234
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Q. REPAIR
X
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage 30 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code..
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
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
$2,502
$1.25
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-
$74.75
Fire SC $2.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTA E
$ .50
SIGN TUBE OF CONTRACTO O FIORIZED AGENT IDATEI
P OP ALIDAT D IS IS YO R PERMIT
� SIGNATURE OF OW NER,IF OW R BUILDER) IDATEI
NSp
r�ATE
J
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �.
s
ConstructionAddress:3y O apo Z?
Legal Description: o �Ji -� ✓� a o -
Owner Name & Address: / 17,7e- -tI7 ZV .0 his O h Tel. # 7
Contractor: MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: --3 v
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: -- i I—APPLICANT: w Tel. #
CITY USE ONLY
Permit Fee $ ��r Fee Schedule on Reverse Side
Fire Surcharge $ a .001 of Permit Valuation (1/10th%)
State Surcharge $ 7 $.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 Oficial 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 $1,000,000
$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.
01,
ling
SUBJECT
PE R
City of Fridley9
3 6 0
AT THE TOP OF THE TWINS
BUILDING PERMIT
P
�
RECEIPT NO.
v COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
aLl7
I
i CITY HALL FRIDLEY 53432
'
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
4/30/9
JOB ADDRESS 7430 Tempo Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
Melody Manor 2 Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Ken Johnson 7430 Tempo Ter NE
786-1234
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Renewal By Andersen 350 73 Avenue NE Fridley, MN 55432
502-4777 20040620
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 Q ALTERATION ❑ REPAIR
O MOVE ❑ REMOVE
B DESCRIBE WORK
21
Replace =n windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on
all levels of the dwel
per Section 310.9.1.2 of the 1994 Uniform Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
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
$9.15
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$18,300
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-
$274.75
Fir SC $18.30
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOT FEE
Lice C $5. 0
$307.2
.1
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
ENRD A IOAT
THIS I Y�F✓
S-GNATURE OF OWNEROF OWNER BUILDER. iDATE,
BLO INSP
DAiE
01,
ling
Prepaid Plan Check $ Effective 1/1/99
Estimated Cost $ CITY OF FRIDLEY
Receipt #
R-3, COMMERCIAL & INDUSTRIAL
BUILDING PERMIT APPLICATION
as . , • . , � �•.
-# Engineer
1-1
F�
Zoning
Tel# i9(e--123LJ
Tel# ,9W- 44'7 7
Reg.#
BUILDING 'ICONSTRUCTION
TYPE OF aR••• eration m -Describe ' / • ��
J
OFC. AREA: Tenth
WHSE AREA: Lexxj h
APPLICANT
Sq. Ft.
Sq. Ft.
Width
Width
Width
Height Sq. Ft.
Height Sq. Ft.
Height Sq. Ft.
31
Date /a3/l
X $
Cost/Sq. Ft. =
Valuation
$
) Q
lC>,®o
X $
Cost/Sq. Ft. =
Valuation
$
) _ $
X $
Cost/Sq. Ft. =
Valuation
$
) TOTAL VALUE
Building Use
Air Conditioning [] Yes [] N
Performance Bond Amount S
U
Construction Type Occupancy Grc up
No
Fire Protection Provided [] Yes [] No
See Reverse for Schedule Received [] Yes' [] No
Permit Fee $ C / ; %Sr
Plan Check $ l °b
Fire Surcharge $ , f
State Surcharge $
SAC Charge $ =CSU
Erosion Control $
Park Fee $
Spec. Assessments $
Driveway Escrow $
TOTAL $ 3 a 20
See Fee Schedule on Reverse Side
in Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/10th o)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$1050 per SAC Unit (Plans to mgCC for determination)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [] Not Necessary L]
feet x $13.50/foot
ATTACH STIPULATIONS
BUILDING PERMIT FEE SCHEDULE
$1 to 500
$21 (Minimum Fee is $21 plus surcharge) .
501 to 2,000
$21 for 1st $500 plus $2.75 for each addn'l $100 or fraction, to and including
25,000
$2,000 -
2,001 to 25,000
$62.25 for 1st $2,000 plus $12.50 for each addn'l $1,000 or fraction, to and
including $25,000
including $25,000
25,001 to 50,000
$349.75 for 1st $25,00 plus $9.00 for, each addn'l $1,000 or fraction, to and
including $50,000
50,001 to 100,000
$574.75 for 1st $50,000 plus. $6.25 fore each addn'l $1,000 or- fraction, to and
100,000
including $100,000
100,001 to 500,000
$887.25 for 1st $100,000 plus $5.00 for each addn'l $1,000 or fraction, to and
including $100,000 -
including $500,000
500,001 to 1,000,000
$2887.25 for the 1st $500,000 plus $4.25 for each addn'1 $1,000 or fraction, to
and including $1,000,000
1,000,001 and up
$5012.25 for the 1st $1,000,000 plus $2.75 for each addn'1 $1,000 or fraction
$1 to
2,000
$29.25
2,001 to
25,000
$29.25 for 1st $2,000 plus $5.85 for each addn'l $1,000 or fraction, to and
including $25,000
25,001 to
50,000
$163.80 for 1st $25,000 plus $4.225 for each addn' 1$1, 000 or fraction, to and
including $50,000
50,001 to
100,000
$269.43 for 1st $50,000 plus $2.925 for each addn'l $1,000 or fraction, to and
including $100,000 -
100,001 to
356,000
$415.68 for 1st $100,000 plus $2.275 for each WWI $1,000 or fraction, to and
including $356,000
Over $356,000
$1,000 (Balance due with issuance of building permit)
PERFORMANCE BOND POLICIES
When a building permit is issued for a commercial, industrial or a multiple dwelling residential project which, requires
outside improvements,a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover
all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences,
lighting, water & sanitary sewer services, and storm drainage systems.
Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3 % of the
building permit value up to a 2 million dollar project or a $60,000 bond. Actual amounts will be rounded to the nearest
$100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects
with no outside huprovements, generally will not require -a bond.
Bonds must remain open until the project is fully completed. Reproducible "as -built" drawings of all exterior
underground utilities must be submitted to the City Engineering Dept before the project is considered complete and
the bond released. All bonds will be held over one winter and through the next growing season to insure the survival
of all landscape installations. The City will then inspect these properties in August of the year following the initial
planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed.
CITY OF FRIDLEY INSPEC'1 iON DIV.
6431 University Ave NE
Fridley, MN 55432
763-572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Effective On Jan 1, 2001
TA_ J4
MARK NUMBER
OF
FIXTURES TO BE INSTALLED
ON EACH FLOOR
:::4i. {iw���•-�'••dd:•>)i:�.i{
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
r..;:%t:i.•:.•••:R::R:
�:Foo
1 r Ga`•�"- Auto.
1
i
`�:: GasWater Heate'e{':Wash
s�F
*�m'n
r: ::;:�:Y..dd::..}{::
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
Tra `+tti
%.....:..//.,.:r
D in i3 > Washer
rat3:::r:..
' ' ' ' <>:M: Ran aGas Elec
5e
Urinal
'f`#>.:
Shower
i.
5�:
"::_:::::
Back Flow Preventer Required ( )Yes () No
. .r
Type
$15.00
i:4ir'•:::
.: �e...
_: ::•.; :::: v. :.
............
: S::r:::r:•:
r.:iL.
:.•:::::.iF"+..K..•
dr v
:: <4, •d
��:4fv{i::�:� iii„'{:;
:ii iJf+•:+i'':'•
.�v
�(
...drd:.!:j
21oorl
.a:%t4r':.
.•xd.:d.{:.•::,..:::::.:}::::........r
00
PLUMBING FIXTURE RATES: NO.
RATE
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$ 7.00
Water Heater - Gas"
$10.00
Gas Range"
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
TOTAL JOB ADDRESS ZYY) �ewn ( e y
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.
200(
Owner
Building Used Ash-—�C:SC[/fit-
Estimated Cost /� PERMIT NO.cr-
$ .50
$ c;?"®. 10
PLUMBING COMPANY
SIGNED BY
Approved By
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required.
Yes ( ) No ( )
The venting system is 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 manufacturers 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 ( ) 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( )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: