AF - 35574SUBJECT IT N O.
City of Fridley � 16 2 0 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� `L _____ COMMUNITY DEVELOPMENT DIV. ��G �
r � � PROTECTIVE INSPECTION SEC. ��� �
� ' r"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�"""� � ,�� 612-571-3450 910-F15 5/27/81 / /
JOB ADDRESS 7661 Brigadoon Place N.E,
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 4 1 Bl�nberg Esta.tes SHEET
2 PROPEiiTYOWNER MAILADDRESS ZIP PHONE
Garjac Inc, 7635 Arthur Street N.E. 434-7096
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
�FN! �"f O�� I�tiDLEY Di�FS NOT Gt1A1RA�ii�E
5 ENGINEER MAIL ADDRESS �,(� iQ���� �jpP�A��CENSE N0.
Y� ��� {� � ���R��� �{i���� �
6 USE OF BUILDING P M (��� �{ �Q`jj,(� �� TME ����N
Residenti.al fJN 1hlE SITE.
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Cbnstruct a 46` x 30' D�relling and a 33' x 22` Garage
9 CHANGE OF USE FROM TO
STIPULATIONS provi�e a hard s.urface. driver+�zay. 8rovi.de Ci.ty vdi..th copy of verifying
survey before capping, Provide sod i.n the front and side yards,
SEG�IER LOCATION : 10' E. of T�iater Service� Service out of M. H. �l:nv. 895 0 3 Q)
TOP OF FOOTING: 898,30 M:inimum
WATER LOCATIQN: 52' N.Ee of M.Ho 10607' N.Eo of Hydrant
DRIVBniAY DEPRE55ZON COST: 16' + 6' = 22' x$13050 =$297.00
WA►RiV�NG ,
�efare digging �all 1�cai ufiiities SEPERATE PERMtT� REQt,h�iEp �(iR i�'I�t� .
TEIERHONE-fIECTfiNC.G�SEtc. HEAT��1G, PLU(�tBlNG AiVD- SIGf!��.
REQUIREIp .BY t
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. 6�TOOC� FY'aIllC.'
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIfD HEREIN OR NOT. THE GRANiING OF A PERMIT $57 650 1SZS. S3
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STfiUCTI N R THE PERFORMANC OF CONSTRUCTION. $�-27oOS $425eOO
� _(1 ' PLAN CHECK FEE TOTAL FEE
�V
$3�.. 77 $612. 68
SIGNATUREOFCO T3KCTORO AUTHORIZEDAGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
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SIGNATURE OF OWNERIIF OWNER BUILDER� IDATEt BLDG iNSP �AT
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� Ot-Jt1ER:
noa�;�ss:
C�TY (?� 1=itIDLEY • .
/�Pt'Li[:/1'fIU'J f'O�t (;ESIU("f��Tlll�_ E3UILDi�Ir t��(u�TTS
(1Je��r, A1 t�.r��t�ons, Additions, or Rc�airsj
TCI. �0: '
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L'UILpER: ` �� � �,f �'� � %"" �. .
n�n�ess: r7��`` ,�,�� �; � ,�.1.��
TCL (�d0: � `� A(� ' °%O � �
- , iS���s�� .
Construc�ion Location '
. sxzu�� rio : �l � � ( sm��:T: ,� /'� ( G ��l 0 6 �v � L v� c �
r.o�.�: _ � �ax,oac: � �nzTxo�a: � .� � �,��I �� � � f sT'.�T',E'f . ^
,--
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Corner Lot: Ins.icle Lot: c.�` SefibacY.: .-3s Sideyards: �(, �(
Ap�ili.cant attach to i.liis form tcva Certificates of Suxvey of lot and
proposed building locat�.on drawn on cer�i�icates to scale.
. DESCRIPTIOiv OF CQhJSTRIICTIQPd -
� ��� Front: � �� Depth: � ��
Squa�e. �"eet_ l 2� Z Gtibic Feet:
, _ l. �s A���.�- � lr'x'ont : � � �p� : � / .
Square• I'eet: � Cubic I'eet: .
Iieight: ,� � ��'j
Height: %(�1 �
�l �a�
Type of Co�lstruction : �F�� � �1 � EstimaL-ed Cost: $ ���6
�.b Be Oor,�pleted: � �� � / � � �� t �,��j. AC: �
� . _ � Z� ��� Alt. A Alt. B
Proposed . Drive��ay tvidth if New Opening Is Desired: r��` (. $' . Qd �
. . .. S�L R�,VER;E SIDE OF SHEET
�iie undersigned hereb�� ma};e� app�ication for a pernli� icr. the �;�orl�� herein speca.fied,
agreeinq to c.7o ,all wozk ir� stz�ct �ccardance ��.i.th tlie City o£ I'ridley prdinan�es aiYd
ruliiigs o� i:he De,��artmez�t of Bui].dinc�s, and herebX declares tha� �].1 the �acts .and
represent�itions siated �l this applicatian e true and co:r ct.
D.iT�: � 2� �/ S7.GNA�UF.'r;: ,
St:iz�ulzCions :
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ru� �nr���c c�%i�r�"��r r-►:�� :>c:��r:j:�u�_e� �� .
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�;L•:C'i'xO1J Z. �'J'l�b 7n�.:)�eeL•ar. �L• l3ui.]:c?ituJ:; ::}iri).1., }icf.a�:c� i.r; ,ui►uJ- �,�c»niLs far t:lie erccL�.vn .
af: �x�►y i�u�.l.cl.u��r{ ax :�t:�•uc;t:tir:c, �1: fc»: t�n�� �zdQi.t::ir�rl !:o uuy cr,a_�La.�i�1 l�tiilclinc� oi ::L•x.licGur.a,
. i»' f`c»� t,�;y �il.t.r.i-r.�t.i��iti vr. r.r.�,air.:, l:o •�-�ny c>:i.�,1:in�J }�ui.l.cli.�i<� or. :;f:�:ucttirc, ul��rl n����li.c:aiion
L11r,Y.�f.or.c, �r.equ.i:r.e f.hc }���ymr��i: l�y t]�c aj,z�].i.c:ai►t: fo�- :�ucl� per.mi.L• nf' fec.; to tl�e �ina�anL•_
hcr��.iri bcJ.c�t•� sc.L ro�:u� ��„a i.�� t:he »anr►ez }�ci:eS.n �ja:ov�.c]::cl L-�-wiL: ' •
1�1:1�I CUtd�;`I'}:UC`i'xOIQ: Singl.e l.'��mi1.y llotcse:s and Gar.�ZC{c::: ;:�1.00/1,G�0 cubi.c �ec:t:. •
3'J.A:� CI11:C1;: ?.5 �,�er.cclit: UL' bu�.lcli_ncJ J�c�r.mii: fce. .
llRl:Vl:t•;A}.' ll1i1'P.i:SS:COI:: (Cqncretc, Ctiixb :;i:rcets Only) '
• n}.tcrnai:e n: ltcmoval and re��l.acr;nent of concrete cur.b and
qui�L•cr O)lIY; l�rive�oay �:+iath nJ_us 6 fee�: y$13. �0
t�]_i�crnaLc I3: Remo�lal and re�,�;.accmcnt of cancrete cnzrb and
. guttcr and instal.l a 3 toot t•�i.de a�proach �eiL-h �'
' ,. 6 inch depth; Drivc�•�ay wic:th �pJ.us G feet r. $15., 75
.1�,]�DI T 1 ���/1L I 1��OR+�1(IT I OT
For the purl�se of ca�nputi_ng �ees for buildincJ permits�,. tiie cuUi.ca]_ co::tents of any
bui.ld�.rlg or a.ddition, zs detcr.�nined by rnuli�ip7_yir�g fihe ground area covered f-rorn a
p�zn� six (6) inches below tY�e L-loor J_a.ne of t.he basement: or the cellar to 'khe
avexage heiqhts ai the �upper sw-face or to ihe average lieight of the roof surface
oi t�ie ;aain gab3.e oi a pztclZed zoof. �
Fox xeFai.zs c�r �lterations to an er.istang str_ucture, the fee shall be at the r�te
o� $3 .00 xiex eacli f-ive l�undred do]�lars �� ($500.00) or iraciion tlzercaf �.n thc cost
oi' aI� progosed wor.Y.. . , '
Ii� •no r.ase sha.'..l the fee cliargea ic�r any per►n.it as set iorth i.n Sectian 2 be �.ess •
tiian $7.50 pJ.us $.50 state surcharge. ' �
V�RTFICATI��! OF %OU��(D111-IOtd
' NOTE: Pcra.nits �or constL-uction ��ill be isst�ed a minimuri af 24 hours from the tim�
of a�},�Ia.cation to a].].ow fox proper reviec� of ihe proposed structure and of the
construction site.
A Certi�icate of Survey of the lot, sho�,*ing the locatS.on of the foundation once i.t
has been cons�nicted �.=ill be required be�ore �roceeding c•ritii the �raminq.
2 �' � . . •
�,�� ,.�_RT I F I G�TE OF ��� l_,j_P/�(�CY .
' nPp7.ication �'ox a Ge�:tificate oi Occ�ipaiicy shal]. kie mad:� ten (lt1) d��►s prior i.o �he
tx, e ox OCC1tr3I1Cj► oL any sL-z-uctuLe foi �aiiicli a�.i,zxlcliiig permit i.as bcen �.ssued� �iIICI
stiicl stLtict:uz-c s;iiall. Jiot i�e used or. oCcu�,�ied t:ii'L-i.l a Cez-ta.iica�e oi' Occu��ancy h�s
bcciz �,ssu4d.
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' CC3R�iS�OC� & DA'VIS, IN�. � C�n�utti� Engineers �ad I.and S�urv�yars
� . .
� 144b County Road J, 16�inn�a�lis, i5�I1Q1 �5432, (6i2) 7�4-9346 . -
I SURVEY FOR: . • -
B & G Investments
96Z Hillwind Road
Fridley, Minnesota 55432 -
. � . .�`.,! %d'6A�*f �°V r a s s, . r.: �`J - ?E� 1e. i� C �.
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TH4S DATA IS FOR INfO�tMA71COiV PURPOS� Q1VEY Ai�l� ' :yn, :�a,�, �, a' =-:;-e,� ,,:� �
��.� ���d.���.vo a� �ae�s��'+;a� �;���
PERSAPiS tlSkAlG 6�' Si1OUtD VERI�'1f 7HE fOdiN►ATI� •
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Befae d'+gging cal� 1aca1 utilities
' . ,p . - TELEPHONE - ELECTR9C - GAS Etc.
. { �' RE��9�R�� �Y 1.�'�Y���
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DESCRIPTION '(�
Lot 4, Block 1, Blo?�.?�erg Es�tates, City of Fridiey, Anoka County, Minnesota.
SCALE: 1" = 40
O Denotes 1/Z" diameter iron pipe monument set and capped No. 10832.
� Denotes found iron monument.
I hereby certify that this survey, plan or r�port was prepated by me or under my direct
supervision and that I am a duly Registeaed Land Surveyor under the laws of the Stat�
of Minnesota.
� --- �- - � ` .. P
10$32 Nov. 17, 1980 4278 � 9
Reg. No. '"� '�ate Job No. B�ok ldo.
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Surveyors Certific�te U
COMSTOCK & DAVIS, INC. Consulting Engiaeers and Lattd Surveyora
1446 Couaty Road J, Minneapolis, MN 55432, (612) y84-9346
1 �URVEY �oR
Gar jcxc Cans-� ruc-t iort
� 48 1- Zp6 t-h Ave. NE.
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;DESCRIPTION �
�Lor 4, Block 1, Blomberg EsLates, Gity of Fridley, Anoka County, Minnesota.
scALE: i�� = 40 .
� � .. , _ y . , . .�.._ . ' ,. . .
� O Denotes found irun monument. '
I hereby certify that this survey, plan or repart was prepared by me or under my direc�
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota. .
�. ��a�'I!�,1 lv8.t. Z � (� l 'Y� { �'�?g
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August 10,
1981
CITY OF FRIDLEY
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Gary D'Aigle
Garjac Inc.
481 - 206th Avenue N.E.
Ceda.r, MN 55011
Re: Final Inspection at 7661 Brigacbon Place N.E.
Dear Mr. D'Aigle:
TELEPHONE ( 612)571-3450
A final ins,pection was made on August 7, 1981 of the above address and
the following items were noted which must be completed before the
structure can be finaled outj
1. Provide a ball check in the floor drain.
2. Provide Ci.ty Frith a copy of the.verifying survey.
We are also waiting for the verifying surveys for 7631 Brigadoon Place,
7671 Brigadoon Place, 7540 Brigadoon Place, and ?650 Brigadoon Place.
We will expect the above ite�ns to be co�pleted and a reinspection called
for to detennine c�apliance. I#' you have any questions on these items,
please feel free to contact me at 571-3450.
Sincerely,
DARREL G.
Chief Building Offici.al
DGC/mh
sue�ecr PERMITI�IQ,
City of Fridley �=- ^--------
. ��
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� ` E1P�-AdO:
COMMUNITY DEVELOPMENT DIV.
, �� ------, 1 �
r j � PROTECTIVE INSPECTION SEC.
� _ �
`.--.� � ���,,� CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVEO BV
i 612-571-3450
siaF�s 5/17/94 / /
JOB ADDRESS 7661 Brigadoon Place 1VE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
OESCR. �F 1 Blomberg Estates SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
John Harwood 7661 Brigadoon Place NE 784_7287
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Milton L Johnson Co 525 Lowry Ave NE, Minneapolis MN 55418 781-9548 2083
4 ARCHITECTORDESIGNER MAILAODRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF HUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Re lace sk li hts• re lace da e
9 CHANGE OF USE FROM TO
STiPULATIONS provide smoke detectors as per UBC 1210 adjacent to all sleeping areas
and in basement.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 6U 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 APPLICATION ], STALLS GAFiAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2 a 8OO � I.�FO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @
STRUCTION OR TH�E PERFORMANC OF CONSTRUCTION. y�S�F.00 �L.80 Fire SC
PLAN CHECKFEE TOTALFEE
�` 's �7-yf` License SC $5.00 $63.20
SIGNATUREOFCONTRACTORORAUTHORI2EDAGENT IDATEI H PRO ERL ALIDAT�D TNIS IS YOUii PERMIT
��� �-��`��
SiGNATUREOFOWNERt�POWNERBU�LDERI iDATEi c BLDG WSP r�a7E
NEW
ADDN
ALTER
[ 1 , .. . '' Effecti��`=lftl9� . :.., ,: ,
[ 1 CITY OF FRIDLEY
(] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 , ���"�
Building Permit Applicadon
Construction Adciress:
Legal Description:
7661 Brigadoon,Place
Owner Name & Address: John Harwood - Same as above
�
Tel. # 784-7287
Contractor: Milton L. Johnson Company MN LICENSE # 2083
Adciress: 525 Lowry Ave. N.E. Mpls. , 55418 Tel. � 781-9548
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the � proposed construction drawn on it to scale.
DESCRIPTION OF IMPR�yEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
.
Sq. Ft.
Sq. Ft. s
Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of ConstruCtion: Replace existing skylights ��at� Cp�; $ 2, 800.00
• wit new, replace amaged
Approx. Completion Date: _ _ sheetroc�c
(Cost on Back)
Driveway Curb Cut Width Ne.eded: Ft. + 6 Ft = Ft x$ _$
DATE: 5/17/94 APPLICANT: < ;���-�; �� �� �' � Tel. � 781-9548
i% �
Permit Fee
Fire Surcharge
State Swcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park F.�e
Se�uver Main Charge
TOTAL
STIPULATIONS:
$ J�`�• �
$ ` �- +�
$ E @ ��
$
�� E ��
$
S
$ �
$ .
'�,� ,, Y
�ITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation {1/lOth%)
$.50/$1,000 Valuation
$800 per SAC Unit '
$5.00 (State Licensed Residential Contractots) `
Alt. "A" or Alt. "B" A�ve
$450.00 Coaservation Plan Review
Fee Determined by Engineering '
Agreement Necessary [ ) Not Necessary [ ]
� � � � ; � .
�'t� `°_°�,`�•' �,��. �i.�� � k.k �_: f.� w �.� ��'��,,�c" E�.�
r.
BUILDING PERMIT PEE 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, requ've the payment by the applicant for � such permit
of fees to the amount herein below set focth and in the manner herein provi�ied to-wit: ''
.
TOTAL VALUE
$1 � � to $500
$501 to $2,000
$2,001 to $25,000
$?.5;001 to $50,000 '
$50,001 to $100,000
$100,001 to $SOU,000
$500,001 to $1,OOO,UflO
$1,000,001 and up
FEES
• , � ,r,
$15 (Minimum Fee is $15 plus suncharge)
$15 for first $500 plus $2 for each 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 pl�s $6.50 far each addi6onal $�1,000
or fraction thereof, to. and including $50,000
$414.50 for first $50,000 plus $4.50 for each add.itional
$1,000 or fraction thereof, to aad including $100,000
,, .
$639.50 for fust �$lOD,000 plus $3.50 for each additional�
$1,000 or fraction thereof, to and including �$500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereaf, to aad iacluding $1,000,000
$3539.SU for the fust $1,000,040 plus $2 for each additional
$1,000 or fraction thereof -
DRIVEWAY DEPRESSION ESCROW
(Concrete (�rb 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 gut�c;r and install a 3 foot wide.
approach with 6 inch depth -. Driveway width plus 6 feei times $15.75.
VERIFICATION OF FOUNDATION
Permits for coc�stcuction 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 cons6ruction site. .
A Certificate of 5urvey of the lot, showing the location of the foundation once it has it has been
constructed will be required before proceeding with the framing:,
City of Fridley
AT THE TOP OF THE TWINS
;�
; �v _ COMMUNITY DEvELOPMENT OIV.
r j � PROTECTIVE INSPECTION SEC.
l, _ ,
�._�� �"' �,� CITY HALL FRIDLEv SS132
L 612-571-3450
JOB ADDRESS 7661 B
1 LEGAL �OTNO.
DESCR. 4
2 PROP�qTY OWNER
John Harwood
3 CONTRACTOR
Advanced Home
4 ARCHITECT OR DESIGNER
5 ENGINEER
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW
8 DESCRIBE WORK
Rebuild exis
9 CHANGE Of USE FROM
SuBJECT
�U ILDING PERMIT
NUMBER I REV
910-F15
doon Place NE
K TRACT Ofi ADDITION
1 Blomberg Estates
MAIL AODRESS
7661 Brigadoon Place NE
MAIL ADORESS
ovement 1501 78 Ave N, Br
MAIL AODRESS
MAIL ADDRESS
O ADDITION O ALTERATION
deck (13.6' x 20')
TO
DATE I PA(iE OF
4/27/99 / /
ERMIT NO. -
29306
RECEIPT NO.
a3�a
IPPROVEO 81I
SEE ATTACHED
SHEET
784-7287
Z�P PHONE LICENSE NO
Park, MN 55444 566-0233
ZiP PHONE UCENSE NO
20017269
Z�P PHONE LICENSE NO
C� REPAIR � MOVE ❑ REMOVE
STIPU�ATIONS
� Rear yard variance approved 1/13/99 from 10' to 13'.
See notations on plan.
CONSTRUCTION WORK HOURSs 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
�����
Be�xe di�i�� � �
�11 u�ih�i ��s
��-�
������� � �� ��
SEPARATE PERMITS ARE RE�UIqEO FOFi EIECTflICAL, PLUMBING, HEATING, ��rt Ur cvnsr. OGCUPA
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT
AUTHORIZED IS NOT COMMENCED WITH�N 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFV THAT I MAVE READ ANO EXAMINED THIS APPLICA710N 1 STALLS
ANO KNOW THE SAME TO BE TRUE AND CORREC7. ALl PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING 7HIS TYPE Of WORK WILL BE COMPLIEO
WITH WHETNER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �Z,489
OOES NOT PRESUME TO GIVE AUTNOqITY TO VIOLATE OR CANCEL TNE pERMIT FEE
PROVI S Of ANY OT STATE OR LOCAL LAW REGULATING CON-
S U O OR TME PEi; O MA OF CONSTRUCTION �74'.7S
PLAN CNECK FEE
License SC $5.00
�G TU�7EOF ON.WACTOAORAUTMOp�ZEDoGENT IDATEi �....�.. ______.._ .
I l �
�DAIE� BIOG �NSP �
6
GROUP �OCCUPANCVLOAD
CU FT.
OFFSTREET PARKING
GARAGES
SURTAX
$1.24
SAC CMARGE
Fire SC $2.49
TOTALFEE
$83.48
,IOATEO THIS IS YOUR PERM
I� w 41 _
f
NEW
ADDN
ALTER
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ConstructionAddress:
' CITY OF FRIDLEY
SINGLE FAMILy A1VD Di1pLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
L�:gal Descrip�ion: � � �/ � ��� � l
i��7
Effective 1/1/98
o� �
�� ,�j'h
� �
Owner Name & Address: � � L.. � � �� ;.� �, Tel. # �a'�� �� � �
Contractor: P -°°�
� � �' MN LICENSE # �,� � �� �, �
Address: �'.��/ `����� � e ��� �n r-��.�r r �r� � °��-e G�TeI. # �� ���.�
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:
OTHER:
DESCRIPTION OF IMPROVEMENT
�ng� W idth Height
�ng� Width Height
Length % 3 jf Width �_ Hgt/Ground
Sq. Ft.
Sq. Ft. Z7rJ
Sq. Ft.�9 ��
�
�� ��r � � y��, Yc°u
�
Construction Type: �'��,�(� ; ��,'�, �r�� E�imated Cost: $ �� -��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ —$
DATE: �� G l� e
d � APPLICANT: «� '� Tel. # ��i� � �� � �
��� �i
. CITY USE ONLY ��y-�C ��� (v����'c�
. ,Ld�l � �D l�f� t4" ��'�
Permit Fee $ 7.� Fee Schedule on Reverse Side �� '
� � � ,�d /3
Fire Surcharge $ , .001 of Permit Valuation (1/lOth%)
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ I,
$
$ �>�
$
$
$
$
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450. QO Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
�
%��� • •
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$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 $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 $50,000
$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 $SOO,OQO
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
�
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� . Surveyors Certific�te U
COMSTOCK & DAVIS, INC. Consulting fingiaecrs and Land Surveyors
1446 Coutity Road j, Mi�neapolis, MN 55432, (612) y84934b
�URvEY F'oR •
Gac-jczc Cons-�ruct iorl
. 48 t- 206 th Ave. NE.
Gedor , {Yln. 5501 1 � �
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iDESCRIPTION � ..
�Lor 4, Block l, Blomberg Estates, City of Fridley, Anolca County, Minnesota.
SCAI,E: . 1�� = 40 ,
� . ... . - � .� •. . . , . - _ . .,.,. • • . ., ..
, .
I 0 Denotes found iron monument.
�
I hereby certify that this survey, plan or report was preparad by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota. .
,�. ����r�y lvsj Z � �, �Ye r ��78
.� �- Reg. No. Date Job No. Book No.
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City of Fridley
AT THE TOP Of TNE TWINS
�
� �
; `V � COMMUNITY DEVEIOPM�NT DIV.
r � � PROTECTIVE INSPECTION SEC.
� �
`"--� ��""i.J CITY HALL FRIOLE� 551�2 N
` 61 �-571-3450
108 ADDRESS -
7661 Bri adoon Place NE
t IEGAL LOT NO. BLOCK � TfiACT OR
oesca. 4 1 Blomb
2 PfiOPERTY OWNER MAIL ADpR�S$
John Harwood
3 CONTpACTOR MAIL ADORESS
Dahl Bldrs & Rem. 451 Maple St. NE
4 ARCMITECT OR DESIGNER MA1 DL A DRESS
5 ENGINEER MAI� ADDRESS
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION
8 DESCRIBE WORK ^
i�C\. �
�U fIDIN� �ERMIT �
�9EA REV OATE PAGE OF
9t0-Ft5 6/23/99 / /
Estates
PERMIT NO.
29751
CEAE IPT NO.
� ���
1PPqOVED 8V
SEE ATTACHED
SNEET
��P PFIONE LICENSE NO
�4-4833 20050777
21P PHONE LICENSE NO
ZIP PHONE IICENSE NO
� ALTERATIpN O REPAIR O MOVE O REMOVE
Remove existing deck an.d construct a 14' x 20' new deck
9 CHANf3E OF USE FROM
STIPULATIONS
TO
See Stipulations on plan
Rear yard variance from 20' to 17' for deck - Jan. 13, 1999.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. pCCU�
VENT�LATING OR AIR CONDITIONING
7HIS PEHMIT BECOMES NULL AND VOIO If WORK OR CpNST1iUCTION 20NING S�. f7
AUTHORIZED IS NOT COMMENCEO V�(ITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIpD OF 120 DAYS A7
ANY 71ME AFTER WORK IS COMMENCED NO. DWLG. UNITS
I MEREBY CERTIFY 7HAT I HAVE READ ANO EXAM�N�O THIS APPLICA710N STA�L
AND KNOW THE SAME TO BE TqUE AN� CORRHCT. ALL PROVISIpNS Of �AW$ ypLUATION
AND ORDINANCES GOVERNING THIS TYPE OF WpRK WI�L BE GOMPLIEO
WITH WHE7HEii SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT $2556. SO
DOES NOT PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEI TN� pEfiMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION 7HE P f0� RJ�Aq�iCE OF CONSTRUC7ION S3 . ZS
,� ��� � � � �� PLAN CMECK FEE
License SC $5.00
S�GNATUAE OF CON•AACTOp Op 4U�NOAIjEO AGENT �DATEi WMEN PROPE � Vi
e
S�GN4TUqE OF QyyNEA��F QyyNE� BU�LDEFiI IOAT�i � 8L �NS� '
b' �
��� ■��
Before d�gg(ng calt f�
all utility locations
454-0002
REQUI��� ��Y LAVI�
CY GROUP OCCUPANCVLOAD
EU FT.
OFFSTHEET PARKING
GARAGES
SURTAX
�1.2%
SAC CHARGE
Fire SC $2.56
TOTALFEE
$92.08
IATED THIS IS �OUR PERMIT
�
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ADDN
ALTER
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Construction Address:
Legal Description:
Owner Name & Address:
Contr�ctor: ��(�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
Effective 5/10/99 � � S
CITY OF FRIDLEY Y � �(,
SINGLE FAMII.Y AND DUPLEXES R-1 AND R 2 /�
BUII.,DING PERNIIT APPLICATION �r� �
�j� �
sf
�
� o�-/� �»� � .S° 5� 3 �
L1�����a' (� •
�- �
� ,�LI
Tel. #
MN LICENSE #_�j'�� ��
Tel. # �� —��� �
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.
L.e Width �J H Ground Sq. Ft. � t�i�— �� �% Z
��� � � x � ��
_ !� V
Construction Type: ..�Li(- Estunated Cost: $ � ���
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
—$ .
DATE: �° � � APPLICANT: ���� ����� Tel. �#` ��� (�,�i.��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Maui Charge
TOTAL
STIPULAI'IONS:
� g3�2�
$ `.
� 1- 2
$
$ � �
$
$
$
$
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.� (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
� ���
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�� .�`c -�J �1-�-� /.�, 199�
� � � � �%
�
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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 fpr such �ermit of fees to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $SOU�
$501 to $2,OOU
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES v � , .
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,OQ0
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional �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 $1�,000 plus $5.60 for,each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $SOU,O� plus $4.75 for each additional
$1,000 o�fractior��t..hereof,.taand including $1,000,000°
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete G�zrb Streets Only)
�
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15 .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 $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minunum of 24 hours from the time of application to a.11ow for proper
review of �he proposed structare 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. ,
,
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SuB�ECT
c�ty of Fridley
AT THE TOP OF THE TWINS g U I L D i N G P E R M I
r �
� �
; �L __��_ COMMUNITY DEVELOPMENT OIV.
r j � PROTECTIVE INSPECTION SEC
� i .
l____� ��"'�'� CITY NALL fRIOLE� SSIJ2 NUMBEa REv
i 612-571-3450
s�aF�s
J08 AODRESS �661 Bri adoon P1ace NE
1 LEGAI �OT NO. BLOCK TRACT OR ADDITION
oesca. q. �. Blomber Estates
2 PROPERTY OWNER MAIL AODRESS
John Harwood
3 CONTRACTOFi MAIL ADDRESS
Town $ Country Roofi.n� 17201 113th Ave N Ma.pl
4 ARCHITECT OR OESIGNER MAIL AOORESS
5 ENGINEER MAIL AOORESS
8 USE OF BUILDING
Residential
7 CLASS OF WOqK
9/3/99
ZIP
� /
PHONE
-5566
PHONE
PHONE
IT NO.
30167
IPT NO.
`.J tiJ ( �
�vvnOVED er
SEE ATTACMED
SHEET
LICENSE NO
�91282
LICENSE NO.
LICENSE NO
O NEW O ADD�TION O ALTERATION � REPAIR ❑ MOVE O fiEMOVE
B DESCRIBE WOF;K
_Reroof house and �arage f25 Sal Tear-n-Ff
9 CHANOE OF USE FROM
STIPULATIONS
TO
Underlayment must comply with the State Building Code.
SEPARATE PEFiMITS AqE HEOUIRED FOR ELECTRICAL, PLUMBING, HEATINCi, TYPE OF GONST.
VENTILATING OR AIR CONDI710NING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTpUCTION IONING
AUTHOR12E0 IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTFUCTIpN
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
I HEREBY CEHTIFY THAT I HAVE READ AND EXAMINED TNIS APPLICATION
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
ANO OROINANCES GOYERNING THIS TYPE OF WORK WILL BE COMpLIED
WITN WHETHER SPECIFIEO MEREIN OR NOT. TNE GRANTING OF A PERMIT .�Z�.HrJ
DOES NOT PRESUME 70 GIVE AUTMOR�TY TO VIOLATE OR CANCEL TME pEFMITfEE
PAOVISIONS OF ANY OT R STATE LOCAI LAW REGULATING CON-
TRUC N OR 7ME PE MANC O CONSTRUCTION �$3.25
� �` PLAN CNECK FEE
c•d I,].00
- �GN4TUAE OF �pN'RACTOp O UTMO 2E0 AGENT iDATE� EN�
S�GNATUAE O� OWNEA ��F OWNEa BwIDER� �D�TE� e. ...�.. `
r
STAILS
�ROUP OCCUPANCVLOAO
CU f T.
OfFSTFEET PARKING
IGAqAGES
SURTAX
$1.09
SAC CMARGE
Fire 6C $.2.19
TOT EE
� .53
TMIS I,�YQUR Q�`MI
1�� "'S
+\L �• [ ] b
ADDN
ALTER
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Construction Address::
I.egal Description:_ __
Effective 5/10/99
CITY OF FRIDLEy
SINGLE FAMII,Y AND DUpI,EXES R-1 AND R-2
BUII,DING PERNIIT APPLICATION
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Owner Name & Address: p� Tel. #
Contractor: � �, �
t � NIN LICENSE # � �
-- -Address: r � � � d��'9� Tel.. #' ���
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:
OTHER:
Length
Length
G
D�SCRIPTION OF IlVIPROVEMENT ' � ` -
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
.��� ���1 � ���' I % /�'�(
Construction Type�� �`� �(,� � Estimated Cost: $ �/ aS
.
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ —$ .
�
DATE. T�-- APPLICANT: Tel. #� �'�� C�
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Cha.rge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� 3 ��_
$ ./
$ �, 4
$
� � � �a
$
$
$
$
$ �'/ �
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,0� Valuation
$1050 per SAC Unit
$5.00 (State L'acensed Residential Contra�tors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
� � v-
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 e�sting building or structure, or for any alteration or repair to any existing building or structure,
upon applicarion 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,(�1 to $50,000
$50,001 to $100,000
$1�,001 to $5()0,000
$500,001 to $1,(�}0,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $SQO pIus �3:05 for each additional $100 or
fraction thereof, to and: ineluding $2, 0� :
$69.25 for first $2,000 plus`$14.00 for each additional $1,0�
or fraction thereof, to and including $25,000
$391.25 for first $25,(�0 plus $10.10 for each additional $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 $I00,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1, 0� or fraction thereof
DRIVEWAY DEPRESSION E5CROW
(Concrete Curb Streets Only)
Alternaxe "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $15 .50.
Alternate "B": Removal and replacemento€ curb and.g�ter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours froin 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.
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CgIIlaINEY AND STACK VERIFICATYON
The undersigned hereby verifies that the existing chimney or stack: ��
I. Has been carefully examined yeS �� �O ��
2. Is free from rust or. deterioration � Yes (/� No O
3. Has no foreign objects lodged withia� Yes {/S No ()
4. Is secureiy :supported . Yes {� No ()
5. Meets all current Code requirements for size
and total BTU's conn�cted Yes (� No ()
6 Has total heating BTU's of j 7('"g .��
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All other BTU's
TOTAL �TU's
7. Has a liner been provided for water heater Yes () No {)
�• . S. Has combustion air been provided for water h�ater Yes () No ()
Remarks:
�.ist A�LTEI2ATIONS ��in I3one•
HEATING CO:
Signed �y:
Date:
a
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�-,;
� _
CIIYOF
FR[DLEY
FRIDLEY MIJNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 12, 2001
John Harwood
7661 Brigadoon Place NE
Fridley, MN 55432
Re: Final Inspection at 7661 Brigadoon Place NE
Contractor: Daves Appliance Heating & Air
Dear Mr. Harwood:
A mechanical permit was issued on October 8, 1999 for the installation of a furnace at
your address. According to Section 305(a) of the 1991 Uniform Mechanical Code, a
final inspection shall be performed on the work. As of this date no inspection has been
called for.
The permit fees that were paid covers the inspector's time to check to make sure the
appliance was installed correctly. We also check to make sure combustion air was
installed and that the vent and vent connectors are sized properly.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, your permit will expire and any inspections on this installation will require
a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
D J �'
BuildinGJ�f
DJ/mh
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions, Yes () No ()
and is securely supported and firestopped where required.
The venting system is plastic/PVC and meets all current codes and manufacturer
specifica�ons including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the cuRent codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan Yes () No ()
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the current codes Yes () No ()
and manufacturer's speciflcations.
When required to install a new combustion_a�it will be sized and installed Yes No
to meet the cuRent codes and manufacturer's specifications. { � � �
When installine a new ventina svstem, 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 Furnace Yes () No ()
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 Yes () No ()
separately as per current codes.
A liance T e and Size/Common Vent and Vent Connector Information
Appliance #1 Type 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 _ inches
Appliance #1 Vent Connector Height _ft Length ft Diameter _i� Type _
Appliance #2 Vent Conne�tor Height ft Length ft Diameter in Type
Appliance #3 Vent Cvnnector Height ft Length ft Diameter _,in Type
ALTERATIONS: Describe
HEATING C0:
Signed By: Date :
_
_
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
August 16, 2002
Mr. John Harwood
7661 Brigadoon Place NE
Fridley, MN 55432
Re: Fina1 Inspection at 7661 Brigadoon Place NE
Conlractor: Shiloah Water Co
Dear Mr. Harwood:
A plumbing permit was issued on Ju1y 31, 2001 to install a water softener at your address.
According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be
conducted on the work authorized by this permit. As of this date the inspection has not
been requested.
The pernut fee that was paid covers the inspecdon to make sure the work was completed
according to the Codes. We will keep your pernut open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the pernut "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
Building � PY.,UN.�3I1�TG Permit No.: � �
Inspections �+ SID�+ l�TT��L APPIlICA�IC)1\T Re�ei B,��- �' '�' �°"
763-572-3604 Dat � 'd �
763-502-4977 FAX �I'T� OF �'R�DLE'�'
EFFECITVE 1-i-08
DATE � � ` YOUR E-MAIL ADDRESS
SIT'E ADDRESS '� �
THIS APPLICANT 1S: k7 OWNER �ONT'R.ACTOR •
PROPERTY �pME: �, e �, d
O�VNER/ ADDRESS: � D. CITY STA'I'E ZIP
TENANT PHONE: `7 ,��
CONTRACTOR �ql,,�: a e
SUBMTf A COPY OF STATE LICENSE # EXP DATE
YOUR STATE
LICENSE, BOND AND STATE BOND # EXP DA7'E .
CERT'IFICATE OF ,qDDRESS; � ti (; , CITY��J � o�i���l � 4�c. STATE ZIP
INSLTRANCE . PHOI�tE F�
PERMIT TYPE '� SINGLE FAMILY ❑ TWO FAMiLY O TOWNHOUSE
TYPE OF WORK: ❑ NEW [�REPL,ACEMENT'
DETAII,ED DESCRIPTION OF WORK _ �Q �� � _ � �� � � �L �
PER MS 16B.665 the permit fee is a minimum of $15.U0 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, insta.11ation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of latior )
Labor cost under $300 =$15.00. La.bor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge
OR
FOR PROJECTS VdIiERE LABOR EXCEEDS 5500, FEES ARE BASED ON $]U.00 PER FIXTURE, EXCEPT WHERE NOTED. FIX'I'IJRES: (INDICATE TOTAL
TIZJMBER OF EACH BEiAV�. MINiMUM FEL $15.50.
BATH SR1K/LAV _FLOOR DRAINS SHOWER _ WATER PIPING
gp'['H'f(JB GAS PIPING (NEED C1TY LIC) SWIMMING POOL _ WATER SOFTNER ($35)
CLOTHES WASHER KTTCHEN SINK WATER CLOSE7' BACKFLOW PREV. ($IS)
DISHWASHER LAUNDRY TRAY �JATER HEATER ($35) FOR IRRIGAl'ION
— WATER METER _ OTHER
V Permit Fee $ ` ° ` - V Number of fixtures @ $10.00 x $10.00 = $.
Surchar e .50 Number offixtures @$15.U0 x$15.00 =$
TOTAL DUE $ OR Number of fiactures @$�5.00 x$55.00 =$
Staxe Su�charge = $ .50
(MiNIMCJM $]5.50 (MITTIMLJM $15.50 Tota1= $
THiS 1S AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I her'eby apply for a plumbing permit and I acknowledge that the information above is complete and accuraxe; 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 agplication for a permit and work is not to start without a permit on site; that the work wiil be in accordance
with the approved plan in the ca/s�e of a�ark which requires review and approval of plans.
SIGNATURE OF APPLICANT G � � PRINT NAME d� a U �� � V 1R �n c.. U 1 DATE ' ��
APPROVED BY DATE
� � F..
Ciiy of I+'�-idley
D�uilding Inspections I?epartment
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building BUILDING Permit lvo.: �+' � � �� �' �
Inspections RESIDENTIAL APPLICATION Received By:
7b3-s�2-3604 CITY OF FRIDLEY ��:� � � �
763-502-4977 FAX ��cTTVE �-i-ZOio
DATE��D — Z S �L o YOUR E-MAIL ADDRESS �� !��- Sl�tY �� S 6W G C� v`�_
SITE ADDRESS %(o CU� dL /.�vA.� �o� � �
THIS APPLICANT IS: ❑ OWNER �.."ONTRACTOR
PROPERTY OWNER/ NAME: ZfL"� /fYtu+�c)�O
TENANT �DRESS:�� �/Ylo/Fl�e�a� .%�e- CITY !/-x STATF/��ZIP
PHONE:
CONTRACTOR N,qME: ,� rt�55c�� �'i �s �✓e—
SUBMIT A COPY OF STATE LICENSE # SS EXP DATE
YOUR STATE LICENSE
AND CERTIFICATE OF ADDRESS:� f�o T��/�u S %�— CITY�� .'�c.?/1� STAT�%?�ZIP `'�
INSURANCE PHONE — .2 FAX
PROPERTY TYPE /NEW CONSTRUCTION sTZE
FAMILY/NEW CONSTRUC'ITON STORIES
PERMIT TYPE � �DITION ❑ GARAGE/SHED WS
� BASEMENT FIMSH ❑ ROOF 0 DRAIN TILE
❑ DECK �IDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR REMODELING
DESCRIBE WORK BIING DONE: G�lt�/ 2- ��'+�v v s -�- 3 o e F� r �'1 /��
SIZE OF IMPROVEMENT LENGTH WIDTH GHT S FT
1200FING O HOUSE ONLY BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: ❑ DE'fACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
SIDING FOR NEW CONSTRUCT[ON INCLUDING DECKS,
❑ Vi 1 ❑Soffit ADDITIONS_ & PORCHFS SUBMIT:
m' 1. Site Plan/Survey showing the existing slructures
❑ Aluminum ° ❑ Trim
�!Other �� ❑ Fascia and proposed project
� � � 2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS�TYes �IVo LOCATION OF WINDOWS FOR W[NDOWS — PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES & B� ?^
TYPE OF WINIIOW TO BE INSTALLED jx1 � v�t���ER OF WINDOWS
ALL N�;�;� AKL KAtiN:ll U1V VALUA11U1v,11vt;LUUlnli lti�; �usi vr Lanvx ar�li lviair.iuAw:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �G �� � OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Chazge
Total Due
$ ! I I L'� See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ .001 times the total job valuation
$ ,� �pi .0005 x Permit Valuation Minimum $.50
$ ' ��lr :n �� $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ °:� °�. .; .�A Make checks Aa_yable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge 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 o� v6 c uires review and approval of s. �
SIGNATURE OF APPLICANT PRINT NAME �,—"r"�'S�O DATE G D� Z.� �o
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Departrnent
6431 UniversiTy Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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