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PRE 2010 DOCSCity of ]Fridley, Mann. 9069 BUILDING PERMIT Date: OCTOBER 27, 1966 Owner: Builder ._._ HOMEDALE BUILDERS, INC. Address Address 7000 HUMBOLDT AVENUE NORTH MINNEAPOLIS, MINNESOTA LOCATION OF BUILDING NO. — 7517 Street _.._ TEMPO TERRACE N. E. — Part of Lot Lot — 14 --- Block 4 Addition or Sub -Division MELODY MANOR, 4TH ADDITION Corner Lot . Inside Lot ____ X Setback 35' — _ Sideyard _... 10' and 5' Sewer Elevation 878.57 . _ Elevation __ . 881.57 TOP OF FOOTING DESCRIPTION OF BUILDING To be Used as: DWELLING Front 46 Depth 24/28 Height 20 Sq. Ft 1,152 Cu. Ft 23, 040 GARAGE Front 20 Depth 24 Leight 10 Sq. Ft 480 Cu. Ft 4,80 Type of Construction FRAME Est Cost 18 500 __ To be Completed SEWER LOCATION - 81' East of Manhole WATER LOCATION - 10' East of Sewer In consideration of the issuance to me of a permit to cons a building described above, I agree to do the proposed work in accordance with the description above t rth and in compliance with all provisions of ordinances of the city of Fridley. __._ _,° 7 .2 /j In consideration of the payment of a fee of $ 28.00 , permit is hereby granted to HOMEDALE BUILDERS INC. 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. CLARENCE BELISLE Building Inspector NOTICE: This penndt does not cover the construction, installation for wiring, ph nnhing, gas heating, rower or water. Be sure to see the Building Inspector for separate permits for them hens. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA NAME ADDRESS ADDRESS LOCATION OF BUILDING N0, STREE PART OF LOT LOT BLOCK —ADDITION OR SUBDIVISI CORNER LOT INSIDE LOTSETBACK SIDE YARD SEWER ELEVATION ZI Al ELEVATION Ap icant attach tois form t ficates of Survey of Lot and proposed bu lding location drawn on these ertificates. DESCRIPTION OF BUILDING To be used as; ' Deptb,40LHeight Sq, Ft. /A3 Cu. Ft. � y� Frontes � Dept eight Sq. Ft.,_Cu. Ft. Type of Constructi i,i��?�� Estimated Costt,��r"�s To be completed L� 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 /� SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side +'1 BUILDIf4d '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 structure, or for any alterations or repairs to any existing building or structure, upon applichiion..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. Yor�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 foi: 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 .rateof$1.25 for each one thousand cubic feet, classified as "fireproofft), 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 -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 (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.. 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.fae charged for any permit asset forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE FEES; Residential; Estimated Cost of work up to 8500.00 - $5.00 Estimated Cost of cork ober ';300.00 - $10 00 Commercial; Estimated Cr of wr)rjc uta to ` Estimated Cc,.. of work over $500.00 - $20.0, f Application for Power Plants and Hearing, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR ✓ Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ (.-- 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 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $� ROUGH FINAL Dept. of Bldga. Phone 860-3480 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. Fridley, Aline-, c�� 19/a Owner .. of ding1 Used as To be completed about Cost, $ 74 /qo G wilding Permit No. � C1 0/' Permit No. J DESCRIPTION OF WORK HEATING or POWER PLANTS—Ste Hot Watef, Warm Air—No Trade Name , oL4� � Size No �DN Capacity I Sq. Ft. E.D.R ®d BTU H.P. Total Connected LoadT� % s�i Kind of Fuel— %�i✓ _� BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R I BTU H.P. (REMARKS -OVER) RAY N. WELTER H EA-T"I PSI C Co. signed 4637 CHICAGO AVE. By 42 Business Phone No �� 7 CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures N $ Water v `aZ .qi Beer Dispenser $ 4.00 H ro tl1 Q N N pa', _ �" a Rain Water Leader Heater 14al y Hydraulic Valve Gm $ C a9[ q a 3 g � 4 U) 6d fJ 4j.0 y u Hot Water Heater w $ 5.00 $ Gas Range_ u a Gas Dryer y 3 Q w Back Flow Preventer Required. . . Yes ( ) No U `� 3 Type � ii O as lec U) le of Value of Fixture or Appliance mro $ State Surcharge to $ .50 Reinspection F,±a $ ao 0 ($15.00) TOTAL FEE $ 15"'5-0 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range_ Gas Dryer 037-00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 $ ALL OTH99S AND/OR REPAIRS AND ALTERATIONS le of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection F,±a $ ($15.00) TOTAL FEE $ 15"'5-0 Effective Date May 1, 1988 Job Address 75(7 ` SMP® TL�kk, Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. OWNER KIND OF BUILDING jP= A mE" USED AS,/( ogE&)0'5 TO BE COMPUTED ABOUT �i - ( ( -90 ESTIMATED COST ®® OLD - NEW BUILDING PERMIT NO. PERMIT NO. -o ROUGH INSP. INSP. Date FINAL INSP. 4-11 Date APPROVAL FOR PERMIT Company (I��LL?E~�ASCO Sign By Tel. No. MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Aiso Replacement Furnace $30.00 -- (Side 30.00• -(Side Vent - Fill Out Back) . Gas Piping (Needed with new furnace) $10.00. $ Gas Range $10.00 $ Gas Dryer $10.00 $ *Air Conditioning - All Sizes $ 25.00 $ 8W -co All Others/Repairs & Alterations (UST ON BACK) 1 % of Value of Appliance or Work $ Commercial/industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATINGICOOLINGNENTILATION REFRIGERATIONIAIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. .50 Effective On August 1, 1995 JOB ADDRESS ;The undersigned hereby makes application for a permit for the work herein specfied 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. OWNER--�6-1-� BUILDING USED AS ESTIMATED COST / PERMIT NO. No. of..Heating Units Circle One (Steam) (Hot Water) (Warm Air) Tmde.Name Size No. BTU HP EDR .Fuel . Total Connected Load . Burner Trade Name Size No. BTU* ` • HP EDR HEATING COMPANY SignediL v ��II4'o. 4— -7 Approved ByRough-In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes O No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes O 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 water heater Yes () No ( ) HEATING CO: Signed By: Date: l SUBJECT City ®f Fridley 11 26 �4 6 AT THE TOP OF THE TWINS BUILDING PERMIT ' , R-E-CUPTNO. �• COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. t � NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 �"""�'� ,•d 612-571-3450 910-F15 7/27/98 JOB ADDRESS 7517 Tem o Terrace 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 4 1 Melody Manor, 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mar aret McCullough 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. uarve Contracting Inc. 8427 Center 785-1472 6016 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 11 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (24 Sq) Tear-off; fascia wrap 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2 6O1 —$-&5-&& a $1.30 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. $74.75 Fire SC $2.60 PLAN CHECK FEE TO FEE Lice S$5.0/83.65 7-- 0 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI P OP Y A IDA BLDG SP THIS IS OUR PERMIT BATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI l NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY .. ALTER <. [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ' �t BUILDING PERMIT APPLICATION ConstructionAddress: 7�� `� � .lN� %.�-r C Legal Description: Owner Name & Address: M Q,Ma r -P- P M C C IA I1OU M Tel. # Contractor: Address: MN LICENSE #�goI 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: Construction TypeOXjre_r60f$06.. Estimated Cost: $ "O -P f'� - r`�' (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 1 bj 6)g APPLICANT: Q(. arye- &n-h-a� hG J n� . Tel. # -15- 1147A. CITY USE ONLY Permit Fee $ —/) Fee Schedule on Reverse Side Fire Surcharge $ 0 .001 of Permit Valuation (1/10th%) State Surcharge $ /'36 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $yam $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 $ A` 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 hereinbelow 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 a $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 i $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. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALt_FD ON FACH FI ()OR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: New .Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric NO. RATE TOTAL JOB ADDRESSNNE- i -S &431E�IZ. Water Heater - Gas*" -� Gas Range** Gas Dryer" Back Flow Preventer Requited ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.001Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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 guilding Division, and hereby declares that all the facts .and representations stated in this annliratinn nrom tnie and correct. MCCULLOUCH, MARGARET I 7517 TEMPO TERRACE Ill Z� , 200.E FRIDLEY, MN 55432 (763)786-4340 Owner _ Building Used As `-eat G.Aj C.;P-; Estimated Cost . PERMIT NO. _ PLUMBINGCOMPANY--�vv'�� ?ll✓I A� SIGNED BY TEL N0. IZ"6V- �O Approved Rough -In Date Final Date $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT L $20.00 $ .= PLUS THE $.5® STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 7mam om PLUMBING FIXTURE RATES: New .Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric NO. RATE TOTAL JOB ADDRESSNNE- i -S &431E�IZ. Water Heater - Gas*" -� Gas Range** Gas Dryer" Back Flow Preventer Requited ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.001Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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 guilding Division, and hereby declares that all the facts .and representations stated in this annliratinn nrom tnie and correct. MCCULLOUCH, MARGARET I 7517 TEMPO TERRACE Ill Z� , 200.E FRIDLEY, MN 55432 (763)786-4340 Owner _ Building Used As `-eat G.Aj C.;P-; Estimated Cost . PERMIT NO. _ PLUMBINGCOMPANY--�vv'�� ?ll✓I A� SIGNED BY TEL N0. IZ"6V- �O Approved Rough -In Date Final Date $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT L $20.00 $ .= PLUS THE $.5® STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 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..Aystem is. plastic/PVC and meets all current codes and manufacturer specifications .including sizing, length, number of elbows and termination, Yes O No (= ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () 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 ( ) Agoliance 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 Diarrieter 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 : Building MECHANICAL Permit Inspections RESIDENTIAL APPLICATION Received By- 763-572-3604 CITY OF FRIDLEY D'�a aC DATE 0'7 YOUR E-MAIL ADDRESS �n r t of vn-rm ov-_ SITE ADDRESS -750 ? Cl Tt rr THIS APPLICANT IS: dOWNER ❑CONTRACTOR PROPERTY NAME: at" c 16- C Ec 5 ADDRESS: .z 5 bwk6�a. Ap S CITY G 5 59/.t Id ,� V � 1 J STATEM� ZIP OWNER/ TENANT PHONE: `7CQ3 S/3 5a/ 9 �o/a W91 CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERNM TYPE -®'SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW P-REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK (- r P (c. c A Fv e n q C.c. /Q if r' OLA_ � r U I,*-, -t6 kOd k l-41 G'G-1 d1)ZT �+ PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) A _. Equipment Installed MFG: i "" MODEL: �� i 1Q ` C7 i "d SIZE/BTU MFG: MODEL: i s c7 7 . l SIZE/BTU MFG: -+'� MODEL: h_ t> v `Z `t'� SIZF/BTU /� �� - , 4, '--VC $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRII L $10.00 BOI ER $35.00 Z FURNACE $35.00 GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 _DUCT WORK $10.00 PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 / x$10.00=$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ -7—x$25.00 TOTAL DUE $ Number of fixtures @ $25.00 = $ Number of fixtures @ $35.00 ) x $35.00 = $ State Surcharge = $ .50 Total = $7010—D THIS IS AN APPLICATION FOR A PERMrr 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; 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 APPLICAN'�� PRINT NAME �4� r` t G r rim, �- LG S DATE � ' ' a / PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUftbil lb ELECTRICAL AND MECHANICAL WORD City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit Ivo:: ( 00 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DatJEMA 6 200 763-502-4977 FAX EFFECTIVE 8-19-09 DATE YOUR E-MAIL ADDRESS C C, vv� SITE ADDRESS %SI 7-'r^i0d T,-gg p/e THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: I'AllC 11,4 EL /� ��; � ��LL Y L 4! Gf1 TENANT ADDRESS•?S/ 7 i EI'�pa 746;6e17Cpe .OL-cITy t'141_61 STATE ^WZIP SS5/3 2 PHONE: (6-2) 738^0622 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE 06 S7'�' ❑ TWO FAMILY/NEW CONSTRUCTION STORIE I PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 1]l EC i SIZE OF IMPROVEMENT LENGTH 6 " I /1,2 WIDTH S r HEIGHT S FT v ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 171, 0-0 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ b .001 times the total job valuation Surcharge $ w .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( } Non Necessary ( ) Total Due $ Make checks payable to: City of Fridlev Attach Stipulations 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 coffaall work which requires review and approval of plans. SIGNATURE OF APPLICANT/ ��,- , PRINT NA�/� �f j��L c DATE �/I Od C Page 2 - Building Residential Application 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 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1" $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1' $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1' $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1' $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the V $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1" $1,000,000 plus $3.15 for each additional $1,000 or fraction 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 proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 vt Mmug IMI 1-4 -4 Ell :: , P v Ell V Wft %7- Mmug IMI Ell :: , P v Ell %7- rTl A Gl- r -<: . r:�:-; Build*mg $ BUILDINGS Perms Inspections $ 7,13 RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date Rec'd: 763-5024977 FAX $ Erosion Control $ Park Fee EFFECTIVE I-1-09 Sewer Main Charge DATE I el 10 of YOUR E-MAIL ADDRESS 1n l Keo KtA 1 10 K @y u h J 0 C v 00 SITE ADDRESS :1-,51-7 ( eel j% L �e YrGt Gt �% THIS APPLICANT IS: [OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: -e I tJf� ADDRESS:_ -7K I ":I TtJ2d y �' -e (a —1 �f i� G>s CITY i STATE LIP Z,) TENANT PHONE: 6j,�- 2 ik—U (0'qa_ CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILYNEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK MrSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 6 (MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 51 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, EMING ADDITIONS & PORCHES SUBMIT: Vinyl ❑Soffit I. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OEWINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ �) -30 OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ 7,13 Surcharge $ License Surcharge $ SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ - 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) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) 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 fo 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 w e r vO and approval of plan . /� SIGNATURE OF APPLICANT, ` PRINT NAME Z(klq / l l lla DATE Page 2 - Building Residential Application 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 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for V $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1' $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for I" $100,000 plus $5.60 for each'additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1' $1,000,000 plus $3.15 for each additional, $1,000 or fraction 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 proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Iv x15 . III•`,