AF - 43490sus�ecr P .
City of Fridley � 16 3 2 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
, � RECEIPT .
� 1 L__��� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � fj�
� O
i
' � �'�'�1 � CITY HALI FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
� ____1l: `.�
612-571-3450 910-F15 8/4/81 � �
JOB ADDRESS '7540 Brigad�oon Place N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 2 $lOIILI�P.Y' EStd.'teS SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Garjac Inc. 481 - 206th Avenue N.E. -
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS S�'�RAi"E P�RMITS ��@UtRE�O�Qit l��t
6 USE OF BUILDING
♦ •
Residenti.al
� CIASS OF WORK
�J NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOFK
Construct a 24` x 46' Dwelling and a 24' x 28' Gaxage
9 CHANGE QF USE FROM TO
STIPULATIONS
Provide a hard surface driveway. Provide sod in the front and side
yards. Provide City with. copy of verifying survey before capping.
SEWER LOCATION: Served out of Manhole. Expose before setting foundation elev.
INV. OF NIANHOLE : 895.39 MIN. TOP OF FOOTING: 898.39
WATER LOCATION: Stop Box 47.5' S.W. of M.H. 93.3' S. of Hydrant.
DRIVEWAY DEPRESSICI�I: 16' + 6' = 22' x$13.50.= $297.00
� «n o� � � � �,� ,�:, V�aRHIHG
,rccvRa+e,ir or urtmr Loc�►n�s a�o �v�,T,c..
t� o�►t� a I�Ot �c�+►110++ �varo�6 o+��Y f..,:_. Qtfo�t.i'utin� wll hal uQ�itiec
nR�io�rS twi4 R siOtA� vE�'1r t� w�O�ir+�Tio� �M1QNE • El.ECTRtC • 6AS lte.
c�t e�t �t
REQtl�RED BY L�iH
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCZ Fr3IRE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. 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 HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S%�IOO yS2S. SrJ
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISI S OF ANY OTHER STAT OR LOCAL LAW REGULATING CON-
STRUCTI OR THE PERFORMANC OF CONSTRUCTION. y53O%.00 4ZrJ.00
� � � �� PLAN CHECK FEE TOTA� FEE
�v $76.75 $837.30
S �n7UREOF ON�RACTOROR w NOR12EDAGEN7 IDATEI WHEN PFOPERLY ALIDATED THIS IS YOUR PERMIT
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S�iGNA7UREOFOWNER�IFOWNERBUILDEAi IDATEI BIDG WSP DPT
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CITY 0� FRIDLCY Effective Aug. 1, 1981
Hf'PLICIITIO:J FOR RL"SIDLi�1TIR� E3UILDIi1G PERifITS
� (tder�, Alter.�i;ions, AddiLions, or Repairs)
OIdNER: �UI LDER : �d`��� � � �/C ,
ADDP.ESS : IIDDRESS: `�'8 I a. ��e ���t n�
TEL N0: TEL td0: �l3 `� %� 9 L
Consi:ruction Location
STItI�T NO: ��� Ci STREET: `�� !� � �p e,t�� � ,� �. C •P
L07': �� BLOQC: 2, ADDITION: ��U q�n ��'t F' S T� ��
Corner Lot: Inside Lot: �^ SetbacY.: �� Sideyards: $
Ap�licant attach to t3iis form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTI01� OF COPlSTP.UCTIOPd
I'ront:
Squane �'ee �:
Depth :
Clibic Feet:
i
Height: �
�'ront : Depth : H eight:
Squar.e� Feet: Gvbic I'eet:
Type of Cor,struction : �/ `�ti� r Estimated Cost: $( U�
� c� � ��' g�) 40
RU Be Oor,�pleted: �Sr� �) b�� .,20? x f� ,�� _
� J Alt. A Alt. B
Proposed Drive�•iay Width If New Opening Is Desired: � Z% Cl $�_ $
. . SE� REVER;F: SIDE OF SIiEET .
�iie undersigned hereby ma}:e� application for a pezznit fcr the �:vrk herein specified,
agreeing to c� ,all work in strict accordance F�ith the City of I'ridley Oxdinances and
rulings of tlte Department. of Buildings, and eby declares that all tlie facts and
represnntatiens stated :s� this application a true and correct
�
D.iTE: `�'�" � SIGN7ITUF�: �
--o
Stipulations:
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sue�ecr PERM
City of Fridley 19009
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
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; � R IPT NO.
� • COMMUNITY DEVELOPMENT OIV.
' j L �
r � � PROTECTIVE INSPECTION SEC. � �Q �-�j
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1 � /"'1 � CITY HALL FRIDLEV SS432 NUMBER REV. DATE PAGE Of .. qPPqpVED BY
� ----�: `.�
612-571-3450 910-F15 6/15/87 / /
JOB ADDRESS �540 Brigadoon Place N. E.
t LEGAL �OT NO. . BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 3 2 Blcanberg Estates sHeer
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
A1 Yee/Litt 7540 Brigadoon Place N.E.
3 CONTqACTOR MAII ADDRESS ZIP PHONE LICENSE NO.
Pacific Pool & Patio 6922 North 55th_Street, 0akdale, MN 5510� 770 1313
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICEN$E NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
�7 NEW O ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20` x 40'' Inground S�nrimming Qool
9 CHANGE QF USE FROM TO
STIPULATIONS See stipulations on letter dated snne 12, 1987, The neHr ,fence that has
been installed is not hi:.gh enough � it must be 6 feet,
!
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOFi 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 EXAMINEO THIS APPLICATION 1 STAILS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-O�OOO S5.00
DO�S NOT PRESUME TO GIVE AUTHOfiITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTI OR TH ERFORMANCE OF CONSTRUCTION. $HO. SO
� PLAN CHECK FEE TOTAL FEE
$85.50
si NATUAEOPCONTRACTOAOAP.U7 DAGENT IDATE� WHEN PFOPERLY VALIDATED THIS IS YOUR PERMIT
_ � 'i� �.9, li �.�QC�t�J cg
S�iGNA7URE OF OWNERUF OWNEA ILDEFl� IDATEI -.BLDG INS7 DaTE
ng� �'+ C� �n ' ,$ �
�tt1'- �e 11w%.� � ��.;:.r��' •�`�
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84rnsvI1N, Nn. 55937 MMnstonks, Mn. 53943
(435-3600) (541-�1 �?j
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ACCOUNT i�lAtSER POOI 81ZE OATF
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Pac'rfic Pool & Pat'ro wlll make appiicati�or► tor and pick-up your swimm+ng Qod building p�rmd. �EleclriCal, gas, tence or c�wt p�rtr�ls are 1hs ��
responsibil►ty af the contractar doing the work�. s;�
The actual cosi af the p�rmft is the resDOns�bilit�r oR tt►e home o�mer and Pacific Pa� 8 Pallo wiN expsct b bs nkriburs�d to► � pinnit coet 4�
within 30 da ih@ �~ '
Si�fleEi /' � � ��� �r � �
,�E�rk bca#an af �r and/or hesesr �
� bil i�• Loe�am► br dlspo�ti of dht
m t s�e aeep e�d �r (�. ,'
Cr'� c� wis#��Q rNan �ny or eli dirt fra� pool �adAc !bd � P�rNo r�com
cawntie�n: �.r t J t n� t� M n M o � u M� r N t+ k� p
b (As sow► as poNil� hiNowir� Pooi oo�oY�nk
VWiil any obstruci�ons be encounf�red — auch as tr�sm, i. f9�Jn pultmr� ��c�nt b pod �
e cic�thes poles or pg�v��/ph� e I�nes etc.: r::r�,f ,� .2. Reteii�ting wall whero c1ie�Q►am�d �.' :�`
__ � ` ; �' Y � '/ ;�.� �1, •,r/�: ) 3. R�n off ccfntrol or dreinfield � �, ► ''�
,, 4. Permanent or temporary fence �' ;�r � � '� �
� �. , Y�tn �ctn � t�►nrkad „A,� #� • ' � '
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GZYOF
FRtDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 57t-3450
Jtuie 12, 1987
Pacif ic Pool & Fatio
6922 North 55th Street
Oakdale, NN 55109
i'e: S�aimming Pool Constructian at 754� Brigac�oon Place N.E., FrictlEy
Dear Sir�:
This letter is to maJce elear this degxrtment's requir��ents for the sw'iruning pc�ol
construction at the above address.
1. As indicated, two (2) skirnners apprwed by tt�e P�atianal Sanitation Foundation
will be pravided.
2. As indicated, two (2) inlets of a�raved de�ign for fresh and/or repurified
water will be provided.
3. As indicated, a main drain of agpraved constructior will t�e prwided.
4. The filter and pump shall be agproved by the N.5.F. and be af sufficient
c:a�city to pravide a minimum turnover of at ieast two (2) times in 24 hours.
This de�rtment reoommends a turnover rate of 6- 8 hours.
. A deck of at least three (3) feet wide, measured f rom the pool waters edge,
shall be pravided which e:ttends completely around all grivat� residential poola.
Above ground private residential pools r,lay k�e praviaed ��aith decking of a minimtun
size of 4 feet by 4 feet at pool entr�� poir:ts anci prwic�eci that ; uch decking has
the approval uf the City.
5. The diving area will be acc:e�table grovicled there i:> no overh�ad cbstructian.
7. F�ncinc� or other �ffective r��eans including but r=_ot } iniit�c to 1,�a11:.� or
l�uildings, acce�able Lo the City, shall. be provided to �s�tively cantral ail
ac.ce:;:� to public arr�� private resic7ential swimming paol �. FE�ncinr� shall meet th�
f�llowing criteria:
(a) The fencing shall pr�vent th� Fntrance of chilclren and be withou�. hand or
fc,�t i:olds that would eiiable a persan to clim� ovcr it.
fb) The fencing shall be aL- least 6 feet hxc�h and en.tr�,nces shall be equipped
with self-closing and self-latching gat�s ca��ble of being lock�a.
(c? Self-closing arid sel� latch:�ng c?evices shal.l b� F=l��ced a� the top of the
gate or otherwise inaccessible to srnall �hil.dren.
fd) The opening }aet:�,��en thE bottom �f the fence anci thE �z�uncl or other
surface shall k� not rlore t:tian four inches,
A
, June 12, 1987
Pacif ic Pool & Patio
Re: 7540 Brigadoon Place N.E.
Page 2
8. An autanatic chlorinator should be provided with a suitable test kit.
9. All electrical and gl unbing installations shall be inspected and approv ed by
the City Inspection Degartment.
10. All overhead electrical lines must be a minim�m► of 10 feet horizontally from
the pool surface, and 18 feet straight 1 ine di stance f rom the waters edge . An
alternative is to bury said lines.
11. The pool f il l spout must be protected by a vacutun breake r or ai. r-gapped.
12. S�itable safety equignent to i.nclude but ryot limited to a ring buoy and rope
that is 1-L2 times the pool dia�neter and shepherds crook pole must be provided
and maintained with the pool at all times.
F'urthermore, these and any other requirements must meet the provisions of the
Fridley City Code, Section 115, S'�vimming Pools. The building permit is approved
contingent on final i.nspections and approval of the City.
If any questions or probleins arise froqn this letter, please feel free to contact
me at 571-3450.
Sincerely,
I�1R�tEL . Q�ARK
Chief Building Off icial
DGC/mh
CC: Mr. A1 Yeelitt
7540 Bri�oon Place N. E.
N�r L l
City of Fridley Effeetive �/1/86
ADDN. [ 7 R-1 A1�D R-2
AL,TER. [ � Building Permit Application
� . _ _ .�
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Construetion Address:
Legal Description: �
Owner Name & Address: � ��� S�� �l ��� Tel. # - -
Contractor: /gC�� �� Tel. # �� ���
✓� �%%� .�'�/�
Address• /�
LIVING AREA:
GARAGE AREA:
DECR AREA:
____---
OTHER:
Attach to this application, a Certifieate of Survey of the
lot, with the proposed construetion drawn on it to seale.
DESCRIPTION OF IMPROVEMENT
Length
Length
Length
� ^ /.�ri_�� :
Width __ Height _______ SQ• Ft. -
Width Height Sq. Ft. -
Width _ Hgt/Ground Sq. Ft.
_ _ , _ . . _ �... .� %
Corner Lot [] Inside Lot �] Ft. Yd. Setback __ Side Yard Setback _
Type of Construction:
G Estimated Cost: $ ��/ �
Approx. Completion Date: �� C� ` ��
Alt. A Alt B
proposed Driveway Width If New Opening Is Desired: __ $ $
See Baek Page for Explanation
DATE: �^�� �� APPLICANT: ��( Tel. # // � ����
CITY IISB ONLY
Permit Fee $ B��S � Fee Schedule on Reverse Side
Plan Check $ 25� of Building Permit Fee
State Surcharge $ �' ��� $•50/$1,000 Valuation
SAC Charg� $ $ 525 Per SAC Unit
Park Fee $ Fee Determined by Engineering
SeWer Main Charge $
. �. �--� Agreement Necessary [ ] Not Necessary [ �
TOTAL S
STIPULATIONS: (cl1,U�, '��v� � � S-�c /1'Uh�R,����t'ck't-�.•. � %l7 F�� i��i
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Surveyors Certificdte '
COMSTOCK & DAVIS, INC. Consulting fingineers and Land Surveyore
1446 County Road J, Minneapolis, MN 55432, (612) 7'84-9346
SuRV�Y F'�c-�
Gor jctc Cons�-ruction
481- Z06-�h ,�v¢. 1�1E
Cedo� , Mn. 55011
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Lot 3, Blocic 2, Blor►berg Estates, City of Fridley, Anoka County, Minnesota.
� � . , � .: . . , ,. . .
SCALE: 1 " = 4 0' . _ _ .. .. _ _ .. , . . _. .
� � �.�ENOTES �Ron� MolvIIM�NT �ou�vo
. ❑ ��NoTES �K %lAl�., �S�'�' . . .
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.
� ������� /0831 Dc�: /� �98f �f78
Reg. No. , .D�t� Job No.
Book No.
CITY OF FRIDLEY
APPLICATION FOR PWMBING AN D �AS FITTING PEPMIT
y T m c u • x v Water
� � .-ai � n F C m M � m ro w p�', tr a Heatec
�.ui Y 4 C 91 .�S N � Np t� B d K • � N
M 6! O � �y N � N ...Ci � O O V V� O N u1 YI U1 L
v�i i � m eii v�i � o w° ai w u m a s u � �i o.as 'lec
lrt
2nd
3 rd
a cn
(R) � iUture Connection Opening Connected with Sever
(�) � New Fixture, Old Openinq Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
Mar ti:tur�•
luture listura�
Old Op�ning, Nev li:tur�
0aar Dispenser
alov Oft Da�in
Catch Basin
Rein Mater L•ader
Hydraulic Valv•
Susp or R�ceivinq Tank
Na[.r Treating Appliance
Not Metar Hutet
Gas Ranqe
Gss Dryer
N0. RATE
S 5.00
S 3.50
S 1. 50
S 4.00
$ 5. 00
S 5.00
S 5.00
S 5.00
5 5.00
5 7.00
S 5. 00
� 10.00
S 10.00
ALL OTHERS AND/OR REPAIRS Ji1ND ALTERATIONS
1� ot Vslut of tiYture or Appllance
State Surcharge
Rrinepaction !�a s
i515.00) TOTAL PEE
�-f�.�,�
TOTAL
S
S
S
S
S
S
S
S
S
S
S
S
S
5 .50
5 J-���
EtLective Auy. 1, lvcfl
<'
Job Address �S �%G � jtq,qt��� � •
Department of euildings
City of Fridley
Tel. �571-3450
The undersiqned hereby makes application foz a permit for the w rk herein
specified agreeinq to do all work in strict accordance with the City Codes
and rulings of the Departaen[ of Buildinqe, and hereby declares that all
the facts and representations stated in thia application eze true and correc:[
Fridley, Mn. 6' z s , 19 $%
04iNER
KIND OP BUILDIt�
.
USED AS
TO 8E COFa+LETED ABWT '�„�,u�.p 6 � �% > �� � � /v%1
ESTIMATED COST � � SD. O !J
OLD - NEN BUILDING PERMIT NO. PERMIT NO.
�°°panY �
Signed By ,. � t� �� -
Te�. �. � 3 �— � �z r�
ROUGH INSP.
.
naca
3 � � ���f �
_/��
FINAL INSP. �^/O'�p �
Date
APPROVAL FOR PERMIT �i��"
HINIMUM FEE FOR ANY PLUMBINC PE
PLUS THE S. SO STATE SURClIARGE
6- z S- � 7 10 ,�i►-�
�
sue.,etT PERMIT NO.
c�ty of F��aley 2 8434
AT THE TOP OF TNE TWINS g � I L D 1 N G P E R M I T
� �572-3604
RECEIPT NO.
� ; y ___._ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. 736 �
� � V
� � �"'1 � CITY HALL fR10LE� 55�32 NUMBEP pEV O�TE P�GE Oi •PVnOvED Br
�'""'�" ,'� 612-571-3450 910-F15 � �
10/27/98
J08 ADDRESS
7540 Bri adoon Place NE
1 IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHEO
DESCR. 3 2 Blomber Estates SHEET
2 PROPERTV OWNER MAIL AD08ESS Z�P PMONE
Al YeeLitt 786-2777
3 CON7RACTOfi MAIL ADDRESS Z�P PHONE LICENSE NO
Ri ht Wa Roofin 1200 E. 79th St. M -
� ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK � pEpAIR O MOVE O REMOVE
❑ NEW O ADDITION ❑ ALTERATION
8 OESCRIBE WORK
Reroof house and garage (27 S) Tear-off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE fiEOUIRED FOFi EIECTRICAL, PLUMBING, HEATING,
VENTIIATING OR Alq CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTFUCTION 20NING S�. fT CU iT
AUTMOq12ED IS NOT COMMENCED WITHIN 60 DAVS. Op li CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOFi A PERIOD OF 120 OAVS A7
ANY TIME AFTEF WORK IS COMMENCED NO DWLG. UN17S OfFSTREET PARKING
I HEREBV CERTIFV THAT I MAVE READ AND EXAMINED THIS APPLICATION STA�LS GARAGES
AND KNOW THE $AME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WQRK WI�L BE COMPUED
WIThi WHETMER SPECIFIED MEQEIN OFi NOT. TME GRANTING Of A PERMIT $2313 $1. 16
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pEqMt7fEE SACCMARGE
PqOVISIONS OF ANV OTH TE OR LOCAI LAW REGUTATING CON-
STR 1-<? F MAN Of CONSTRUCTION �7�F.75 Fire SC �2..31
P�AN CMECK fEE TOTA� FEE
�T17 cl d Lic nse SC $5. $83. 22
5� N aEOFCO Q.t •uTwOQi1E0�GEHT iDATEi WMEN PROPE VALIDATED THiS IS VOUp PERMIT
S�Gtia1uAE O� OwaEp��F pWNEQ BU�LDEii� iD1TEi � � / � ���� �
B G �h5� � r��tE
NEW - [ ] _ Effective 1 / 1 /98
ADDN [ ] CITY OF FRIDLEY
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �..� Z�
BUILDING PERMIT APPLICATION �� � �
_ , , �, __ . �� ,� 2�0
ConstructionAddress: �-�(C;' �; ( ' �'x;� � �
Legal Description:
Owner Name & Address: �(� Tel. #� 4S (� ' Z��-�
Contractor: ���Lt.�{- 'Lt;�:t : 1 I �%C`�1C MN LICENSE #�3C1C(C.�
Address:�12�-%'�-' r:" , �-}Cl`�Y�� ���� Tel. # �3��G
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:
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
OTHER:
� � r ����
Construction Type: �,����� Estimated Cost: $ ����
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: AL\21.��� ��`� APPLICANT:��� l ���.���.c�� f���-,��`�1.��.. Tel. #��`��X?�tC�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ � � �S
$ �. � �
$ , �v
$ ,��
$ _� �U
$
$
$
$
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
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
� 3.a�
� - � � � SUB�EGT .. . � . � PE
City of Fridley 30556
AT THE TOP OF THE 7WINS g � I L D i N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY OEVELOPMENT DIV.
r � v � PROTECTIVE INSPECTION SEC. ���7
� ,
� � ,
� � /"'1 � CITY MALL FRIDLE� SS�3T NUMBER NEV OATE PAGE Of APiROVEO BY
�----�•� �•' 612-571-3450 9t0-F15 12/2/99 / /
JOB ADOHESS 7540 Brigadoon Place NE
1 LEGA� �OT NO. BLOCK TfiACT OR ADDITION SEE ATTACMEO
oesca. 3 2 Blomber Estates SNEET
2 PiiOPERTY OWNER MAIL AODRES$ ZIP PHONE
A1 Yee Litt 86_277�
3 CONTRACTOR MAIL ADORESS ZIP PHONE IICENSE NO
Panelcraft of MN Inc. 3118 Snellin Ave S s
� ARCHI7ECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL AODRESS 21P pMONE LICENSE NO
6 USE Of BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADOITION O ALTERATION � REPAIR O MOVE O REMOVE
e DESCRIBE WORK
Reside house and
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
Provide soffit ventilation to meet the State Building Code.
TVPEOFCONST, pCCUPANCVGROUP OCCUPANCYLOAO
SEPARATE PERMITS ARE REOU�RED FOFi ELECTFICA�, P�UMBING, HEATING,
VENTI�ATING Oii Alii CONOITIONING
TNIS PERMIT BECOMES NUII ANO VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT
AUTMORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONS7FUCTION
OR WORK IS SUSPENDED OR ABANDONEO fOR A PER100 OF 120 OAVS A7
ANV TIME AfTER WORK IS COMMENCED. NO DWLG. UNITS OFfSTREET PARKING
1 HEREBY CERTIfV THAT 1 MAVE REAO AND EXAMIN�O TMIS APPLICATION STALIS GARAGES
AND KNOW TME SAME TO 8E TRUE ANO CORRECT. ALl PROVISIONS Of LAWS VALUA710N SURTAX
AND ORDINANCES GOVEqNING THIS TVPE Of WORK WILL BE COMPl1E0
WiTM WHETHER SPEGFIED HEREIN OF N07. THE GRANTING Of A PERMIT �iS,336 $7.E)%
DOES NOT PRESUME TO GIVE AUTMOFITY TO VIOLATE OF CANCEL THE pEqMl7 fEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR IOCAI LAW REGULATING coN- �$15.34
STRUCTION HE PERfOiiMANC CONSTRUCTION �ZC)S.ZS Fire S
� PLAN CHECK FEE TOiAL F
. ^ Lic C $5.0 $29 .26
S�GN UAEOFCONCFA(;TOAOQA r.+OQ� ED�GENt iD�iE� MEN OP A IDATED IS V "PE IT
/
S�GrvaiuQE O� OwtiEa��c OWNEQ BwLDEfi� iDATE� � Bl0 �ti5� � ���1E �
NEV`i' - ( ]
ADDN [ ]
ALTER [ V]'
• :'
ConstructionAddress:
Legal Description: �_
Owner Name & Address:
Contractor: �/7{,�L'�"Q'
Address: .3//8 V��/,i
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ih'�
� i
> `fG' ;��-%�cc�/�G'�Z_>
� it1L-
T � .
Effective 1/1/99
, 9q—
��; ��v��
� �aq3,ab
�
��o�� Tel. # ��� � �'%7
MN LICENSE # a/7g
Te�. # ((o%?� 7a?/—leG�-�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCit�'Ti�N t7F IIi�it�RO iiEMENT
W idth
Width
Width
Height
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: ���c�..�,,����{�,�y0� Estimated Cost: $ /.���� —
� (Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: APPLICANT: • Tel. #(10�2�7oZ/r�i��
� /3/
Permit Fee
rire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
�OTAL
STIPULATIONS:
CITY USE ONLY
$✓���-� Fee Schedule on Reverse Side
$ `� %.5�.� .00i of Permit Vaivation (1/lOth%)
$ `� % � �7 $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ ;�o O $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 [ ]
� ��'1�',,:� �
CITY OF FRIDLEY INSPECTION
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604
RATE SCHEDULE
DIViSiON
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner -
Afso Replacement Furnace
(Side Vent • Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - Alf Sizes
All Others/Repairs & Alterations (LIS� ON BACK)
��Jo of V lue of Applian or Wor
� ��o " �p�S �M� ��
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
� 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
JOB ADDRESS %�
�
OWNER �� �� �r ��
Effective On January 1, 2002
A + �d
iv�
TOTAL
BUILDING USED AS
$
ESTIMATED COST �� � U PERMIT N0. -���� ?�J
$
$
$
$
�
$
$ .50
� �,�' S�b
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEATING (;S�-, ��� " l�
Signed
FAX # S �
Approved By� Rough-In Date
DATE �� � � 6 Z-
TEL# ls-���i��-�31Q�
V
Final Date '/ -0�
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
CnMMnN VFNT� V NT .nNNF .TnR AI`D .�Il�g 1ST1(�I` AIR �� RIFI ATlnl�
When rP lacin� an pxic+in� f�rance, 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.
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 Fumace Venting Tables for fan
assisted and natural draft appliances.
The Pxictin� cemb ��t��r, a�r is sized and installed to meet the current codes
and manufacturer's specifications. _
When required to in�tall a new comb �c ien air it will be sized and installed
to meet the current codes and manufacturers specifications.
Whe� inctallin� a new �� _n in�y�c Pm� the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
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()
Yes ( ) No ( )
Yes ( ) No ( )
Yes( ) No( )
�/ ,�
C
Yes No (
Yes( )No( )
�.. .. - .- .�. - .����.. -� ... -. ...- . � ..��. ..
A liance #1 T e �
PP Yp �° 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
Appliance #1 Vent Connector Height ft Length ft Diameter in
Appliance #2 Vent Connector Height ft Length ft Diameter in
Appliance #3 Vent Connector Height ft Length ft Diameter in
� �
� ,
�� � �
! � /� �� �" .
��
inches
Type
Type
Type
?/j�� �
HEATING CO: ��J�l' -�=, �
Signed BY� - Date : l� � ' � �--
Building MECHANICAL
Inspections RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX
_ EFFECTIVE 2-19-09
DATE � /
-�T
SITE ADDRESS
TI-IIS ?,PPLICANT IS:
PROPERTY
OR'NER/
TENANT
0
❑ O�'NER
N.��:
?�DDRESS:
PHONE: '
�YOUR E-MAIj, ADDRESS
•
7
Permit No.:
. . . . , : i►L�:F�►�� �
�.�-�-�� �� 1 I
Co1v'I'RACTOR �o��� N;�¢:— Stanaard Heating S� AirCondrt�ornng
CONTACT PERSON: y
SUBMIT A COPY OF ---�j���jg---�M--�§q.a-a--�q.��
YOUR STATE STATE LICENSE # R 17_R7d_7� DATE
LICENSE WITH �DRESS: CITY STATE ZIP
APPLICATION
PHONE FAX
PERMIT TYPE
TYPE OF WORK: I � ��i'
F�IILI" ❑ 'I'R�O F.AI��III,I' � TOWNHOUSE
DETAILED DESCRIPTION OF WORK
0 ALTERATION�'REMODEL
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBII2 OF EACH BELOV�
Equipment Installed MFG: MODEL: SIZEBTU
MFG: � MODEL: S SIZFJBTU�
MFG: ('iy+✓ MODEL: SIZE/BTU �
�1/C 525.00 PLACE ( AS) S15_00 _GAS RANGF/OVEN Sl�
AIR TO AII2 EXCHANGEER $15 PLACE (WOOD) �35.00 NEW GAS GRILL 510.00
_BOII,ER 535.00 �FURNACE 535.00 GAS iJNTI' HTR SI0.00
_CFlIlvvfNEY LINER 510.00 GAS DRYER $10.00 POOL HEATER �i5.00
_DUCT WORK 510.00 GAS PIPING 510.00 VENTII,ATOR 515.00
I hereby appl_y for a b�
confoimance with th r
not a pemiit but o� an
approved plan in e �C9{
SIGNATURE OF
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
nit and I v ge that the information above is complete and accurate; that the work will be in
�d cod i th C of Fridley and �-ith the Minnesota Construction Codes; that I understand this is
for rmit n work is not to start with t a permit; that the wo wrill be in acco ance �vith the
k whic require review and approval of p . -/
V
N.��
'" City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley; MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
� NEW HOMES/ADDITIONS ��EXISTING HOME LJ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
l. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Ma.ke-up Air (See note below)
a IMC Chapter 5 with MN Amendments
3. V enting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel trther than gas IMC Chapter 8 with MN Amendments
REQUIREI) FOR NEW �IOMES
4. Heat loss & cooling load per room
a Required on new construction IMC 1346.0312
S. Venrilation
a Per MN Energy Code 7670 or 76'�2
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manua1 D
NOTE: �Centerpoint Energy IVlechanical Co�e Guidelines software may be used for
combustion and make-up air calculations.
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE '
SITE ADDRESS �
THIS APPLICANT IS
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSIJRANCE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRIBE WORK BEING
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
BUILDING
RESIDENTIAL APPLICATION
❑ OWNER
rrAr�:�vl�� �
STATE LICENSE #
ADDRESS:
CITY OF FRIDLEY
EFFECTIVE 1-1-2010
Permit No.:
YOURE-MAILADDRESS � 'Q Si(��/IGYA�l\.lSC�qLII�°SID�ICC� �h-�
[v� , �' il 1� �—
�CONTRACTOR
PHONE /(a ��s��
�SINGLE FAMILY/NEW CONSTRUCTI(
❑ TWO FAMILY/NEW CONSTRUCTION
❑ BASEMENT FII�TISH
❑ DECK
❑ NEW HOME CONSTRUCI'ION
E� MAINTENANCE/REPAIR
� �nr�Y STA
EXP DATE
TA
FAX
SIZE
STORIES
❑ ROOF
❑ SIDING
0 SWIMMING POOL
❑ ADDITION
❑ REMODELING
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑ DRAIN TILE
❑ OTHER
ri �3�� O
ZIP
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑Soffit ADDITIONS. & PORCHES SUBMIT:
❑ Trim 1. Site Plan/Survey showing the existing structures
❑ Fascia and proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS �Yes ONo LOC ON OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND
OR FOR NEW OPEI�IINGS-DESCRIBE SIZE OF �[�� MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED � NUMBER OF WINDOWS S'}'�
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
QT��G THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ I�,�'( OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ ���=�� See Back Page for Fee Schedule
$ •— 65% of Building Permit Fee
$ .001 times the total job valuation
$ � ,�7� .0005 x Permit Valuation Minimum $.50
$ 'rj�(� $5.00 (State Licensed Residential Contractors)
$ �--, $2100 per SAC Unit (Plans to MWCC for determination)
$ �-�' ft+6ft= ftx$24=$
$ .--- $450 Conservation Plan Review
$ -r"' Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ � y%, n Make checks navable to: City of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all � rk which r� u'�s review,a d approval of pl s.
SIGNATURE OF APPLICANT �_ �� T NAME �� 7 `��A'T,� � DATE t�-
NOTE: SEPARATE R�I�MITS ARE RECI�ED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK