AF - 35561SuBJECT
City of Fridley E - - ' �`
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �o � � 14 3
i � - -
' ` EI T
; �L _ COMMUNITY DEVELOPMENT OIV.
r j ' PROTECTIVE INSPECTION SEC. � l
1 � i 0
l__-. ,� �r���;`� CITY HALL FRIOLEY 55432 NUMBER REV. OATE PAGE OF APPROVED BV
i � � 612-571-3450
910-F15 � �
108 ADDRESS
7625 Hrigadoon Place N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. '] 1 Blomberg Estates SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ga.r'ac Inc. 481 , 206th Avenue N.E. 434-7096
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS E E NO.
8 USE OF BUILDING �
7 CLASS OF WORK
❑ NEW � ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
� � t �
9 CHANGE QF USE FROM TO
STIPULATIONS p�vide � a hard surface driveway. Provide Ci.ty with co of
PY
verifying survey before ca,pping. Proyide sod in the front and side yardse
SEWER LOCATION: (Inv. 895.30) 200' S. of Manhole
WYE ELEV: 894.50 Expose 5ervice prior to esta,blish footing elevation.
WATER LOCATION: Approx. 10' N'. of 5ewer Service
(Approx. 5' Deep In Street) ����'��
BEW.ARE OF SHALLOW SANITARX sEwEx �6ef� digging eall I�c� �filities
� - ELE�i'��� � ��� Etc.
��QE,d%i��� �� �v�
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 ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1' STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVEiiNING THIS TYPE OF WORK WILL BE COMPLIED $�6, 600 yS`3S.3O
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS Of ANY OTHER STATE OR LOCAL LAW REGULATING coN- $425.00
STRU N OR THE PERFORM CE OF CONSTRUCTION. $3�.00
�
� LAN CHECKFEE TOTALFEE
$91.00 $918.30
' IGNATUREO CONTRACTOR R UTHOR12EDAGENT �DATEI F WHEN PROPE ALIDA ED THIS IS YOUR PERMIT
SiGNATUREOFOWNER�IFOWNERBU�LDERi IDATEI BLDG iNSP DA E
0
C1T1( Or FRJOLCY Efteetive �►ug. 1, 19B1
APPLIUTla� fOk R[SIDCNTI/1� BUILOli1G PLRi77ITS
(Nc,,r. Alteratians. Additions. or Rcpai�s)
ONt�ER:
ADDP.ESS:
TEL M0: ' -
BUILDFR: _ �.�'�iQ.1 �'� �/i-��
__
ADDRLSS: � � l � � � �, �✓�e svr�
TE� No: �=� - y.� y — �G ��
. Constrvction Location
• lTR1T.T NO: � c� � 6TJtF.hT: l� � �'i � /� 06 /U � � !� C -P
s,o�r= 7 ei,00c: -� —�nir�: �.�. o o� ��,�, c s7�–r-�
Cornez I,ct: ___ =nsiae Lot: � _ ktb�cka .3� � _ Sid�yazlLs: �� ��
J1p�licant attach to tl�is fozm !�o Ccrtificates cf S1�rvey of lot and
pzcposed buil�ing Iocation drawn on ceztificetes•to scale.
OESCRIPTIOit OF (�pI�STP.UCTI01�
�__ Fr+�nt: °
� �P�= _ !i �O__ Height: ��
6quare Faet: Oubic Feet:
, � Froat: �C� � Dept?�: �' �teight: %Q'
6quare Fest: A�bic Peet:
of /�-° , . � � �oCiC�. v (�
�Tpe Cbrstructim s ���� — Esti�ated Cost: : 4"G
7b Be O�r.�plcted: _ _ � (,f �j �
. ------�
Alt. A Alt. 8
5 n� c Drc r� .
- --� -- ------- •
. -----____ ..__
• • . 6Et RiVER;E SIDE OF SHEET
. •
��e undersigne3 ?�ereby ma);e� applie�►tien foz a per�it icr the ��ezk herein specified,
eg�eeir�g to !!o ,all vork L, atrict accozdsrrce with the Gity of Fridley Ozdivances e,�d
t�►��i��9s of the Del�.�str►ent of Duildingt, and l�ereby declazes tT,r�t all t1�e fects and
sep�escy�►Gtiens stated 3n this appiacatio�are true and c�rrect.
aarr: �--� °�� aicN�►1v�:
at lecions: . ,
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sUILDING PERMIT ?EE SCHED�LE
The inspectoz oi buildinqs shall, befose i�suing pczmits tor the
�z�ction o! •ny buildinq oz atructare, oz toz any addition to any
�:i�tiAq buileiAq oz stzuctnrt, or !or any altezition or s�paizs
to aay •:istiny buileinq oz •tzucture, npon applieation thesetoze,
s�quire the payaent by tAe applieant toz su�h permit oi t��s to tDe
saonat S�rein belov s�t iortl� •na in the s�nnez �ezein p:ovided tc-vit:
'1'0?11I. V�LU�TION
il. oo � j Soc. o0
i501 �o ;2.000
i2, 001 t�c t25, 000
:25,001 to 550.000
i 50. 001 to 51 D0, D00
:10 0, 001 ard up
�
!gS
i10.00 �lin3si� Fee 515.00 plus surcharge
:10.00 toz the iirst t500 plus S1.S0 foz each
additional i100 oz fraction tAezeof. to and
inclu3irg i2•0�0
=32.50 ior the fir�t S2.000 plus 56.00 foz each
additional 51.000 oz fzaction th ereof, to and
tnclu din9 i25,000
i170.S0 foz the first S25,G00 plus Sa.50 ioz
eaeh •dd�tional s1,000 oz traction thezeof, to
.na incivain9 tso,000
:283.00 for t?►e lirst i5�, 000 plus
each �dditional 51,0�0 oz tzaction
ar�d includir�g S1G0, 000
i443.00 toz the first 5100,000 plus
each additional 51,000 or iraction
PI.AN C�iEOC: 25 percent of puiiding pe�it i�e
S3. 0� foz
tAezeof , to
S2. SO foz
thereof
DR2VfliAT DEPRESSION ES(St�fJ: Goncttte Q�zb 5tseeta �ly
]1lteznate 'A': Relcov�al and teplace�o�t of cuzb and guttez �oaly ,
Oriver+ay vidth plus b feet : 513.50
111ternate 'B'a Renoval and zep2scw�oer�t of cvzb and guttez and install a 3 foot
vide approach vitA 6 inch depth
Dzive�ay vidth plut 6 teet x:15.75
VERIFICATION OF FOUNDATION
Pe�r�+its tor constructio�n viil De issued a �einim�n of 24 houzs tzan the time of
application to allow foz proper sevier+ of the pzoposed structuze and of the
constn�ction site.
11 Certificate of S�rvey of the lot, shaaing the Iocation of the four�dation once it �� �/
Aas been oonstsvcted vill be zequized betore �roceed� with the tza�nir�q. ���
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c��sT�cac $c DAVgs, �c. co�W�g ��,� �,a �a s�►Q�
1�146 Couixiy Road J, 1�$inneapolis, Ml''+T 55432, (6I2) 784-9345
SURVEY FOR:
B & G Investments
961 Hillwind Road
Fridley, Minnesota 55432
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" DESCRIPTION
Lot 7, Block 1, Blomberg Estates, City of Fridley, Anoka County, Minnesota.
SCALE: 1" = 40
p Denot�s 1/2" diameter iron pipe monument set and capped No. 10832.
I hereby certify that this survey, plan or aeport was prepared by me or under rny direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of 1►�iinnesota.
_ � ��`'�� 10832 � ' � Nov. I7, 19£30 4278 �
Reg. No. Date Job No.
9 8
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CITY OF FRIDLEY
6�31 UNIVERSITY AVENUE N.E.� FRIDLEY� MINNESOTA 56432
TEIEPHONE ( 812)571-3450
July 22, 1983
Mr. Gary D'Aigle
Garjac, Inc.
481 - 206th Avenue N.E.
Cedar, NIld 55011
Re: Final Inspection at 7625 Brigadoon Place N.E.
Dear Mr. D'Aigle:
A final inspec tion was made on July 22, 1983 of the above adciress and
the following items were noted which must be completed before the
construction can be finaled:
l. Post address on structure.
2. Provide City with copy of verifying survey.
3. Provide sod in the front and side yards.
A check of our files noted that the verifying surveys are also due for
7532 Brigadoon Place N.E. and 7601 Arthur Street N.E.
We will expect the above it�ns to be completed by September 15, 1983
when a reinspection will be conducted to dete�ine compliance.
If you have any questions on these items, please feel free to contact
me at 571-3450.
DARREL G. CLARK
Chief Building Official
DGC/mh
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OOST SHARE AC1tEE?�NT
`�"� Ye, tAe un0ersigned� reaieina at ?6 as ���� �� v0°'� /" L �L
� �-. , (Addresa)
4 ��• � O % �L o C �C / �10 �'r+ �oi � ESTA�.O 1 S� i� `r0 �4 i�c o� �c' G
"�'� (Legal Descriptio�) �
:� . ' .. _ ;i
' a�p��• to participate ia a coat ��i�r os 6reesea tor tbe.toat�ll�tion and
, � oy�ration of a atreet lisht at _1/'/. �� -�/�� � K ��,�G �. d �P�Q � �
' .��� (Locatioa)
Y� tinderatand tQat tee decisioy aa �o -�bea :�e li��t is !' 0� !ns•.alled vil]
pe �t tDe sole discretion ot tbe Citr. Ie� additioa the Cit� vill b�ve aol•
desretion aa to vhen tse li�ht ia removed.
Ye agr�e t0 par our percentage of � of tse total cost incu�red py tAe
City for the in�tall�tioA and operai��� ot Lbia light each year. Ye also
agree to aAare •ny coats iacurr�� b' tbe removal or �epai� of thia 116ht.
Ye �gree Lbat this eoat vill se paid Lo tDe Cit� 0� Auguat 1 of eacA �ear or
tAe coat vill pe automatically added to our propert� aaaessment Oy OctoDer 1
of each �ear for tAe life of tbia lisht.
?his agreement vill continue as lona as tbe liaht i• •t tbis location.
Y� •g�ee tbat tDis agree�ent ia piedins u�oo our beirs� auecesaora.
tranafereea or aa�i�a la interest.
?t•_t x�-'��e;.t 1� x��:e !�fs ��dt o' �_� �� A.�Mo�n the Cit� of
Fridl ey and � er J'. � �e.�.s..� �7_ �/��c o 7G�2S -r3�.%bAOCk�+v +P �rE
Fridley, Minnesota. ,
�, C
�er Signature
B
Amer Sign ure
State of !linaesota)
)aa
County of �noka )
On tdis �
� day of � Oefore ie� • Iiotary Publie vitbin and
, for tb County of Ano a d tAe State of Minneaota� Deraoeully aDpearee
!'� �/j�.1_ •n ,� hu�D�ed Rn� YSfe� Lo me kr.�wn
Lo � the same peraona d acribea in ard vho ezecuted the toregoing inatrvment�
aad �oiatarledged tsai t6ey esecuted tbe aame as their tree �ct and deed.
- ,. =� �_ , . . n � � -
Tbis ieatr�ent vaa arafted b�:
Cit� Fridley
6A31 Qnlverait� �v�nue
fridley,.Mianeaota 55�32
3/5/1?!t0
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l�otary Dlie �
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TBtESA Il SCHttAI -
I�TARY PUBtJC MIM�TA
AM�1cA ODtINTY
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Surueyors Certi uate ����
�
COMSTOCK et DAVIS, INC. Consulcing F,agineers and Laad Survryors
1446 Couary Road J, Minaeapolie, MN 33432, (612) 784-9346
SURVEY FOR:
Gar-Jac Construction
481 206th Avenue NE.
Cedar, Minnesota 55011
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DESCRIPTION
Lot 7, Bloek 1, Blomberg Estates, City of Fridley, Anoka County, Minnesota.
SCALE: 1�� � 40
p Denotes 1/2" diameter iron pipe monument set and capped No. 10832.
S ET IN PLAT QF L7rt�OM��R6 ESTATE,e� � NoT �p, TMtS yvta�yg,y,
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that T am a duly Registered Land Surveyor under the laws of the State
of Minnesota.
�
- , 10832 OcT. t 6, tgSS y.8 30 q D
Reg. No. Date Job Na Book Na
sue�ecr PERMIT
City of Fridley 219 4 5
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
i�
� � •
� ; y _����_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �Q�Q
� _ �
� �'��1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OP APPROVED BY
�"'"'� � ,�� 612-571-3450 9t0-F15 6/30/93 / /
JOB ADDRESS 7625 Brigadoon Place NE
�
t LEGAI • LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 7 1 Blomberg Estates SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Bob/Joann N�cNeil 7625 Brigadoon Place NE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Caribou Canstruction �nc. 180 Transa,t A e o 483-8346 5903
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO-
5 ENGINEER MAIIADDRESS Z�P PHONE UCENSENO.
6 USE OF BUILDING
Residenti al
7 CLASS OF WORK
O NEW �7 ADDITION O ALTERATION 0 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Constx�uct a 14' x 12� Deck.
9 CHANGEOFUSEFROM TO
STIPULATIONS �ee notat%c�ns on lan, �nsta�ll smoke detectors as
p � per UBC 121Q, adjacent
to all sleeping areas and in basement.
�IAR � G
SEPARATE PERMtTS REQt1tRED FOR ����ng ca11 for
WIRING, HEATING, PLUMI�IN{� ,A)�(� S� �� � ��2�►ons
�'.ED BY L�W
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS RERMIT 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 ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATIOPI 1' STALLS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED ,�`1, � 3O3 a 68 .� � C15
WITH WHETHER SPECIFIED HEREIN OH NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO VE AUTHORITY TO V LATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OT R STATE OR LOCA L W REGULATING coN- $33. QO �'ire SC $�., 3D
STRUCTIO Fi THE P ORMANC OF CONS CTION.
PLAN CHECK FEE TOTAL FEE
�� , � �_ 3 License SC $5.OQ $39.95
SIGNATUREO TRACTOFORAUTHOR12E AGENT IDATEI W P VALIDATED THIS IS YOUR PERMIT
' a � � ���
SiGNATU E FOWNERUFOWNERBUILOERi �DATEi BLDG iNSP D4iE�
NEVV
ADDN
AI,TER
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CITY OF FRIDLEY
SINt�LE FAMILY AND �DUPLEXES R-i AND R 2
Building Permit Application
Effe�tive 5l26/93
Consbruction Address: '�DaJ'f ����rs� O/�l /�i�
Le,gal Description: . `�GDC.� � _ �LQi�?$c5.��-- �.��'A7,EL
Owner Name & Address:
Com�actc�r:
Addres.s:
M1�I LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed G��on clrawn on it to sc�le.
DESCRIPTIUN UF IMPROVEMEI+IT
��� 90
Tel. # 3 �
LIVING AREA: Length Width �eight Sq. Ft
GARAGE AREA: Lengtb Width H�ght �. Ft.
DF.C�C AR.EA: Lengtt► �-�-� Width l,�_'___� �IgtlGtvund o�0,� �. Ft. ��
OTHER:
Corner Lot [] Inside Lot � Ft. Yd S�back S/ � Side Y�d��cks .3� �
T}�pe af Co�utiog: �w� ��i�r�l�' Es�n�ttet� �..$ � ��'�C:��. ��
Approx. Com�pl�tion Date: 7•�� • p3 � �-
{Cost � Back)
Driveway Curb Cttt Width Need�l: F�. + 6 Ft = Ft x$ _�
DATE: _�•�� 1�PPLICANT: i� .---//���G�/.�,�i Tel. # %8�•�357
Pexmit Fee
Fire Surcha�ge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Maia Charge
ToT�.
S
$
�
�
�
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S
$
$
���� C�GO
/ ��
,���
�
� 6�� (.J
� .=� �' -� � �
�f. ._�. _ .. ' � .�I_
�ee Sch�iule an Reverse Side
.001 of Permit Valuation {I/li�h%)
$.SO/$1,000 Valuation
$750 pex SAC Unit
$5.00 ($taLe Lic+ensed Resldeutial CoIItractors)
Al� "A" or A1t. "B" Above
Conservation Plau R�view $4g0.�
Fee 1?�t�ermined by Engin�ninS
Agreement ATecessary [' j Not Necessary I]
s�rui..A�or�s:
�
,
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. . '' {v. •. .
BUII.DING PERMIT FE� �CHEDUI-E
The Chief Building Official shall, before issuing permits for the erection of any building or structure,
or for any addition to any existing bnilding or sbrucd�re, or for any alteratian or regair to any existing
building or structure, upon application thexefore, require tfie �y3aen�t by the applicant for such permit
of fees to �the amaunt herein below sgt forth and in the manner �erein provided to-wit:
. -� ,-, a
TOTAL VALUE �- '° . _ � . ' �EES
. ..
$i . . to $500
..... . . .
$501 to $2,(l00
$2,001 to $25,0�
$25;001 to $50,000
$50,001 to $100,000
.� .
$15 (Minimum Fee is $15 plus surcharge) , - _
$15 for first $S00 plus $2 for �ch additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
� $252 for first� $25,000 ples �.50 far each additional $1,000
., . or fraction ther�i, to. and including $SQ,000 -
$10(?,001 to $50fi3O(�0 ����
$500,001 to �1,000,�
$x�,U00;001� �nd up
$414.50 for fust $50,Oa! plus $4.50 for each additional
$1,000 or fi�cctii�on thereof, �o .aad inclnding $100,000
�39.30 for 5rst $1�,OOU pl�s .$�tSD for each additional
$1,OOQ or fraction th�eof, to and incluci�ag $500,(m0
$2039.50 for the f�rst $SOO,OOQ pins $3 for each additional
$1,(�0 or fraction ther�f, to and including $1,�0,040
$3339.50 for the - first $1,O�y000 plus $Z for eaCh �ddifional
$1,000 or fraction �thereof -
DRIVEWAY I3EPRESSION ESCROW
(Concrete Curb Streets Only)
Alternaf.e "A": Removal and replaceme� of caub 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 .
approa.ch with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for constiuctioa will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed stiructure and of the conshuction site.
A Certificate of Survey of the lot, showing the locadon of the foundation once it has it has been
constructed will be required before proceeding with the framing.
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SUBJECT PE-FFI�!-�iV{T.
c�ty of Fridley � 2 2 3 2 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � -C-EFFfi .
� i L_ COMMUNiTY OEVELOPMENT DIV. ��
r � � PROTECTIVE INSPECTION SEC.
i i �
� /"'1 � CITY HALL FRIDLEr 55432 NUMBER REV. OATE �AGE Of APPROVEO BY
�..___h.' '•� 612-571-3450 910-F15 3/9/94 / /
JOB ADDRESS �625 Hrigadoon Place NE
t LEGAL LOT NO. BLOCK TRACt OR ADDITION SEE ATTACHED
DESCR. 7 1 Blomberg Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Robert McNeil 7625 Srigadoan Place NE 786-5916
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
S azne
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS Z�P PHONE LICENSE NO.
8 USE OF BUILDING
Resident%al
7 CLASS OF WORK '
O NEW ❑ ADDITION � ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reznod.el basenlent
9 CHANOEOFUSEFROM TO
STIPULATIONS
See nc�tati,ons on �lan,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOO 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' STALIS 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 $3�500 $l, %rJ
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTFiUCTION. �`F?3 e QQ F1x2 cSC y�`3. JrO
PLAN CHECK FEE TOTAL FEE
$68.25
SiG rua FC TRACTOaORAUTFjflR�ZEDAGENT IDATEI _ m � p{IHEN PROP LY VALIDATED THIS IS YOUR PERMIT
��iii �Cl % 3 � s y� .� 2� _ � -- �o -9 �+
� � r„a
SiGNATURE OF O ER UF OWNER BUILDERI ID E� LDG �� SP O!•TE
"_�,
: r�w
ADDN
' ' AL'I'ER
Cl � . .
( . . - . CTI`Y. OF FRIDLEY � � .
� SiNGLE� FAMTLY AND DUPI:EXES R-� AND �t-2 �
� ' ' � �. Building Permit Applica'tion .. '
� Effective 1/1194
ConstructionAddress: ��� a s' /� i�� � ra J v u�J � L--
Lega1 Description:
Owner Name & Address: �j �,e,, � 1 � rn � /�l -� � �- Te1. # 7C�(� - � `�1 � �
Contractor:
Address:
LIVING AREA:
GARA.GE AREA:
DECK AREA:
OTHER:
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, �vith the propose�d construction dra�vn on it to scale.
Length
Length
DESCRIPTION OF III+IPROVEMENT
n��.
Corner Lot [] Inside Lot [] Ft. Yd Setback
Type of Construction:
Approx. Completion Date: _
Tel. #
Width Height Sq. Ft.
Width Height Sq. Ft.
---_---
Width Hgt/Ground Sq. Ft.
Side Yard Setbacks
Estimated Cost: $ �� S U � %---"�
` (Cost on Backj
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft $ _$
DATE: ��� �- � 1� APpLICANT: �� �cr� Q�✓ Tel. # 7�� -� � l
Permit Fee
Fire Surcharge
State Swcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Cantrol
Park Fee
Sewer Main Charge
TOTAL
$ � ��
S D
$ 3 �
$ � �s
$
$ � -
$
$
$
$
�
� � • 2�
CITY USE UNLY
F� Scheciule on Reverse Side
.�1 of Permit Valuation (1/10th%)
$.50/$i,000 Valuation � �
$$00 per SAC Unit
$5.00 (State Licensed R�idential Contractors)
A1t. "A" or Al� "B" At�ve
$450.00 Conservadon Plan Review
Fee DeterQUned by Engineering
Agreement Ne��essary� [ ] Not N�essary [ ]
STIPULATIONS: ` s
� � BUII.DING PERMIT FEE SCHED�JLE � . - • �
The Chief Building Official shati, . tiefore issuing permits for tt�e. erection of any building or structure, �
or � for any addition to any existing building or 5bntc�re, or � for any � alteration or repair t� any existing
building or s�tcucture, upon application therefoze, require the payinent by the applicant for such permit
of fee.s to the amount herein below set forth and in the manner herein provided to-wit�
TOTAL VALUE
$1 ' � � to $500
$501 to �$Z,000
$2,001 to $25,000 �
FEE,S
$15 (Minimum Fee is $15 plus svrcharge)
$15 for first $SQO plus $2 for each additional $100 or
fraction thereof, �to and� including $2,OOU � � _ . . . � � . .
$45 for first $2,OU0 plus $9 for each additional $1;000 �
ar fraction thereof, to and including $25,000 . -
$25;001 to $50,000 - _$252 for first $25,000 pl�s $6.50 far each addifional $1;OOQ
- or fraction ti��eof, to. and including $50,000
$50,001 to $100,0IXi
$100,001 to $500,000
$500,001 to $1,000,�4
$I,(�Q,001 and up
$414.50 for fir� $50,OOQ plus $4.50 for each additional
$1,000 or frac4ion the�eof, to aad including $1Q0,000
$639.50 for fiist �$i00,000 plus $3.50 for each additional�
$1,000 or fradion the,r�f, to and including -$500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or firaction thereof, to and including $1,000,000
$3539.50 for the fust $1,000,000 plus $2 for each additional
$1,000 or fractioa �thereof -
DRIVE�VAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alterna.te "A" : Removal and repla.cement of curb and gutter only - Driveway width plus 6 feet times
$13.50.
Alteraa.te "B": Removal and repiacement of cwrb and gutter and install a 3 foot wide.
approach with 6 inch depth - Driveway width pius 6 feet times $15_75.
VERIFICATION OF FOUNDATION
Permits for construction vvill be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed slructure and of die 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.
-- -- - - _
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' �• SU8J8CT �
City of Fridley
AT TNE TOP OF TME TWINS g u I L D I�l G P E R M I T
r
� .
� ��°��������MITY DEYELOPM�NT OIV
�d1' TIVE INSPECTION SEC.
� . ,
� = i"'1 � CITY HALL FRIOLE� 83�32 NUMBER
�""� � �'� 612-571-34b0 9t0-Ft5
�oe aooaess
7625 Bri adoon Place NE
t LEGAL �OT N0. BLOCK TRACT OR AODITION
DESCR. '� 1 Blomber Est
2 PFOPERTY OWNER MAIL ADQR�S$
Bob McNeil
3 CONTRACTOR MAIL ADDRESS
Thurs Roofin� 5717 113th Ave N Cham_n -tn
4 ARGHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAILADDRE$S
8 USE OF BUILDING
Residential
7 CLASS OF WORK
REV DATfi
10/13/98
ZIP
�2y
21P
PAGE OF
� �
PHONE
PMONE
PHONE
8215
�� �
EO Br
SEE ATTACNED
SHEET
LICENSE NO
A�G.h
LICENSE N0.
LICENSE NO
❑ NEW ❑ ADD�TION O ALTERATIQN �} REPAIR O MOVE � O REMOVE
8 DESCRIBE WORK
Reroof house and �arat�e (27 Sq) Tear-off
9 CHANGE OF USE FROM
STIPULATIONS
TO
Underlayment must comply with the State �uilding Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED VIIITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK tS SUSPENDEO OR ABANQONED FOR A PERIOD OF /20 DAYS A7
ANY TIME AF7ER WORK IS COMMENCEO. NO. DWLG. UNI
I MEREBY CERTIFV TMAT I MAYE REAO AND EXAMINEO TMIS APPLICA710N
AND KNOW THE SAME TO 8E TF]UE AND CORRECT. ALL PROVISIONS OF LAW$ yALUA710N
AND OROINANCES GOVERNING THIS TYPE OF WpRK WILL QE COMPUEO
WITM WMETHEF SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT 2313
DOES NOT PRESUME TO GIVE AUTMOFi�TY TO VIOLATE OR CAMCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE Oii LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $]L�.. ]S
ta�r� � f(7�l �=„_,ci �
S�GNATUAE O� CON'aACTOQ Op AUTMOp�ZED nGENT IDATEi
iDATE�
UPANCV
FT
STAILS
ROUP OCCUPANGYLOAO
CU FT
OFFSTREET PARKING
IGARAGES
SAC CMARGE
Fire SC $2.31
TOTALFEE
83.
D S VOUA PERMIT
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NEW [ ]
ADDN [ ]
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ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
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�
Effective 1/1/98
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Owner Name & Address: � ah i'Y1c N e. ; L"�l�. S R r;�C .D.�ru Tel. #�?cS��' S'���
Contractor: --�.�rS �' � v.� '� _MN LICENSE # �,3 � (o,
Address: .S� � 7 — J ( � � ,�1- v � {U� , Tel. # � L
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
��
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: �o � � r o�1� Estimated Cost: $ r� -�- ��i-3
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: /�'i � ' �l � APPLICANT: �� � Tel. # `�� �-��o � y
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
I,icense Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ '7. SJ
$ 02. 3 �
$ %i�
$
$ S OC�
$
$
$
$
$ �� o?�-
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,OOQ Valuation �
$1000 per SAC Unit
$5.00 (5tate Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ )
y �
BUII.,DING PERMIT FEE SCHEDULE
The Chief Building O�cial shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,0(}0
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,OQ0
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,0� �
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,0OO,OQO
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIYEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Altemate "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.
SuB�ECT r
c�ty of F�idle� �
AT THE TOP OF TME TIMINS B u� L D I 1 ,� P E R M I T
� 1
� �
� `v ____�_ COMMUNITY QEVELOPNIENT DIV.
r � � PROTECTIYE INSPECTION SEC.
l_---� ��"' �•� CITY HALL FfiIOLE� 53��2 NuMBER AEV
L 612-571-345p 910-F15
10B ADDRESS �625 Brigadoon Place NE �
1 LEGAL �OT NO. BLOCK TRAC7 Ofi ADD�TION
DESCR. ] 1 Blomberg Estates
2 PROPERTY OWNER MAIL ADpRE,S$ �
Robert J McNeil
3 CONTRACTOR MAIL ADDRESS
Owner
4 ARCMITECT OR DESIGNER MAiL ADOFES5
5 ENGINEER MAILADDFiESS
8 USE OF BUILDING
Residential
7 CLASS OF WOAK �
OATE PA
10/16/98 /
28280
T NO.
p� 1 �
Oi APPROVED BY
/
SEE ATTACHED
SHEET
Z�P PMONE LICENSE NO
YIP PHONE LICENSE NO.
ZIP PHONE LICENSE NO
,
❑ NEW 0 ADDITION � ALTERATION � q�PAIR D MOVE • O REMOVE
8 OESCRIBE WORK
Replace cedar shakes on west side of house (storm damaael
9 CHANGE OF USE FHOM
STiPULATIONS
TO
SEPARATE PERMITS ARE IiEOUIREO FOR ELECTiiICAL, PLUMBING, MEATINCi, ��re �r
VENTILATING OR Alq CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WQRK OR CpNSTRUCT10N IONING
AUTHOR�2ED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
Ofl WORK IS SUSPENOED OR ABANQONED fOR A PERIOD OF 12Q DAYS A7 '
ANY TIME AFTER WORK IS COMMENCEO. ' NO. DN
I HEfiEBY CEHTIfY THAT I HAVE READ ANp EXAMINEO THIS APPLICA710N
AND KNOW THE SAME TO BE TFiUE AND CORRECT. ALl PAOVISIQN$ OF LAWS VALUATi
AND ORDINANCES GOVERNING THIS 7VPE OF WpRK WILL Q� CI�MPUED
WITH WME7HER SPECIFIED MEREIN OR NOT. TWE GRANTING OF A PERMIT SOO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CAMCEL THE pERMl7 i
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TME PERFOiiMANCE OF CONSTRUCTION �77 �
S�GN4TU�7E O� CON'AACTOA OA AUTNOA�2E0 AGENT �DATE� �
�� � ����
�GN4TUAEOTOWNEp��fOWNEAB ILDEA� IOAiE� �
UNITS
STALLS
�
STREE7 PAqKIN(
GARAGES
ITAX
)�
CMARGE
� a7\. ..��-
LfEE
�.��
�IS �S YOUR PER
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Cr LOAD
r
�
0
NEW
ADDN
ALTER
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ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
CI'TY OF FRIDLEY
SINGLE FANIILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�'' f
a�v -� o o�,+� %��
Effective 1/1/98
(� b�✓�"' i w� c d� l�' Tel. # 7�t�' -J �l �
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
I.ength Width Height
L,ength W idth Height
Length Width Hgt/Ground
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
OTHER:
�1 �
'� Q a�,� y S� �" .� Estimated Cost: � ��
Construction Type: � e Joo-� �,.�, o...�-s �� f��
�`�"`"{ �°'��� w� �ee Schedu.Ie on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � a- r sr• � �` APPLICANT: �� /L2 ��e�-/ Tel. #��`G� �`�'�'�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sew�r Main Charge
TOTAL
STIPULATIONS:
$ �� v�
$ s�
$ S,�
$
$
$
$
$
$ -
$ o2�Z� �v
CITY USE 4NLY
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 [ ]
BUII,DING 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
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100, 000
$100,001 to $SOO,OQO
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for fust $2, 000 plus $12.50 for each additional $1, 000
or fraction thereof, to and including $25,000
$349.75 for first $25,QQ0 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,OQ0 or fraction thereof, to and including $100,000
$887.25 for first $100, 000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1, OOQ or fraction thereof, to and including $1, 000, 000
$5012.25 for the first $1,0OO,ODO plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $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.
sue�ecr P •
City of Fridley P E R M I T 3 3 � 2 6
AT THE TOP OF TNE TWINS g � I L D I N G
� �.
i �• COMMUNITV DEVELOPMENT DIV. � ��j (�
V PROTECTIVE INSPECTION SEC { ��
� V "��
r � �;
� � /�"1 � CITY NALL FRIDLEV SS��Z NUMBER REV DATE PAGE Of APPqOVEO BY�
�--��� � �'' 763-571-3450 s�aF�s 7/21/03 � /
JOB ADDRESS �625 Brigadoon Place NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
DESCR. ] 1 Blomberg Estates SMEET
2 PROPERTY OWNER MAIL AODiiESS ZIP PHONE
Robert & Joann McNeil, 7625 Brigadoon Pl NE, Fridley, MN 55432 763-786-5916
3 CONTRACTOFi MAIL ADDRESS ZIP PHONE LICENSE NO
Wellington Windows, 3938 Meadowbrook Rd, St. Louis Park, MN 55426 952-933-6300
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
Exempt
5 ENGINEER MAIL ADDFiESS 21P PNONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW � ADDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replacement of 3 windows
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on a11 levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Caulking and flashing for all exterior openings.
TVPEOFCONST OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING. MEATING,
VENTILATING Op AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. fT CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANDONED FOR A PER100 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OffSTREET PARK�NG
I HEREBY CERTIFV THAT I HAVE REAO AND EXAMINEO THIS APPLICATION STA�LS GAFAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VA�UATION SURTAX
AND ORDINANCES GOVEFNING THIS TVPE OF WOfiK WILL BE COMPLIED @
WITH WHETHER SPECIFIED MEFEIN OR NOT. THE GRANTING Of A PERMIT �I.,434.00 `I'•72
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI TME pEqMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING cor,• Fire SC �I.�F3
SiRUCTION OR TNE PERFORMANCE Of CONSTRUCTION �,rj�F.00
PLAN CNECK FEE TOTA� FEE
$56.15
$�GNATU�7E OF CON'AACTOA OQ AUTNOp�2ED AGENt iOATEi N PqOPERLY VALIDATED THIS IS VOU PERMI
S�GN4TUAEO�OWNEA���OWNEpBUILDEpi �DATEi iNS� �� E
NEW [ ]
ADDN [ ]
ALTER [ ]
g���3
Construction Address:
Legal Description:
Owner Name & Address:
CITY OF FRIDLEY Effective 1/1/2003
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
Z6��
Tel. # lf7s �IUC?—
Contractor: � � M ICENSE #
Address W o . . f'�[ Tel. # cl - '� DD�
Attach to this application, a Certificate of S� of���j � ���G ��
lot with the ro osed construction drawn on it to scale. � �
, P P
LIVING AREA:
GARAGE AREA:
��SCFi1�Tf��1 C�� BiiliFRO'10�t�iEi�'i
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
DECK AREA: Length
Width Hgt/Ground Sq. Ft.
OTHER:
�t� ����� � , �
Construction Ty'e: a � � Estimated Cost: � .3
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _�
DATE: �� d �%3 APPLICANT: ( 1.��"� Tel. #�7r� ���'�3d�
Call (763) 572-3604 fo� Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ � ��
.
� 3
$ .72
$
$
$
$
$
$
$ �"�,�5
%
?� �3
CITY USE ONLY -
Fee Sdiedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Vaivatio�
$1275 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 [ ]
�
_ •►
BUII.DING PERNIIT FEE SC�ULE
The Chief Building Official shall, before issuing permits for the erection of any buildi.ng 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 pernut of fees to the amount herein
below set forth and in the mauner herein provided to-wit:
TOTAL VALUE
$1 - to $500
$501 to $2,000
$2,�1 to $25,Q00
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $SQO,Q�
$500,001 to $1,000,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$6�.25 for first �2,{� plus �1Q.00 fo� each �.ddi�ienal �? ,OOQ
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each a.dditional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,0� or fraction thereof, to and including $SOO,OQO
$3,233.75 for the first $500,0� plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $S,f�8.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fiaction thereof
CURB CUT ESCROW
- - (Con��ete Curb 5treets D�iy) - -
Removal and replacement of curb and gutter only - driveway width plus 6 feet times $17.00.
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.
VERIFICATION OF FOUNDATION
A Certifica.te of Survey of the lot, showing the location of the existing founda.tion will be required before
proceeding with the framing. New Houses Onlv
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THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPUCATION WILL BE RETURNED
�- �►� ���� �► � : / : � � •►
�u��i•► I ► i ►� e►� - - -
Wh� mY �==-^-� 9" �Ya`�'"p �`'.�nca, the undersigned hereby verifies that the
ver�ting has been examined and is free from rust, deterioratian, obstructians, Yes�� No (}
and is secureiy supported ar� �irestopped where required.
The venting system is plasticlPVC and msets aU a.+rrent c°des and manuiacturer
speci�cations including sizing, length, number of eibows and termina�on. Yss (� No �}
The unders�gned aisa ve�ifas that the repiacement unit is a listed assembly
and meets the airre Cacode�s al C ntral �'umace V��a�l s ior�f n�s
indud� AGA-GANU°� eg rY tr
assisted and natural draft aPpl�ances.
The is sized and installed to meet th� cur�er�i r.�des
and manufacturer's spe�catiar�s.
YY11eR �V�,v� �O _�-_�� wAMI711�CSii 91i �t wiN bs sized and installed
fo meei the current codes and manufacturer"s specifications•
When iosta�in aA.sYste�m� �e ur►dersigned hereby veri�es that
it is a listed assembly and meets the c�rrent codes and ma��ctu Ur�
s�ec�ficca�o�s. This�do�ss�sted andG atural d�a PI an�es.
a
Ven�ng Tables %r
!s the common vent and ve�v d from the commonv nt and e ed y��r
a n a p p l i a n c e h a s b e e n r e m
separatelY as per cuRerrt cxsdes.
Yes � No ( }
Yes �? No ( j
Yes( ) No�}
Yes � No ( }
Yes�No( )
� Fan Assisted or Nat ��"�
qppliartce #1 Type �, ,_____ BTU lnput�,� Fan Assisted or Nat t� r� �C
App�ance #2 TYpe � "^""' B7U Input Fan Assisted or Nat
qpp�iattce #3 Type Tc�ta1 �ltu input ��
ToiaO Appliances � ,,
r
�,� Diary'ieter incl�es
Commoi'ti Vent Type L 9�� R- o� �- v�,=�fVent Height —
App�ance #1 Vent Cannedor Height �ft Length -� ft
qppfiance #2 Vent Connector Height �� �gn� ��
qppiiance #3 Vent Conne�tor Height _�
ro
Diameter in
Diameter ° i�
Diameter in
m
Type �_
Type __�___.
Type _._.
�E�
HEATING CO:
Date :
�
_
C[TYOE
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 30, 2004
Mr. Robert McNeil
7625 Brigadoon Place NE
Fridley, MN 55432
Re: Final Inspection at 7625 Brigadoon Place NE
Contractor: Dave's Appliance Heating & Air
Dear Mr. McNeil:
A mechanical permit was issued on November 5, 2003 to install a fumace at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this pernut. As of this date the inspecrion has not
been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your pernut open for another 30 da.ys and if we do
not hear from you within this tune to set up the inspection, we will mark the permit "no
inspecrion called for by homeowner after notification and the permit will be expired.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely,
,
DAVE SEN
Building pector
DJ/mh
3uilding
nspections
;%63-572-3604
.4TE J � � /� �
i E ADDRESS _�
-IIS APPLICANT IS:
'ROt ERTY OWNER/
TENANT
CONTRA.CTOR
� SUBMIT A COPY OF
I, x'QtJR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT Ti'�'E
TYPE OF WORK:
BUILDII\TG
laESIDEI�TIAL A�''PLICATIO:I�T
CITY OF FRIDLEY
YOUR E- L ADDRESS
' r��Q bon lttu �
❑ OWNER I�ONTR.ACTOR
aDD�ss: - r� n c �n
PHONE:_ , L'3 ��_g •'S Q I Cs
Pella Windows & Doors
x`�'— 15300- 25th Avenue N.- Suite 100
STATE LIC P1j�710UiI1, MN 55447
avDx�ss: �63/ 745-1400
Pxo� License# 20165884
❑ SINGLE
❑TWOFA�
QADDITION ❑ GARAGE/SHED
� BASEMENT FINISH ❑ ROOF
� DECK ❑ SIDING
❑ SWIMIvIING POOL
❑ NEW ❑ ADDTI'ION
ESCRIBE WORK BEING
FZE OF Il��PROVEMENT
IIMBER OF SQUARES _
4RAGES
_OPOSED SIZE:
,OPQSED HEIGHT:
.DING
Vinyl
Aluminum
Other
.�IIt ❑
� HOUSE & GARAGE
O ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
� Trim
❑ Fascia
�TDOWS
EXIST'II�IG OPENINGS �es �No IA�AT'ION OF WINDOWS
: FOR NEW OPININGS- ESCRIBE SIZE OF L i vi n tt �(�., n �n c} r o o�
LNWG CHANGES & � � S� � �,�.�� ��ER OF WII�IDOVTS �
PE OF WINDOW TO BE INSTALLED
Permit No.:
Received B,
Dat�e�C'd:
b�1�ts _�oM
CITY �rf CL'l V STA'� nLIP SS�i � 7
�odr m Fldr r o�u s
R�'�134S-G�k�
CITY STATE ZIP
❑ DRAW TILE
0 OTHER
� j� +
F�
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
F�R NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing siructures
and proposed project
2. Two sets of construction plans •
3. Energy Caiculations
ALL FEES ARE BASED ON VALUATION, TNCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
. TOTAL JOB VALUATION $� 4� L OCCUPANCY TYPE
rmit Pee
3.n Review
rcharge
-e Surcharge
�ense Surcharge
�.0 Charge
u-b Cut Escrow
osion Control
� k Fee
wer Main Charge
�tal Due
$ ( S 3.2 � See Back Page for Fee Schedule
$ 65% of Building Pertnit Fee
$ .? (.0005) times the total job valuation — Minimum $.50
$ . �i � .001 x Permit Valuation (1/10%)
$ S'' . o � $5.00 (State Licensed Residential Contractors)
$ $1450 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$20=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ O.. 1 i, Make checks pavable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMI'I'-NOT VALID UNTIL PROCESSED
iereby appIy for a building permit a.nd I acknowledge that the information above is complete and accurate; that the work will be in
iformance with tl2e ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
-mit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
n in the case of all work which requires revi d approval of plans.
NATURE OF APPLICANT � pRTTIT NAME � l'"1� S r h e n�' Dq� � �O� �
Page 2- Building Residential Application
BUILDING PERM�T FEE SCHEDULE
The Chief Building Official sha11, before issuing permits for the erection of any building or
structure, or for any addition to any e�isting building or structure, or for �any alt�ration or repair
to any existing building or structure, upon application iherefore, require the paymeni by the
applicant for such permit of fees to the amount herein below set forth and in fhe manner herein
provided to-wif:
TOTAL VALUE FEES
$1 to $500 $23.50 (Minimum Fee is $23.5.0 plus svrcharge)-
$501 to $2,000 $23,50 for 15` $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,OOi to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000 $39125 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and
� including $100,000
$100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional$1,000 or fraction to
and including $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fractaon to and incIuding $1,000,000
$1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional$1,Q00 or
fraction
VERIFICATION OF FOUNDATION
Pernu.ts for construction wil.l be issued a ininunum of 24 hours from the time of applicatian to
a11ow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the e�.sting foundation will be
required before proceeding �vith the frasning. New Hou.ses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Frid.ley, MN 55432
763-572-3604
F�: 763-502-4977