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AF - 43492sue.iecT P MIT NO. City of Fridley 16 4 6 4 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T „ , � RECEIPT � • COMMUNITY DEVELOPMENT DIV. �y ,/ ' � �: ----- � � -I `t`� r � � PROTECTIVE INSPECTION SEG 1 � i �l �� "'1 � CITY HALL FRIDLE� 55432 NUMBER REV. -0ATE PAGE OF APPROVE BV ..'��'J \�I �.J 612-571-3450 910-F15 11/17/81 � / JOB ADDRESS '7550 Bri.gadoon Place N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. t� 2 Blomherg Esta.tes SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Garjac Inc. 481 - 206th Avenue N.E., Cedar, MN 434-7096 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS SEPERATE PERMtTS RE ZIP t PHONE UCENSENO. U RE. 5 ENGINEER MAILADDRESS' t-- , �pIfV�7 ANUP�fCjNS+PHONE ENO. 6 USEOF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ EMOVE X 8 oescR�eEwoRK Before digging ca�l locat utiiiti�:� Construct a 26' x 43' Dwellin and a 24' x 24' Gara e - iC. 9 CHANGEOFUSEFROM TO STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards. Provide City with_ copy of verifying survey. SEWER IACATION: (Approx. 6' Deep In Street) 30.5' N. of M.H. WYE ELEV: Expose sewer service prior to establishing footing elevation. WATER LOCATION: 10' S. of Sewer Service, 46' S.W. of Hyd., 56.5' N.W. of M.H. DRIVEWAY DEPRESSION ESCROW: To be performed by City �� Contractor in Spring of 1982 at request of property owner. Amount to be determined after letting-of 1982 contract. s":;� LiTY C�t= F�;IDL�Y DO�S fvOT GUAi;,�I�T�C: i•;,€� r�.'Ct1=; ".�Y Q� UTIL�TY LQCi�TIO�tS AND ��yATfG; ::,. `; s;>> !.�r.T.A {5 FC3� l,�f��=:.�'1�4;tc�N PU?PGS:S C,��.Y r,��:; f'::•'•=:t�'{�S US?NG !I SHC3UdD VE�tF'Y 1'}�: itiFt7::n°:�3i; s; _.;°�i . .�?"E:. �t,: TYPE OF CONST. OCCUPANCY GROUP OCCIIPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTfiICAL, PLUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING. �11�OOd FrdIlle 7HIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTFiOR12ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT �.�.ZS+6O1 22, 360+6010 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WIL� BE COMPLIED $S3� SOO $26.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT RESUME TO GI fiORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE PROV ANY S TE LOCAL LAW REGULATING CON- C N OR H PERF NCE OF CONSTRUCTION. S29S.00 $425.00 PLAN CHECK FEE TOTAL FEE r $73.75 $820.50 si n7ua coN�RACTORORAUTHORIZEDAGEN7 A WHEN PROPER�Y LIDATED THIS IS YOUR PERMIT _ r S�l^ •- / F"�`--�'" �X^O� �� r � /9 ' V � SIGNATURE OF OWNER IIF OWNEFl BUILDERi IDATEI BLDG iNSP OaTE . ,,, . . � CIT�' Of� FRIDLEY Effective Aug. 1, 1981 APPLICI1TIa'J fOR RLSIOLi�TIA� [iUILDIiiG PEFti�IITS (We�•r, Alterations, Additions, or Repairs) �r Ot�1NE R: � /�'�� .. ADDRESS: TEL n10: 6UI LDER : ��fi�'G � �-'v '�S'� 11DDRCSS: �7�/!" p� oC'� G�°� %l� � ��z-- TEL I�O: Y ��/` �G � � Construction Location ST7t�GT NO : /�� U STREET: �� G f� /� Gm �'� L'{ G E= Lo��: �`/ si,ocx: _�_ p.nnzTZOrt: ��o� f��R �� 5'Ti� 7`�S' . Corner Lot: Insicie Lot: `'` Setback: Sideyards: Ap�licant attach to t2iis form two Certificates af S�rvey of lot and pzoposed building location drawn on certificates to scale. DESCRIPTIOi� OF COt•�STP,UCTIOPd __<�� F_ I'ront: �!(r, Depth: '-�,� Height: o7'O Square. �'eet: /�� C�,ibic Feet: ;,7,;?_,Jl�(� /`t' . 1..�- fi k' �1�, �:-- rront: r�7�-/ Depth: ;�� Height: i0 Squar.e Feet: (�� ;/ Gtibic Teet: � c; i� . � i� Type of Cor,struction : �/4 �%/r/ L= Estimated Cost: $ ^ �� Zb Be O�r,�pleted: �� -- Alt. A Alt. B Proposed Drive�Jay Width If New Opening Is Desired: / $� $ , . SE� Re�VERSE SIDE OF SHEET . ?►ie undersigned hereb�► ma3:e� application for a permit fcr the �:vrJ: herein specified, agreeing to co ,all work ir� strict accordance ��ith the City of I'ridley Ordinances and rulii�gs of tlte Dep�rtment. of Buildings, and hereby declares that all tl�e facts and rcprescnt�ltions stated ;n this application true rrect. D.:T�: i'GGt�' r� �� SIGNATUFtE: Stipulation - P. Q, 73� � �2w o2qj,d� . _�A'� U c,': e� �'. f �/` � tcf U.� +J.t.� K' E' i`j �" �.. �JK l �,''T "J " �/c-'(14� / C) `„_ ,r� ,._ l S��%'� �/ �� f'e� fi,�; i t� a� C) �_. ��f�i� � S. �K`� d�,''� Q� � `j �.�i�8 �7s' C.� r-�� u.' , n-� ('�,, �� r �1��.��"� �,�c.1� 5.�.�..�e.�'�'�, . .. ' C. J "� �'� � ! � � ' ' �JK �v� : � � 2G. � � .� �� . ) � . J- _._,-- ,� " �..� c,��L � � � � �"�, .°.` �� . ��- �% � -r`. ia � '= � ,� � ,t,'Ik`,,—r-,2m �,U1-D f}/►k�c,�c.� % r� � Q .� - � ' iv v�. ��.�+.c. lrt�c`a`�tj �7. Uv ..- �0 i� %G � �u�.� r y�.��2 - �"� i /i'1 .�-� BUILDII�iG PE�RMIT FEE SCHEDULE The Inspector of buildinqs shall, before issuing permits for the erection of any buildinq or structure, or for any addition to any bxisting buildinq or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant f or such permit of fees to the amount herein below set forth and i.n the manner herein provided to-wit: TOTAL VALUATION $1.00 to $500.00 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 and up FEES $10.00 Minimum Fee $15.00 plus surcharge $10.00 ior the first $500 plus $1.50 for each additional $100 or iraction thereof, to and including $2,000 $32.50 for the first $2,000 plus $6.00 for each additional $�,000 or fraction thereof, to and including $25,000 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000 $283.00 for the first $50, 000 plus $3. 00 for each additional $1,000 or fraction thereof, to and including $100,000 $443.00 ior the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof PLAN CHEQC: 25 percent of building pezmit fee DRIV�IAY DEPRESSION ESCROW: Concrete G1irb Streets Only Alternate "A": Remov,¢al and replacement of curb and gutter only Driveway width plus 6 feet x$13.50 Alternate "B": Renoval and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 feet x$15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours fran the time of application to allow for proper review of the proposed structure and 4f the construction site. A Certificate of Suxvey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with.the framinq. � � J v �� 2. oU _ ?�� S� v o � � . � ` � w . k�w�. �.,R.c�.. 2��a 43 = �i t � � G. �-S = u�n I��. ��c � = �t t� , ar S� 17 = $J �2�3 ��n�� l X a� = 5x -t' SXs'� _ Z.. � - Goi � k 33. �3 X' �'f. �lJ m ��t b. S� 4�ZIb, 2g S `�. u� �� .2 , . y .�'� �' � S�ra��rs Certificate COIVISTOCK & DAVIS, ING Consulting Engineers and Land Surveyora 1446 County Road j, Minneapalis, MN 55432, (6I2� 7849345 SURVEY FOR: B & G Investments 961 Hillwind Road Fridley, Minnesota 55432 � `� � , � � i i �' �� Y� ' � � � � Id � L � �� 1 u � .-- ., ; N 88° 59"53"W /37.08� ! �7 � LC .- ,` % � : � l, ,` � j '" ` � / �' � �� v��tb' V � � f o � 49° 59'4I" R= zo.00' L= /7.-¢5' � — 3 ; :�` �,i o° N ° � N i' � �; N � aQ � �t � R' �9� 1 � Q � o � � �� x � __.._ . �K -� .-, � t � � � ,,, N �s � �_ `-' � o �ll�.l7 \ � o I 1 ��„ � i N 77 , �1' � ', DESCRIPTION Lot 4, Block 2, Blomberg Estates, City of Fridley, Anoka County, Minnesota. SCALE: 1" = 40 p Denotes 1/2" diameter iron pipe monument set and capped No. 10832. I hereby certify that this survey, plan .or report was prepared by me or under my direct ��,� �S supervision and that I am a duly Registered .Land Surveyor under ths laws of the State of Minnesota. u1$�� N�v_ 1, 198Q 4273 9 + Rcg. No. ,, Date Job No. Book No. . ; CITY OF FRIDLCY Effective Aug. 1, 1981 APPLICIITIO:� FO�t RCSIDLi�TIII�. DU1LDIi1G PLiL`�iITS (t��►•r, Alterations, Additions, or Repairs) /� � O�JNFR: QUILDER: C-�i`�'/�l �vI C �l/�- ADDRESS: I10DRCSS: L/� 1 � U G�� -P �r� 7EL N0: TEL f�0: . C-Q d�f�-i2 Construction Location - ST7tIiET NO: ��U STItEET: �/Q ( C� lJ O O�l/ L07.': BIAQC : ADDITION : Corner Lot: Inside Lot: SetbacY.: Sideyards: Ap�Iicant attach to tliis form two Certificates of Survey of lot and proposed building �ocation drawn on certificates to scale. DESCRIPTIOi� OF COrdSTP,UCTiOr� � I'ront: Depth : Neight: Square Feet: Gl.ibic Feet: Front: Depth: Height: Squar.e� Feet: �bic I'eet: Type of Cor,struction: Estimated Cost: $ Zb Be Cbr,�pleted: �3.J� Alt. A Alt. B Proposed Drive�iay Width If New Openinq Is Desired: � $� $ C.CJ . , SE� REVERSE IDE OF SHEET . T'iie undersigned hereby mal;e� application for a pezmit fcr the �,vrk herein specified, agreeinq to c?o .all work ir, strict accordancc ��ith the City of I'ridley Ordinances and rulii�gs of tl�e Department. of Buildings, an hereby declares that all the facts and repres�tatiens stated ;n this application are true and corre . D.'lT�: t— Z I SIGNATUI�: � . Stipulations: 1r�iA�� f � � CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND NEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CANDiTIONING SYSTEMS AND DEVICES RATE SCHEDULE QESID81�iTIAL Furnace Shell and Duct Work, Burner Gas Piping (pipinq needed with new furnace) Gas Ranqe Gas Dryer Air Conditioniny (all sizes� Al1 Others/Repai.rs and Alterations li of Value of Appliance or Work CpMMERCIAL/ INDU STitIAL 18 of Value of Appliance or Work RATE TOTAL -�/� �� $ 2�. 0� $; `�' ,_ $ 1D.OU $ �^` C�� $ 1a.00 $ G�+ $ ].0. 00 $ $ 10.00 $ State Surcharge • �: Reinspection Fee ($15.00) Rouqh Insp. Date Final Insp. �� 2-L ' ��3 Date Approval for Permit � MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS S.50 STATB SURCHARGE $ S $ .50 $� � , C./ � Attach stack verification tosa with replaceeent fuxndce peimita Effective Aug. 1, 1981 , z�- , Job Address ��l � � . Departa�nt of Buildinqs, 6431 University Av . N.E., Fridley, NN 55432 City of Fridley Tel. M571-3450 The undersiqned hereby makes application for a permit for the work herein specified agreeing to do all wryrk in strlct accordance with the City Codes and rulinqa of the Departmen*. uf Huildings� and hereby declares that all the facts and representations st�ted in th3a application are true and correct. �='I � � �ridley, Minn. � ` � ' i9— � � OWNER �/ � KIND OF BUILDING ussn ns TO BE �OMPI.ETED ABOUT " ESTIMATED COST ,/'—�� _ �} NSW BUILDING PFj�iNIT ND FEAMIT NO. C'� J� % DSSCRIP;'IOIi OF F[3RtiACEIBUIt�iER HEATING or POWER PLANTS, Ster�m� Hot Water, Wa� Air- No. ! Trade Name Size No. ��l��z Capacity � Sq.. Pt. EDR BTII �,� ) HP Zbtal Connected Load �� v _ Kind of Fuel ��"�•—� / BUttNER - Trade Nane Site tio. Capacity Sq. Ft. E7R B �,!_ HP C�wpan ' k� .. S:iqned By ' �r E�--��1.� Tel. No. � X'/ "" La� �� U - August 16, 1982 CITY OF FRI�LEY 8131 UNIVEiiSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 Mr. Gary D'Aigle Garjac Inc. 481 - 206th Avenue N.E. Cedar, MN 55011 TELEPHONE ( 612)571-3450 Re: Final Inspection at 7550 Brigadoon Place N.E., Fridley, NIDI Dear Mr. D'Aigle: A final inspection was made on August 9, 1982 of the above address and the following items were noted which must be completed before the structure can be finaled out; 1. Provide sod in the front and side yards. 2. Provide a hard surface driveway. 3. Post the address numbers on the structure. 4. Submit a verifying survey of the lot to the City. We will expect the above items to be completed and a reinspection called for before the structure is occupied. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK C,hief Building Official DGC/mh sue�ecT ERMIT City of Fridley 2�25 8 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � REC � � � � • � ; L___�� COMMUNITY DEVELOPMENT OIV. r � � PiiOTECTIVE INSPECTION SEC. �� , �"'1 � CITV HALL FRIDLEV 55<32 NUMBEfi REV DATE PAGE OF ACPROVED BY �----'�: ,.' 612-571-3450 9�0-F15 8/18/98 � � JOB ADDRESS 7550 Bri adoon Place NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. (� 2 Blomber Estate SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE D. J. Dull - 3 CONTFACTOR MAIL ADDRESS ZIP PMONE LICENSE NO. Ri ht Wa Roof'n - 4 ARCHITECT OR DESIGNER MAIL AOORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZtP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW O AODITION � ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (22 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAO SEPAFiATE PERMITS ARE RE�UIRED FOR ELECTRICAI, PLUMBING, HEATING, VENTILA7ING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. • AUTHORI2ED 1S NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION OR WOfiK IS SUSPENDED OR ABANDONED fOFi A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UN17S OFfSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. AI.L PROYISIONS OF LAWS yq�UATION SURTAX AND ORDINANCES GOVEFiNING THIS TYPE Of WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN Ofi NOT. THE GFANTING OF A PERMIT $1834 �.92 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITfEE SACCMARGE PROVISIONS Of ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERfORMANCE OF CONSTRUCTION �59. SO lr2 SC � 1. H3 PLAN CNECK fEE TOTAL FEE �Z%U��- � a Licens C 5. 6.25 S�GNATUNEOFCON'RACTOAOFlAUTH0�71ZEDAGENT IDATEI P PER IIDATE �S I�H RMI SiGNATUREOFOWNEAUFOWNEABUILDEAi IOATEI 8L0 �NS� F NE� »[] ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: `�-�-�('j �rlQ(7dDdM Legal Description: Effective 1/1/98 �as� � Owner Name & Address: (J� n�� Tel. # G�?��-�'jp� Contractor: ��.q�- �� p��y_�Q MNLICENSE# (7�q'4' Address: ��('� � .�� , �j� j'y� . Tel. # ��iq LIVING AREA: GARAGE AREA: 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. DECK AREA: Length Width Hgt/Ground 5q. Ft. OTHER: `(�-Q.GI.f �i �� U' -✓�G�- 422- %C� . 22 Construction Type: � � Estimated Cost: $, � � f �� '�� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: I� �I,� APPLICANT: ��-�'_Q�Vv�--��„ Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ S . S� $ C� v � $ 9� $ $ �- (�O $ $ $ $ � $ ��-5 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 [ ] c�� v oF F�� ENSP�cr}o�v r.}fv. S4:3i U^iuezsi'iy.t-`i'e R1c Frx�!�^};, S�fiV 5�43:: :i/z—:3cC}� B a : , � �•(, , �j4 / r tsec:tiv�� f�n 1±arr1� 1, 1 g<36 I � %i �- �� / J�J C� �� %� .��0 �%.�i �� l�� / ��.�r� `� ��.L �j � j�� N � I� �--��..`� l��o �• � v!-F � S e r..) � S c� . � G� � -,�3.� 3 C� ��:�,��1 � �� J�� - U�:� _ . _ ��C . .�.. ADDRESS PIN LEGAL DESC PERMIT TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 1631572-3604 FAX: (7631571-1287 : 7550 BRIGADOON PL NE : 123024110109 : BLOMBERG ESTATES : LOT 4 BLOCK 2 : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RESIDING PERMI NO.: 2004-01623 DATE ISSUED: 09/16/2004 VALUATION : $ 10,000.00 NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATHER RESISTIVE BARRIER BE PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN APPROVED WEATHER BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE COVERING OR TAKE PICTURES. RESIDE HOUSE; SOFFIT & FASCIA. STATE LICENSED CONTRACTOR 1 APPLICANT MINNESOTA EXTERIORS INC (2877) 8600 JEFFERSON HWY P OSSEO, MN 55369-0266 (763) 493-5500 OWNER DULL EDITH N 7550 BRIGADOON PL 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 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 regula ' cons ction or the performance of construction. Applicant � Date Bldg Insp � (l �� • BUILDING PERMIT FEE FIRE SURCHARGE STATESURCHARGE,VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 139529 �� n��on i►ar�� INil6 �e Mailed �'� ��+��er Tia Post SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 181.25 10.00 5.00 5.00 201.25 NEW [ ] ADDN [ ] ALTER [ ] Construction Address: � �� CITY OF FRIDLEY Effective 4/1/2004 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION . �C-%�C-' A � � ��' `�� a %��d�� Legal Description: " Owner Na e& Address: Y Tel. #��03 -%9.j �%� Contractorrr�� c� MN LICENSE # Address: �� ✓�,i� �/'�/�i-'��olo /��in� .�f�b�_Tel. # 76.3 �� / �Lii�:rtiiG AR�A: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length VVidth Height Sq. Ft. Length Length Width Width Height Sq. Ft. HgUGround Sq. Ft. Construction Type� r ' Estimated Cost: $ �� Qf+�• � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _� DATE: �1�� U APPLICANT: � Tef. #763 :39/ s'Ji 5` Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharr�e SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL �/��,� $ � �v- $ ,-; "_ � $ $ � , $ $ $ $ �� $ 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 Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] � STIPULATIONS: � � � � CITY OF FRIDLEY PERMIT NO.: 2004-02125 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/18/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 7550 BRIGADOON PL NE PIN : 123024110109 LEGAL DESC : BLOMBERG ESTATES : LOT 4 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 19,500.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. APPLICANT BUILDING PERMIT FEE 321.25 D&S BUILDING BLOCKS INC PLAN CHECK FEE 208.81 938 BROOKS AVE FIRE SURCHARGE 19.50 ROSEVILLE, MN 55113 STATE SURCHARGE, VALUE 9.75 (612) 986-4422 TOTAL 55931 OWNER DULL EDITH N 7550 BRIGADOON PL 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 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or c cel the provisions o any other state or local law regulating �struct}o or p ormance of constn}�tion� Applicant �'�� Date � y Bldg Insp Da�` SEPARATE PERMITS REQUI D FOR WORK OTHER THAN DESCRIBED ABOVE. City of Fridley *� CUST�R RECEIPT �� Oper: KIRKH�1 Ty�: � Drawer: 1 Date: 11/18/44 QO Receipt no: 6073 Bescri ptian Quantity � PFRMIT-BUILDIN6 PERMIT 1.� Trans nu�ber: G!l account nu�►t�r: 10100Q03221041 RR PL�I REVIEW FEE 1.40 Trans number: 6!L accaunt number: 10100003221541 FS FIRE SURCt#aRt� FEE 1. d0 Trar+s numl�r: 6/L acrnunt nu�ber: Id1Qt1QQ34�a721 SlJ 5l1RTAX 1.� Trar� nue�ber: 61L account nue�ber: 101�02050000 A�ount f321. �5 517554 $248. 81 517555 �19. 50 5175� 39.75 517557 D � 5 �.Dfl: � #P�4-021c''3 FOR 7550 BRI6AD�1 PL I� Tender detail CC VISR/�1STERC �559.31 Total tendered f559.31 Total pay�ent �559.31 Trar�s date: 11l18/04 Tivae: 12:56:17 ,� , � � �` � � `' � +� �1 � ! I � 1 \ \ � \ ,� � � � 1 . 0 ��nl �� a , � �i � _ `.� ., , . \ _ , � �J 1 � �� ! „ ., , � � \ � � � � n State of Minnesota Department of Commerce 85 - 7th Place East, Suite 600 St. Paul, MN 55101-3165 Department of Commerce Licensing Division Telephone: (651) 296-631 S E-mail address: licensing.commerce@state.mn.us Website address: commerce.state.mn.us ; Residentiat Building Contractor License �ega►�vame: D S BUILDING BLOCKS INC �usinessstructure: �BA. CQRPORATfON Address: 938' BRpOKS AVE . .. __ _ _ . ROSEVILLE, MN 55113 License Identification Number: BC- 20133674 Qualifying Person: DAVID COUENHOVEN �icense Expiration Date: 3/31/2005 Continuing Education: 7 HrS CE due by 3/31/2005 � 0 P CITY OF FRlDLEY fNSPECTION DIV. , 6431 University Avenue NE Fridley, MN 55432 t763) 572-3604I572-3602/572-3603 0 G�NTRACTOR LICENSE EXPIRES: April 30, 2005 APPLICATTnN FOR rRIDLEY LICENSE 535.00 EACH - Mark only one license per application form ( J Blacktopping [) Commercial or Specialty ( j Plasterinq ( J Chimney Sweep [ j Hea�ing (] Roofing [ ] Excavating [ J Masonry ( ] Siqn�Erector [ j Gas Services [ J Oil Services � [] Wrecking REGISTRATION FOR STATE LICENSED CONTRACTORS NO FEE For the follcwing registrations [ ] Electrical ' [�j Residential Contractor [ J Mobile Home Installer TQ THE HONORABLE CITY COUNCIL: [ ) Moving [ ) Plumbing [ ] Well Driller I herewith submit an application for a license to perform construction within the City of Fridley� in accordance with the ordinances of said City regulatinq the same. I am over twenty-one years of age. Submitted herewith is a Certificate of Insurance evidencing the holding of Public Liabil�ty Insurance in the limits of $50,000 per person, $100,000 per accident for bodily injury and $25,OOQ for property damage, and Workers Compensation as required by State Statute Section 176.182. Attach Copy of CERTIFICATES OF INSURANCE Public Liab. ,�c � � 81� Exp ration Date Worker's Comp._� G1� `� � � Expiration Date *MINNESOTA LICENSE # �D ( �i � `� 7 ` *ATTACH COPY OF STATE LICENSE FILL IN REVERSE SIDE OF FORM FOR OFFICE U3E ONLY 0 ��S a, �.,.,� � oE ��. �� l a v(� -� •�- Name of Your Company to be Licensed/Registered � Je ��.e�, �I�e,� Name of Individual to Contact �C3 � �r� �� - . Address of Company s�-�,"i � P� � � �—�< < 3 City Zip Code + 9 diqits �Sr�- �66-��'61 6�i-�6�-- d96/ Tel N oL•� Dusiness / F1�C � of Business Receipt # License # Council Date � ,' NEW [] CI1 Y GF 1=RIDLEY ADDN [] 6431 University Ave NE, Fridley, MN 55432 ' ALTER [] StNGLE FAMILY AND DUPLEXES R-9 AND R-2 BUILDING PERMIT APPLICATIO�,iI � C�---. ` Construction Address: '� � 5� ��z� Gi��o a,� I� ��LC� (763) 572-3604 Bidg Insp (763) 571-1287 Fax r ' DZ/2� _ G�" ' �� 0�3 Legal Description: Owner Name & Address: � � � � e �� Tel. # � �' � " 7�.(-- �� b Contractor. �S a�,�� ^� � �� L--e- MN LICENSE # Z �� 3 3 6"� c� Address: �J 3�� i� � ��S (�-�E `�s � v� �u.: , n�.► r-s �c 3 Te�. # b� Z—��6 -�r � Z i LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. � DESCRIPTION OF IMPROVEMENT ` Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length �� Width t� Hgt/Ground � Sq. Ft. Construction Type: � � ( � 1 � � �-� �'^� ►�-i� �`"�ated Cost: � 1 �1 r S� � ' � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: j�'��0 � APPLICANT: L�J e. ��,� e.-..�-a Je--- Tel. #� I 2-�i�6 ��t4 2 L Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 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 License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL � ��• Z�_ $� �S' _� � �' � � �. �� $ $ $ $ $ $ — $ '�� 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 Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ J Not Necessary [] STIPULATIONS: