AF - 43973_
_
CfIYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, M[NNESOTA 55432 • PHONE (612) 57l-3450
October 28, 1985
�
J. A. Menkveld & Associates
P.O. Box 34004
3laine, MN 55434
Re: Address Changes on Brookview Drive N.E.
Dear Sirs:
�.
�, ..
It has been necessary for the City t�o list the follrnaing changes of �tddress
for your homes under construction in Fridley.
NAP�1E: House Under Construction
FROM: 6771 Brookview Drive N.E., Fridley, t�IlJ 55432
TO: 6770 Brookview Drive N.E., Fridley, I�IlV 55432
LEGAL: Part of Lot 2, Block 1, Brookview Second Addition
P7AME :
FROM:
��
House Under Construction
���?��e�i� r��i�� �v:�. ; ;i�r�d�����, �. ;,�
��3��'�'�'�''iP��` �'�:�i'a�'r::����1!`#"':� k�'��?,�
I�EGAL: Part of Lot 2, Block 1, Brookview Second Addition
tde have notified the foll�wing companies of this change and also various
dep artments in the City Hall. If you hav� any questions on these changes,
please contact me at 571-3450.
Si ,
DA.;REL G . CI,ARK
Chief Building Official
CC: f•liruiesota Gas Company City Water Billing Depart�nent
Northwes tern Bell Telephone Co. City Assessing Departanent
Northern States Power Co, City Police Department
Minneapolis Post Office City FirF• lleti�artment
sus�ECr N .
City of Fridley 18255
�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
' ' RE
� � •
� • COMMUNITY DEVE�OPMENT DIV.
' i a: ----- �
r � � PFiOTECTIVE INSPECTION SEC. % �Q/�/ �
i , � v w
i
,` � ����� � CITY HALL FqIDLE� 55432 NUMBER REV. DATE PAGE OF APPHOVED BY
`.�«, `'/ ��� . . �
612-571-3450 910-F15 1Q/21�$ � �
�oe DRESS 679p Brookview Drive
t IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. '�pt 2 1 Brookview Second Addition SHEET
2 PROPERTYOWNER MAiLADORESS ZIP PHON
J. A. Menkveld P.O. Box 34004 Blaine, MN 55434 75�/-0094
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
7 CLASS OF WORK
C� NEW ❑ ADDITtON ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
House and Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Drivewa,� paid - $243.00
SEPARATE PERMITS AFE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. F1'�aITIe
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEO 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 STA��S GAFAGES
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 �1
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �JH 4000 �Z7.ZO
DO S NOT PRESUME TO GIVE AUTHORITY TO VIO E OR CANCEL THE pERM1T FEE SAC CHARGE
P VISlO OF ANY OTHER STATE OR CA A REGULATING CON-
S, UC O T E PERFO ANCE OF RU ION. �310.00 $425.00
G PLAN CHECKFEE TALFEE
� ��'"a � $1834 . 70
i T C o A H GENT ion7Ei WHEN PROPER ID IS 1S YOUF PERMIT
�
�
iGNATUAE OF OWNER�IF OWNER BU�LDER� IDATEI BLOG iNSP �FiE
�} 0 'i� � o �' � v?1f-
pgy,J [� City of Fridley
ADDN. [ J �R-1 AND R-2
pLTER. [ ] Building Permit Applieation
2'�Z. � aF.
Construction Addre
h�q. / `� ✓ �:J
Legal Description: % � � L- '
�/�
Effective u/1/8�t
�� /
. � .. - � l.�•Ti % � �% �'.�� .
Contractor
Address
LIVING AAEA:
GARAGE AREA:
DECR AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, �ith the proposed construction draxn on it to scale.
DESCRIPTIOp OF IMPR09EMENT
Length � � width �� Height � �
Length �-� iiidth Z� Height �
Length � � Width �,�� Hgt/Ground ,.�
Sq. Ft. ���
Sq. Ft. �
Sq. Ft. �
Corner Lot [] Inside Lot �Q Ft. Yd. Setback _�- Side Yard Setback �!
Type of Construction: �� � Estimated Cost: ���� v
Approx. Completion Date: _�� � � J � �
�'
� Alt. A Alt B
Proposed DriveWay Width If Nex Opening Is Desired: �� �$_�L �� � a
See Back Page for Explanation
` X .— '' "'��
DATE: `�v' 9 u� APPLICANT: Tel .#�._._._*�
Y OSE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Hain Charge
� R, w/�
Tf3T1lL
STIPULATIONS:
rn�-9 �- �
� 3100 �
� 7 7 . Sa
s a�. av
� � �. J�OU
� i�.Oc�
E
a �13, �o
s l g3�t.��
�E�o2n�a
a�'C r��' ��
Fee Schedule on Reverse Side
254 of Building Permit Fee
�.50/�1,000 Valuation
a425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
PE2 4ya'
�-r /o io-� �
�
BIIII.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 Lo �he amount
herein beloW set forth and in the manner herein provided to-�it: _
Total Yaluation
=1.00 to �500.00
�501.00 to �2,000.00
�2,001.00 to a25,000.00
�25,001.00 to �50,000.00
�50,001.00 to �100,000.00
�100,001.00 and up
Fees
�10.00 (Minimum Fee is �15.00)
0
a10.00 for the first �500 plus �1.50 for each
additional �100 or fraction thereof, to and including
�2,000.
�32.50 for the first a2,000 plus �6.00 for each
' additional �1,000 or fraction thereof, to and
including $25,000.
�170.50 for the first �25�000 plus �4.50 for,each
additional �1,000 or fraction thereof, to and
including �50,000.
�283.00 for the first �50,000 plus �3.00 for each
additional �1,000 or fraction thereof, to and
including ;100,000.
�433.00 for the first �100,000 plus �2.50 for each
additional �1�000 or fraction thereof.
DRIVENAY DEPRESSION ESCROiW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Drivexay rridth plus
6 feet times �13.50
Alternate "B": Aemoval and replacement of curb and gutter and install a 3 foot wide
approach With 6 inch depth - Driveuay 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 reviex of the proposed structure and of the
consLruction site.
A Certificate of Survey of the lot, shoWing the location of the foundation once it
has been constructed will be required before proceeding r�ith the framing.
�8 �av ����s" .�
' Dy7,d`�
5�, u� �— ��3, 6 v a�l�!"3� _�i►2� 9.`iZ- = R,
�u� a�
�Lv, U�
v. �... q ,z
� G x�c, = 9t� IUuBXN�. �y �1�i, �I�t3 � i^v
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MINt�ESOTA STATE f.:��RGY �:OnE CALCULATIOt15 7-9x�`�,
���"•_ ,� BASi.D O�V �tiAP7'ckTGr TNE <,:�j��
MO�E�ERGY �:r»E: - 1 ytsj EDlTiON
AdopLiun Effrc[1vF lil/84
rner �� , Q, N1 ����z-D � A�so�,f-�'r� a ��� Phone �����=��'��`�
a _. .
t e d d r e s s d��� .� .1��1G� �����-4�� ' I V�� _
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�ntractor c��M-� - �hone �
,ilding Classification: Type A1 (Single Fa�il� S D��plex) b� 7ype �2 (Residential
(3 stories or ess
(Other)
:NE�AL I NFO�Mf17I0N
Suilding Perimeter � �� ft.
�;al l�� ; �ht (Qround to eave) �{'� 1� ft.
�OVE!' 3 s�ories) _
2
l. x 2. (abave) gross wall a_rea: � 9� ft.
2
8uildin� a�mersions (L) � x(N) =���� ft, roof b floor area
Sq�are Tcot area of rim joist - Floor joist size (2 x t0 ? ) 2
? x Perime.er = Rim joist area =���. rt
-3 2 -
�oors - �rea ��� � � .
' 7ni_ckness / �n. U actor �
iype of Cons �ruction ��5��,�•�� � Perimeter
P�anutacturer �1,AC�� �� ��.�i-�
7ota] 000r's perimeter
ft
Windows: Manufacturer ����� �� S�ate approve�
U r d C LO T' w) �'�
7YP�
��-��-
l��ti � L
SIZE
Z.��35 -r� � �J
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2�iG;� `r' (�i �J
!g/3�
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AR�R (F�.2;,
cp,r}{
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0
��U,'�SFR 0�
UNI7�
, � �
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7�
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1
TO'A� FE�T �
ft.
��
I�.a
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! ��—
�
g.7otal ft.2 Glass �� � 2
��� Fireplace area: Width x heiuht = x = Ft.
11. Exposed found3tion: Height x Perimeter x = �� Ft.2
;"�PLETION OF iHIS FORM IS R�QUI�E� FOR ALL P;Eil COi1STRUCiI���. �1AJOR REttOD�LING AF�D BUILOIi�GS BEING
��'�� '�INERE t�ERGY, 07HER THA� TN� t�IINIMA� CODE ALLO:•JA�10E, IS USED.
' .
.arr;i nc;, area ■ l OX of gross wal l arta .
Gross wall area ��p � �
1�indow area A. � � ft.2
Rim joist area A� �� � ft.2
Door area A �� ft.2
Fireplace area A � ft.2
Exposed foundation A � �� ft.2
Framing area A �%� ft.2
Net wall area A � Q� � ft.
ft.2
U wi ndows =� ��-�_ U x A= fd c�
U rim joist = �Q 1 U x A= �
r
U door area a ���_ U x A= -�
U fireplace = n U x A= d
U founddtl0n = • 0 U x A=_ r�
U frami ng area =. Q U x A= ���
Uwall = ,O� UxA= 4- -
(138 ) TOiF,L . . . . . . . . . . " U x A =
i4. Gross wall area x Q. �-c,�le fami�y b duolex
, (73. above) . ��'�
x A- �er resident�al)
x .23 Other buildings)
x .28 (Over 3 stories)
� � �� ` x U Cod� .
= al iowable U x AiCode
BTUH Must be laraer tha�
_ � r% �F . 136 a bove
?;,. Ceiling framing area (Af) equals lOX of ceiling area C_ or the same as�
;�A. Gross cei�ing area = (t) x (k) _ � � � ft.2
,�B Joist area (Af) = i0a ceiling arEa = �� � ft.2
?5C.
;SD.
m
t�et ceil ing a�ea (A�) �(15A - 158) _ �d 8 ft.2
U cei 1 f ng x A �_ ��� x t� 2 = ��
U f rami ng x A f= �� � x i� 7 = � g
iOTAL U x A ........................................ Z C�
.
Ceiling area (15A) x 0.026 (A-1 single `.� duplex - code allowable U x A
x 0.033 (A-Z other residential)
x 0.06 (other)
/� BaUN Must be larger than 150 (ab�ve)
A 15A ��� �j x U(code)= ��J _ F (or the same as }
NOTE: Use U and A values obtained from �ps 1, 3 and 4.
-
_
C�iY�
FR[DLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEV, MINNESOTA 55432 • PHONE (612) 571-3450
October 10, 1985
Mr. Jack Menkveld
,7. A. tdenkveld & Associates Inc.
P.O. Box 34004
Blaine, NID1 55434
Re: 5692 Regis Trail N.E. and 6791 Brookview Drive N.E.
Dear Mr. Menkveld:
Please be advised that before we can isswe the two building permits for the
homes at 5692 Regis Trail N.E. and 6791 Brookview Drive N.E., we need the
following infom.tation:
5692 Regis Trail PJ.E.:
Because of the very unusual terrain and fill already placed on this lot,
we ask that you have a registex�ed engineer examine the site and design
the foundation systeri for the house:
:6-7�� Brookview Drive N.�. i
Because there is no City sewer and water servicing this property, you
must meet with the City �ngineering Departruent to agree upon a method
of service and grant to the City any necessary u tility easements.
If you have any questions an this matter, please feel free to cont+act me at
571-3450. '
Sincerely,
__.___ = �
� �
i C
, :
DA G. CLARK
, Chief Building Official
DGC/mh
CC: Mr. Mark Burch, Asst. City Engineer
�
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_
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CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY. M[NNESOTA 55432 • PHONE (612) 571-:�450
Jar�uary 27, 1986 �
Mr. Jack Menkveld
� J.A. Menkveld & Associates Inc.
P.O. Box 34004
Blaine, [�IIV 55434
Re: Final Inspection at 6790 Brookview Drive N.E, Fridley
Dear Mr. Menkveld:
A final inspection was conducted on January 22, 1986 of the above
address and the follawing items were noted which must be completed
before the structure can be finaled out:
1• Ct�ange double cylinder lock on front door to single cylinder by
February 10, 1986 (see attached Code).
2. Provide a hard surface driveway by June 15, 1986.
3. Provide sod in the front and side yards by June 15, 1986.
4. Provide the City with a copy of the verifying survey by February 10,
1986.
5• �btain a final test on the pltanbing by February 10, 1966.
We will expect the above itgn.s to be canpleted by the scheduled dates
when reinspections will be conducted to determine compliance. If you
have any questions on these items, please feel free to contact me at
571-3450.
Sincerely,
L1�RRF�, G. Q.�itiC
CYiief Building Official
DGC,/mh
IIJC: L1BC Section 3304
OC: 6790 Brookview Drive N.E.
�
N_
C[TYOF
FRtDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MINNESOTA SS432 • PHONE (612) 571-3450
July 28, 1986
J.A. A�enkveld & Associates
1299 t:ississippi Street NE
Frialey, ri� 55432
Dear rlr. Fenkveld,
It nas oaae to my attention that you have not yet paid the park fees for your
�roperty at 6770-�780�790-6796 Srookview Drive NE. Tne sole stipulation
accan�xriying the Lot S�lit that was granted to you on this property was that
you pay a�ark fee af $750 per lot with the next three builiting permits.
I have enclosed a copy of the Action Taken Notice, complete with your
signature agreeing to the above-�:�entionea stipulation. Please pay the
require�3 park fees b� August 11, 1986. It you have any questions, please fc�e1
tree to oontact me at the Friciley Civic center, 571-3450, extension 166.
�,ar�}: you for your 000peration.
Re pectfully yours,
Daryl t ey
�
Planning Assistant
C-86-334
SUBJECT � P . �
City of Fridley 19381
�
AT THE TOP OF THE TW INS g U I L D i N G P E R M I T
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
' j L ��-��-, .
r � � PROTECTIVE INSPECTION SEC. ��"� �
1 � �
�-.-- �;�'��;•j CITV HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVEO BY
� � 612-571-3450 910-Ft 5 88 / /
JOB ADDRESS �,�90 Brookview L�rive N. E,
1 LEGAL LOT NO. BLOCK TRAC7 OR ADDITION SEE ATTACHED
�escR. N 75' of S. 232' of Lot 2, Hlock 1, Brookview 2nd SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Stephen Miller 6790 Brookview Drive N.E. 571-4486
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE tICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO.
6 USE OF BUILDING
Residential
7 CI.ASS OF WORK
�l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR p MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10` x 14� Shed in Rear Yard
9 CHANGEOfUSEFROM TO
STIPULATIONS
SEPARATE PER�IITS RFQ�,I�REp FOR
WIRtNG, HEATfN�, FLUN�gtNG q�p S1GN�
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR COND�TIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHOFiIZED IS NOT COMMENCED WITHIN 60 DAYS, OR If CONSTFiUCTION
OR WORK IS SUSPENDED OR ABANDONED FOf; A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPL�CATION l, STALLS GAHAGES
AND KNOW 7HE SAME TO 8E TRUE AND CORREC7. ALL PROVISIONS OF LAWS VAIUATIOM SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT $%OO $.SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHAFGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $1rj.QQ
LAN CHECK FEE TOTAL FEE
$15. 50
si NATUREOFCONTRACTOAOAAUTNOAIZEDAGENT �onTE� WHEN PROPER Y V I ATED THIS IS YOUR PE MIT
l
� /� y��-�� �
SiGNAT RE OF OWNER IIF OWNER BUILDERI IDATEI � BLOG INSP � � � pT �
NEW [ J City of Fridley Effective �/1/86
ADDN, [] � R-1 AND R-2 �
pLTER. [ ] Building Permit Application
Construction Address: � �
Legal Description
u
�.---- .-
Owner Name & Address : -� t � � � � � �� • �"y'� � �� � Tel . # 5 7� � �% �
Contractor: S-�-� �he�, �. i�� i/%U Tel. # 57/- �1�/��
Address: � 7�0 �lt�d% V `re �u �: ��z ✓V�
Attach to this application, a Certifieate of Survey of the
lot, With the proposed construction draWn on it to scale.
DESCRIPTION OF IMPROYEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER : �J h e� J u�C I y
,
Corner Lot [ J Inside Lot [ j Ft. Yd. Setback Side Yard Setback �2
Type of Construction: �� c� d
Approx. Completion Date: ���.�-.,t.._ �O . 1 ���
Proposed Driveway Width If New Opening Is Desired:
Estimated Cost: �
Alt. A
%�� . OU
Alt B
� �
See Back Page for Explanation
DATE: I'�'��i APPLICANT: 5�-e✓� he�, i=- YV) v��t� Tel. #�7�- y��%
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY QSE ONLY
s /.�'� �
$
� ��
�
$
�
$ i�.�v
Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
a �,50 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [] Not Necessary [ J
.. ,_ . ,�
CA�+I/E � ASSOCIATES
LAND SSt//RVEYDRS, �lV'C.
/7720 NigAway 65 N. E. Sodervi/le, Minnesolo 55304
43�I-7646
AS BUILT SURVEY FOR: Jack Menkveld
DESCRIBED AS: The north 75.00 feet of the south 232.00 feet of Lot 2,
Block l, Brookview Second, according to the recorded plat
�s thereof in the office of the Registrar of Titles, An�ka
r(D County, Minnesota .
bject to easement"s� of record.
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�/�� o�� �32 r,W "°"'° NEREBY CEI7T/FY TMAT TN/S SUNYEY� PGAN,
�� OR REPORT WAS PREA9RE0 BY ME O/i GVDER
MY D/AECT S(/PfRV/S%ON AND THAT / AM A
�` DULY /iEG/STEf7E0 LAND SURVEYOR UNDER
q� `�, TME LAWS Of' THE STATE OF AI/NNESOTA.
67' TH AVE" N.�' �' � '
SCALf : / /NCN • 3 � iEET. �
Q DENOT[S //t /NCN /RON I/PE S£T. �-- . _----.__ __ _ --
� DENOTES f0(JND /RON MOMUMEN7. - -
/EAR/N6S JNOWN AAE ASSUAIED. �, •> LUTE qEC. NO. �Zps�
R c,, .. . .. . . iJ G T. 2 5� , �'l.ti . _
✓0I MQ � j ".� _ ./ --ti �-�; SEC. ;' _} T. � C.' /i. ' �
� SUBJEC7 � P O.
c�ty of Fridley 19 8 3 8
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
- "";' � RE T NO.
� ; L __�__ COMMUNITY DEVELOPMENT DIV. �J
r � � PROTECTIVE INSPECTION SEC. �� � ` �
� � �
' � �'��1 � CITY HALL FRIDLE� SS4$Z NUMBER REV. DATE .PAGE OF APPROVEO BY
�"'°� � ,'' 612-571-3450 910-Ft5 4/20/89 / /
JOB ADDRESS 6790 Bxookview Drive N. E.
1 �EGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACHEO
DESCR. Pt.. 2 1 Brookview Second Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Stephen Miller 6790 Bx'ookview Drive N.E. 571-4486
3 CONTRACTOR MAIL ADOFESS ZIP PkONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE rICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE UCENSE NO.
6 USE OF BUILDING
Res idential
7 CI.ASS OF WORK
❑ NEW O ADDITION (� ALTERATION ❑ REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Install masonry fireplace
9 CHANGE OF USE FROM TO
STIPULATIONS
Footing must be 12" thick, maintain 2" clearance between masonry and
wood on inside and 1" to wood on outside,
SEPARATE PERMITS ARE REQUIRED FOR ELECTFICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AMD VOID IF WORK OR CO►JSTRUCTIOM ZpN�NG S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STA��$ GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S2 �OOO $I..00
DOES NOT PRESUME TO GIVE AUTHOfiITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGUTATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $4S.00
PLAN CHECK FEE TOTAL FEE
$46.00
SIGNATUREOFCON'RACTOFlORAUTMOA� P.GENT IDATEI .. , WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT
-� SiGNATURE OF OWNER IIF OWNER BUII RI 10ATE1 BLDG �NSP �
�4TE
� [ �
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�T� [ ]
I�I AND R-2
�iildiryg Permit Application
Effective 5/1/88
Construction A�ddress : ,�o % 7� �ld/� .� v% f c.�l f%� i r� t-
.
�
Legal Description:
o�r rr� &�aa�s: S�- e �l�-e� �-.- ✓Vl �, I(�_ z�.t. # 3�7�- y�/.�
Contractor: �J �{ ,D � � . ►/V� u j � •� Z�1. # �7/' � �r�b
P,c3dress : �j l I� f ���C U� G�-� �% r c � C.
Attach to this application, a Certificate of Suzvey of the
lot, with the prq�ased oonstxuctioai drawn on it to scale.
�I' �V��1'�]�I�4 ++
a•• �11Ri �i 1C.�1 WZbll.11 17C1�t �• �•
GAR�GE ARF�: Iea�gth Width Height Sq. Ft.
DDCR ARE�,: Length Width Hgt/Ground Sq. Ft.
OR'f�it: C.Qa o+'1 d" �l 1- ,✓ � D1d r C_
Oorner Lot [] Inside Lr�t [] Ft. Yd Setbac3c Side Yard Setbacks
Z�pe of O�nstxuction: Estimated Cost: $_�, D�D� 6n
Approx. C�anpletion Date:
Piroposed Driveway Width If New Openi.t�g Is Desired: Ft. $ $
Width 6' See Back Page
�: 1/-/7-�" %' �c�rrr: f �. # �7�- yy�?'e
P�etm.it Fee $ '� � , C� 0
state ��ge $ % , U (��
SAC Charge $
Driveway E.sc�xxa $
Park Fee $
Sewer Main C��arge $
Q'I'Y tTSE �II,Y
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" AUove
Fee �ined bY �9��
Agree�nent Necessary [ ] Not Neoessary [ ]
�, $ � -c��
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�,,�, C: � � CA/NE � ASSOC/ATES
4n � LAND SURVEYORS, /NC.
/7720 Highway 65 /V. E. Sodervi//e, Minnesota 55304
434-7646
AS BUILT SURVEY FOR: Jack Menkveld
DESCRIBED AS: The north 75.00 feet of the south 232.00 feet of Lot 2,
Block l, Brookview Second, according to the recorded plat
thereof in the office of the Registrar of Titles, Anolca
County, Minnesota. ;
Subject to eafs�ements of record.
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NEREBY CERT/FY THAT TN/S SURYEY, PLAN,
OR REPORT WAS PREPARfO BY A/E OR UVDER
MY O/RECT SUPERV/S/nN AND THAT / AM A
DULY REG/STERED LAND SURVEYOR UNDER
THE LAWS OF THE STATE OF AI/NNESOTA.
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FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 57(-3450 • FAX (612) 571-1287
May 15, 1990
Sandy Peterson
6790 Brookview Drive N.E.
Fridley, MN 55432
Dear Ms. Peterson:
Enclosed please find copies of the assessment records for your
property which you requested at the April 25, 1990, Planning
Commission meeting. Page 1 of the records lists those items which
were assessed to your property and indicates that those assessments
are paid in full.
I hope this answers any questions you may have. If you need any
further information, please contact me at 572-3593.
Sincerely,
Michele McPherson
Planning Assistant
1�II+I: ls
C-90-268
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e
CITY Of fRIDLEY
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sue�ecr P N O.
City of Fridley 6 3 5 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � RECEIPT NO.
� ` COMMUNITY DEVELOPMENT DIV.
r � � � PROTECTIVE INSPECTION SEC. �� � 7
i �
i•--- �;�"';•; CITY HALI FRIDLE� 55�32 NUMBER pEV DATE PAGE Of APPROVED BY
L �� 612-571-3450 9i0-Ft5 6/25/98 / /
JOB ADDRESS 6790 Brookview Drive NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE AT7ACHED
oESCR. Pt 2 1 Brookview Second Addition SHEET
2 PROPER7Y OWNER MAIL ADDRESS 21P PHONE
Janet/Steve Tranby 6790 Brookview Drive NE 571-6369
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION �FJ REPAIR O MOVE ❑ AEMOVE
8 DESCRIBE WORK
Reroof House & Garage (21 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIRULATIONS
Roofing can be the 2nd layer but not the 3rd.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OH WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OF NOT. THE GFANTING Of A PERMIT �1,315 �.66
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STA7E OF LOCAL LAW REGUTATING CON- $4S.7S Fire SC �1.32
TRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$47.73
6rypTUA F ON' TOROAAUTHO EDAGENT IDATE� WHEN PROPER VALIDATED THIS IS VOUR PEAMIT
i. ' �a� � � ^ �
S�GNATURE ON'NEPUF ERBUROER� iDATEi BLO �NSP ���TE
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �j 6
BUILDING PERMIT APPLICATION �. �O 3 � ��
.�J
r /� .
ConstructionAddress: �;� `%�G ti[�2r�L` v� c�..� J�/ %Z� � �r�a'/4, /h�tJ �S �.� �--
Legal Description:
Owner Name & Address: �l'l e.�- �
Contractor: �I,�
Address: ,
� Gc.�,a v�i�/he, f�S � � Z'el . # J`J%/ -�a �3 � %
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. #
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width � Hgt/Ground Sq. Ft.
OTHER: �/ � ✓� �o� �' ��� � 4��� � - �',a � �e�
�
Construction Type: Estimated Cost: $ f� f
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: l���S S� APPLICANT: 7�� Tel. #��� � 3��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
f
CITY USE ONLY
$
��: r Fee Schedule on Reverse Side
$ �,cj.Z .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 [ ]
$ �• �
�
sue�ec� PEftM1T NO.
City of Fridley 9 8 2
AT THE TOP Of THE TWINS g � I L D I N G P E R M I T
f
� �
� � '
� ; L �_��� COMMUNITY OEVELOPMENT DIV.
r � � PR07ECTIVE INSPECTION SEG L.��% �
t �'�
� � /'��\ • CITY HALL FRIDLEV 55�32 NUMBfR NEV OAiE pAGE O� AVPpOVED BY�
�""��� ��' 763-571-3450 910-F15 8/13/02 / /
JOB ADDRESS 6790 Brookview Drive NE
t IEGAI ��7 NO. BIOCK 7RACT OR AODITION SEE A7TACNED
DESCR. pt 2 1 Brookview Second Addition SNEET
2 PpOPERTV OWNE17 MAIL ADDRESS ZIP PNpNE
Steve & Janet Tranby 6790 Brookview Drive NE 763-571-6369
3 CON7AAC70R MAIL ADORESS ZIP PHONE LICENSE NO
Renewal By Andersen 1920 Co Rd C W, Roseville, MN 55113 651-264-4777 20130983
� ARCMITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADORESS IIP PMONE LICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW O ADDITION O ALTERATION �7 REPAIR ❑ MOVE O REMOVE
8 OESCRIBE WORK
Replace 12 windows within existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dweiZing
per Section 310.9.1,2 of the 1997 Uniform Building Code.
Permit Inspection Cards
Wil1 Be Mailed
To Homeowner To Pos#
TVPE OF CONST OCCUPANC`/ GROUP OCCUPANCV lOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PIUMBING, MEATING.
VENTII.ATING OA AIF CONDITIONING
TNIS PERM17 BECOMES NUIL AND VOIO IF WORK OR CONS7RUCTION ZpNING SO. FT CU FT
AUTMORIZED IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED fOii A PERIOD OF 120 OAY$ AT
ANV TIME AFTER WORK IS COMMENCED. NO OWIG. UNfTS OfFSTREET PARKING
I HEfiEBY CERTIFV TNAT I MAVE F1EAD AND EJ(AMINED THIS APPLICATION 1 S7All5 GARAGES
AND KNOW TME SAME 70 BE TRUE AND COpRECT. ALL PROVISIONS Of �AWS yq�UAT10N SURTAX
ANp ORDiNANCES GOvERNING THIS TvPE OF WORK Wi�L BE COMPLIED @
WITH WHETMER SPECIfIED MER�IN Op NOT. THE GRANTING OF A PERM17 �12,639 W6.32
DOES NOT pRESUME TO GIVE AUTHORITV TO VIOIATE Op CANCEL TNE p�qMiT fEE - SAC CHAAGE
PROVISIONS OF ANY OTHEq STATE OR LOCAL lAW REGULATING CON•
STRUC7iON OR TNE PERFORMANCE OF CONSTRUC710N �2.23.25 Fire S�.' �12.6�F
PLAN CHECK fEE TOiA� FEE
Licen SC $5. 0 247.21
SiGNATUAE OF CON"A4CTOQ OA AUTM0�7iZE0 �GENT iDATE� HE PR �VALIOAT THIS I YOUR PEAMIT
� .�(
S�Gti4TUQE O� OwHEQ�iF OWtiEABU��OEA� �OATE� � INS7 � +���1 �
n A
rrEw [ �
ADDN
ALTER
[l
[l
Effective 5/10/99
CITY OF FRIDLEY �1
SINGLE FAMII,Y AND DUPLEXES R-i AND R-2
BiJII.DING PERMI'T APPLICATION ��
�onstruction Address: (��'q b �cc�s1�. ' .�,�3 � � 4
Legal Description: �
Owner Name & Address: ��.Q a SO�.,�,� '"��p�bu �' Tel. #_�(n3 • S� �•(0 3(0 9
Contractor:; 1�t,�,Wq� �u A,�,�,�5�, MN L-ICENSE #_0"�0130`�$3
Address:_]�i 2l p CA�.�n� t�oo.c� C. W�.S�: �t,nSCV� t;�r1� � l l� Tel. #(_c`�I • 01104 • y�'�"
Attach to this apglication, a Certificate of Survey of-f�e �
lot, with ttie proposed�canstr�ctinn drawn �n-it to scale.
DES.C�ION' QF �1`.#'�Q��VSENT . '
LNING AREA:
GARAGE AREA:
DECK AREA:
� � �
Construction Type:
Length Wirlth Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
�2_ „�„ �., �-_� � . _.,.a - -� � - << • ,. _..� L--- --- - •
Driveway C�,trb C�t Width Needzd:
� • � y � �
.
Permit Fee
F�xe Surcfiarge
State Surcharge
SAC Charge
Lic�nse S�rcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPLJLATIONS:
� aa3.�
� � a•�
$
$
$ `a•��
$
$
$
$
$ o"�v�f�
��°�. � l
Fstimated Cost: $ j a � (p � � �-
Ft. + ti Ft =_ Ft x$ _$
Tet. # q5a .34,5•100�4�-
CITY USE ONLY
Fee Schedule on Reverse Side
.C�1 �f Pett►�1't Vaiu3tiou !1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Detemuned by Engineering
Agreement Necessary [ � Not Necessary ( ]
� b�
�
.
,
sue�ecr PERMI NO.
City of Fridley 33015
AT THE TOP OF TME TWINS g U I L D 1 N G P E R M i T
� ` RECEIPT NO.
� • COMMUNITY DEVEIOPMENT DIV. ,.`���
r � L � PROTECTIVE INSPECTION SEC ���
� , /'�'1 � CITY MALL FRIOIE� SS13Z NUMBER pEV OATE VAGE ,OF APPROVEG 8�
�'""'�"� ��' 763-571-3450 910-F15 8/26/02 / /
JOB ADDRESS 6790 $rookview Drive NE
t LEGAL LOT NO. BLOCK TFACT OR AOOITION SEE ATTACHEO
oescR. Pt 2 1 Brookview Second Addition SMEET
2 PROPER7YOWNER MAILADDRESS ZIP PHONE
Steve & Janet Tranby 6790 Brookview Drive NE 763-783-9664
3 CONTRACTOR MAI� ADDRESS Z�P PHONE ItCENSE NO
Same
� AqCH17ECT OA OESIGNER MAIL AOORESS ZIP PHONE LICENSE NO
5 ENGINEER MAII ADORESS ZIP PNONE LICENSE NO
6 USE OF BUILDING
Residentiai
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR p MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 3' x 20' Garage Addition
9 CHANGEOFUSEFROM TO
STIPULATIONS ,
See notations on plan.
� � RNING
Before dig9ing cail fo�
all utili�ty lo�etions
45�(1�02
��Q��RED BY LAW
TYPEOFCONST OCCUPANCVGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOq EIECTRICAL, PLUMBING, MEATING,
VENTI�ATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION 20NING SO. FT CU FT
AUTMORIZEO IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO POA A PERIOD Of 120 DAVS AT
ANY TIME AFTER WOFK IS COMMENCED. NO DWLG. UNITS O�FSTFEET PARKING
1 HEREBY CERTIFY THA7 I MAYE pEAO ANO EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT ALL PROVISIONS Of �AWS VALUATION SURTA%
ANO ORpINANCES GOVERNING THIS TVPE OF WORK WILL BE COMP�IED � 1� 22S �. 61
Wl7M WHE7HER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMI7
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEI THE pEqMIT FEE SAC CHAAGE
PROVISIONS OF ANV OTHER STATE OR LOCAI LAW REGULATING CON- $47.90 Fire SC y�1.Z3
STRUCTION OA THE PEAFOFiMANCE Of CONStRUCT+ON
PI.AN CHECK FEE T A� FEE
$49.74
`/ $ TURE OF CON' ,TOR OA • iHOQ�2ED �GENT iDATE� yyH PRO Y VAUpAT D THIS IS UR PERMIT
I 5 NsTUqE O� OWNER �if QWNEA BU� DER� �O�TE� B G�NS� ��• �<<E ��
T
NEW ( J CITY OF FRIOLEY Effective 1/1/2�2
ADDN 64 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ( � f � ; '� �
f � � f j�, � �. ' , i E � `��l,
" �'��.R.1 k � � �
Canstruction Address: �p� q(, 9 g A 1 t�P
Legal Description:
Owner Name 8 Address: ���S,�,Q�,�10�- T+�'� �t,� Tel. #?(� 1�3 � 9b�y CQQQ �
Contractor. (�117�'11 ,Q� MN LICENSE #
Address: ,�,YYI o Tel. #
LMNG AREA:
GARAGE AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction draw� on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width - Height Sq. Ft
Length 3�r-i�_ Width Height Sq. Ft � ,
DECK AREA: Length Vlfidth HgtlGround Sq. Ft
OTHER: �
` `�� �aS� o►� �� � �
Construction Type: Estimated Cost: $ a ��� a°� 8- ��
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: b' I(n' �c� APPLICANT: �'71?�Q 1 1t.4• Tel. #7(e� ''� ��qG(� y
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we wil!
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Pa�lc Fee
Sewer Main Charge
TOTAL
$ � �I O
� a �
$ , �
$
$
$
$
$
$
� � '�
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1, 000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by�Engineering
Agreement Necessary [ J Not Necessary [
STIPULATIONS:
. , ; ` CA/NE � ASSOC/ATES
' � LAND SURVEYORS, /NC.
�\ /7720 Highway 65 N. E. Sodervi//e, Minnesolo 55304
434-7646
AS BUILT SURVEY FOR: Jack Menkveld
DESCRIBED AS: The north 75.00 feet of the south 232.00 feet of Lot 2,
Block 1, Brookview Second, according to the recorded plat
thereof in the office of the Registrar of Titles, Anoka
County, Minnesota. I
Subject to easements of record.
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HEREBY CERT/FY TNAT TH/S SURVEY, PLAN,
OR REPORT WAS PHEPAREO BY ME OR GYDER
MY O/FECT SUPERV/S%ON AND THAT / AM A
DUGY RE6/STEHED LAND SURVEY0l9 UNDER
TNE GAWS OF THE STATE Of M/NNESOTA.
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10i29/2003 01:49 �fr37842375 CM CONTRACTING P�GE 01
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Bui�iding'
Inspections
763-572-3604
DATE J"" ��—C��
SITE ADDRESS i'�
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
�OWNER
NAME: � / C�
ADDRESS:��
PHONE: /�j •S _
NAME:
STATE LICENSE #_
ADDRESS:
PHONE
Permit No.:
Received By�
Date Rec'd:
YOUR E-MAIL ADDRESS ��-•� J� I(a �%;i S%J � L�
D!L - 1L' G - —
❑CONTRACTOR
0
� SINGLE FAMILY/NEW CONSTRUCTIi
❑ TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION
❑ BASEMENT FINISH
❑ DECK
C
��,?C't'� CT'rY �]�-(�✓c..c
EXP DATE
CITY_
FAX
SIZE
❑ ROOF ❑ DRA1N TILE
� SIDING ❑ OTHER
❑ SWIMMING POOL _ __
❑ ADDITION
�AIR � REMODELING
T��:� a
STATE ZIP
DESCRIBE WORK BE1NG DONE:%��'� vCtiv'N G=�Sl1�`77�� Sfitr -� ��t1L� �"�'�� �/�L
SIZE OF IMPROVEMENT LENGTH � WIDTH HEIGHT S. Ft. �
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan
PROPOSED SIZE: � DETACHED GARAGE 2• Proposed floor plan
PROPOSED HEIGHT: 3. List of structura] members to be used
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SLJBMIT:
❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia and proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Caiculations
IN EXISTING OPENINGS ❑Yes �No LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE WSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $�iP;� �`" OCCUPANCY TYPE
Pernut Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Totat Due
$
$
$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Pernut Fee
.001 times the total job valuation
.0005 x Pemut Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Deternuned by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks pa�able to: City of Fridley Attach
THIS IS AN A�PLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building pernut 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 pernut and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all wo w h requ es r�w approval of plans.
SIGNATURE OF APPLICANT U�`- PRINT NAME �I CJVI_.J`j �' `` / U�l DATE� �l � Q 10
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ESTIMAT'� FOR:
S^'rVE TF.�.ArFiY
;��
Mir.r�eapol'_s, MN 55921
?�'�: 763! 571-6369
SKU NUMBER DESCRIPTION
1i:0-4557 MM TRUSS CUSTOM
,
Estimate From
J ! �
STORE # 3018 FRID PHONE: (763) 571-8689
5351 Central Ave. NE FAX: (763) 571-1932
Fridiey, MN 55421
Estimate # 34037
Page 1 of 1
ESTIMATE BY ESTIMATE DATE
RICK 03/16/06
QTY TO ORDER ADDITIONAI_ ITEM INFORM ATION
RESIDENTIAL 6 EACH ** Special Order "•
6 16- 0- 0 27.31/12-Pitch Gambrel Room In Attic
HEELS-10 8/16" LOH-12.00" ROH-12.00" LOADING-35-7-0-10
:0:;-4547 MM TRUSS CUSTOM RESIDENTIAL 2 EACH
2 lo- 0- 0 27.31/12-Pitch Gambrel Room In Attic End
HEELS-10 8/16" LOH-12.00" ROH-12.00" LOADING-35-�-0-10
At[ention: EMPLOYEE
*" Special Order *•
Thi: is an e;iimaie. It i, given only for general price infomiation. This is not an offer aud there can be no legally bindin; contract TODAY'S SIJB-TOTAL: 9 oa .�6
bei�� een ihe par�ies based upon this estimate. The prires stated herein are subject to chan�e dependin; upon the market conditions. .
Thr prices staied on this es�imate are not �imi for any time period unless specifically written otherwise on this fomi. The availabiliry
of mairnals is subject io inventory conditions. MENARDS IS NOT RESPONSIBLE FOR ANV LOSS INCURRED BY THE
�;l'F:S'f �1'HO RELIES ON PRICES SET FOR7'H HEREIN OR ON THE AVAILABILITY OF ANV OF THE MATERIALS
ST.aTED H EREIN. All inl'ormation on this fonn, other than price, has been provided by guest and Menards is not respousibk Cor
�ny errors in che infomiation on this estimate, including but not fimited to quantiry, dimension and quality. Please examine this estimare .
care(ully. M1IEN.4RDSi�1AKESNOREPRESENTATIONS,ORAL,WRITTENOROTHERWISETHATTHEMATERIALS GUEST COPY
LISTED ARF StiITABLE FOR ANY PURPOSE BEING CONSIDERED BY THE GUEST. BECAUSE OF WIDE
�':�RIATIO,�'S Iv CODES,THERE ARE NO REPRESENTATIONS THATTHE MAT'ERIALS LISTED HEREIN MEET PAGE 1 OF 1
1'Ol'R CODE REQUIRE�tENTS.
. S i s 'fs' � e, Y�
w�.u:o`'^'^ _..
� .
Store #: 3018 �� �
Date: 2006-03-� 1 14:08:01 ��`�����'��� ������
Guest Name: STEVE TRANBY �
Guest Phone: 763-571-6369 ��"�' ���°'"�'° �.� s��� 1 2
Team Member:
*�'PLEASE i'�KE THiS ESTItV1ATE ft7 T�E*''
**BUILDlNG 14ilATER1�LS DESK �"C7 BE GQ6�1�����'E�**
Truss Type:
Sku:
Span:
Pitch:
Bottom Pitch:
HEeI Height:
Left Overhang:
Right Overhang:
Left Cantilever:
Right Cantilever:
Bearing Wall Size
Loadina:
Truss Type:
Sku:
Span:
Pitch:
Bottom Pitch:
Heel Height:
Left Overhang:
Right Overhang:
Left Cantilever:
Right Cantilever:
Bearing Wall Size
Loadinq:
Gambre! REA
1004547
16' 0" ,•
0/ 12
N/A
0" 0/16
1' 0"
q � On
N/A
N/A
iJif1
35-7-0-10
End Gambre! RiA
i004547
� 6' 0"
0/12
N/A
0" 0/16
� � ��,
1 ' 0"
�!/A
N/A
NiA
N/A
"?�2��
�D
� Z f�uantit;�: g �
;
ib
�This truss wiil need to be sent to our Truss Design
Depa�tment for proper Engineering and Pricing.
,�
�uantity: 2
*This truss wi!i r�eed to be sent to our Truss Design
Department for prcper EngireP;ing and Pricing.
Comments:
'Truss estimates usually get returned within 1-2 hours during re�ular bus;ness days.
-Truss picture(s) are for representation on!y.
-Loading values are just an estim,ate. Plea�e contac[ your loca( b�:ildirg insp�ctcr to veriiy your code
requirements. _ ___ _
This is an estimate. It is �iven on�y for general price inforrratioh. This is not an o`fer and there can be ne Icgaliy bindi�g cor,irac: behveen the
parties based upon this estimate The prices stated herein are subj=ct to change depending upcn the rriarket corditicns. 'fhe prices stated on
this estimate are not firm for any iime pericd unless specifically vor;ter otherwise on this form. The availabifity of materials i> ;ubject to inventory
conditions. MENARDS IS NUT RESPONSIBILE FOR APJY' LO��S INCURRED 6Y THe vUEST WHO P,E!.IES ON PRICES uET FGRTH
HEFEIN OR Oh THE AVAI�F,6iLITY OF ANY OF THE MATER;AI.S STATED HGREIhJ. h!I information on ihis Tor�;., cther!tian price, has been
provided by guest and Menar�s is not responsible for any errurs in the informaton on this es•.+mate, in:�i!:�i-g G;!t rn�f Iir.7ited to quantity, dimension
and quality Please examine inis estimata carefully. M�NARDS MAKES NO REi-RESEN�fATiONS, ORAL, WRII"i E�' Oft GTNERWISE THAT
?HE MATERIALS LISTED ARE SUITABLE FOR RNY PURPO.riE E3EIiJr CG�NSiDERED 5Y TH't GUES?, HEi,.4USE CF VVIDE VARIATIONS
IN CODES. THERE ARE NO REPRESENTATIONS TH.4T THc �JIATERIALS LISTEC HEREIN MEET YCUP, :,ODE RE«I.�IRFMENTS.
**PLEASE TA�E T�IIS ESillili6ATE TO TH�**
**BUIL�ING MATE�IALS �JESK TO BE GOl�iP���`E�**
�
�
, h / t n I
. . ��� �, �,��
� � ��
fiS'f I �1 ATE FOR: •
_r.e•✓e
_ .,_ �okview dr
=ri;:;zy, MN 55432
.... 'S3` 571-6369
Estimate From
, - .
STORE # 30l8 FR1D
5351 Central Ave. NE
Fridley, MN 55421
PHONE: (763) 571-8689
FAX: (763) 571-1932
ESTIMATE BY ESTIMATE DATE
kje 03/11/06
Estimate # 34023
Page ] of' 3
SKI.�L'.�9BER DESCRIPTION QTYTOORDER ADDITIONALIT6MINFORMATIQ\'
__� '_:i0� 2X2X8' FURRING STRIP 4 EACH
SOFFIT SUPPORT
__:. _C9: 2X4X92 5/B" SPF CONSTR STUD 54 EACH ON �.ALE THRU �?:'.:!,'?,
WALL STUDS
iC%--130 2X4-14' q2+BTR SPF CONST LUMBER 9 EACH
TOP PLATE
._.. �. 2?;;-16' tf2*BTR SPF CONST LUMBER 4 EACH
TGF PLATE
.;i :.c_ 2XoX10' STUD/#2+BTR SPF CONSTR LUMBER 8 EACH
SPF FASCIA
102-2155 2X12X10' ti2&BTR FIR CONSTLUMBEA 2 EACH
OH DOOR HEADER
lu� 1528 1X3X8' PURRING STRIP S4S PINE/SPRUCE 9 EACH
SOFFIT SUPPORT
�.- _-._ 2X4-B' AC2 TREATED AG ARSENIC FREE LW 1 EACH �� �AhE��L' 03!C��^�
^ SILL PLATE y_ 1^^,�A� , ` �
. ,i947 2X4-19' AC2 TREATED AG ARSENIC FREE LW 2 EACH
V V V �'�' �
SILL PLATE M�� �'S �� �
11;-0650 2X9-16' AC2 TREATED AG ARSENIC FREE LW 1 EACH
S1LL PLATE
'_?;-?�^9 '/2"-4'XS' ORIENT STRAND BOARD 14 EACH
� `
,., 7... �/2"-S'X8' ORIENT STRAND BOARD 16 EACH '-- �L�
4JAL.'_ SHEA"PHING � r
� �'i'?,'r�:'T'cR STRiP 10' iVINYLi 6 EACH
_'.'=,RTER STRI P
145-,392 12"X12' VENT SOFFIT WHITEBASKETWEAVE 7 EACH
VINYL SOFFIT
:�, =�:2 UND^cRSILL 'PRIM 10' WHITE 8 EACH � y� `� r
FIN;SH TRIM I
,. 1c.�5 F-CHANNEL I2'6" VINYL WHITE/WOODGRAIN 12 EACH
FnIEZ.E RUNNER
. `✓�^d'zL FASCIA B" X 12'6" WHITE 7 EACH
V?NYL FASCIA .
_�,�. �5_L S.O. DOUBLE 4" S.BLUE .040 60 EACH ** Special Order ** ON SALF. TiiRli ,_ -. ..
VINYL SIDING
l;c-�2<^2 OUTSIDE CORNER POST 10' S.BLUE 4 EACH ** SpeCial Order *'
OUTSIDE CORNER
.�i, 3%43 5/8" J-TRIM 12'6" S.BLUE 8 EACH *" Special Order **
J TRIM
., ._ . i2'6" DUAL UNDERSILL S. BLUE 3 EACH
P.TN=SH TRIM
., -..,. 5.0. COLOR EZ-CORNER B/PKSTANDARD 1 EACH *" Special Order " O�� SAL� T�.f•:': ' <
51.-SLATE BLUEEZ-CORNERS
Thi. i: an esiimaie li fs �i� en onh- for ;eneral price inl'omiation. This is not an offer and there can be no legally binding contract .
bcn� een ihr panie5 bused upon ihis es�imaie. The prices stated herein are subjeci to change depending upon the market conditions.
1'hc pnces swizd un this estimate are no� lirm for any time period unless specifically written otherwise on this (orni. The availabiliry
ol maierials i; ;u�ject to imeniory conditions. MENARDS IS NOT RESPONSIBLE FOR ANY LOSS INCURRED BY THE
C;!'F:ti'I' �1'HO RELIES ON PRIfES SET FORTH HEREIN OR ON THE AVAILABILITY OF ANY OF THE MATERIALS
ti 1�l FJ1 H EREI\'. :all inlonnaiion on this fomi, other than price, has been provided by guest and Menards is not responsible for
...� .: � �:�:, �n ihc mionnaiion on this estimate, including but not limited to quantity, dimension and qualiry. Please examine this estimate GUEST COPY
r.iirtu�l�. �IE�ARllS 11AKES NO REPRESENTATIONS, ORAL, WRITTEN OR OTHERWISE THATTHE MATERIALS
I.ItiTFD .-�RE Sl'ITABLE FOR ANY PURPOSE BEING CONSIDERED BY THE GUEST. BECAUSE OF WIDE
\'.�RIATIO\S I� CODES, THERE ARE NO REPRESENTATIONS THATTHE MATERIALS LISTED HEREIN MEET pAGE 1 OF 3
ti'Ol R CODE RFQt�IRE:YIENTS. �
FST1:�1;�TE FOR:
.ra°ty, Sceve
�7>G hroo'�view dr
-.... M� �sa?z
Estimate From
i ! �
STORE # 3018 FRID PHONE: (763) 571-8689
5351 Central Ave. NE FAX: (7G3) 571-{932
Fridley, MN 55421
Estimate # 34023
Page 2 of' 3
� 7��: ='-Fs ESTIMATE BY ESTfMATE DATE
kje 03/11/06
;U ��U�9BER DESCRIPTION QTY TO ORDER ADDITIONAL ITEM fNFORM.ATlO�'
_, a.5 FE:,T UNDERLAYMENT 3'X149' (4 SQ) 1 EACH
RGOFING FELT
�Fi;td;�ic �TARTER STRIP 7.2"X33'4" ROLL 1 EACH
SH?NGLES
':-?5i3 SUPERGLASS 25YR DUALBLACKCRC F/G 3-TAB 11 EACH
SHINGLES
,-;356 STYLE_"D"_10'_ROOF_EDGE WHITE B EACH
ROOF EDGE
7'_�5, 1-1/4"X10' DRIPCAP WHITE WINDOW/DOOR 1 EACH
DR?? CAP
] 1/2" X 50' SILL SEALER FOAM 2 EACH
;:LL SEAL
?�_=pC �/2"PLYWD CLIP ALUM 25/BGS56-BMC lOBGS/ 2 EACH
a-CLIPS
?'� '__,-. NA1LS i-1/2 JOIST HANGER 1LB GALV 2 EACH
lq Tie Nails
:;,�� RAFTER TIE U SHAPED IPC RT15 100/ 12 EACH
R4F"_'6R TIES
. .. , i;/2" VINYL SIDING NAIL 2 LBS 1 EACH
_..�:\C NA?LS
_..;;� tvAIL BD C.C. SINKER 5 LB BOX 5 BOX
SHEA'PHING NAILS
;._ ,3�,3 NA?L 16D C.C. SINKER 5 LB BOX 4 BOX
FRAMING NAILS
,__ :.;=7 NP.I� 6G GALVANIZED BOX 1 LB BOX 1 BOX
GALV BOX NAILS
,. _, NAIi loD GALVANIZED BOX 5 LB BOX 1 BOX
FRAM?NG NAILS
,, ":=e NAI:. 16D GALV CASING 1 LB BOX 1 BOX
�ASING NAILS
�a�:.'%3i NA.L 1-1/9" GALV ROOFING 1 LB BOX 1 BOX
ROOFING NAILS
:.`i ",r NP.I i. 1-,/4" GALV ROOFING 5 LB BOX 1 BOX
7 > .. . _
200P1NG NAILS
. V!N'fL JAM& 'T'R1M WHITE 7' 11/16X5-13/16 2 EACH ON �Ai.E ":'iitiU �., -_.. ..-
. . . ^:' :)OOR JAMB
�',iN'fi. JAM9 TR1M WHITE 10'll/16X5-13/16 1 EACH ON SALE TFiRG :._._�...
OH DOOR JAMB _
;7-y7<0 VINYL BRICK MLD WHITE B' 1-1/4X2
2 EACH ON SALE THRU L_ _�. .
OHDR BRICKMOULD
,_�.y�._ VINYL BkICK MLD WHITE 10'1-1/4X2
1 EACH ON SALE THRU �?%:�::
0:'.11R 2R:CKMOULD �
,._ _„__ REAR Tl2ACK HANGING KIT IDEAL 1 EACH
�.=A.R HANGER KIT
1 1.; .�n rsum:uz li is ,�i� en unl� lor �eneral price infomiatimi. This is not an offer and there can be no legally bindin; contract •
h�•i�� r; n d�z panies based upon this estimate. The prices stated herein are subject to change depending upon the market conditions.
I Iie prires ;iaied on ihis esumate are not fimi for any time period unless specifically written otlierwise on this form. The availabiliry
oi m;iiznal> is �ublect to inventory conditions. MENARDS IS NOT RESPONSIBLE FOR ANY LOSS INCURRED BY THE
(; l' F�T ��'HO RELIES ON PRICES SET FORTH HEREfN OR ON THE AVAfLABILITY OF ANY OF THE MATERIALS
tiTA'1'ED N FREI�'. All infonnation on this 1'orm, other than price, has been provided by guest and Menards is not responsible for GUEST CO PY
�n� rnun in ihe infom�aiion on this esumate, including but not limited to quantiry, dimension and qualiry. Please examine this estimare
carrli�ll� >IE�.iRDS�1AKESNUREPRESENTATIONS,ORAL,WRiTTENOROTHERWISETHATTHEMATERIALS
I.i�l"FI) :�RE Sl`ITABI.E FOR ANY PURPOSE BEING CONSIDERED BY THE GUEST. BECAUSEOF WIDE pAGE 2 OF J
�.�Iti �'fln�'S I� CODES, THERE:�RE \O REPRESENTATIONS THATTHE MATERIALS LISTED HEREIN MEET
1 ��I It ( ()I)F: Rf.QI'IRE\IE�'l'S.
, � Estimate From
r�
, ! �
� �i��,�ir�roa
. . :..: v, Sceve
o�;G b.col�view dr
_d1ey, MN 55932
��:: '�.3 571-5369
;I<l''�U!��1BER DESCRIPTION
STORE # 3018 FRfD PHONE: (763) 571-8689
5351 Central Ave. NE FAX: (763) 571-1932
Fridley, MN 55421
2:-3C15 8X7 MADSNJGLOSS WHT. #200ROLL-UP DOOR
nVERHEAD DOOR
ESTIMATE BY ESTIMATE DATE
kje 03/11/06
TO ORDER
EACH
Estimate # 34023
I'age 3 of 3
ADDITIONAL 1TEM INFORM.ATIO�
I hi; u �n c;uma�e li ii �i� en only lor oeueral price inl'omiation. This is not an offer and there can be no legally binding contrac� TODAY�$ $UE3-� UT.A I..: :, 0 7 4.�-' �
hri�� ccn ihe paruzs based upon this estimate. The prices stated herein are subjec� to change depending upon the market conditions
I'h� pnrr. ;i�ied on ihis esiimaie are not finn for any iime period unless specifically written otherwise on this fomi. The availabiliry REGULAR SUB-TOTr�I_: �,�oc .:; -
��� n,.�:c-_�!c i. ;uhjeci io in�'cntory condiiions. ME�ARDS IS NOT RESPONSIBLE FOR ANY LOSS INCURRED BY THE
c; t Fti t��110 RF.LIES O� PRICES SET FORTH HEREIN OR ON THE AVAILABILITY OF ANY OF THE MATERIALS
> I� I h:U I i I:It F.I �. All in fonnauon on this I'onn, other than price, has been provided by guest and Menards is not responsible for
,�n. �rr„r, m ihe in1'urniaiion an ihis esiimaie, including but not limited to quantiry, dimension and qualiry. Please examine this estimate GUEST COPY
c�rriulh. >IE\.4RDS�'I,�KESIOREPRESENTATIONS,ORAL,WRITTENOROTHERWISETHATTHEMATERIALS
I.ISTFD :�RE Sl'ITABLE FOR ANY PURPOSE BEING CONSIDERED BY THE CUEST. BECAUSE OF WIDE
\,U21..1Ti0\S 1� CODES, THERE ARE NO REPRESENTATIONS THAT THE MATERIALS LISTED HEREIN MEET PAGE 3 OF 3
1'OI R CODF REQI'IRE�tE\TS. '
AS IIUILT
DESCft I f3L'D n5 :
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CA/NE f� ASSOC/ATES
' LAND SURVEYORS, /NC.
/7720 Highwoy 65 N. E. Sode�vi/le, Minnesolo 55304
43 4-7646
SURVI�Y rOR: Jack Menkveld
'('1ie north 75.00 Leet ot the south 232.U1� f.c��t ��L LuL 2.
[31ock 1, IIrookview Second, accordinc� t.o the recordc�d plat
thereof in th� office of: the Rec�iStr��r of 'I'itles, Anok��
County, Minnesota.
Subject to e�sements of rc�cor.d.
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L � OR REPO/9T WAS PREOAl�ED BY ME OR UVOEF
MY O/RECT SUPEFV/S/ON ANO THAT / AM A
�� DULY FEG/STEHED LANO SURVEYOR UNOER •
��� �` iHE GAWS OF THE STArE OF M/NNESO�A.
' 6iTH Al/E. N.E. tt, ,
SCAL E : / /NCN • -3 � FEf T. � " �
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CITY OF FRIDLEY
6431 University Ave NE
Fridley MN 55432
�� L l'� � Effective 1/ 1/04
�� ,G� �c-.—�� - �
MOVING [ ] WRECKING [� PERMIT APPLICATION
(763)572-3604 FAX (763)571-1287
Job Address: �?�7 �i� ������L�i/�-� �1` 1"'�
Legal Description: % /�� �(J ��� �� ��^- `�-(t S' �3a �' l.d� a $Ca�/< /
Owner & Address: �;��,�'�� �•-�A,�;�.� ���p (�.rZcx„tt,�r�� �2 ,�rG Tel. #�'%l-(0�9
Contractor: �;� L /� Tel. #
Address: State License #
HOUSE: Length
GARAGE:Length
OTHER: Length �_
Estimated Cost $
DESCRIPTION OF BUILDING
Width
Width
Width �_
Height
Height
Height
Approx.
Sq. Ft.
Sq. Ft.
Sq. Ft.
Completion Date
Cu. Ft.
Cu. Ft.
Cu. Ft.
�"�� �
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL
UTILITIES FOR DISCONNECTS BEFORE WRECKING/MOVING STRUCTURE.
Water Bill Paid: Yes [�f or Collect [$
/'
Moving Route:
] Signature � �
The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing
to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State
Code which requires any water well on the prop�erty to be sealed by a State licensed water well driller, and
hereby declares that all facts and representations stated in this application are true and correct. ALL
1�F,M()T,TTnN nFRRT�_ TNC'i,iTnTNCT F(1T1Ni)ATTnN R� Si,AR_ SFIA�;L BE REMOVED FROM SITE.
�--.3f - o �: _J��- �
Date Signature
Movin�
Principle building into Fridley . . . . $300.00
Accessory building into Fridley ...$ 42.00
Through or within the City ......$ 20.00
Move a building out of City ......$ 20.00
Wrecking
For each 1,000 cubic feet or fraction.. ....$1.25
For structures which would be impractical to
cube, the fee shall be based on the total cost
of wrecking at the rate of $6.00 for each $500.00
or fraction.
PERMIT FEE: O� �b MINIMUM $20.00 STIPULATIONS:
Building PLUMBING Pexmit No.: (�07- `7�
Inspectio�.s �Sjj)]���j,�L APP`LICAT`ION Recexved By:
' 763-572-3604 CITY OF FR�DLE � D��'�
� DATE_ September 21. 2007 Youx �-�arr, n.ti�ar�ss wnelsonCa)larsonplumbinq.com
, s�r�.ann�ss 6790 Brookview Drive NE
TFI]S APPLtCAi�'C iS: ❑ OVdNER (�CONTRACTOR
PROPERTY N,�M�: Steven Tranby
owN��tl �D�ss. �7gp grookview Drive NE cr-r�r Fridlev sT�-r�MNziP 55432
T�NANT P�oNE: 763/571-6369
� co��i�TOR �,�: Larson Plumbinq, Inc.
SUBMIT A GOPY pF STATE LICEI`SE � 3341 PM EXP DATE 12/31 /2a06
YOUR STATE a,�Dx�ss: 3095 - 162nd Lane NW c�rY Andover s�raTSMN z�P 55304
LIGENSE WITH p�o� 763/427-7680 ��c 763/427-9448
APPLICATION
i'ERMIT TX�E � SfNGLE FAMTLY ❑ TWO FAMTI.Y ❑ TOV�'NHOUSE
TYPE OR WORK: � NHW � REPLACENiEN'1'
' DETAILED DESCRIPTION OF WO�tK Water Heater Replacement
PER MS ] 6B.665 the permit fee is a minimum of 515.00 or 5% of the total c�st up to 5500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixtwe, excluding the fuctures. (This should reflect only the cost of labor )
Labor eost under $300 =�15.UU. Labor cost between $300 to �500 = cosi o£labor �c .OS =
FOR PROJEGT5 VVHER� 1..ABOR E�CCEEDS $500, FEES A4tE BASED ON $10.00 PER FIXTURE, FXCEPT WHERE T30TED. FIXTqRES: (CNDICATE TOTAL
NUNIBHR OF EACH SBL04�
BATH S�NTC/LA'�+ ,�FLOOR DRAT]QS 3HOWER VdA�'ER PTPING
BAT�ITUB GAS PIPING ��o cmucExsEj SWI?.4M7NG PO�L WATER SOFT't�TER ($3S)
CLOTHES'VJASi{ER �KITCHEN SINI: WATEA CLOSET BACiC.FfAW PR�V, ($15)
DISHWASHER _ LAUNDRY 'iRAY X WA'1'ER NEATEIt ($35) FOR IRRIGA"i'lON .
WAT£R MEFER OTHEEt
; ��1Z1vIi"�' 1�E;�Rj03;ECT�:�O,R._i7�DE� �5:{ib Y . ; �'�'t � x •a x r ;�_ }j'11fln` Ch' �.� �E�:(�'F.EE_FO�Z; P�flJE?G�'S'OI�ER ��0(�:":
r {, t.. . : fi n t;�n.,,. A��, ci. }.:
. . . . . .. . . .. �.. -. . :..,. ....-.. .... .,.:. . . .
Permit Fee . $ 35 �,Q� Number of fixtures @$10.00 x$10.00 =$
Svrchar �e .SO Number of �xtures @ $i5.00 x $IS_00 = $
T��'AL DUE $_ �.�Q Number of fixn�res @$35.00 x$35.00 = S
State Surcharge = $ .SO
T�tai = $
T'HIS Z5 AN APPLfCAT10N FOR A PERMIT-NOT VALID UNTIL PROCESSED
i hereby apply for a building perntit and I acknowledge that the in;formation above is complete and accurate; that the work wi11 be in
` canformance with the ordinances and codes of the City of Fridley and with the Minnesota Consm�etion Codes; that I understand this is
not a permit but only an applicarion for a permit and work is not to start witb.out a penmit; that the work will be in accordance with the
appro�ed pian in the c e f all work w' requires review and approval o#'plans.
SiGT3ATtTR� 0� APPLJCA P121MNAME Michael Malinoski DA� 9/21/�7
�. .. }PLEASE;�TO:�'� �z'S�S��T�.P�:E ,. ._ �S ATt�;;it� TJTR�.D;���;73��%�iN�; �IrE��R1��,:�2�„`�;D, Ic!I�C�i�4.NT�CAT, �i?��LK. ...:� .;�
City of Fridiey
Bu�id�ng xnspecf�ons Aepariment
6431 Universit� Avenue NE, Fridley, MN 55432
763-572-3604
�AX: 763-502-4977