PRE 2010 DOCSDate:
Owner:
May 15, 1969
Builder
Homedale Blders.
Address ____ A&ress 5217 Wayzata Blvd.
,41 , 6 0AUT e �, a, e'
Ij�7opfr
N° 923'7
No. 7542 ` Street Tempo Terrace part of Lot
Lot 3 Z Y --Block 3 Addition or Sub -Division . Melody Manor 4th Addn .
Corner Lot —_ Inside Lot — x Setback 35 Sideyard 71
Sewer Elevation 883.00 996-00
Ton of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling
Front /±2
Depth 26 Height
� 20 Sq. Ft. 1092
CU. Ft.
21840
Garage
Front 20
Depth 24 freight
10 Sq FL 480
Cu. Ft.
4800
Type of Construction
Frame
Est. Cost $20,000
_ To be Completed
_Aug. 1,
1967
SEWER LOCATION- 23.5' East of Manhole
WATER LOCATION- 33.5' East of Manhole
In consideration of the issuance to me of a permit toco a building described above, I agree to do
the proposed work in accordance with the description above t and in coxzliance with all provisions of
ordinances of the city of Fridley. effJJ•.
100.00 NSSSD
In consideration of the payment of a fee of $ 40.00—,
0.00, 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 anypart 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 construction, installation for whbg, phunhing, gas heating, rower or wafer. Be sure to see
the Building Inspector for separate permhs for them atoms.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEYJ,MXNNESOTA
OWNER'S NAME BUILDER®_
ADDRESS ADDRESS. _.
�^ LOCATION OF BUILDING
N0. 7 r7` ?i STREET ^i PART OF LOT
LOT BLOCK ,,ADD TION OR SUBDIVISION2?,�? �e
./�`"r
CORNER LOT INSIDE LOT A` SETBACK. SIDE -YARD
SEWER ELEVATION FOUNDATION 'ELEVATION.
Appl ci-ant attac ro this Uform o Certificates of Survey of Lot and proposed
building loc tion dr wn on these Ce tificates.
DESCRIPTION OF BUILDING
To be used as:
Front /' .Depth s/4 Height
Sq. Ft.—®i`?�- Cu. Ft.
Front Depth.�Height/z5
Sq. Ft. !z j?to `Cu. Ft. C,
Type of Construction a'!!)L� � 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 Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.,
DATE /i�;,7 SIGNATURE
70
(Schedule of Fee Costs can be found on the Reverse Side
/ E
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing any permit for- /
the erection of any building or structure, or for any addition to any existing
building or structure, or for any alterations or repairs to any existing
building or structure, upon application therefore, require the payment by t'h�
applicant for such permit of fees to the amount herein below set forth and in�f
the manner herein provided to -wits
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 they --
rate of $1.25 for'each one thousand cubic feet, classified as "fireproof" A
by Section 502 of.the Minneapolis Building Code.:<5
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.
22.5. 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 fracV�.vn
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 X1000.00
- 95.00
Estimated
Cost
of wow k c-;er
Commercial; Estimated
'-)st
of xjrn a. u -y, .o
Estimates.
.,st
of work over � 00. Vii -
$2C. i
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 .......................... 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 Bldgs. Phone 560-3450
Location
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 �J ��d�� y 16�
Owner
Kind of Building��
Used as.
To be completed about
Estimated Cost, $_6
Old uilding Permit No. 9�2.�'% Permit No. �31?6
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water arm —No
Trade Name— 5_e-� Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Loath Kind of Fuel
h BURNER —Trade Name—,- �/ �. Size No-
Capacity Sq. Ft. E D.R I BTU H.P.
(REMARKS -OVER)
sigRnedAY N ®WELTER HEATING a
4637 GHIC.;4Gf_? AVE.
By—i Y i .Rous 20
e¢w42 Business Phone No-
City of Fridley,
BUILDING PERMIT
Date: — July 25, 1967
Homedale Blders
�Vl/ 9
N® 9310
Builder A.B.C. Blacktop Co.
Address 1308 Main St. N, E.
LOCATION OF BUILDING
No. 7542 Street Tempo Terrace — part of Lot
Lot 37 Block - 3 Addition or Sub -Division . Meldoy Manor 4th Addn.
Corner Lot — Inside Lot _ _ Setback ... - Sideyard
Sewer Elevation
To be Used as:
Foundation Elevation
DESCRIPTION OF BUILDING
Front
Depth
Height
Sq. Ft. Cu. Ft.
Front
Depth
Height —
Sq. Ft. Cu. Ft.
Type of Construction Asphalt
Drive Est. Cost_
$148.00
To be Completed
In consideration of the issuance to me of a permit to construct the building described above I agree to do
thordinpa�nces od work the in accordance
Frdanc with the description above sit f�rtt� and "mpliance with a'll provisions of
In consideration of the payment of a fee of $ 5.W0 , permit is hereby granted to A. B. C.
131mkt v Co. to construct the building or addition as described above. This pern►it 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 pennh don not cover the construction, installation for wiring, plumhing, gas heating, sewer or water. Be sun to see
the Building Inspector for separate permits for these Mena.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME
�'� L
�l/GAS �� S
S.
BUILDER
ADDRESS __?6gb�
4/6
ADDRESS
/ �� _ d�'Jiq jai , •[ `
LOCATION OF BUILDING
NO. j V;,% STREET l) 4 PART OF LOT
LOT &) BLOCK
ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK
SIDE -YARD
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form two certificates of survey of lot and proposed
building location drawn on these two certificates.
To be Used as:
DESCRIPTION OF BUILDING
_Front Depth
Sq. Ft.
Front Depth
Sq. Ft.
Cu. Ft.
Cu. Ft.
Height
Height,
Type of Construction Q rc n Estimated Cost
To Be Completed /���
ZZ
The undersigned hereby makes application fora permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley 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.
DATE _SIGNATURE
_e�,4e, d&&-,, c, -
(Sche ule of Fee Costs can be found on the Reverse,Side).
r
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
building:or structure, or for any alteration or repairs to any existing building
or structure, upon application therefore, require the payment by the applicant
for such permit of fees to the amount herein below set forth and 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.
U I T Ut' r-M[L)LCT INOt'tU i IUIV UIV,
6431 University Ave NE
Fridley, MN 55432
572-3604
tnective un January i, iyya
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EAOH FLOOR
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
Water Heater — Gas
Gas Range
NO. RATE TOTAL JOB ADDRESS_ _ I_ _Z e'5e P 10C 1 e
Gas Dryer
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00 6
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$5.00
Reinspection Fee $30,00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
State Surcharge
$ .50
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.
�3 1 / -) ( , 199f
Owner TA 'i 'Do N Ne
Building Used As eSq
Estimated Cost 5Z . PERMIT NO.
PLUMBING COMPANY !1
SIGNED BY -6J Gvr ' TEL N0. -79 2- G%
Approved Rough—In Date Final Date
. 4
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS 7542 TEMPO TERRACE N.E.
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work
Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the
Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares
Also Replacement Furnace $ 20.00 $ that all the facts and representations stated in this application are
true and correct. 8-17-92 ,199
Gas Piping (Needed with new furnace) $ 10.00 $
OWNER JOHN STEFFEN
Gas Range $ 10.00 $ RESIDENTIAL
BUILDING USED AS
Gas Dryer $ 10.00 $
ESTIMATED COST $1380.00 PERMIT NO. xF
"Air Conditioning - All Sizes $10.00 s --!O-.00
BRYANT 594CNX024 DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
Commercial/industrial BTU HP EDR
1 % of Value of Appliance or Work $ Fuel Total Connected Load
State Surcharge $ ` .50_- _., Burner Trade Name Size No.
TU HP EDR
TOTAL FEE1BLAINE2 CENT& lLE�CT�i..�IP
-
iHEATING COMPANY BUINE HEATING, AIR COND & '11W
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed By ckj.�JTel No.
PLUS THE $.50 STATE SURCHARGE 6
9�y
REINSPECTION FEE $30.00 Approved By Rough -in Date Final Date G /ry
laced in a side and without iY /
Air Conditioners can not be p Y
written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
SUBJECT
PERM]_-':
City of Fridley
21570
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
' ,
R
Lu »tee_ COMMUNITY DEVELOPMENT DIV.
r %
r � PROTECTIVE INSPECTION SEC.
�
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/24/92
JOB ADDRESS 7542 Tempo Terrace NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
37
3
Melody Manor 4th Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Steffen 7542 Tempo Terrace NE 780-9375
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
The Carpenter Inc, 19014 Wolfram St NW, Anoka MN 55303 753-1663 4037
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 C�1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Enlarge closet and remove knee-wall
9 CHANGE OF USE FROM TO
STIPULATIONS
Smoke detector must be installed if not already installed,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. -
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,280
$.64
WITHWHETHE PECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT P EES-"AE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISION OF/ ANY OTHER STATE OR IOtAL LAW REGULATING CON-
Fire SC $1.28.
STRUCTIO -OR THE PERFO E F ONSTRUCTION.
$31,00
PLAN CHECK FEE
TOTAL FEE
",'
License 5C $5.00
$37.92
SIGNA RE OF CONT A R AUTHORIZED AGENT (DATE]
_g
HEN VA I D THIS IS YOUR PERMIT
Z
INSP nATE
SIGNATURE OF OWNER IIF OWNER BUILDER] (DA'
NEW [ ] Effective 3/1192
ADDN [ J CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
Legal Description:
Owner Name & Address: EJo,* 0 Tei. # '760 ,374,
L
Contractor: Dht-e— 1- • Pt�Tt�� 5v-yj �A—le 4 / MN LICENSE # LPOO '%Q 3 7
Address: 1?e/
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
1, AIAJ 553®3 Tel. # `%5 - ?-
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length 'Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date:
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $ /fig® 0
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. Ft $
DATE: APPLICANT: �� ^~ Tel. # 1
Permit Fee
$
00
Fire Surcharge
$
Z
State Surcharge
$
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Park Fee
$
Sewer Main Charge $
TOTAL $
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,00 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary [ )
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure,
or for any addition to any existing building or structure, or for any alteration or repair to any existing
building or structure, upon application therefore, require the payment :by the applicant for such permit
of fees to the amount herein below set forth and in the manner herein provided to -wit:
TOTAL VALUE FEES
$1 to $500 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times
$13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been
constructed will be required before proceeding with the framing.
SUBJECT
E NO.
City of Fridley
2673 4
AT THE TOP OF THE TWINS
BUILDING
PERMIT
'r ,
T NO
COMMUNITY DEVELOPMENT DIV.
T ,df
r PROTECTIVE INSPECTION SEC.
1 r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/21/98
JOB ADDRESS 7542 Tempo Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.SHEET
37
3
IMelodyManor
4th Addition
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Stock Roofing Inc
780-3561
3112
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO,
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION M REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 22 S Tear-off
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 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 1 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
$1834
.92
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY O R STATE OR LOCAL LAW REGULATING CON.
STRUCTION OR THE PECRFORMANCE OF CONSTRUCTION.
$59.50
Fire SC $1.83
PLAN CHECK FEE
TOTALFEE
License SC $5.00
1$67.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
HEN PROPERLY LIDATED THIS IS YOUR PERMIT
BL INSP
�� 0
F)ATE
_
SIGNATURE OF OWNER IIF OWNER SUILDERI IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
e,
Effective 1/1/98
A 1b
0 0
Legal Description: '
Owner Name & Address: Tel. #
Contractor: r c�9� - .z! !253 � - MN LICENSE # 31 2
Address: 2,, b exA Tel. # ;-;Vd — 3 S w'
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: Estimated Cost: $ /
'(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. #
CITY . USE ONLY
C�
Permit Fee �$Fee Schedule on Reverse Side
Fire Surcharge 1. e- $M..$.501$1,000
.001 of Permit Valuation (1/10th%)
State Surchargenf $ Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $_
STIPULATIONS:
CITY OF FRIDLEY PERMIT o.: 2004-00851 1
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 06/10/2004
572-36U4 YAX: (763)571-1287
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APPLICANT
FULTON, JOE & KHIENGCHAI
7542 TEMPO TER NE
FRIDLEY, MN 55432
OWNER
FULTON, JOE & KHIENGCHAI
7542 TEMPO TER NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulaftg construction or the performance of construction.
Annlicant\ I Date
Bldg
SEPARATE PERMITS
BUILDING PERMIT FEE 97.25
PLAN CHECK FEE 63.21
FIRE SURCHARGE 3.98
STATE SURCHARGE, VALUE 1.99
TOTAL 166.43
FOR WORK OTHER THAN DESCRIBED ABOVE.
ADDRESS
: 7542 TEMPO TER NE
PIN
: 113024120036
LEGAL DESC
: MELODY MANOR 4TH ADD
: LOT 37 BLOCK 3
PERMIT TYPE
: BUILDING
PROPERTY TYPE
: RESIDENTIAL
CONSTRUCTION TYPE
: DECK
VALUATION
: $ 3,975.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE
AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 20'X 16' DECK.
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APPLICANT
FULTON, JOE & KHIENGCHAI
7542 TEMPO TER NE
FRIDLEY, MN 55432
OWNER
FULTON, JOE & KHIENGCHAI
7542 TEMPO TER NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulaftg construction or the performance of construction.
Annlicant\ I Date
Bldg
SEPARATE PERMITS
BUILDING PERMIT FEE 97.25
PLAN CHECK FEE 63.21
FIRE SURCHARGE 3.98
STATE SURCHARGE, VALUE 1.99
TOTAL 166.43
FOR WORK OTHER THAN DESCRIBED ABOVE.
Pr 06/07/04 08:23 FAX 612 340 8622 THRIVENT FINANCIALOD
JUN-441—;eW4 11s01�1 FROM CITY OF FRIDLEY TO
NEW CITY OF FRIDLEY
ADDN (] 6431 Universlty Ave NE, Fridley, MN 55432
ALTER (i SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address.
Legal Description: _A&W nc e c- -
owner Name & Afddress:
Contractor..�r/ ) uL-#A ee - 1-1
: c
R
8002
6123408622 P.02iO3
Effective 4/1/2004
(763) 573-3604 Bldg Insp
(763) 571-1287 Fax
Tel. # 2;?:� "717" .7W:S
MN LICENSE #
Address:
`l TeL #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction dmwn on It to scale.
DESCRIPTION OF IMPROVEMENT
LMNG.AREA• Length_ Width Height Sq. Ft
GARAGE AREA; Length width Height Sq. Ft AA
IV aKU
DECK AREA: Length Width � � HgtiGround . Sq. Ft
o-rt`tett:
ConstructionTy _ AeA Estimated Cost
6i PpS,1`C velct-36"
Driveway Curb Cut 'Width Needed: Ft. + 6 Ft = Ft x
DAT-: C� �'��i APPLICANT: -rtoe- V%,AzJ'"1 Tel.#
WoeV
Call (763) 572-3604 for Perm t Fees If mailing In application. Fax to 763-5714287 If using credit card and we will call
you for card number.
CITY USE ONLY •
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
Llcense Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ eq;?
$
$
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of. Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or AIL "W Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ STIPULATIONS:
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