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AF - 43481� SUBJECT P E IT . City of Fridley o- 17980 BU ILDING PERMIT - AT THE TOP OF THE TWINS " f ; � RE . � `L _�_�� COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. % % _ / � � . i [v v � A� /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY `.��J`.I �.J 612-571-3450 9�0-F15 5/14/85 � / JOB ADDRESS '7526 Brigadoon Place N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �. 2 B.�.Q1R1,�YrJ ES.'td't@S SHEET 2 PROPERTY OWNER MAII ADDRESS ZIP PHONE H. Volker 3 CONTRACTOR MAIL ADDRESS Z�P PHONE I.ICENSE NO. Garjac Inc. 481 - 206th Avenue N,E., Cedax, MN 434-7096 4 ARCHITECT OR DESIGNER MAIL ADDRESS i1P PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ��R `�� '"�� rT� �� PHONE LICENSE NO. � � ! 6 USE OF BUILDING Residential ' �MBING ��,fl ' 7 CLASS OF WORK � ♦ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOFK Construct a 39� x 36' Dwelling and a 20' x 20' G a� /�� pN��' E`CECr lo�� tilifres 9 CHANGE OF USE FROM Tq �i cD �� t�, r STIPULATIONS provide a hard sur�ace driveway. Pxovide sod in the front and side yards. Pravide City with a copy of the verifying survey before capping. SEWER LOCATION (6' to 7' Deep in Street) 75' E. of MH (Inv. 895.39 WYE ELEV: 895.69 Expose Service prior to establishing top of footing elev. WATER LOCATION: 76` SW of M.H.. 84' ESE of M.H. DRNEWAY DEPRESSION: 16' = 6' = 22 x$13.50 = 297.00 THE CiTY OF FRIDLEY DOES N0� GUARANTE� THE ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS. 7HIS DATA IS FpR INFORMATlON PURPOSES ONLY, AND PERSONS USING THIS INFORMATION SHOUJ.,� VERIFY IT ON THE SITE, SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED �S NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APP�ICATION STALLS GAfiAGES AND KNOW THE SAME TO BE 7RUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $G2� OOO $31.00 OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHAfiGE P OVISIONS O NV OTHER STATE OR LOCAL LAW REGULATING CON- S CTION OR E PERFORMANC� OP CONSTRUCTION. $319.00 425.00 ("� P A�I CHECK FEE TOTAL fEE lJ 79.75 8 4 7 s�GNntu E OF CONTR TOA OA AUTHORt DAGEN7 IDATE� WHEN PROPEFLY V ATED THIS IS YOUR PERMIT SiGNATURE OF OWNERiIF OWNER BUILDEAi �DATEi BLDG �NSP ��07 N� [] City of Fridley Effective 4/1/84 ADDN� I] R-1 Al1D R-2 AI.TER. [ ] Building Permit Application Construction Address: � � ��-� ��"� ��-�' Legal Description: J � %' / � �- 2 ��a� ryt ��e 7 /if`�'��5' Owner Name & Address : �� i/ a��p 2 Tel .� Contractor: /�� Tel . � �� ^ �� Addresa • � � � D � � a.v-c /�� '�e 01J2 /II �v � Attach to this application, a Certificate of Survey of the lot, With tihe proposed construction draxn on it to scale. DESCRIPTION OF IMPROYBHENT t LI9IIiG AREA: Length _ J� iiidth �� Height � Sq. Ft. �-� � GARAGE AREA: Length �_ Width � l3 Height �_ Sq. Ft. �� DECR AREA: Length Width Hgt/Ground Sq. Ft. dTHER: Corner Lot [] Inside Lot [�(� Ft. Yd. Setback -� � Side Yard Setback 16-� S Type of Construction: �/e��'R 1 � � �i Estimated Cost: # � �o?� c�o Approx. Completion Date. �T,. Z,��'•�� Alt. A Alt B Proposed Driveway Width If NeW Openiag Zs Desired: �•'i`�e _� � See Baek Page for Explanation / DATE: � �S Permit Fee Plan Cheek State Surcharge 3AC Charge Park Fee Setirer Hain Charge lOTAL STIPULATIONS: APPLICANT: Tel. # CITY �SE ONLY � 3 1�,� Fee Schedule on Reverse Side � '�%C(��'� 25i of Building Permit Fee � I�OC� _ �.50I�1,000 Valuation � �'L �i� =425 Per SAC Unit � �-- Fee Determined by Engineering � Agreement Necessary [ ] No� Necessary [ ] � �� vZ � �,f� _ �< s � .�� ...� ,�� . � _ UIYOF FRt DLEY CIVIC CENTER • 6431 UNIVERSITY AVE N.E . FRIDLEY. MINNESOTA 55432 • PHONE (612) 571•3450 Septanber 27, 19ti5 0 Mr. Gary D'Aigle c��'_ 709� Garjac Inc. 481 - 206th Avenue N.E. Cedar, MN 55011 Re: Verifying -Survey for Properties in Fridley Dear Mr. D'Aigle: The following are addresses where your co.�any constructed dwellings and the City is in need of the verifying surveys: r�u7601 Arthur Street N.E. �v7535 Arthur Street N.E. dN7547 Arthur Street N.E. �M 625 Brigadoon Place N.E. �h,7551 Brigadoon Place N.E. o�t�7526 Brigadoon Place N.E.� ;�, c�it, 1341 Creek Park Lane N.E. �13 60 Creek Park Lane 2J. E, �pi7600 Lakeside Road N.E. ,��7630 Lakeside Rpad t1.E. �i1�640 Lakeside Road N.E. �d544 Osborne Road N.E. �564 Osborne Road N.E. �i3�� e�� r'a�� [�� . We will appreciate receiving these surveys as soon as possible. If you have any questions on this matter, please feel free to contact me at 571-345Q. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh SUBJECT . P . City of Fridley � 8679 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T r � � ECEIPT NO. � ; y _._._ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � 1 � i , � /'��1 � CITY HALL FRIOLE� SS432� NUMBER REV. DATE PAGE Of APPROVED BV �'"""�" ,�� 612-571-3450 910-F15 10/3/86 / / JOB ADDRESS '7526 Brig�doan Place N, E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. 1 2 Blomberg Estates SHEET 2 PROPERTY OWNER MAIL ADORESS 21P PHONE Heinz Volker 7526 Brigadoon Place N. E. 780-5665 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WORK 0 NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 12' Deck onto Dwelling 9 CHANGE QF USE FROM TO STIPULATIONS See plan revisions. Use all treated wood. 8� �� d, G tECEPHQ ��g :c�� k�a! utiii;y�.� �EPARATE A!�RMITS R� ► .►� � Q�i�E' �t�c��. �E ��s F� Q _ . R .n FoR �'�� o � �� V��i��;�iG, HEA ("Ii�G, FLt�i'v��li`dG �1�dD SIGNS,, SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VEN7ILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZEO IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORFECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $800 �`. SO WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OFi LOCAL LAW REGULATING CON- ]_S.00 STRUCTION OR THE PEFIFORMANCE OF CONSTRUCTION. � PLAN CHECKFEE TOTALFEE $ 3 J5 $19.25 sicN�CONTRACT ORAU RqEDAGENT IDATEi WHEN PFIOPERIY V I ATED THIS IS YOUR PERMIT �2� `i �. c�� ' �� 3 /�� SiGNATURE OF OWNERiiF OWNER BUI�DERI IDATE� BLDG iNSP 147E �— NE� () City of Fridley Effective 4J118c ADDt; . I 7 R-t AND R-2 ( A1,TER. I 7 Building Permit Application Construction Address: -7 2� r; PL Legal Description: �� G� . . Ownez Name i l►ddress : _ h�e��Z [)ol�c� �526 �Q,-,'��.�Cov,�., /°�. _ Tel. � ��o —s66r � Tel . # S/�'►�- c� Contractor: � �� N � J� � �`� Address• � s"�-6 t3r ,� LIVIl7G AREA: GARAGE AREA: DECR AREA: OTHER: Corner Lot [ ] Attach to this application, a Certificate of Survey of the lot, With the proposed construction dravn on it to scale. DESCRIPTION OF IMPROYEMEh'T Length �lidth Height _ Sq. FL. Length �_ :lidth _ Height Sq. Ft. �d��. Length �� Width I 2� Hgt/Ground L�1 Sq. Ft. ��o[� � � '" `� � �� Side Yard SetDack Inside Lot (] Ft. Yd. Setback _ �U� Type of Construction: /l%�W 1�-� �'� Approx. Completion Date: �Na' �G vc� Estimated Cost: � �� Alt. A Alt P Propose� DriveWay w'idth If Re� Opening Is Desired: _ _ � - � See Back Page for Explanaticn /%� r f% Te 1. �?� Sb 6� D�TE: zn�.�� ?� � APPLICAhT: -- ��"` � � " CITY OSE ONLY Percit Fee : ��v Fee Schedule on Reverse Side Plan Check � 25x of Building Per�it Fee State Surcharge S �.50/�1,000 Valuation SAC Charge � �u75 per SAC Unit Park Fee � Fee Determjned by Engineering SeWer Hain Charge f / AgreemenL Necessary [ ] Not Necessary � � TOTJIL : • STIPULATIO2�S : 1 I � � �-� I � , , ../,/ : , , i.�l� � , : 'i � �;��, r , � �, . � • � Surv� s Certificate COMSTOCK dC DAVIS, INC. Consuldag Eagin«rs and Laad SotveYoes . 1446 Couaty Road J, MinneaQolis, MN SS432, (612) 784-9346 d � SURVEY FOR: � � � �a � Gar-Jac Construction � 481 206th Avenue NE. � Cedar, Minnesota 55011 `n �' �� h � M �'S %z AvENUE A /t/GADoON OLqCE " .N B9°p/'49"W l00.00� � — — � Or.:w. -N r O •� 2'�_70 � � .� \ 3 � o t. � .—� �.��_�y ��.:M..,.�-- ---- � � . .� � O LO-44 'N N N o ' N � u_u :1{SI �-_ 0 N b J � iu r N N ltl �'1 � �0 ��,�� N � �N � � r P � � .�O _2�RG 36.i.4� . O . � O O �., o T 1 O � � • D��:.�.�s. �c �l:�:�y E�x^twk � . �' O �� 5 89°02' /O'E /00.00' � DESCRIPTION Lot 1, Block 2, Blomberg Estates, City of Fridley, Anoka County, Minnesota. SCALE: 1" = 40 O Denotes 1/2" diameter iron pipe monument seC and capped �To. 10332. S�T �N Pt�A.T QG BLOMgSRG EZT.yTE�� i�10t' FO. TH13 $YRVCY• I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. � ].�5.32 Oc�r. 16, 1485 �i83o Reg. Na . Date Job No. 9D Book Na �- t ,'i. , 1 , � � F � -�- v ,..� tia .� ` J � �� .� V� � J � �_ � + � � � � � � � �4 � V p � 1 � Q � � �+ -�.- ti o, � � -�J �_ � ,' i _ i �" ; r � � • O. � r ; x � i f l� +,ryF i I � S c.�.�� ; � S� �,� �� .�.,�e . . �,� �� s� � ■ I 4�z � c��P c�� ; � !'> ]- � ``r Y' � � _ y� —� y ► �1' �K10 Scist I�a�.S�u1ALt / �� ' ti�°. •a � � � ,�� .�. . `'' �' , �� ,� �` ` - � ��` �'�� .?c;�Y <ar�;..- M��, �(�.. 2xio�l6 o�.. cwtc.a. �2x/v S o� 5'T a �..r•��. .�-Hx� p_,�, . n)s•c ::a�.-, sue�ecr RMIT NO. City of Fridley 27 25 6 AT THE TOP OF TME TWINS g U I L D I N G P E R M I T � � RECEIPT NO. � • COMMUNITY OEVELOPMENT DIV. �� i ; L��'�� , r � � PROTECTIVE INSPECTION SEC. � _ � 1 �'��1 � CITV HALL FqIDLE� 55432 NUMBER REV DATE PAGE OF AGPROVED BY �'.-•-�: �.' 612-571-3450 9�0-F15 8/18/98 � � JOB ADDRESS 7526 Bri adoon Place NE 1 LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED DESCR. 1 2 Blomber Estates SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PHONE Tom Wenskan 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Ri ht Wa Roofin Inc. 1200 E. 79th St. Bloomin ton 4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS Of WORK ❑ NEW O ADDITION ❑ ALTERATION �x REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WOHK Reroof house and garage (20 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATfONS . Underlayment must comply with the State Building Code. TVPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOfi 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, OF IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TIi1S APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPUED WITH WHETHER SPECIFIEO HEFEIN OR NOT. THE GRANTING OF A PERMIT $1668 .93 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING CON- S�R TION OR THE PERfORMANCE OF CONSTRUCTION. �S�F.�� lY'e SCi 1.66 � � PLAN CNECKFEE TO FEE License 5.0 61.59 SIGNATUAEOFCON'RACT0�70RAUTHOAIZEDAGENT IDATEI N P O VALID D TMIS IS Y �RMIT � i SiGNATUREOFOWNER�iFOWNERBUiIDERi 1DATE1 BL �NS� �� E NE�J � [ ] ADDN [ J ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1 / 1 /98 � �� ConstructionAddress: `�-52(p (lj(' � q 0.d.d b i�l Legal Description: Owner Name & Address: Tel. # �� - �(',o(p�j Contractor: ��q �-- �1� I c�dp� nq MN LICENSE #��'�{q Address: � Z,QC� � .`3-G�ih � }- . Tel. # �5��-l�i 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: t.P �u-f . [�l � �I�. �(�l ZC� Construction Type: `�'�I�, Estimated Cost: $�'��s�^ ��fl j (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � APPLICANT: ��Q{',U,�v�.Q.�.. �-��-t�1•�, Tel. �# Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ .��r�Q $ � � $_�� $ � �, vC� $ $ $ $ � ��`� CITY USE ONLY Fee Schedule on Reverse Side 001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] �ITY OF FRIDLEY INSPECTION DtV. Effective April 1, 2004 �431 University Ave NE =ridley, M'N 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT �� 763) �72-3604, FAX (763) 571-1287 � MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR .:..:..::.>;.::::n:. ....,.:.:.:..., .,..,:.;:::;:..::. ..,.. . , .. : .... :„.�s:.:��.;:,:�>,_;: �:�y •;.•:{: •:�.{,..,: .:-:.� -��F:>�: :��:a �t-.�: v� .. � Wash �v`4� Floor °-{��+�.. A . � ��>: �`:: {..::�4. .:�:„;,.:,�r. .~.,Y�`� ._,,;.:%...{ ��I;-� uto ��':�;:°`.; Gas _..,.�.. WaterHeater .}.:,•`'• h.y. :; ::.yiy'i.� v:{..i:ii:}".:i ::4�5?,::;"•4�:'v,:•�.�' :.'•:^'i: �n':'�' �'tt.+:.j. ':'�^.�:'�,'�, ..,.ti ;v,uti,,: .`.t..�...:�::;'y,: :,.a:�f,:;��;'<; �::%:;.i:••.%;;-:<:`: ;' -}=x�?{`•}:a;::y;'.•:;. ^'++�::•�'::�;:�: �;: .,y,,,�.} . ' � ' �� .• # Shower � k� Stones �: -. ..:.:::<� Unnal �`�:•Y:.:� :.'�.�. �1�:..,;:r TraY ;.. : �.,- Dr .. . .�::�><::<� Q t:::: . :�� '�.�«<_«> ain :��#=r::;::; Washer �: � �, Ran_ e:�a: v._ Gas Elec Floor 1 Floor 2 Floor 3 Floor 4 �LUMBING FIXTURE RATES: Jew Fixtures �Id Opening, New Fixture 3eer Dispenser 31ow Off Basin �atch Basin �ain Water Leader 3ump/Receiving Tank Nater Treating Appliance Nater Heater -Electric Nater Heater - Gas*' 3as Range** NO. RATE TOTAL � � 3as Dryer'* 3ack Flow Preventer Required ()Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.Q0 $15.00 �einspection Fee $50.00/Hr aLL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25°/a of Value of Fixture or Appliance State Surcharge TOTAL FEE ,ti:;i'>',::a:;•,:�::.�r;:;:::; +`c:::}: i;:ti�:;;::i::::' S%tiy::-}ix'•}"C:: }i 'v+�iir '�'�{:.5. wiii`:: . .: ..: , :.::.;r,.:. : : : : : : :.: :: : : ::: :.:...: .... . ., . ,..... . . ... . . .: .. .:.x.:.: >:..a.............::::: :.:.� :..:::::::..:::. .�:;...:::,,:..:;,.. ;;.:... ... .... ....... ... .: :.:::...... :..:. �� -�oo� t� �� JOB ADDRESS �` nnn,2, � at.S o'I,�) yV�n� The undersigned hereby makes application for a permit for the work herein specified agreeing to do ali work in strict accordance with the city codes 8(ld �UIIIIOe nf thc R� iilrlinn (livicinn anri hPrphv rla�la�gS that 811 the fBdS and repr� PnTH, TIMOTHY/ANGELA ie and correct. 7526 BRIGADOON PLACE NORT�HEAST FRIDLEY, MN 55432 �/�' ' 20 /'�/�J (763)792-9052 �-- ��.I�i�I i1�7 �� BUILDING USED AS �St �e.✓�G� ESTIMATED COST �6 O� PERMIT N0. �� -'� �( � c� �f � C� �� PLUMBING COMPANY O ��` 0'V✓i �jt SIGNED B TEL NO.��o�Z� i�Z%—�(033 /� Approved By $ -� Rough-In Date Final Date ... „,.. ... $�S � OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. i COMBUSTION AlR SHALL BE PROVIDED PER UMC SECTtON 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE VALUATION CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57Z-36U4 1�'AX: : 7526 BRIGADOON PL NE : 123024110106 : BLOMBERG ESTATES : LOT 1 BLOCK 2 : PLUMBING : RESIDENTIAL : ADDITION/ALTERATION : $ 400.00 # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES # WATER TRMT APPLIANCES APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S MINNEAPOLIS, MN 55408-2173 (612)827-4033 OWNER TIMOTHY POTH 7526 BRIGADOON PL NE FRIDLEY, MN 55432 0 0 0 0 0 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days ar 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 wor� 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 regu�ing construction or the performance of construction. Bldg Insp Dat�li�l�� 571-1Zt�7 PERMIT O.: 2004-01586 DATE ISSUED: 09/13/2004 '� , VALUE OF FIXTURE/APPLIANCE # GAS WATER HEATERS # GAS RANGES VALUE (FOR MINIMUM CALC) PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 29032 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 1 0 400 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.00 0.50 35.50 Building MECHANICAL r�►�tNo.: k �U Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D�� 763-502-4977 FAX �� Z_,�, DATE ! Z Z- �% �l YOUR E-MAIL ADDRESS SITE ADDRESS ,% �.o ri o� v�o ^ �(� THIS APPLICANT IS: ❑ O �CONTRACTOR PROPERTY N,�: r � r ��E� ADDRESS: % S o� LO �� CI'I'Y I' /' i o� �� STAIE�ZIP��,� TENANT � � �� `� `� "� � Pxor�: %(� 3 -7 �3 - 70 � �jl CONTRACTOR COMI'ANY NAME: FleSfth d� H� T� � �p.n� � CONTACP PERSON: db8 Fif98 8 SUBMIT A COPY OF s��OS� 2� YOUR STATE STATE LICENSE # EXP DATE 2700 N•� a��} �� LICENSE WITH ,�DRESS: c:ITY'B�� raz?�-2581 STATE� ZIP APPLICATION pHONE FAX PERMIT TYPE �SINGLE FA.MII.Y ❑ TWO FAMII.Y Q TOWNHOUSE TYPE OF WORK• �NEW ❑ REPLACEMEN'f ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK j n,s� �► �� ► $�: r e p� a� � w��ti5 � i.� G FEES ARE BASED ON 510.00 PER FIX'P[TRE, EX�� RE NOTED. FIXTURFS: (INDICATE TdTAL NQMBER OF EACfI BELOVI� Equiproert Installed MFG: �.la� d►ru F:!` � MODII.: ��(.� e� h:.� • STZFJBN _�CJUZ7 A MFG: MODEL: � SIZFJBIU �G: Mon�.: s�z�slv NC $25.00 �FIREPLACE (GAS) SI5.00 GAS RANGFJOVEN 510.00 AIR TO AIR EXCHANGEIIt Sl S FIItEPLACE (WOOD) 535.00 NEW GAS GRILL SI0.00 BOR.ER 535.00 FURNACE $35.00 GAS UNTT i1TR SI0.00 CHIlVINEY LINER SI0.00 GAS DRYER 510.00 POOL HEAIER 535.00 DUCT WORK 510.00 GAS PIPING S10.00 VII�TQ.A'I'DR 515.00 Number of fixtures Q 510.00 � x�10.00 = S � Number of fixtures (� 515.0(1 � x$15.00 = S Number of furnu+rs Q 525.00 x$25.00 = S Nianb� of fiactures @ 535.00 x$35.00 =$ State Surcharge = $ SO FEE 535.50 Total = S 3 S� , sV THIS IS AN APPI,ICA7TON FOR A PERMIT-NOT VALID IINTII. PROCFSSID I hereby apply for a building permit and I aclmowledge 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 Mirmesota Construction Codes; dzat I understand this is not a permit but only an application for a perniit and work is not to start without a permit; that the work will be in a�ccordance witli the approved plan in the case of ail which rectuires reviewv and appmval of pians. re SIGNATURE OF APPLICANT' _"-'- PRIlV7' NAME�C V� n (- i I�,I '� ! C-' DATE_17�y O/ PLEASE NOTE: SEPARATE PERMI7S ARE RE UIltED FOR BUILDING, ELF.GTRICAL AND MECHAIIICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977