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PRE 2010 DOCSCity of Fridley, Win. N® 9 319 BUILDING PERMIT Date: June 16, 1967 Owner: Builder HOMEDALE BUILDERS Address Ades 5217 -Wayzata Blvd. LOCATION OF BUILDING No. 7513 Street_ Tempo Terrace part of Lot Lot 15 _ Block 4 Addition or Sub -Division MelodY–Manor 4th Corner Lot _ Inside Lot — x Setback 35' _ _ Sideyard __ 10' Sewer Elevation ___ _ 878-03 _ 881 03 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwel l ing Front 46' _ Depth 24128 Height Z�L....._. Sq. Ft. 11-52 Cu. Ft 9-1,0 — Front Depth Height _ _ Sq. Ft. Cu. Ft Type of Construction Frame Est. Cost _ $18000 To be Completed Aug. 15: 1967 SEWER LOCATION - 6' East of West Manhole WATER LOCATION - 10' East of Sewer In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set orth and in compliance with ail ons of ordinances of the city of Fridley. 19 z) , In consideration of the payment of a fee of $___24. 00 , permit is hereby granted to HOMEDALE BLDERS . 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 asci his agents, employees and workmen, in all work. done in, around and upon said building, or any thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and thus permit may be revoked at any time upon violation of aay of the provisions of said ordinances. CLARENCE BELISLE NOTICE: This penit does not cover the construction, Installation for wiring, plan"g, an heating, sewer or water. Be son to sea the Building hupector for separate permhs for these home. C, 4 APPLICATION FOR BUILDING PERMIT OF FRIDLEY9. MINNESOTA OWNER'S NAME BUILDER 6t,,r� ADDRESS ADDRESS LOCATION OF BUILDING NO. STREET %. PART OF. LOT LOT__ZABLOCK j ADD TION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -YARD SE ELEVATION 71- -3 FOUNDATION ELEVATION NX Applicant attach to t'vis form TwoL;etificAtes of 'Survey of Lot and proposed building location d awn on( -these Certificates. DESCRIPTION OF BUILDING F �V To be used as: Front Yj( DepthHeight 0 .2 �L- ;--1 Sq. Ft,_ Cu. Ft.. Front Depth Height Sq. Ft. Cu** Ft. Type of Construction 0_Estimated Cost. To be completed _ I!! ��/ Z 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 repre's'entations stated in.this application are true and correct. DATE-- SIGNATURE (ScheduleofFee Costs can be found on the Reverse Side) w a " 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 existing building or structures or for any alterations 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 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 19fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for .the erection of any uon•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 -fire -proof 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 the 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 (b) 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. 2.5. 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 work. 2.6. . In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE FEES: Residential: Commercial; Estimated Cost of work up to $500.00 - X5.00 Estimated Cost of work over Estimate " ^-ost of work tl. +: _• . ; .') .n, Y" " 0 Estimate ,ost of wozk oJar yJOO.OU Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 560-33450 GRAVITY WARM AIR: RATE TOTAL Location Furnace Shell & Duct Work .......................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ NECK. 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 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. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. a y/% Fridley, Minn Owner B _ Kind of Building Used as—,t ! f 4 -112' 1x Il i To be completed about / yrs/�z 1452= Estimated Cost, $ ��1 Old ew building Permit No. ` Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water,arm —No Trade Name—''' Size No- % Capacity Sq. Ft. E D.R ��BTU H.P. Total Connected Load—� - - Kind of Fuel BURNER — Trade Name_ _ /� �' Size No Capacity Sq. Ft. E.D.R ��BTU H.P. (REMARKS -OVER) S eY N. WELTER HEATING CO. igneci 3 By rMi N FAPOLIM 7. MINNNNI®®T <z Business Phone No- =atee- e HOUSE HEATING TEST RECORD ADDRESS ® '° APT. F OR CIMY URR -09:29& OCCUPANT OWNER HEAT LOSS DATE HTG. INST. GAS CO. METER BADG SOLD BY INSTALLED BY ot3 Electrical Work By Gas Line By All L.0e TYPE OF HEAT GA - FA W STEAM SPACE HTR. UNIT HTR. OTHER GA ESI CONVERSION MAKE MAKE OF BURNER Model Model Serial •S`5" �6 '-:Z.2 Max. BTU Rating INPUT MAKE OF FURNACE Model � + CONTROLS THERMOSTAT / aeZ^eat Plug Valve � d ` Limit et'A�� Limit Setting AffA'e Fan Setting " a '—Ze-s— Pilot Type Pilot Make Pilot Model '0010 - Pilot Timing 6U.4 a-9 Vent Size KIND OF LINER E 4 NONE Draft Hood 4;9ZRegularor F1 Iters Size " Nu�mber Chimney Location Inside •�� Outside Chimney Construction Smoke Bomb Wiring & 14 Draft Test Tog— L.W. og L.W. Cut Off Doo Pressure— Lighting Inst. PressurePercent CO ate Tested Input CFH gee Pe.9eri?t ® .Ampany Testing 9 Stack Temp. .e percent CO eA Name of Tester Form 235 City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 8 7 Q° 0 7 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location 75 3 Tempo Tarr M I N vxf } Z RC Qz uz! o "yS', ul J u1 (�`1 u1 Z • • I00 UU33 — x $1.50 � vZ� Z a C p — x $3.00 J oz ~` R< a3 a d (7 °d 6 Z c�cS a d Uo F N WATER F+r2. GAS ELEG Base 1st C o 11 2nd 3rd 4th • Future Connection Openings I Connected with New Fixture, Old Openings 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 fact and representations stated in this application are true and correct, Fridley, Minn- 18 oat 67 , 19_ Owner Ho me d a l e B l n s Kind of Building Sewer M Used as Ce PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ...... .................. .. Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: — x $2.00 $ — x $1.50 $ — x $1.50 $ — x $3.25 $ — x $3.00 $ — x $3.25 $ — x $2.00 $ NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. l x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code To be completed about Estimated Cost, 441 res CMIC--New. Building Permit No Permit' Signer i By Business Phone No ROUGH FINAL Description .......... . . . .................TOTAL FEE $_ KE $ 5 42 City of Fridley, Minn. BUR DING PERMIT Date: .lune 23, 1969 Owner: Charles Reid Builder Address 7513 Tempo Terrace Address #�7133 Statewide Garage Blders. 4221 Excelsior Bld. No 10302 LOCATION OF BUILDING No. 7513 Sit Tempo Terrace part of Lot Lot 15 Block 4 Addition or Sub -Division Melody Mayor 4th Addn. Corner Lot _ Inside Lot Setback — __ _ Sideyard Sewer Elevation ____ __._ — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Qarage Front 20' Depth 22' height 101 Sq. Ft. 440 Cu. Ft 4400 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction _ Frame Est. Cost __.. $2,200.00 To be Completed 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 fo and in compliance with all provisions of ordinances of the city of Fridley. g In consideration of the payment of a fee of $-1=0 , permit is hereby granted to Statewide Garage Blders . 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. t Clarence Belisle NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, on heating, sewer or water. Be sire to we the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME -�e� BUILDER,%it& 'tib4' ADDRESS ADDRESS LOCATION OF BUILDING N0. 7 5-/a STREET V LOT / ,® BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDEYARD % C� SEWER ELEVATION TOP OF FOOTING 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:_ -`V11 �i'G� 1 --Front G Depth Height w Square feet 4-1 q V Cubic Feet 4/0 0 Front Depth Height Square feet Cubic Feet Type of Construction�. � _ Estimated Cost �? �. To Be Completed � V ._T. 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 L� � �SIGNATURE ?Zverse .(Schedule of Fee Costs can be found on Side.) BUILDING PERMIT*FEE SCHEDULE SECTION2. -The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing structure or building, 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 in the manner herein provided to -wit - Uniform Building Code: Type 1, 2, & 4 - $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical contents; Type 3 & 5 $1.50 for each one thousand cubic feet. 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 the 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. 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. NSSSD Connection Charges based on location - Area 1 or 2. CITY OF FRIDLEY Effective Date May 1. 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE QESIDMiTIAL ` RATE TOTAL /� Job Address / 1-9 lelh Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $D G� Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ OD: Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Air Conditioning (all sizes) $ 10.00 $ Fridley, Minn. , 19_ �e All Others/Repairs and Alterations OWNER 18 of Value of Appliance or Work $ '✓��® �ho3� KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS sod✓ O� / �°��=��� 1% of Value of Appliance or Work $ TO BE COMPLETED ABOUT o/ � ESTIMATED COST ® ®� State Surcharge $ .50 / OLD PERMIT NO. PERMIT NO. - NEW BUILDING TOTAL FEE— keinspection Fee ($15.00) $ DESCRIPTION OF FURNACE/BURNER Rough Insp. Date HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. % Final Insp. Trade NameI Size No. Date Capacity � �® V Sq. Ft. EDR BTU 7so.00 HP Approval for Permit >T Total Connected Load Kind of Fuel /'!e-- BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP / MINIMUM /FEE FOR ANY HEATING PERMIT IS $15.00, Company PLUS $.50 STATE SURCHARGE Signed By _ � • /�-� Tel. No. *Air Conditioners can not be placed in side yard without written permission frau adjoining neighbor. Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. !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 connected Yes ( No ( ) 6. Has Total heating BTU's of X00 All other BTU's TOTAL Remarks Companyy�-� �- l/ Signed By�� Date SUBJECT MIT-N0 City of Fridley 219 9 AT THE TOP OF THE TWINS B U I L ®I PERMIT i � �J RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. )) C16 r I , NUMBER REV. DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/22/93 JOB ADDRESS 7513 Tempo Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 4 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Chuck Heid 7513 Tempo Terrace NE 7846842 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Quality #1 Plumbing & Remodeling 11033 Terrace Rd NE, Blaine 755-5198 7640 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 Construct a 201 x 181 Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations. on plan. WARNING 0,1011 digging can 11w all "fility 1matim RvyUi, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $23,000 $11.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $234.00 Fire SSC $2.3.00 STRUCTION FSE PERFORMA CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ,Q 7 .9,3 License SC $5,00 $273.50 ` SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WH OPE Y VALIDATED THIS IS YOUR /ryPERMIT BLDG ,NSP DATE SiGNATUREOFOWNERIIFOWNERSUILDERI (DATEI NEW [) Effective 5/26/93 ADDN ALTER [] SINGLE FAMILCY RAND DUPLEXES R-1 AND R-2 0;3460 Building Permit Application Construction Address: 75-/3 TGA Po Ts /z,?. Legal Description: % 1,!3 L L !z AIL�6'13 C'1L Owner Name & Address: CA oc, he i ® 7 s/ 3 T e g! o Tarn. Tel. # 7,Fti . Cad qw Contractor: Q v L i� , 1 �) �, �� �rti d ca a �� MN LICENSE #__ Z6 e-10 Address: Z033 T e4moc - Ao "`_ Tel. # 715 S / 9 F- �-- Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF 11"ROVEMENT LIVING AREA: Length Width /,r— Height �_ Sq. Ft. -3.90 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Grvund Sq. Ft. Coiner Lot [ l Inside Lot )d Ft. Yd Setback Side Yard S Type of Construction: -5'1,-5)e Oee s L Estimated Cost: $ , Approx. Completion Date: 9- `- 93 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $. DATE: 7-20 - S3 APPLICANT: -&eA^✓ Ci e- ea,u e- Tel. # Permit Fee $ b 0 CM USE QN" Fee Schedule on Reverse Side Fire Surcharge $ s 0 0 .001 of Permit Valuation (1/10th ',) State Surcharge $ 11.6-6 $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ 00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. *Be Above Erosion Control $ Conservation Plan Review $450.00 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ j Not Necessary [ j 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 $15 (Minimum Fee is $15 plus surcharge) $501 to $2,000 $15 for first $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 $509000 $252 for first $25,000 plus $6.50 for each additional $11,000 or fraction thereof, to and including $50,000 - $50,001 to $100,00} $414.50 for first $50,000 plus $4.50 for each additional .$1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $639.50 for first $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 $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. PREPARED ROOFING SHINGLES PRODUCT DATA COLORS SPECIFICATIONS Black x Class A Asphalt Shingle Bundles Shingles UL 790 Class A Fire Resistance Nickel Gray Size Exposure Per Square Per Square 25 Yr. Ltd. Warranty Black 12" S" 3 80 Custom SealdonTM 5 Yrs. SureStartTM Protection Gray Frost x Class C Asphalt Shingle Nickel Gray 36" UL 790 Class C Fire Resistance Oakwood UL 997 Wind Resistance Star White ASPM E108 Class C Fire Resistance Timber Blend Mint Frost ASTM D225 Type I (Heavy Duty) Weathered Wood ASTM D 1922 (Outstanding Tear ASTM D3161 (Self Sealing) ASTM D1922 (Outstanding Tear Oakwood Resistance) 220 lbs per square Sandalwood 250 lbs per square ■ �"" 25 Yr. Ltd. Warranty Autumn Brown 12" 5" 3 80 Cert inTeed �.1�2.s 5 Yrs. SureStart' Protection Black x Class A Asphalt Shingle Gray Frost 36" UL 790 Class A Fire Resistance Nickel Gray UL 997 Wind Resistance Oakwood ASTM E108 Class A Fire Resistance Sandalwood ASTM D3161 (Self Sealing) Star White ASTM D3462 (High Tear Timber Blend Resistance) Weathered Wood 235 lbs per square o 25 Yr. Ltd. Warranty Black 11/2" 3'h" 4 128 5 Yrs. SureStartTM Protection Master Slab Gray Frost x Class C Asphalt Shingle Mint Frost 32" UL 790 Class C Fire Resistance Oakwood ASTM E108 Class C Fire Resistance Star White ASTM D225 Type I (Heavy Duty) Timber Blend ASTM D1922 (Outstanding Tear UL 997 Wind Resistance Resistance) 280 lbs per square ASTM E108 Class C Fire Resistance Sealdono 20 20 Yr. Ltd. Warranty 3 Yrs. SureStartTM Protection Autumn Brown Black 12" 5" 3 80 x Class C Asphalt Shingle Cinnamon Frost 36" UL 790 Class C Fire Resistance Coral Frost UL 997 Wind Resistance Evergreen ASTM E108 Class C Fire Resistance Gray Frost ASTM D225 Type III Maple Red ASTM D3161 (Self Sealing) Mint Frost ASTM D 1922 (Outstanding Tear Nickel Gray Resistance) Oakwood 220 lbs per square Sandalwood Star Wbite Timber Blend Weathered Wood 20 Yr. Ltd. Warranty Black 2013/16" 14" 3 99 Safflokm 3 Yrs. SureStartTM Protection Coral Frost x Class C Asphalt Shingle Evergreen 21'h" UL 790 Class C Fire Resistance Gray Frost UL 997 Wind Resistance Mint Frost ASTM E 108 Class C Fire Resistance Oakwood ASPM D225 Type III Star White ASTM D3161 (Lock -Type) Timber Blend ASTM D1922 (Outstanding Tear Weathered Wood Resistance) 240 lbs per square CITY OF FRIDLEY INSPECTION DIV, 6431 University Ave NE Fridley, MN 55432 572-3604 .Jab Effective On January 1, 1993 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shelf and Duct Work, Burner — Also Replacement Furnace Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes Ail Others/Repairs.& Alterations (LIST ON BACK) I% of Value of Appliance or Work Commercial/industrial I% of Value of Appliance or Work JOB ADDRESS 7513 Tempo Terrace 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 $ representations stated in this application are true and correct. 08/19/93 ,1993 $10.00 $ OWNER Chuck & Linda Heid $ 10.00 $ BUILDING USED AS Residence $ 10.00 $ ESTIMATED COST $525.00. PERMIT N0. $10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load State Surcharge $ .50 TOTAL FEE $1-6, MINIMUM FEE FOR ANY HEATING/COOLINGIVENTILATION 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. Burner Trade Name Size No. BTU HP EDR DEPENDAM INDOOR AIR QUALITY. INC HEATING COMPANY_ 2619 COON RAPIDS BOULEVARD COON RAPIDS. h1w 5,5453 Signed By Tel No._ �� Thomas L. Chouinard, Jr. Approved By Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE I CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: I. 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 Remarks List Alterations Bein4 Done: Installing three new supplies and two returns from existing furnace and duct work. 2619 COON RAPIDS E30U1 F-VARD HEATING COMPANY CAnN R pltj n�54'�� Signed By, Date ,7 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR ae �•t.`tO::.lt�>::::>:: PLUMBING FIXTURE RATES: NO, . . ..Urinal New Fixtures Shower wer �a 4. Floor rainWasher Beer Dispenser Auto. Blow Off Basin Gass Range eater S Gas Elec Basement m nt Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas $10.00 Gas Range $10.00 Floor 1 $10.00 Back Flow Preventer Required ( )Yes () No Type •$5.00 Floor 2xx Floor 3 00 FI r 4 PLUMBING FIXTURE RATES: NO, RATE TOTAL 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 •$5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge TOTAL FEE 50 JOB ADDRESS_ Z�13 Te,,-; o 2—CA d . 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. — -0 '1993 Owner Building Used As Estimated Cost PERMIT NO. PLUMBING COMPANY_ (X�aL��y #/ ®/v,�,�✓•-� /2�.� ��e�� S J��7T J SIGNED BY Approved Rough—In Date TEL N0. %,T J-1 Y J -- Final Date GAS PERMIT IS $15.00`` 142 SUBJECT PER City of Fridley 29913 AT THE TOP OF THE TWINS BUILDING PERMIT r RTIZ- COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. PROTECTIVE 1 � = CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L J` 612-571-3450 910-Fl5 7/21/99 JOB ADDRESS 7513 Te o Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 4 iMelodyManor 4th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charles Heid 784-6842 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ea leview Const. Inc. 2937 174th Lane NK Andoy er S753-5469 20067043 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 XX REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage C29 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 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2535 $1.27 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 $83.25 0 Pipe SC $2.54 PLAN CHECK FEE T AL FEE 7 Lice 5 92.06 NaiURE FCONTRACTOR ORAUTHORIZED AGENT iD E, EN FIF Y VA ED THIS IS 1 UR�1T S,GNATUREOF OWNER0f. OWNER SURDERi iDATEi P5G -NSP QAfE 142 NEW1 l ` Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �\ Construction Address: -%�l3 /�m� t) % Legal Description: Owner Name & Address: Naxles 0 Tel. # Contractor: &� O'LCA-'r 4rra. MN LICENSE # �_ O C&?O S<3 Address: ' 3 % % of�=' Lg Tel. # -75 3--S"Y� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: /.&0 .e Estimated Cost: $ 2 � S Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee APPLICANT• Tel. # CITY USE ONLY $S Fee Schedule on Reverse Side Sewer Main Charge $ TOTAL STIPULATIONS: s d o(1---1 .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] 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 $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up 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 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $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 $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. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2000 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 TOTAL JOB ADDRESS �� ��-. �> �e <1 The undersigned hereby makes application for a permit for the work herein specified agreeing b do all work in strict accordance with the city codes and rulings of the Auilding Division, and hereby declares that all the facts and representations stated in this application are true and correct. Back Flow Preventer RequiredX)Yes ( ) No Type W/L */,vs CUs -fir) $15.00 I�"00 lWo deL 7ao,4 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ • 4b.. Owner t Building Used Ash Estimated Cost PERMIT NO. c� PLUMBING COMPANY SIGNED COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "'COMMON VENT -INFO ON BACK SIDE ,20eO 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 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 wiil be sized and installed To meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new ventina 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 : 09/18/2005 11:58 7637856954 QUARVE CONTR.! N �/(,p PAGE 02 NEW 1 ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 64$1 University Ave NE, Fridley, MN 55432 (763) 572.3604 Bldg Insp ALTER [) SING1l E FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION 1-17 _ r Construction Address: Legal Description: . Owner Name & Address: Contractor: ' QUARVE CONTRAC CINE INC Address: 8427 CENTER DRIVE NE SpFiNG LAKE PARK NiN 55432 J0,3 Yl DO ' Tei. #- & MN LICENSE # 14-1; ' Tel. # �trC �`t r rtificate of Survey of the _.. _.,kion 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: curiSl i uvti0l iI' jrc;: - I� , . 'UJC((A4 Estimated Cost: Driveway Curti Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: �-I�� APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailln n application. Fax to 763-571-1287 If using credit card and we will call you for card number, CITY USE ONLY - 9 Permit Fee $ ® �i�^ Fee Schedule on Reverse Side Plan Review $ : 65% of Pem►it Fee Fire Surcharge $ .;� '� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ ®20 $1350 per SAC Unit License Surcharge $ 5-.00 $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park I-vo $ f=ee Determined by Engineering Sewer Pv9awn CslllaiLiW 4, Agreen-gent Necessary (] Not Necessary TOTAL ° �5,-- STIPULATIONS: CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE FRIDLEY, MN55432- // ISSUED:05252010 (763)572-3604FAX: (763)502-4977 Permit #2010-00770 7513 TEMPO TER NE ADDRESS: PIN:113024120046 LEGAL DESC:MELODY MANOR 4TH ADD :LOT 15 BLOCK 4 PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:WINDOWS/DOORS VALUATION:$2,400.00 NOTE: CONSTRUCTION IN THE CITY IS UNLAWFUL EXCEPT BETWEEN THE HOURS OF 7:00 AM AND 9:00 PM, MONDAY THROUGH FRIDAY AND BETWEEN THE HOURS OF 9:00 AM AND 9:00 PM ON SATURDAYS. NO WORK IS ALLOWED ON SUNDAYS OR ANY LEGAL HOLIDAY UNLESS AN ALTERNATE WORK HOUR PERMIT HAS FIRST BEEN ISSUED. FLASHING PER R 703.8, 2006 I.R.C. COMBUSTION AIR PER CHAPTER 1322, SEC. N1102.6 (SEE EXCEPTIONS) SMOKE DETECTORS PER R 313.21, 2006 I.R.C. CARBON MONOXIDE DETECTORS PER STATE STATUE 229F.50 REPLACE 4 WINDOWS W/NEW INSERTS. BUILDING PERMIT FEE83.25 APPLICANT FIRE SURCHARGE2.40 QUARVE CONTRACTING INC STATE SURCHARGE, BLDG VALUE1.20 8427 CENTER DR NE LICENSE SURCHARGE5.00 SPRING LAKE PARK, MN 55432 TOTAL 91.85 (763) 785-1472 Payment(s) Minnesota State License #: 6016 CHECK940491.85 OWNER HEID CHARLES G & LINDA E 7513 TEMPO TER NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 180 days or if construction or work is suspended or abandoned for a period of 180 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 work 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. Applicant____________________________Date________ 5/25/10 Bldg Insp____________________________Date ________ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE ISSUED:05/25/2010 FRIDLEY, MN55432- (763)572-3604FAX: (763)502-4977 Permit #2010-00770 7513 TEMPO TER NE : ADDRESSPERMIT APPLICANT: PIN:113024120046QUARVE CONTRACTING INC LEGAL DESC:MELODY MANOR 4TH ADD8427 CENTER DR NE :LOT 15 BLOCK 4SPRING LAKE PARK, MN 55432 PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL(763) 785-1472 CONSTRUCTION TYPE:WINDOWS/DOORS : VALUATION$2,400.00 BUILDING INSPECTION RECORD 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM INSPECTION TYPEDATEINSPECTORCOMMENTS EXPIRED. NO REQUEST FOR INSPECTIONS. EXPIRED PERMIT06/01/12RONJ INSPECTION COMMENTS: IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT. THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE. uilding $5.00 (State Licensed Residential Contractors) BUILDINGIA $2100 per SAC Unit (Plans to MWCC for determination) $ Permit No.0 3 spections r76 $450 Conservation Plan Review RESIDENTL APPLICATION Fee Determined by Engineering Received B 3-572-3604 FAX CITY OF FRIDLEY M . Make checks payable to: City of Fridley Attach Da ° 9 R 763-502-4977 EFFECTIVE 1-1-2010 DATE 5-"® Q "/10 YOUR E-MAIL ADDRESS SITE ADDRESS pd��/�IO'� d �/'�� J /'G /J S THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT --- ADDRESS: '75/3 ��D ®f7Pii%�L CITY STATE/�x-JzIP 625 11'3oZ PHONE: -Aa, 3 — % R`Y CONTRACTOR NAME: a[gyp r V e—c3 n -frC2 c -�z ai SUBIVIIT A COPY OF STATE LICENSE # tO O I 60 EXP DATE�— YOUR STATE LICENSE / - J k- AND CERTIFICATE OF ADDRESS: CITYc^ l � STATEM�✓ZIp5S INSURANCE PHONE J471-7.2— FAX % 3' - -PROPERTY PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 19MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: S o SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, S^ IN ❑ Vi ❑Soffit ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum ❑Trim 1. Site Plan/Survey showing the existing structures El Other 11 Fascia and propos project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS es ON, LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & PP&e-S'T)( TYPE OF WINDOW TO BE INSTALLED 7 ER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U -KC FEE SCHEDULE) TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due .177•l ' � � • See Back Page for Fee Schedule 65% of Building Permit Fee _ .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $2100 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$24=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ W M . Make checks payable to: City of Fridley Attach 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 requires review and approval of plans. / SIGNATURE OF APPLICANT 11011PRINT NAME 4 Z OeIXIS DATE ,6 E NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK