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AF - 43986Date: Owner; Addres; City of Fridley, Minn. BUI�DING PERMIT N° 4� � � �� . . . - �oc, io� :o� ILDtNG No. -� �i�-.�� Street ---_.:.. ••---. __.. _#�!�-,. .:.......�"..._..... P of Lot ;�!"_..._�._......._ ..._...._......_.__..,..�_ Iat ......:�1 .:... . ....:.... Block ...._.--:.. ..,---_.:. ....._...... �dditian or Sub-Divisi � _ .'.�� ,/� � -� ��r��• Corner Lot ..........-� ................. Inside Lot • �-,�r"= -�� ......... Setback :.;�`�.................: Sideyaxd ...---.�` �..---...................._....----...._._._.. .. SewerElevation ...................._..--��---�--�---.........-----..........................................-----.... Faundation Elevation .........--�--........................._..__..._.............._.:..._.�_..........._.. DESCRIPTION 4F BUILDING To Usea a • ,, _ � . .. .� Front ... ...: --- - Depth ,. :.� Height _Il�� . .: .. Sq. Ft. .� , _ �--- .. .�=_... - ... ...... Depth - ' eight ...... ._.._ Sq. Ft. , � ... C�1. P't. ... :: . Type o Canstruction -:-- Est. Cas ........._ To be Completed ..: ._......:_...._.._..._..__...... _: . -� " �.�?�.�J�"��l�1 TF-{I�� PE;�f,11 i(�. i=:i fVUT N:.?�I �IORIZE VIOLAT- ION OF Ai�Y f':;; :.q"fc LAi�D CGVENANTS F��ID BUILDING REST-RICTIONS. `,> In consideration of the issuance to me of a permit to construct the building described above, I agree to do the prop�ed wo�k in accordance with the description above set forth and in compHance with all praviatoa�s oE ordinances of the city of Fridley. � ;In consideration of the payment of a fee oi��:, permit is hereby granted to...__ ......:......__. ......-----•...._.._.._...___ ,,;.; , _..._...--•-•----...._.........---.•--------.--......._...._........ to construct the buildin� or addiiaon as descrfbed above. This permit ia granted upo�t the express conditian that the person to whom it is granted and his agents, empioyees and w�orkm�n, in a1i a►4rk done in, around and upon said building, or any part tliereof, shall c�farm in all respects to the orditnax[ods o� Fridley, Minnesota regarding location, construction, alteration, maintenance, repair axui moving of buildiri�t within the city limits attd this permit may be revoked atti�t►y time upon viola. ' of any of the provisioas oi setid ordinance�. , . .�'"'�i .� .%� � � _� "'7�' , � �, � • �, � NOTICE: �aq i This psrmit does no� eover fh� eonslweffon, int1a11aHen for wiring, plwsbiny; 4s hsatin�, »w�e er wafK. p sdN f� Ms fh� Building In:p�elor for aparab p��mks for 1h�a iNms. { , i � �4 �� -�.p- `;; t._ ` �� _ � APPLICATION FOR BUI�DING PERMIT � CITY OF FRIDLEY, MINNESOTA b � �� ^ ; Owners Name Builder �Q • � `�'`�t �� Addxess Address �� --�`°`_� �-�'`-'E°`- �� ; LOCATION OF' BUILDING No.� � Street��-c-�-�-�-' �C-�-c'� Part of Lot . Lot ;� � Blbck � _ _Addition or S�.b.Div. ' � Corner Lot Inside Lot 1� Set Ba.ek �� r� Side-Yaxd �D �o � S�"4JII3. ELEVATION FOUNDATSON ELEVATION Applican-E atta,ch to this form Certifica.te of Survey of Lot and proposed building loca.tion. • . _ . ' DESCRIPTION OF BUILD IlJG To be used as: ^ G�e-��T-�,: Front �� Depth_�'•f ^ � Height �� 5q. Ft. Cu, Ft. . . G�� Front ��. o Depth ��- a Height / 9. Sq. Ft. Cu. Ft. Type of Canstruction �a-�t�_ Esti.mated Cost . To be completed The undersigned hereby makes application �or a permi.t for the work herein,specified� agreei.ng to do all work in strict accordance with the City Ordinances:and ruling of the Depaxtment of Buildings, and hereby declaxes that all the facts and representa- tions stated in this e.pplication are true and orrect. ��-e_-F' �--�cic Q�-dti �J DATE `/ - Y �`o -� SIGNATURE 'ri� � T.� . C3-c T (A Schedule of Fee costs can be found on the Reverse Side.) • � � , �N� sue�ecr P • City of Fridley � �� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �, r � � , � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. r �~ � PROTECTIVE INSPECTION SEC. 3Z�/�7 i i � ' 1 /'��1 � CITY HALL FRIDIE� 55432 NUMBER l7EV DATE PAGE UF APPROVED BV ' �'""'�" ��' b12-571-3450 910-F15 8/22/95 � � JOB ADDRESS 6810 Brookview Drive NE t LEGAI ��T NO. BLOCK TRACT OR ADDITION SEE ATTACMEO DESCR. ].]. 2 Brookview Terrace 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bryce Shimmon 6810 Brookview Drive NE 571-7186 3 CONTRACTOR MAII ADDRESS Z�P PMONE UCENSE NO Same 4 AFCHITECT OR DESIGNER MAIL ADDFESS 21P PHONE LICENSE NO. 5 ENGINEER MAllAODHESS Z�P PHONE � IICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House 18 Sq Tear-off; Reside House 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TVPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REQUIRED FOF ELECTRICAL, PLUMBING, HEATING, VENTILATING OR Alii CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCT�ON OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOfiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEFiEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOfiK WILL 8E COMPLIEO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ��4�%SO �2.3H DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS Of ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE Of CONSTRUCT{ON $99 .% rj Fire SC ��1 . 7.5 PLAN CHECK FEE TOTAL FEE $106.88 S�GNATUREO:CON'RACTOAOA.AUTHOFlIZEDAGENT ioarEi EN fi PE Y V IDATED THIS IS VOUR PERMIT S� NnTUREOFOWti Ri�FOWNERBU0.DERi �OATEi LOG iNSP ��F1 NEW ADDN ALTER [l [l [] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 8/1/95 -��Z �� ConstructionAddress:�� "�� /'� � �/ ,�I^ )` 1/'� _ Legal Descripdon: �O� � g�� Z ��_ ��a �;� �.✓ T�r�q�� 2"'� �.pn, Owner Name & Address: _��l��L�_ S� �f�, �l') �S��O 6rvak'�'�I'el #��.1� y��-i r Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length �.2II� Length DESCRIPTION OF IMPROVEMENT Width wl(��il Width „ _ , .,.�i Height Height Hgt/Ground �� eSi D�= �'joc!5�� G�/�L`�" / Corner Lot [] Inside Lot [) Ft. Yd Setback Side Yard Setbacks Type of Construction: Approx. Compietion Dat,e: Tel. # Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $—�� , (Cost on Back) ; Driveway'` Curb Ctiut Width Needed: Ft. + 6 F Ft $ _$� _ DATE: APPLICANT: � Tel. # r i�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � � �. � 5.� � y� �5 $ � ._��. $ $ $ $ $ $ �� $ J�(%�-c�c7 CITY USE ONLY Fee Schedule on Reveise Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $850 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�ecr PER c�ty of Fridley � � � - } BU ILDING PERMIT ` � �� 5 AT THE TOP OF THE TWINS r � � , ,, RECEIPT NO. � COMMUNITY DEVELOPMENT OIV. ' ; V'�'�� , r � � PROTECTIVE INSPECTION SEC i _ ' ' ��i � CITY HALL FRIOLEv SS432 NUMBER AEV DATE PAGE UF APP VEO B� �"'"�"� �'' 612-571-3450 9�0-F�5 10/20/95 � � JOB ADDRESS 6810 Brookview Drive NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1], 2 Brookview Terrace 2nd Addition SHEET 2 P PEFiTY OWNER MAIL ADDRESS IIP PHONE r ce Shimmon 6810 Brookview Drive NE 571-7186 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO Same 4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIIADDRESS ZIP PHONE UCENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK G NEW � ADDITION O ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 23' x 14' Deck 9 CHANGEOFUSEFROM TO STIPULA710NS See notations on plan. WARNtNG Before d'+�gsR� c�it for al! uti{ity locat�ons 454•0002 R�QUIRED BY LAW TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIFED FOR EIECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OA ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTEfi WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2�622 �1.31 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL 7HE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. �74.75 Fire SC �p2.6L PLAN CHECK FEE TOTAL FEE / � � • ��8.68 aruaeOF ON�RACTOROAF.UTHOAIZEDAGENI iO.aTEi WHEN PAOPER VALIDATED THIS IS YOUR PERMIT c' � ' /�-2.3 — �,i SiGNPTUAEOFOWNEAUFOWNEFlBUI�DEA� �DATEi ' BL G �NS� ��tE NEW ADDN ALTER G� 11 �) CITY OF FRIDLEY SINGLE FAMtLY AND DUPLEXES R-1 AND R-2 Building Permit Application Cffective 8J 1 !95 � � l�'� ConstructionAddress: r`f. L% , �-,.��-�'- �f / i ,� .��-i '� � �� /��f r%_ � (� �'�' �% � �, � r� P•� Legal Description: ---� , Owner Name & Address: ��Yc. ,�' �; -� � Y.,,>,,, Z�ri7 Tel. # .=: � % - �% �' Contractor: Address: MN LICENSE # Attach to this appGcation, a Certificate of Survey of the lot, with the proposed consiruction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # i.IVING AREA: Length Width Height Sq. Ft. CARAGE AREA: Length Width Height Sq. Ft. DECK AREA: I.ength � Width � HgtJGround � Sq. Ft. ��''� % OTHER: �,��L� �LY'�- �omer Lot [] Inside Lot �{] Ft. Yd Setback Side Yard Setbacks 'rype of construction: I,JLI ��; �� Es�nated cost: $_�� E+ „�' , Y �- Approx. Completion Date: �� (Cost on Back) �}riveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ =$ �ATE: � �,�,;�-.��a��/l�` APPLICANT: �' � � C � ,_.__ .�J�.�--__,-� Tel. # S 7� - �J �G. ,___.... ��TIIllt F8C �ire Surcharge ;tate Surcharge ;.�.A.0 Charge .R,�icense Surcharge ��iveway Escrow wrosion Control �ark Fee �ewer Main Charge TOTAL '';TIPULATIONS: r �� . , G� L $ r, .� . � $ $ $ $ $ � � A CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (ll10t�►`Y ) $.50/$1,000 Valuation $850 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.OD Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ] 0 � , _ � � � r � °: ' �sk� ,°{ �� $ � . . . .� � G �. �� .�:.� .n' �'��fi` �s F� ,� . . .. .� . . ' � :..:.. ' ' . '� . .. ;. �: � . °:... . .�� . . ; � . . . ' .'. ' . . ^ .''.`� � .,s�Sti': k i�`s. .�y x'� ' y _ � � � � �`F5 I �U t�� r� � (` . . . � t �; �^$� "��. t�a,�a,,,�;»q �:�� _ ��.. ENGINEERiNG, INC: � C 'I 6- i I' � :- v. +�.. rv► �apv � , �� . — En ineers � Su�veyo�s — i .. 9 cate o� sszsve � Y� a c�'i''tz�i ° ' FAu�. ��. �cHwrA��' � �ocvsY ..� � �� (j �� '� . I ! i =- . ,- .. , �_ ! �. '� .�._T_, �, ;,.i =� �,:1'__ ,{�. �� , � _ � . . - , . : ..._ ?;�'. a . � •� '� . r� . ,�. -. __. _. . __ ._. ..---_ _ _ _. _ . �---::-_ ..__ _..__ __ ._ __ � ._ _ _ , ` i '. . � ` y � � : ', : . _ _ __ _- _ i- . , •: ""'� ' .� jI ( • I 1. � � . � j � � � , � ' � , � 'i t ; � , `;� � i `, :�<., , �� . � i � , �� .? �; - � `��._ •1. � ,,� . .�; . �`Z ` l �' I s: . _ �;�; << � . t ',- � �_� - ._ } �-✓ --,�- ry`� — : �j� r -- -- � ;' ;; ! � _ � i, m. �. . . `D, � -', ', � � ,l !� `�.1� ' `. �, �� ) r . . '^��4� � �' � t, � � � ` � . . . { - ' ♦� 11. [ i i •' •C.. }-', Y�, , i..-?ii !��U �{ �"�f � � k` �`f�� - .�d� `C.tt-�.,� �:. [..� r� �� '��:� i i.. c> , , � 1 � � . � �.c.,ti �.� l ht.reLy ��yrfi�'t� �Yiof �his is o�rue and mrrrcf rt�senfafian o�'a surw�t;� �'il�c be�a,dor�s �'�/�e abair aEsc�er%r1. /an�d; ir�Gl ,'' ot" l f i r / o c a f� n o�'ol l b w l da�s ,� I x�an , a rn d d/ ris� b/e a x r o a c hmen t s , r%�, �' n r n a r a►� s o i d /� d. As wr►ae yed b r t md f/nCS d� � . /,� �'�r= r � � s�_ A.D. �. , � $. ; '� � SUB UR 8AN ENGINEERING , INC. r,`� �noineer's� fi- sur►q�rs � _ ; � €�f _,.J ��..x, .,,.'f. �.-.'� . . � *�.a�.:4i�-. �.�..da,�.°�a�,..s. _ ,. � , � ; M. �..�.... .:.�� . �..:a.os. ........:...�..�..�. .. .�.,.�...�...rn..s�.:..__.n—�r,.�...-�: �.+e 3. :..�. � �,-•.m.,,rrc•..c � . �� -.,,� � �� Q L � � �� .� �Ta # � � `�. `•�E' � �� I ��'' W � � I c �. � � � .�- � � ,� ;� � � � '- � 1 � �. � s 3�� . �x � � .. CITYOF FRIDLEY iNSPECTION DIViSION �� `��".� �=� � °:� 6431 University Ave NE Fridley, MN 55432 APPUCATIUN FOR POWER PIANTS AND HEATING, COOLING, VENTIlATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner — Also Replacement F�tr�ace (Side Vent — FiI� 0�t Back) Gas Piping (Needec,fi�i�h new furnace) ,_ �.. --� � Gas Range � � � ti � �� Gas Dryer � � � �� *Air Conditioning — A�I`Sizes All Others/Repairs 8� Alterations (LIST ON BACK) 1� of Value of Appliance or Work Commercial/1 �dustria) 1.25�0 of Vafi�e of Appliance or Work Rate TOTAL $ 30.00 $_�,_� � 10.00 $ $10.00 $ $10.00 $ $ 25.00 $ a 5� 0� State Surcharge Effective On January 1, 1998 JOB ADDRESS �� I� I;� I�.0 I.(;(„U �. The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Buitding Division, and hereby declares that all the facts and representations stated in this application are true and correct. � — o� � ,1998 OWNER �Ji'�(�l�Jl,.��..'P ��[ � IMI� V� BUILDING USED AS ; U�� l V1 f'Jl ESTIMATED COST � D�� U PERMIT NO. /�/ - DESCRIPTIOPJ OF FURNACE AND OR BURNER $ No. of Heating Units � Circle One (Steam) (Hot Water) (� Trade Name '�" I� Size Na �( (,� �((yl p�, � BTU 1 .(mD HP EDR $ �� Fuel , �0.S Total Connected Load Burner Trade Name Size No. BTU HP EDR TOTAL FEE , �� CJ� • g�,pq,� �Q,1VG ��-� �� MINIMUM FEE FOR ANY HEATING/COOLINGNENTlLAT10N REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. 1��,AVE N.E. HEATING AN �' � � . Signed By Na � �� Approved By Rough—In Date Final DateZ �� FILL pUT BACK SIDE FOR.ST CK VERIFlCATION ON ��G� � REPLACEMENT FURNACE ;� CHIlVINEY AND STACK VERIFICATION ;�2 d�.r � : � � �� The undersigned>$h�r�y verifies that the existing chimney or stack: � 1. Has bee�`;c�r�ully examined °�,: �? �� 2. Is free frot� ;�uust or deterioration 3. Has no foreign objects lodged within � 5 C� 7. � Is securely supported his�ets ��1 current C�de r.eq�iirements fnr size and tot�� BTU's connected � _.. ,�. Has total heating BTU's of �� All other BTU's �O , (� (i (� -T TOTAL BTU's ( � � , �6 I� Has a liner been provided for water heater Has combustion air been provided for water heater Remarks: Yes (� No ( ) Yes (� No ( ) Yes (� No ( ) Yes (� No ( ) Yes �) No ( ) Yes ( ) No (� Yes (� No ( ) List ALTF-RATIONS Bein¢ Done: t�-( °yl� �in �'�� 1 a i �, r�� `i'p.��n ►��i �� .�I�' C�l��(��'�i �-i �. (�1�� C`t' HEATING CO: Signed By: Date: . � � r �� N+(Q.11,rC E�.EC7.� ING 19662 t�� AVE. N.E. _ aNeKl►. MN 55304 u i ,, � • g��,N� AND ELEGTRIC, iNC. AlR CONDITIONINCi �J 2 �� HOUSE HEATiNti TEST RECaRD ADDRESS C��,�CS �,e('c9[SY �titW L��i . APT. FLOOR CITY�SUBURB OCCUPANT S'4�. c �,.yvuS� pyyH�p HEAT LOSS pATE HTG. INST. SOLD BY IN8TALLED BY Elaetrlcal Work By �1�t,..s_ c� Gu Un� By TYPE OF HEAT GA FA �[_ STEAM _ SPACE HTR. _ UNR HTR._ OTHER GAS DESIGN MAKE _��,Q vv�.� ��Q� Modal -� � seria� _ Z $ � Z �] D5S INPUT �%S. [�CX3 co�rrao�s THERMOSTAT .t c.�_ H�at Plup Valw l.�i,. ,'4C- 2r...o Limit ��y� i _� � 6- Limit Sotting � g c] Fan Satting � �,,... a, Pilot Typa �� .s u.,�AC� Pil t M k OONYERS{ON IAAlCE OF BURNER ModN Wx. 0TU R�tinp MAKE OF FURNACE Wodai V�nt Siz� Z �• KIND OF LINER DV'G 81ZE NONE DnR Hood Rpul�tor Filt�n Si� �Cr• X tS �c l Numb�r � Chlmmy Loc�tlon Ins(d� ✓ Outsid� Ch6nnnl f:omtruotion o a • / Pfiot Modal Smob Bomb Wirinp V Pilot Tlming �.%'' SP_C, OraR Tat Tap 4. W. Cut Ott Door Prasun �^0 ��• "� Prassura 3. S P�ro�nt CO, �e pab Tpbd input CFH P�rwnt O� � Comprny Tatinp Stack Tamp. �l S Parc�nt CO f�i`�D1M Nam� of Tat�r Form 235 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572 - 3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On March 1, 1996 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** NO. RATE --t-- Gas Dryer** _ Back Flow Preventer Required ()Yes () No Type _ $ T.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL 0 .50 $�•� JOB ADDRESS (O() ( V ��L�(�.l �/e(U� NE The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and cofrect. V ( � � 4�88G- Owner (D . �j/-� � M,� 1� Building Used As ��(i%�/LiC� Estimated Cost f��__ PERMIT NO. �� PLUMBING COMPANY 1`,1�� J�L(,Y�( /l%, i-. . / �l / � �/ O O PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 S� INCHES. � CITY OF FRIDLEY PERMIT NO.: 2004-02283 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 12/15/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6810 BROOKVIEW DR NE PIN : 133024220023 LEGAL DESC : BROOKVIEW TERRACE 2ND ADD : LOT 11 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RESIDING VALUATION : $ 1,000.00 ' NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATHER RESISTIVE BARRIER BE PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN APPROVED WEATHER BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE COVERING OR TAKE PICTURES. APPLICANT BUILDING PERMIT FEE 38.75 SHIMMON BRYCE & MARCELLA FIRE SURCHARGE 1.00 6810 BROOKVIEW DR NE STATE SURCHARGE, VALUE 0.50 FRIDLEY, MN 55432 TOTAL 40.25 PAID WITH CHECK # VISA OWNER SHIMMON BRYCE & MARCELLA 6810 BROOKVIEW DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regul m nstruc ion or the performance of construction, � Applic nt Date Bldg Insp Dat F SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRI$ED ABOVE. NEW ADDN ALTER [ j CITY OF FRIDLEY Effective 4/1/2004 ( j 6431 University Ave NE, Fridiey, MN 55432 (763) 572-3604 Bidg Insp [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763j 571-1287 Fax BUILDING PERMIT APPLICATION � Construction Address: Legal Description: Owner Name & Address: � ' � e� '��,1� � � �' - Contractqr: MN LICENSE # Address: __ Tel. # LIVING AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width HgUGround Sq. Ft OTHER: _ -� �� I� � Construction Type: ��'�/�� Y- � J ' Estimated Cost: � _ ) C`1 � ?� % �'� Driveway Cur6 Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� APPLICANT: ��J '�5'c � � i � � �� ) � Tel. # 71�. � � �l — ?l � Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using c�edit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $< � �� $ ---------., __. __- $ i.<�� $ ;� �� $ .$ $ $ $ $ $ �C. � �--, " -. Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] � STIPULATIONS: NEW ADDN ALTER [ ] C(TY OF FRIDLEY [] 6431 University Ave NE, Fridley, MN 55432 [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICRTION �-1��-�c� s h immc� �� ►g(a� �f s cr�c� � Effective 1/1/2003 5�`�� (763) 572-3604 Bidg Insp (763) 571-1287 Fax __ .. . _ . ... .: Construction Address: +.�� 'C-nb�'1V 1�V � ��t iV� Legal Description: Owner Name & Address: F�r-c.i [�e Sh�,m►�,-,�,n �n61� 6rc�o� ��-�;�� Ya-ive Tel, # 7(o?- �-1 I--1 I 8(o Contractor: �,t1__C1t5501hf-Q � x}tytcrS MN LICENSE # Z42Z-QZ 'i j Address: �?�Sl K.tr�Cu.�i C.�U N s�i �-e i3G mgpl-P (� r�rP, l�-t �U Tel. # � c�3 -�al [n�—o sS-9 �3(� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVlNG AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Length D_��:(� Width Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type:�Y1S��11 �`�}1 t�1C�Q1)S Estimated Cost: $��q Z- G� Driveway Curb Cut Width Needed' Ft. + 6�t = Ft x$ _$ DATE: GL110 3 � 4(o APPLICANT: M t a f } Tel. # i b?�-�-! !0 3-GS�.�`�4 �'i �,�- Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ / t�7< • va�J $ �� $ �� $ $ �i �"Z� $ $ $ $ TOT/AL $ ��° C� I CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/'i0th%) $.501$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ J Not Necessary [] •► ��(� .r� _ L�,� �` ��7� `i ��:; � - � �. Jun. 12. 2006 1:46PM ��_.Q��rNo. 4732� P, 1�� (��S c� 'i�—� NEW° [] C1TY OF FRIDLEY �ffective 1/112D03 , AU�N I] 6431 L.'�►i��e��sity Ave NE, Fridley, MN 55432 (763j 5T2�604 BId sp AL7�R (� SINGLE If�ANAIILY AND DUPLEX�s R-1 AND R-2 (7S3) S7'l-1Z87 Fdx . 8l.'�I�DiIJG P�RMiT APf?LICATI�N � �$lb � .. .. : .. �.: ;.: - Constructian Address: iD � 'I�_i�.1�► �7t` t �j{' � , � . .._... Legal besc�iption:, . ----- � � - . - Owner Name & Address: �xur�; �1�i mrr;��, ��; i��_r�(.��,`c�? IOr i L� Tei. #'7 t� 3- s� f-�7 ! c�'J� C� Gontrac#or f�� P,1'YY911f5S0��'l(_� . iQ".5--- MN LICENS� #��0�� ___ Address: "73� t ICa r��C.t_�.�r� CaU �U ��_f� . I� a m a.p ti� � r� �(� ) Tel. # 7(ci�- �(0� �' �� . �� Attach to this apF:lic:�tior�, a Certificate af Survey of the lot, with the �ropc�se:�d construction drar�n on it to scaie, DE;S�;R'iPTION O�F iMPRUVEMENT LNiNC AREA: Leagth Ifl►idfh, Height Sq. F#. GARAGE AREA: D�CK AREIA: QTHER: Length V�rdth , Heigh# . Sq. Ft. Lengih --_---- . V'i�dth .� Hg#IGround Sq. Ft. Construction Type:lt�St4�t1 � t�t��nC�t�.J`;�._,1�'Estimated Cost: $� 0�� • C�(� (r'l�.x�� :+�ir"tRS . ... . ,. � .. , Driveway Curb �ut lAfidth NBeded: ,Ft: �• 6�t � Ft x$ =$ DATE; _0.�0' I Z'aV APPLICANT: �;Y.Gk��LLU�� ° __ Tel. # �-G� ,0 �— Call (763) 572-3604 for Permit Fees if mailing iin �p��lication. Fax to 7'63�71-1287 if using credit card and we wili cali you fo� card �umber. Perm�t Fee Fire Surcharg� State Surcharge SAC Ch�rge License Surcharge Curb Cut ESCrow �rasion Cantral Park Fee Sewer Main Charge � f to� , �S � '1 � �{=3 -` $ $—� b $ $ �- --- . _ $ C!' �'1� I.IS� ON�Y » f�'�e "3r,t�edule on f�euerse Side . Q01 of Permit Valuation (1/"i Oth°�6) , :7>:EiO�'$�,000 Valuatio� � "" :E'�1:�!7,5 per SAC Unit $�5..�x:i (State �,icensed Resider�tial Car�tractors} ��►�t. ��n Or I�t, �r�n /�]CIVB a��''�.00 Conservati4i� Plan Review ��e� i:)etermined by Engin�ering d��gre+::ment Necessary [ ] No# Necessary � ] TOTAL $ 1 0�.0�^�r �TIP 1 ATIONS- Jun. 1�. 2406 1:47PM . :.L .5�.° , r 8tate of Minnesota Departmenr af Labor and indus rry � . � 44� l:af�yett�.:Road.N_ �� . $t. Paut; MN 55155-4344 �...� A.i.,.4yyri�r• . . , 'r'iS �: No, 4732 P. 2 Cons#ruc�on Codas and Licensing Dlvislon Tel�apliane: (651) 284=5465. �-maii address: dG.contracka+�state.mn.us VY�bsita`address= www.d�li:stat�.mn:us � .. . ; . . . ' . -"�`_�- , . . r. - . R�s�d�r�►tial B�,Ilding.�ontiwc.tor 4icense �: L�gal.Name: RENAISSANCE EXT�pIOH3 lNC .`•, �usiness Struc�re= ; r, � .DBA: CORPORATI�N - �: °;,,-. A�dr�ss: i3�1 K�RKWOOD U�NE N I � . #i3.0. , '�.� _ i . `. MARL� GROV�, Mtd..a5369 License tdenfifibation Number: 2Q220185 4ualifying Pe�son. RC3NALD R SIMON L+`oensa �xplraban Dat�: �- 3137f20Q7 Continuing E'ducation: 7 hours due by 3/31/2Uo7 .�"�,.,�.?;•rd,�r�°� .�..u:e::,.. ::;:e,::�'_=:ri;�;,+�,'.'sxr�•�; ' &�E�E , , ._ _ . � .. . ,.�. ;, � . , ,. .. ;:} ;`` . . . _ • . . ` . �..- , , —`. � . � � .� . � -- Jun. 12. 2Q06 1:47PM . . � �� No.4732 P, 3 �10��. _ `��1J l� � � � �� \`� � C�C�� r C,r�� ,� � n�n��'a ��-��.� ��,-� � �� J f�1 �.�1n� �� Building PLUMBING Pezrnit No.:i � Inspections R�SI�]E1�7CIAL APPLICATION Received By: � 763-572-3604 CIT,Y OF FRIDLEX Date Rec'ct: �-'(� DATE Novemk�er 8; 2006 YpURE-MAILA.DARESS wnelson larsonplumbinq.com st�.aDDxESS 6810 Brookview Drive NE TIi1S APPLICAi�.'i' IS: O dWNER t�CONTRACTOR PROPERTY NpMg: Brvice Shimmon OWNER/ pnDRESS: �Hln BPOO�iVl@«' Dl'1V@ NFi CITY FT1CllPV STATEI:INZIPrJ`J��3`l. T�NAI�tT PHONE: i�j 3(;i (- r l�f� coNrltac�oR �„r,�E: Larson Plumbinq Inc. SUBMIT A COPY O� STATE LICENSE q 3341 PM EXP DATE 12/31 /20Q6 YOUR STATE .�Dx�ss: 3095 - 162nd Lane NW c�rv Andover sTaTEMN ziP 55304 LICENSE WITH p�orr� 763/427-7680 Fnx 763/427-9448 APPLICATION PERMIT TYPE � SINGLE FAMILY O TWO FAMTLY d TOVdNHOUSE TYPE OF WORK: � NEW �I REPLACEME�ii' DETAILBD DESCRIPT'TON OF WORK �Nater Heater Replacement PER MS 16B.665 the permit fee is a minEmum of $15.00 or 5% o£ the total cast up to $500.00, whichever is greater, for the iinprovement, installation or replacement of a residential fixture, excluding the fixtures. (This should r�flect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of tabor x.OS = FOR PROJECTS RRiEitE LABOR EXCEEDS $500, FEES ARL BASED ON $16.00 PEIt F[XTURE, EXCEPT WHERE NOTED. FIXTURES: ([T1DiCATE TOTAL NUMBER OF EACH SELOW) BATH SINK/LAV ,_FLAOR DRAII�IS SHOWER WATER PJPING BATHTUB GAS PIPING �NF,�o aTYtJCExs� SWIMNIING POOL � WASER SOF►NER ($35) CIATHES Vl'ASHER � KITCHEN SItJT: VIATER CLOSET BACKFIAW PREV. (S15) DtSHWASHER � LAUNDRY TRAY WATER HEATER ($35) ` FOR IRRIGAT'ION • _ WATER METBR � OTHER ' PE12N��;FEEi��OJ�CT�;;�OR,U�DEiZ;�SflO s,;;;` ,,. :. .. . ..:: ..... .: , '..,;: "`,;.,;PERIy1iT`�EB;EOiZP�07E�'`f�:O�ER;;$�00';: Permii Fee $�„_.�Q Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.OQ =$ '�OTAL DUE $ _�_.�Q Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Totai = $ THTS IS AN APPLICATION FOR A PERMIT-T}OT VAL1D UNTIL PROCESSED I hereby apply for a building permit and I ac}caowleclge that the 4nformation above is co�aaplete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Miru�esota Consixuction Codes; that I understand this is not a permit but only an applicatian for a permit and work is not to start with:out a permit; that the work will be in accordance with the approved plan in tbe c all work �Ih` r uires r iew and approval of pians. SIGNATURE OF APPLICA ' PRINP NAME Michael Malonski DAr� 11/8/46 .;;:;, �P��4�E i�'O.�'E.. `S�pAT�.�T. E.3?E. ,; � TS �"s R�QU�RED �O�i Bi:)�LDIi�G, ��E�1`R��}�.i:,:A�D h?lECHA`I�XC,AZ;:WOitiC� . . , ; City of Fridley Bnilding Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3G04 PAX: 763-502-4977