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PRE 2010 DOCSDate: June 15, 1967 311 1;1 (amity of Fridley, Minn.. N° 9317 BUILDING PERMIT Builder HOMEDALE BUILDERS_. Address 5217 Wayzata Blvd.___ LOCATION OF BUILDING No. _ 7522 Street . Tempo Terrace _ part of Lot Lot 30 _ Block _ _ _ Addition or Sub -Division Melody Manor 4th Corner Lot — Inside Lot R Setback 35' Sideyard __ 5' 10' Sewer Elevation 879 .5 7 882.5 7 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling_ Front 46' Depth 24/2 Height 20 Sq, Ft. 1152 fel. Ft. 23,04 Garage . Front 20' Depth 24' Height 10' Sq Ft. 480 Cu. Ft. 4800 Type of Construction Frame Est. Cost _ $18,190 __ To be Completed Aug. 15, 1967 SEWER LOCATION 164' West of East Manhole or 213' W East of West Manhole WATER LOCATION - 11' 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 forth and in compliance with 21 p ons of ordinances of the city of Fridley. / -1 B A 10 100.04 NSSSD In consideration of the payment of a fee of $ * 34.00 , 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 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 permit does not cover the conshvetioe, Installation for wiring, phnnhing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: BUILDER ADDRESS ADDRESS LOCATION OF. BUILDING N0.��STREET _PART OF LOT LOT ® BLOCK -1*5 DITION OR'SbBDIVISIO, CORNER LOT INSIDE LOT SETBACK SIDE -Y 7�]C� SEWER ELEVATION FOUND ION VA04 yeti c [-nom .� %� 7� . d - `, Applicant attach to thi orm Two Certificates of Survey of Lot and proposed building location 4rawn on Mese Certificates. DESCRIPTION OF BUILDING To be used- as; Front 41Z Depths L.eight Sq..Ft• Cu. Ft. � Front Depth,.Height Sq. ' 'Ft.� Cu. Ft. Type of Construction ,/ff��,��, Estimated. Cost To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance.with the City of Fridley Ordinances and rulings of the Department of'.Buildiings.,.an'd hereby declares that all the facts and representations stated in this application are true and correct. DATE? -�140 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side 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 tb any existing building or structure, 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 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 coic 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 00.90) for„each one thousand cubic feet or fraction thereof, in the cubical contents'there-of 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 fee charged for any permit as set forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE FEES: Residential: Estimated Cost of work up to $500.00 $5.00 Estimated Cost of work over S4 Y>._.1.-;,0 Commercial; Estimated -ost of work Estimates At of wo1 < u;r::r _Iec-.fit! Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL 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 $ 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 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 TOT 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 Dept. of Bldgs. Phone 560-3450 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, Minn` ® 19 Owneree m Kind of Building�� Used as�+��% To be completed about Estimated Cost, $�' Old New, wilding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, 40 arm Air— o j Trade Name—¢' %�� Size No.�� Capacity Sq. Ft. E.D.R 0* BTU P. Total Connected Load Kind of Fue BURNER — Trade Name' �� J �� ; � Size No- ��✓%� Capacity Sq. Ft. E.D.R29� BTU H.P. (REMARKS -OVER) Signe Y N. WELTER H EATI N G 00 4637 CHICAGO AVE. ByLA A ALI &10 CQMD.42 Business Phone No r �+; rn% { City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Location— 00 Number, Kind and Location of Fixtures q NO. RATE TOTAL jft Number Fixtures ....... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ y. x $3.25 $ o U0' F N WATER HTR. GAS ELEC. Electric Water Heater �d�O $ GAS FITTING FEES: NO. RATE TOTAL l 1st 3 Fixtures ........................... x $2.00 $ �v Additional Fixtures ..... .............. x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Base 1st 2nd 3rd 4th _ ' Future Connection Openings I Connected with e New Fixture, Old Openings I JJ Sewer Cesspool PARTIAL MATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL jft Number Fixtures ....... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... ..................... x $3.25 $ o Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL l 1st 3 Fixtures ........................... x $2.00 $ �v Additional Fixtures ..... .............. x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Rsfer to Code Description ................................................ TOTAL FEE 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- d Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. _� A ROUGH �/ ( / FINAL Business Phone r3 City of Fridley Applic0ion far Plumbing and Gas Firing Porn* 87 ®°1 Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location 7522 Tempo Terr. y C_}a i N gQz N �uz1 0� q� W o z z �o • F • N WATER HTR. GAS ELEC. Base 1st C nn 2nd 3rd 4th _ • Future Connection Openings New Fixture, Old Openings I Connected with sewer ❑ Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin .... ....................... Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ NO. RATE TOTAL x $1.50 $ — x 1.20 $ — x 1.00 $ — x 3.25 $ — x 2.00 $ — 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 it REPAIRS & ALTERATIONS—Refer to Code Description ...............................................$ TOTAL FEE $ 3.00 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. ?1 sep 67 Fridley, Minn: 19— Owner Homed ale Bldr s Kind of Building Used as re s To be completed about Estimated Cost, $ Old—New. Building Permit No Pe it No ' Si- ° Business Phone No ROUGH FINAL City of Fridley, Nihm. N9 9494 BUILDING PERMIT Date: OCTOBER 6, 1967 Owner: _, HOMEDALE BUILDERS Builder A.B.C. BLACKTOP COMPANY Address 5217 WAYZATA BOULEVARD Address 1308 MAIN STREET N. E. N33NEAP0LXS, MINNESOTA MINNEAPOLIS, MINNESOTA LOCATION OF BUILDING No. 7522 Street TEMPO TERRACE N. E. --__._ Part of Lot Lot 30 Black 3 Addition or Sub -Division . _ MELODY MANOR, 4TH ADDITION Corner Lot _ Inside Lot — Setback Sideyard Sewer Elevation __ _ _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: ASPHALT DRIVE Front _ _ Depth Height _ Sq. Ft. Cu. Ft. Front w Depth Height _ Sq. Ft. Cu. Ft. Type of Construction ASPHALT Est. Cost _$136.90 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 t forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 5 ' O , permit is hereby granted to._.._. A.B.C. BLACKTOP COMPS 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 sad 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 permit does not corer the construction, installation for wiring, plumbing, pas hosting, sewer or water. Be sure to a" the Building inspector for separate permits for them items. CI`sy Ok- I'aiN iESCTA 04MIER' S NAME �� 1) � � � <d��.� �� _ RUf'` ME i-3 ADDRESS _ . �� w 4� � �4 �Z P i.) ADDRESS LOCATION OF BUTLDIING PIO. '% J� . °�-- STREET T /3' PART OF LOT LOT d BLOCK _\2 ADDITION OR SU3D VISION S > • T/ CORNER LOT INSIDE LOT SETBACK. SIDE -YARD SEWER 'ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location dram on these Certificates. To Be Used Ag: DESCRIPTION OF BUILDING- To UILDING Front Depth, Height Sq. Ft. Cu. rt.^ _Front Depth Height Sq. Ft. Cu. Ft. Type of Construction � Rr®Estimated Cost 5 311, 9 /1 To Be Completed - /-:2 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 C , (Schedule of Fee Costs can be found on the Reverse Side).`�� BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building of structure, or for any addition to any existing buildin- 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 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 multipluing 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. 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. HOUSE HEATING TEST RECORD ADDRESS � '� � � APT. F DOR �� CI P ]2,2&U � � �'V, OCCUPANT OWNER;, HEAT LOSS DATE HTG. INST. GAS CO. METER BAD # SOLD BY INSTALLED BY��%' Electrical Work By Gas Line By TYPE OF HEAT GA -FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS E!:Gft -�--� CONVERSION MAKE — L �s MAKE OF BURNER Model®�,�i®� k,� 1 Model Serial -7 Max. BTU Rating. INPUT MAKE OF FURNACE Model CONTROLS a0/ THERMOSTAT Heat Plug Vent Size Valve KIND OF LINER E—NONE Limit Draft Hood 49Z_Regularor Limit Setting az-92nn Filters Size ber Fan Setting ,T�� Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make } Pilot Model Smoke Bomb Wiring Pilot Timing Draft —Test Tag L.W. Cut Off�� E 9 da. � Door Pressure Lighting Inst. � Pressure Per,�,n CO ate Tested Input CFH Pedb�� mpany Testing Stack Temp. --.- �� Percent CO Name of Tester Form 235 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 f46iW.A0111 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 20.00 Gas Piping (Needed with new furnace) $10.00 Gas Range $ 10.00 Gas Dryer $10.00 *Air Conditioning — Ali Sizes $10.00 5R4 (,ti X o D,4 BAvA r)T All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work Commercialli ndustrial 1% of Value of Appliance or Work State Surcharge TOTAL FEE TOTAL $ ®-o-6 $ .50 1'0 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATIONIAIR 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. Effective On January 1, 1993 JOB ADDRESS—/75,2;; %_gm oo / e_,e eA d C' 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. ,1993 OWNER g6IMI-b J • /� L{! V 0 P BUILDING USED AS D 1,0 EL w 4 &- ESTIMATED COST X40, 6b PERMIT NO. / /3 V DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units S Circle One (Steam) (Hot Water arm A' Trade Name 6RVAtir Size No. 39566 V 03(co67l BTU (,?&, a7io HP EDR Fuel 1??.a t 4 Total Connected Load 63, d'M —y Gv t'rH 4" N I M ver' f✓Y 0 A9'CP,_ Burner Trade Name Size No. BTU HP EDR SLAINE M'G, AIC & ELECT. INC 13562 CENTRAL AVL=. N.E, HEATING COMPANY ANOKA, MN 55304 Signed By r Tel No. '75 `2--0-3 ®_6 Approved By < Rough -1n Date Final Date �3 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE HEATING HOUSE HEATING TEST RECORD BIMPAINE AIR CONDITIONING AND ELECTRIC, INC. ADDRESS 75-�- 2 1 'G' iq iP 7-r OCCUPANT r, Lox lcA HEAT LOSS DATE HTG. INST. SOLD BY Electrical Work By As ll TYPE OF HEAT GA FAy HW STEAM SPACE HTR. MAKE (� GAS DESIGN IJP �1M% Model S 0 ®.'s— Serial Heat Plug INPUT (0,000 Form 235 APT. FLOOR CITY V/ % SUBURB OWNER INSTALLED BY ELAINE HT®, AIC A ELECT, INC. Gas Line By 13582 CENTRAL AVE. N.E. UNIT HTR. OTHER CONVERSION MAKE OF BURNER Model Max. BTU Rating MAKE OF FURNACE Model Vent Size �) KIND OF LINER SIZE L! NONE Draft Hood R Regulator Filters Size 14 it2 S / Number Chimney Location Inside Outside Chimney Construction Q nv< Smoke Bomb Wiring Draft Teel Tag Door Pressure Date Tested Company Testing Name of Tester. '� Lighting Inst. ^� CONTROLS THERMOSTAT I Heat Plug Valve Limiteqf-® Limit Setting 100 Fan Setting 1 M e Pilot Type POTSR Pilot Make Pilot Model Pilot Timing 6 L. W. Cut Off Pressure r S Percent CO, Input CFH Percent Op Stack Temp. 'Sdn� Percent CO Form 235 APT. FLOOR CITY V/ % SUBURB OWNER INSTALLED BY ELAINE HT®, AIC A ELECT, INC. Gas Line By 13582 CENTRAL AVE. N.E. UNIT HTR. OTHER CONVERSION MAKE OF BURNER Model Max. BTU Rating MAKE OF FURNACE Model Vent Size �) KIND OF LINER SIZE L! NONE Draft Hood R Regulator Filters Size 14 it2 S / Number Chimney Location Inside Outside Chimney Construction Q nv< Smoke Bomb Wiring Draft Teel Tag Door Pressure Date Tested Company Testing Name of Tester. '� Lighting Inst. SUBJECT PERMIT NO. City of Fridley 23042 AT THE TOP OF THE TWINS BUILDING PERMIT r *Ed —EI PT N0. • _ COMMUNITY DEVELOPMENT DIV L PROTECTIVE INSPECTION SEC. ` _ /� )"" r ; 0 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 J11,,"f 1'' 612-571-3450 910-F15 10/27/94 JOB ADDRESS 7522 Tempo Terrace NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 30 3 I Melodv Manor 4th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron Rloyda 7522 Tempo Terrace NE 784-1434 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sela Roofing 4100 Excelsior Blvd, - 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 X B DESCRIBE WORK Reroof House & Garage (28 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 1 HEREBY CERTIFY THAT IHAVE 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,100 $1.05 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- $54.00 Fire SC $2.10 STRUCTI OR THE PERF ANCE OF TRUCTION PLAN CHECK FEE TOTAL FEE %K -Rh-71W License SC $5.00 $62.15 I ATUREOFCONTRACTORORAUTHORIZE AGENT (D Ei WHEN/PROPER VALIDATED THIS IS YOUR PERMIT ?L'-0CjeINSP GATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEi NEW [ ] Effective 1/1/94 ADDN [ ] CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: Z-5 leAl o &L-:-.0 dCC A107 - Legal Description: Owner Name & Address: A4DAI „ a 752 �r?o �-- ttc r Tel. # 7 ? y - 1,K-? 5/' Contractor: !C'-,c-�'f A,,) Fj,ef MN LICENSE # Address:T Tel. # � . 04f �o Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: e ,co -,4Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: o L APPLICANT: Tel. # ,',)– CITY USE ONLY Permit Fee $ ? `1� � Fee Schedule on Reverse Side Fire Surcharge $ • / C' .001 of Permit Valuation (1 / 10th % ) State Surcharge $ /, C? $.50/$1,000 Valuation SAC Charge $ $800 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 Ofticial 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 FME $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 first $29000 plus $9 for each additional $1;000 or fraction thereof, to and including $25,000 $2.5,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1000 or fraction thereof, to. and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional .$1,000 or fraction thereofto 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 3500,000 $500,001 to $1,000,000 - $2039.50 for the fust $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 b 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 tirne 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 franring- CITY OF FRIDLEY INSPECTION Div. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On August 1, 1995 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR aIrmw , - •:. ! "� Old Opening, New Fixture all i' • • e •� • k g F - � and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 I Y 1 1'1 yllv'� Nf�SEa Catch Basin $ 7.00 a Rain Water Leader $ 7.00 c ,1995 Sump/Receiving Tank $ 7.00ot-q— Water Treating Appliance $10.00 Owner)K'7d_PC;W'00LJ61'6-` Water Heater —Electric $ 7.00 Water Heater — Gas** $10;00 < Gas Range** � Gas Dryer** �� ,�' � '!N++!`"SIF _L�I.�?'1fr�I'�ifl��:e�:�{J�� la: .,=• ':{�1j,'tj��rlv_FP: t•{',��4'-'�-','-_'�°.- $15.00 PLUMBING COME"t Reinspection Fee $42.00/Hr , �,.c-, .k!'9 ° ,Yr'� :;!rnij!!;iG {:.+F :- . i ALL OTHERS AND/OR REPAIRS AND ALTERATIONS �'�':. � •- �k .�^.:_.:n!^_ a 1.5% of value of Fixture or Appl'Iance Approved By Rough—in Date Final Date State Surcharge ,50 MINIMUM FEE FOR ANY PLUMBING GA ERMIT IS TOTAL FEE ._./ PLUS THE $.50 STATE SURCHARGE ---- -----_-.-------� **COMBUSTION A1R;SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. PLUMBING FIXTURE RATES.: NO. RATE TOTAL JOB r Na New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specilled agreeing to do all work In strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 c ,1995 Sump/Receiving Tank $ 7.00ot-q— Water Treating Appliance $10.00 Owner)K'7d_PC;W'00LJ61'6-` Water Heater —Electric $ 7.00 Water Heater — Gas** $10;00 Building Used As Gas Range** � Gas Dryer** $10.00 $10.00 to Estimated Cost ®`�`� PERMIT NO. / fid Back Flow Preventer Required ( )Yes {) No Type $15.00 PLUMBING COME"t Reinspection Fee $42.00/Hr SIGNED F3Y TEL N0. �`` ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of value of Fixture or Appl'Iance Approved By Rough—in Date Final Date State Surcharge ,50 MINIMUM FEE FOR ANY PLUMBING GA ERMIT IS TOTAL FEE ._./ PLUS THE $.50 STATE SURCHARGE ---- -----_-.-------� **COMBUSTION A1R;SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. ' SUBJECT City of Fridley 29231BUILDIN� AT THE TOP OF THE INS PERMIT I.COMMUNITY DEVELOPMENT DIV. I LV _____ r � � PROTECTIVE INSPECTION SEC, 1 NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910415 4/16/99 JOB ADDRESS 7522 Tempo Terrace NE' 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3O 3 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron Kloyda 7522 Tempo Terrace NE 784-1434 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ea leview Construction Inc 2937 174 LnNW Andover, MN 55304 753-5469 A ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20076043 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Q ADDITION ❑ ALTERATION fR7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (22 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State 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 REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] STALLS IGARAGES 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 $1,885 $.94 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- $59.50 Fire SC $1.88 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION G: PLAN CHECK FEE TOTAL F E �yu''�fh Licen C $5.00 `7.32 v NATURELOFCON-RACTORORAUTHORIZEDAGENT IDA l HEN OPE LIOAT IS YOUR ERMIT 8106G INSP r)ATE S-GNATURE OF OWNERO; OWNER BUILOERI IOATEI I Effective 1/1/99 NEW CITY OF FRIDLEY- ADDN [ ] � p ADDN [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 . ALTER BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Tel. Owner Name & Address: E # 71° ®� Contractor: ��'�-✓ � '`�- MN LICENS :P" -7/• ��%'� ��'�' Tel. # %S-3 Address: 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. '" Width Height Sq. Ft. GARAGE AREA: Length DECK AREA: Length Width Hgt/Ground Sq. Ft: OTHER: Construction Type: Estimated Cost: $ / &I (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: Gi APPLICANT: �! �✓�� Tel. CITY USE ONLY Permit Fee $_ 9 �O Fee Schedule on Reverse Side Fire Surcharge $ ' .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAG Charge $ $1050 per SAC Unit License Surcharge $ 6 -- d® $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee.. $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] "TOTAL ' $ STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for action thfirst ereof, and 0Plus $500 $500,00 00for each 01nal $1,000 or f $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 $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. SUBJECT PEPAlf NO. City of Fridley2 945 9 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. SEC. -7q1 r 1 PROTECTIVE INSPECTION 1 � = 1 ----1 CITY HALL FRIDLEY 55432 �'' NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/13/99 JOB ADDRESS 7522 Tempo Terrace NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 30 3 Melody Manor 4th Addition SHEET I 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kloyda 7522 Tempo Terrace NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Phalen Siding & Trim 1528 Lincoln Ave, St Paul, MN 55105 (651) 731-2092 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CA REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House & Garage 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. 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 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 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,950 $3.47 DOES NOT PRESUME TOGIV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTH STATE OR LOCAL LAW REGULATING CON- Fire Ci $6.95 ST UCTIO E PE RMANCE OF CONSTRUCTION $139.25 PLAN CHECK FEE TOTAL E Lice S $5.0 54.67 A TUR 'RACTOR OR AUTHOR, D AGENT ,DATE, HEN QPom1$ I<� - ✓ IT Cyp�a]y'� w BLD ,N$P QAfE S,G UAE Of OWNERoF OWNER BUILDER, (DATE, NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: c Tel. # Contractor: ��-� d ' ��' % '� — MN LICENSE # Address: ,%�--� ti �, '�- G �. /n. S7�r �/"�� / Tel. # 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: � �r 1 a Construction Type:v7 / J7 Estimated Cost: $, Driveway Curb Cut Width Needed: _ Ft. + 6 Ft = Ft x $ VSs � _$ t DATE:�� APPLICANT: Tel. # CITY USE ONLY Permit Fee $ .3 9, a:5� Fee Schedule on Reverse Side Fire Surcharge $ 6.96 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 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 $ 4a, lv STIPULATIONS: BUILDING PERAM 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 $23.50 FEES $501 to $2,000 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $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 $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. - e- CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 PLUMBING FIXTURE RATES: APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR NO. RATE TOTAL JOB Effective On Jan 1, 2000 New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range** $10.00 Gas Dryer** $10.00 Estimated Cost Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Hr SIGNED BY. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By State Surcharge S .50 alb MINIMUM I TOTAL FEE $ PLUS THE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. =— .20CI( '&XIAA PERMIT NO. e Rough -In Date Final Date 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 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 ( ) 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: CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 June 29, 2001 Mr. Ron Kloyda 7522 Tempo Terrace NE Fridley, MN 55432 Re: Final Inspection at 7522 Tempo Terrace NE Contractor: Shiloah Water Co Dear Mr. Kloyda; - A plumbing permit was issued on January 9, 2001 to install a water softener at your address. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Plumbing Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expired the permit and no further action will be taken. To set up the inspection, or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURFS TO RF INSTAI I Fn ON FAr:H 1:1 nnP Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, New f=ixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas*" Gas Range'` Gas Dryer"`* Back Flow Preventer Required ( )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 $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS_ J NIE i -s dW01- �- 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 P,uilding Division, and hereby declares that all the facts and representations stated in this application are true and correct /off 20 Owner lal ata K Loyda — -7522.. f eMPO TC . ,I&. Building Used As F)ESIDcw Cz Estimated Cost PERMIT NO. `k PLUMBING COMPANY /OLU A) SIGNED BY TEL NO.S`�O�j Approved ByRough-In Date Final DaV6� .50 MINIMUM FEE OR ANY PLUMBING/GAS PERMIT IS S20,0Q PLUS THE $.SA STATE SURCHARCF' COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. COMMON VENT INFO ON BACK SIDE New 7mm �■am== PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, New f=ixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas*" Gas Range'` Gas Dryer"`* Back Flow Preventer Required ( )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 $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS_ J NIE i -s dW01- �- 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 P,uilding Division, and hereby declares that all the facts and representations stated in this application are true and correct /off 20 Owner lal ata K Loyda — -7522.. f eMPO TC . ,I&. Building Used As F)ESIDcw Cz Estimated Cost PERMIT NO. `k PLUMBING COMPANY /OLU A) SIGNED BY TEL NO.S`�O�j Approved ByRough-In Date Final DaV6� .50 MINIMUM FEE OR ANY PLUMBING/GAS PERMIT IS S20,0Q PLUS THE $.SA STATE SURCHARCF' COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. 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 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.( ) 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 Cb. Signed By: Date : Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By. 763-572-3604 e CITY OF FRIDLEY Dat • , a 000 1 DATE YOUR E-MAIL ADDRESS E SITE ADDRESS !,W0 THIS APPLICANT IS: ✓ ❑ OWNEA P&NTRACTOR PROPERTY OWNER/ NAME: ?J ian nom. K LexidaL— TENANT ADDRESS:oZ o� r CITY 4 r 1 Q.t/ STATik*ilP S S Y YZ- PHONE: .3' ^- "1 3 7`t CONTRACTOR Nom: SUBMIT A COPY OF 9 STATE LICENSE # 4100 EXAGMSM BIAWDATE YOUR STATE LICENSE ADDRESS: ST, I 5AI CITY STATE ZIP WITH APPLICATION � PHONE&/"$�3— 'l6 MkX PROPERTY TYPE MINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH=ROOF 13 DRAIN TILE 11 DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES Uo ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 13 ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: 1 PROPOSED HEIGHT: 11 DETACHED GARAGE 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF 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) Permit Fee Plan Review Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due JUIS VALUATIUIN $ 000UYAIVCY $ See Back Page for Fee Schedule $ 65% of Building Permit Fee .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $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 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 whi t requires revieLnapp��%% �val of plans. Ul—;C'g' /�SIGNATURE OF APPLICANT 'e'm '7 7l�iC J PRINT NAME Dean AIL DATE [ l ! Co $ �D e .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $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 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 whi t requires revieLnapp��%% �val of plans. Ul—;C'g' /�SIGNATURE OF APPLICANT 'e'm '7 7l�iC J PRINT NAME Dean AIL DATE [ l ! Co Page 2 - Building Residential Application BUILDING PERNUT 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 V $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 V $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 0 $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 In $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 GA91TTlllVerJ'1t Avenue-1VL' Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 uilding $ BUILDING See Back Page for Fee Schedule Permit No. aspections RESIDENTIAL APPLICATION Received By:. 63-572-36-04 $ . 7 Q CITY OF FRIDLEY Surcharge Date R x'11 J U L 0 =:I'E L 11% YOUR E-MAIL ADDRESS O Q�.► A ��d �r b/1 /S tom _. J ADDRESS S 2 P Mb P N' 6 C4_ C11/y S 04 S APPLICANT IS: ❑ OWNER b�ONTRACTOR $ :Ot ERTY OWNER/ NAME: fu Cut Escrow ADDRESS: T iZ 2 7P M D A ?! 1 CITY I (STATE ZIP SS Y3'> TENANT ion Control PHONE:_ 7 G 3.1..7 B Y- 111 3 y / $450 Conservation Plan Review Windows & Doors $ CONTRACTORPella Fee Determined by Engineering Nom'— 15300- 25th Avenue N.- Suite 100 $ UBMIT A COPY OF STATE LIC Plymouth, MN 55447 1 Due ;)UR STATE LICENSE ADDRESS: 763/ 745-1400 CITY STATE ZIP VITH APPLICATION PHONE 'ROPERTY TYPE 11 SINGLE License# 20165884 �E ❑ TWO FA J _ .ORMS PERMIT TYPE ❑ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF DRAW TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL F17PE OF WORK: ❑ NEW ❑ ADDITION MAI1,1TENANCE/REPAIR ❑ REMODELING SCRIBE WORK BEING DONE: W o to1 rn ! ! J / / 1 f OF IMPROVEMENT LENGTH WIDTH HEIGHT S j . Ft. ',FING ❑ HOUSE ONLY :3ER OF SQUARES ❑HOUSE &GARAGE BASEMENT REMODELING SUBMIT: -;.AGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan ., 'OSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used :,OSED HEIGHT: '_NG FOR NEW CONSTRUCTION INCLUDING DECKS, ;nyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: Juminuin ❑ Trim 1. Site Plan/Survey showing the existing structures :,er ❑ Fascia and proposed project. ,,rows 2. Two sets of construction plans _!STING OPENINGS t`es ❑No ATION OF WINDOWS 3. Energy Calculations )R NEW OPENINGS -DESCRIBE SIZE OF I��►t/IAA y D+ 11 y)Q Ii WI U :1NG CHANGES & i f/S /- rA ^ -1 OF WINDOW TO BE INSTALLED ! NUMBER OF WINDOWSB_p ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION (USING THE 1997 -7 .0 FEE SCHEDULE) TYPE st Fee $ a 0. g , See Back Page for Fee Schedule Review $ 65% of Building Permit Fee '.harge $ $ . 7 Q (.0005) times the total job valuation — Minimum $.50 Surcharge $ / /- g' $ .001 x Permit Valuation (I/10%) nse Surcharge $ S 04 $5.00 (State Licensed Residential Contractors) Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Cut Escrow $ ft + 6 ft = ft x $20 = $ ion Control $ $450 Conservation Plan Review Fee $ Fee Determined by Engineering -�r Main Charge $ Agreement necessary ( ) Non Necessary ( ) 1 Due $ ;2 3 t - L 9 Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED _Pby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in ':=ance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a .it 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 ;.n the case of all work which requires r iew and. approval of plans. r � < /1 7 ATURE OF APPLICANT G� PRINT NAME / ✓ 1 ' ` DATE � I] Page 2 - Building Residential Application BUILDING PERNIIT 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 my 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 $23.5.0 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 l' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $39125 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 l- $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 l' $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