AF - 43309sue�ecr M O.
City of Fridley � 0 18 4 7 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
' ' R
� �
� • COMMUNITY DEVELOPMENT DIV. �D ���
� �y---___
r � � PROTECTIVE INSPECTION SEC.
� ' /"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPqOVED BV
�""'��� ,�� 612-571-3450 910-F15 6/6/86 � �
10B ADDRESS 1424 Creek Park Lane N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 �j Creekridge SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Clem/Eva Coverston
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Brickner Builders Inc. 6199 Heather Place N.E., Fridley 55432 574-9871
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Res iden ti al
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a, 56' x 25' Dwelling a,nd a 22� x 24" Garage (P,pproximately) _
S�PA��T� ���� ` � �FO
- i !' 1 � '
9 CHANGE QF USE FROM if �
STIPULATIONS provide a a�[x� hard surface drivews�y. Provide sod in the front and
side yards. Provide City with copy of verifying survey. Paxk Fee of $1500.00
paid.
SE�)ER LOCATION: (Approx. 13� Deep in Stseet) 150' SW of M.H.; 18' N.E. of M.H.
(Inv. 880.09) WYE ELEV: 880.02 TOP OF FOOTING: 883.02 Minimum
WATER LOCATION; In same trench. and west of sewer service.
DRIVEWAY DEPRESSION: N/A
� 5 �
. ^� ������ � .
'�W� CIfiY �� �'�ibLEY DU�� P10T GUA�2ANTEE TH�! ,...
��� ��
ACCUI�ACY OF W7lLItY LOCATIONS AND EI.EVAT10'a�. �,����y��t ,
�-{=;5 [?ATA 15 �OR IN�ORMATtON PURPOSES OiiLY. �' : ,
��� p�R50NS USIi�G THIS INFORMATION SH�U1.Q ���,�'�� �'�' ��
ERIFY 17 ON THE SIT��
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, F#�AT�►JG, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD
VENTILATING OR AIR CONOITIONING.
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 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION STALLS GAqAGES
AND KNOW THE SAME TO BE TRU,E AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES CeOV�RNING.T^HIS SYPE OF WORK WILL BE COMPUED g1,950 $�iO.98
WITH WHETHER SPEGIFIED HERfINPOR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUM GIVE AUTHq TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE
PROVISIONS OF THER STATE R OCA LAW REGULATING CON-
STR TION ERFORMANC AF CiN RUfy�jpN. $379. �� Credit fraan �aC�1001
/�� ��� PLAN CHECKFEE TOTALFEE
�'/�i�-' � ' // .�j $ 94. 75 $514. 73 + PF
si uaEOFCON�RACTO RIZED/GENT IDATE� WHEN PR ER AUDAT THIS IS YO �PE IT�
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SiGNATUREOFOWNEA�IFOWNEFlBUIIDER� �DATEi BLDG WSP qa7E
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NEW /�ADDti .
pLTER. [ ]
Construction Address:
Legal Description:_,
Owner Name & Address:
Contractor:�
Address:_ �� %�
LIVING AREA:
GARAGE AREA:
DECR AREA:
OTHER:
City of Fridley Effective u/1/SG
1^ R-1 AIiD R-2 j
Building Permit Application
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
Length Width Height
Length Width Hgt/Ground
Tel. #
Tel. � `�7 � /�?�
Sq. Ft. ��
Sq. Ft. ��
Sq. Ft.
Corner Lot (] Inside Lot,pC] Ft. Yd. Setback �� Side Yard Setback �U ��
Type of Construction: �i'e�.�i1M� Estimated Cost: $_�����
Approx. Completion Date: � � � _�� gl���
Alt. A Alt P
Proposed Driveuay k'idth Zf Neu Opening Is Desired: $ $ �
See Back Page for Explanaticn
��' f,,,
DATE: (' V �� � � APPLICAhT: `� � ���� Tel . � r ' �'%
�
CITY DSE ONLY
Permit Fee � �` /7 (�1
Plan Check L .� S
State Surcharge '�v �
SAC Charge $
Park Fee � �5�
Sewer Main Charge �
TOTAL
STIPULATI02dS :
� � �t
Fee Schedule on Reverse Side
25p of Building Permit Fee
'3�•50/�1,000 Valuation
���75 per SAC Unit
Fee Determined by Engineering
Agreea,ent Necessary [ � Not Necessary [ ]
O �� �i S�
�, Oe i-- o`��, OcJ
3ax � q � � 06
3��.CY?
BUILDING PERMIT FEE SCHEDOLE
The Chief Building Official shall, before issuing permits for the erection of any
building or structure� or for 2ny addition to any existing building or strueture, or
for any alteration or repair to any existing building or structure, upon applicatio n
therefore� require the pay►ment by the applicant for such permit of fees to the amount
herein beloW set forth and in the manner herein provided to-Kitt
Total Valuation
51.00 to �500.00
�501.00 to �2,000.00
�2,001.00 to $25,000.00
$25,001.00 to 350,000.00
�50,001.00 to 5100,000.00
�100�001.00 and up
Fees
�10.00 (Minimum Fee is �15.00)
$10.00 for the first a500 plus �1.50 for each
additional �100 or fraction thereof, to and including
�2,000.
�v32•50 for the first �2,000 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 �5'0,000.
3283.00 for the first �50,000 plus $3.00 for each
additional �1,000 or fraction thereof, to and
including �100,000.
��33.00 for the first �100,000 plus $2.50 for each
additional �1,000 or fraction thereof.
DRIVEHAY DEPRESSION ESCRON
(Concrete Curb Streets Only)
Alternate "A": Removal 2nd replacement of curb and gutter only - Driveway width plus
6 feet times $13.50
Alternate "E": Removal and replacement of curb and gutter 2nd install a 3 foot wide
approacr. tiith 6 inch depth - DriveWay Width plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Per�its for construction r:ill be issued a minimu� 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 c�f tY:e foundation once it
has been constructed will be required before proceeding with the framing.
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; i.�,ND SI7RVEYOR �
�� LAND SURYHYIN6 SUBDIVIS�ON 17EE16N �
�' �TEL6PMONE 7�1'i-4S86
4
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i. 985 JfiS31E 5T. 5T. PAUL. .MINN. S�S701 . �
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�, I hereby certify thQt this survey was prepared by me and ?� ot I cm a du:r ,
� Registered Land Surveyo� under fihe laws of th� Siate of Minnesota. '
;: �,/
„ Reg. No. 9051 Date: /�O� .3 /i': ;~
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�� • EXTERIOR ENVEIAPE AVERAGE "U" COMPUTATION
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; OWNER C C. E h/�� � I/f{ G O✓E�ZS T O�J ---
SITE ADDRESS ��Z 7 G%�EEk'/dj,Rk' G�j �E -
CONTRACTOR K���G/�CNE/t /3v��0 EiPS r��E G� 3^�b PHONE �%7 "�'! �7�
- • Determine working square footage of each.
1. Total exposed wall� area . . . . '� �g0 sq. ft. x '� = �y ��O
, , D
2. � otal roof/ceiling area ....�! � sq. ft. x"�� - 7
- • Total exposed wall area above floor =
a. Total wa 11 window area . . � 3� 6- k�.
. ....... .................
b. Tctal. aoor area .............................-.., S,y/ �.
c. Total sliding glass door area ................... � 3�1►� •
_ • d. Tota1 fireplace wall area .......... ............ //%
, e. Total �wall framing area (average 10/) . . . . . . . . .. . !'? `�• g.�._
, f. Total net wall area above f loor ................. 5�
•g. Total rim joist�area ............................ g
� • Total exposed foundation area = l�7•'�
,
� h. Total foundation window area ....................
i. Total net foundation area above grade. . . . . . . . . . . / d % -�3 �—
. •
Determine "U�" value of each wall segment.
a. 3/G • �g X ��U �� , ?j'V = ��%/• 7 �
,
� b. .�5.�f X .,U„ ..s-g _ 3 ti .13
�. ?3.�,� x „u„ , 3ti = �3.f� . �
� d. �/ 7 X„U„ . titi =���
e. %% 7• b T X��U �� ,d., , d g _. 1 S• � 3
f. �s"�3- �� X .,U„ , oy = �ti.9
z
g ��1 X„U„ _ o = �. y�
.
e
. , h- X ��U �� _
.
i �d %. � X ��U�� � . %� � _ . ��, �v
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If item #3 on previous page is the same as, or less than item #I, . �
you have met the intent of SBC 6006(c)2. !
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Total exposed roof/ceiling area = /�
� , �
j. Total skylight area .......................... �
k. Total roof/ceiling framing area (average 1C�96) I
1. Total net insulated rqof/ceiling area........� _ �
1 � . I
_-.. Determine "U" value for each roof/ceiling segment� �
�x ��U �� _ , , I
.
. � �
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k X ��U �� -
. .
1� � �(} X •nUn � V 7/ _ i� � •
4 .............. ...:....... ......Total = I
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If total of #4 above is the same as, or less than #2, you have rrey:. ;
the intent of SBC 6�006 (c) 1. • �
A lternate Buildinq Envelope Desiqn_
To utilize the tota 1 envelope system method, the values establis<:�:c:,
by the sum of items #3 and #4 shall not be greater than the sum �
of items #1 and ##2. �
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C11YOF
FRIDLEY
CIVIC CENTER •(r331 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 5543? • PHONE (612) 571-3450
August 26, 1986
Mr. Tc� Brickner
Brickner Builders, Inc.
6199 Heather Place rr. E.
Fridley, NIDI 55432
Re: Final Inspection at 1424 Creek Park Lane N.E., Fridley
Dear Mr. Briclazer:
A final inspection was conducted on August 22, 1986 of the above address
and the following itans were noted which must be completed before the
structure can be finaled;
1. Provide the City with a copy of the veriying survey. C'�Z
2. Provide a handrail on the garage stair that has four risers.
We will expect the above items to be completed by September 12, 1986 and
a reinspec tion called for. If you have any questions on.these items,
please feel free to contact me at 571-3450.
Si ncerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
�� _
�� �F
FRtDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 57t-3450
September 15, 1986
Mr. Tom Brickner
Brickner Builders, Inc.
6199 Heather Place N.E.
Fridley, NIDI 55432
Re: Final Inspection at 1424 Creek Park Lane N.E., Fridley (SECOND NOTICE)
Dear Mr. Brickner:
A reinspection was conducted on September 12, 1986 to note compliance with
our letter dated August 26, 1986. The inspection found the following item
still needs to be corrected before the structure can be finaled:
Provide a handrail on the garage stair that has four risers.
We will expect the above item to be completed by September 29, 1986 when a
reinspection will again be conducted tA determine compliance. Please contact
me if you have any questions abou t this item,
Sincerely,
DARREL G. CLAFtiC
Chief Building Official
DGC/mh
sue.recr P NO.
City of Fridley 2 6 010 ,
' , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T, o
r
� �` COMMUNITY DEVELOPMENT DIV. �
r � v � PROTECTIVE INSPECTION SEC. /� �
� �
� i
� � �"'1 � CITY HALL FNIDLE� SS432 NUMBER REV OATE PAGE OF APVROVEO BV
�""��� ,�� 612-571-3450 910-F15 4/30/98 � �
JOB ADDRESS 1424 Creek Park Lane NE
t LEGAL �OT NO. BLOCK TRACT OF ADDITION SEE ATTACHED
oesca. 3 3 Creekridge SHEET
2 PFOPERTY OWNER MAIL ADDRESS ZIP PHONE
Clem Coverston 1424 Creek Park Lane NE 571-1396
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO
Same
s ARCHITECT OR OESIGNER MAII ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRBE WORK
Construct a 12' x 5' & 6'4" Deck Addition
9 CHANGEOPUSEfROM TO
STIPULATIONS
See notations on plan.
W�ARNtHC
Before digging call for
ali utility (ocat+ons
4540002
SEPARATE PEf�NlITg REQUIaED FQR REQUlRED 8Y LAyy
#NIRII�G� NEATING, PLUMBING APlD StG1VS.
TYPE Of CONST. OCCUPANCY GROtJP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRiCAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 OAYS AT
ANV TIME AFTEfi WORK IS COMMENCEO. NO. DWLG. UNITS OfFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WOFK WI�L BE COMPLIED @
WITH WHETHER SPECIfIED HEREIN OR NOT. THE GFiANTING OF A PERMIT �789 y�.SO
DOES NOT PRESUME TO GIVE AUTHOAITY TO VIOLATE OF CANCEL TNE pEqM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �29. ZS Fire SC �. %9
PLAN CNECK FEE TOTAL FEE
���� � Y � � $30.54
S�GNATUFIEOFCON AC?OAOAAUTHOA�ZEDAGENT IDATEi HEN PROPERLY V I ATED THIS IS YOUR PERMIT
�� � �� /
SiGNATUREOFOWNEA�iFOWNERBUI�DEAI iD�TE� B�DG � P f�qTE
. � �
NEW
ADDN
ALTER
� � �� Eff i e�l 98
[ ] CITY OF FRIDLEY � � �
[] SINGLE FAMILY AND DUPLEXES R-1 AND -2 � b
�� � �
BUILDING PERMIT APPLICATION C �� � $
�
r � � a
ConstructionAddress:
G. �v , l'� �
Legal Description:
Owner Name & Address: ��. G�tit. G�� !/ �l�• S �'�'�' AJ Tel. #��zf—1 .3 ��
Contractor: s�`,�= r.�, , �-!,�(�. ,� /,� �vf /� �� � k'{� tc.. MN LICENSE #
Address: �° �0� Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: ��f �, t: �Cength � /'a � Width ��.. �C,��Igt/Ground � Sq. Ft
OTHER:
��
�us%
Construction Type: Estimated Cost: $ �� // ��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: ��� APPLICANT: Tel. #� —/ �,'��;
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� �� 2S
$ .
$ � ,�,%
$
$
$
$
$
$
$ Or � �
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
$.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 [ ]
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sue�ECT P '
c�cy of Fridley 29041
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
r
� .
� �
� ` _��� COMMUNITY OEVEIOPMENT DIV.
r � v � PR07ECTIVE INSPECTION SEC. /�`
� �
1 � �
( � ��"1 � CITY HALI f RIOLE� SS�JZ NUMBEN pEV DATE PAGE OF AViROVEO BY
�'""�'� �'' 612-571-3450 910-F15 3/22/99 / /
10B AOORESS ���� Creek Park Lane NE
1 LEGAL �OT NO. BLOCK TRACT OR AODITION
oescp. }4- 3 �- 3 Creekridge Addition
2 PHOPERTY OWNER MAII AODRESS
Clem Coverston 1424�4�� Creek Park Lane NE
3 CON7RACTOR MAIL ADORESS
PTL Contracting 2526 N Ferry St, Anoka, MN 55303
a AFCHITECT OR DESIGNER MAII ADORESS
5 ENGINEER MAII ADDFiESS
6 USE OF BUILDING
Residential
7 CIASS OF WOFiK
ZIP
ZIP
IIP
SEE ATTACHEO
SHEET
PMONE
571-1396
PHONE LICENSE NO
323-7400 5294
PMONE LICENSE NO.
PHONE LICENSE NO
❑ NEW O AODITION O ALTERATION C� REPAIR p MOVE � REMOVE
8 DESCRIBE WORK
Reroof House & Garage (41 Sq} Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
ADDRESS CHANGE PER CONTRACTOR 3/25/99
TYPE Of CONS
SEPARATE PERMITS ARE RE�UIRED FOR ELECTi;ICAL, PLUM8ING, NEATING.
VENTILATING OR AIR CONDITIONING.
1HIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONS7RUCTION 20NING
AUTHORI2ED IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONEO FOR A PERIOD Of /20 OAYS A7
ANY TIME AFTER WORK IS COMMENCED. NO DWIG. U
I MEREBY CERTIFV THAT I MAVE fiEAO AND EXAMINED TMIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE ANO CORRECi. A�L PROVISIONS Of LAWS VALUATION
AND ORDINANCES GOVERNING THIS TVPE Of WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT �3�513
OOES NOT P SUME TO GIVE A HORITY TO VIOLATE OA CANCEL TNE PERMIT fEE
PROVISION OF ANY OTHER S A E OR LOCAI lAW REGUTATING CON•
STR CTIQ O TH PE fORM E OF CONSTiiUCTION �$].2,rj
'R PI.AN CNECK f
�,
Licens�
' S�GN4fUpE�,6FCON'QSCTQAOpA�i1�MOQ�ZEDAGENT
r �i
$�GNaTUQE O� OWNEQ��� OWNEABU�LDEpi
iDATE� MEN
iD�iE� 8� u
OCCUPANCY GiiOUP I OCCUPANCV LOAO
SO. fT CU FT
STA�LS
�5.0
r nu0n
�GARnGES
URTAX
$1.76
AC CHARGE
Fir SC $3.51
OTa E
$97.52
HIS IS�+R��ITi
1
r� a
rrEw [ ]
ADDN [ ]
ALTER [ ]
�%`��/
ConstructionAddress:
Legal Description:
Effective 1 / 1198
CTTY OF FRIDLEY �
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PE IT A LICA�'ION �Q y�
���/-�;V���. /'Z"%L� �,b'1,�.7�.�`��'/Zjy�'_ �j�S/�� '] �-
o- ��j
...�� � _ - - ----- i
Owner Name & ddress: Tel. #.��— / 3�,�
Contractor: G., MN LICENSE # .��--��
Address: ,�-,5'-�-� %l c � G��z•��� Tel. # j�� —2 ��
o ,
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length� Wid Hgt/Ground
, 1
OTHER: "� �./�t''�`�� Y ���/ �� l `i �
Sq. Ft.
Sq. Ft.
Sq. Ft.
0
v ' 1
v /�
Construction Type: — �` _ Estimated Cost: $� �' ���J
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: ,3 —�� �� APPLICANI': Tel. # � �3 ?��
�
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 7 �2s.—
$ -� /
$ <%
$
� S�D�
$
$
$
$
� � . ��Z
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
$.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 [ ]
CITY OF FRIDLEY INSPECTION DIV.
6431 �Jniversity Ave NE , � I "� �
F��ley, MN 55432 �
572-3604
APPLICATION FOR PLUMBING AND GAS FITT�NG PERMIT
MARK�NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On May 10, 1999
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fi�cture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heate� - Gas"
Gas Range"
_�
Gas Dryer*' _
Back Flow Preventer Required ()Yes () No
Type
$ 7.00
$ 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 $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
0
g;20. 50
JOB RDDRESS
The undersigned hereby makes applica6on for a permit for the work herein
specified agreeing to do all work in strict accordance with the ciiy codes
and rulings of the Building Division, and hereby declares that all the facts
and rearesentations stated in this aoolication are true and correct.
COVERSTON,EVA
1424 CREEK PlkRK LANE
FRIDLEY; Mf� 55432
(763) 5'11-1396 � ' ^
Building Used
,��2/ 1-�
Estimated Cost � �QQ � PERMIT NO. � % ��
PLUMBING COMPANY I �O ����� l �L-(i�IJ��C�
SIGNED BY ' ';� :�� TEl N0. '��2 " �OJ�
Approved By Rough-In Date Final Date �'���/
'"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES.
.`
-
_
C� � I �F
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 23, 2001
Eva Coverston
1424 Creek Park Lane NE
Fridley, MN 55432
Re: Final Inspection at 1424 Creek Park Lane NE
Contractor: Norblom Plumbing
Dear Ms. Coverston:
A mechanical permit was issued on July 31, 2000 for the installation of a gas water
heater at your property. According to Section 305(a) of the 1991 Uniform Mechanical
Code a final inspection shall be perFormed on the mechanical permit. As of this date no
inspection has been called for.
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.
�Y,
DAV�/J,�NSEN
BuilRfipfj Inspector
DJ/mh
04/02/2004 FRI 13:21 FAX ��� ELDER JONES n a� s �D� � C�OOI/001
. . .. , QC . , •�•. . ..
N� [] CITY OF FRIDLEY Effective 4/1/2004
ADDN [] �6431 University Ave NE, Fridley, MN 55432� (763) 572-36Q4 Bldg Insp
ALTER I a S1NGI�E FAMILYAND DUPLaES R-1 AND R-2 (763) 571-1287 Eax
BUtLDWG PERMITAPPLICATION
Construction Address: __�?��_4 P �'.�e_t.:lc "''�n�Y �c� r+� �
� I
legal Description: .
Owner Name � Address: ���-e �rn Cp � S�-pr� Ji Te1. #`�-to3 - 5�- l• � 39 (v
Contractor. � PELLA WINDOWS & DOORS MN LICENSE #
Addr�ss: 15300 - 25TH AVE. N. STE. #100
PLYMOUTH, MN 55447 Tel. #
763-745-1400 a Certificate of Survey of the
LICENSE # 24165884 ;truction drawn on it to scale.
LMNG AREA:
GARAGE AREA:
DECK AREA:
o-rHER:
DESCRIPTION OF IMPROVEMEN7
Length Width � Height Sq. Ft.
Lengih Width _ Height Sq. Ft
Length � �dth HgUGround Sq. Ft.
Construction Type: Esfimated Cost: $ a7 ,�D� ?J �
ptiveway Curb Cut Width Needad; Ft, + 6 Ft = Fi x$ =$
DATE:1] -rnQ�l�1- Q S ppPLICANT: k� o �,r�n r�7 Tel. � a 5 a-3�! � l�aK �
Call (763� 572-3604 for Permit Fees if mailing in applir.aiion. F�x to 763-571-1287 if using credit ca�d and we witl call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CtTY USE ONLY -
$�3. o?S Fee Schedufe on R�verse Side
� 65% of Permit Fee
$ a. �o lc .00'1 of Permit Valuation (1/9 Oth%)
� 1.33 $.50/$1,000 Valuation �
$ $1350 per SAC Unit
S 5�0� $5.00 (State Licensed Residenfial Contractors)
$ AI�. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
� Agreement Necessary [ ] Not Necessary [ ]
$ a • � STIPULATIpNS:
Building MECHANICAL Permit No.:
Inspections RESIDENTIAL APPLICATION Rece ,�,a sy: O
763-572-3604 Da���e 'd "
CITY �F FRIDLEY
DATE 12 � � D� Z�01 YOUR E-MAIL ADDRESS kt154� r� � S(�-�wr(�o�v�.tM - ohf I�'►e. �• +�+
SITE ADDRESS I 424 Creek �ark t..�r
THIS APPLICANT IS: � OWNER �.CONTRACTOR
PROPERTY NAME: ( "IPW1 VerS{ur1
OWNER/ ADD�ss: lq24 GrtGiLl7arjC, (./1• CITY �t� STATE MN ZIP S S�I3Z
TENANT
PHONE:�G3-�E 5'lJ-I3°I(o
CONTRACTOR COMPANY NAME: �SIA�LuI.L�Gt.r1 �i�•r �'trtd+��7�►3�e
SUBMIT A COPY OF CONTACT PERSON: 1��'ISGi.rl� ►'� tr'1'�-YY�
YOUR STATE STATE LICENSE #! EXP DATE
LICENSE WITH ADDRESS: IZ�O �B �V1u-Q CL-1�+� CITY �f'�'�1. / STATE�ZIP SS 43Z
APPLICATION pHONE�i3-�-(0/00 FAX -7(03 --184 -4�9q
PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW �REPLACEMENT � ALTERATIONlREMODEL
DETAILED DESCRIPTION OF WORK �r,�er�.l n�' a(d e�tc�,�.r,ww••� Q.�d �.v�.s-{a-U l�►� �I�c-rr�u��
a�� .
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW )
EquipmentInstalled MFG: � MODEL:315i1,Ad�i090 SIZg/g'I'[1 L%D�OoO
MFG: � MODEL: Z,S(o�LNAD�A SIZEBTU 24,000
MFG: MODEL: SIZEBTU
X A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
�AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
BOILER $35.00 7C FURNACE $35.00 _GAS UNtT HTR $10.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Permit Fee $ l, 0. Oo Number of fixtures @$10.00 x$I0.00 =$
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $�t 0_. � O Number of fixtures @$25.00 x$25.00 =$
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
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 apptication for a permit 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 work which requires review and approval of plans.
SIGNATURE OF APPLICAN U�YIL� PRINT NAME Ki'��'�'QI'� �l ��rIC.(1 DATE I2 / O 0
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
a ^ - l
s
burban
ir���
EQUI PM ENT SI ZI NG CALCULATI ONS FOR:
1424 Crcek Park Lane, Fridley
Zone Description Sq Foo� Heekin� Requirements Cooling Requirements Ventilation Requirement:
main 1,400 35,000 BTUH 1.75 Tons CFM per Sq Ft
lower 1,400 21,000 BTUH 0.35 Tons Bedrooms
BTUH Tons
BTU H Tons
0 BTU H Tons
Totais 2,800 56,000 BTUH 2.10 Tons 15
Prepared by Suburban Air- 12/4/07
�uilding
-nspections
,�b3-572-3604
�TE 5 a �
i E ADDRBSS
=?IS �PPLICANT IS
'Rt7t ERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
.'pTJR STATE LICENSE
WITH A.PPLICATION
PROPERTY TYP�;
PERMIT TYPE
TYPE OF WORK:
BUILDING Pe�it No.: �t
RESIDENTIAL APPLICATION Received By:
CITY OF FRIDLEY Dat�:���
�nrTUF_Nrart.annRF�.� �o�I�S�D.�1t���*�.bn,t.s �of"�
Crc�. K I�Q f/C L a
O OWNER �CONTRACTOR
N.�: � � t r�� C 0 Y�- {STO �7
.�D�SS: !�1 ��l C rc�, k Aa r� � n
PHONE:_Z � 3 � S�1 I' �_3 a C. _
Pella Windows & Doors
N��— 15300- 25th Avenue N.- Suite 100
STATE LIC P1�ITlOUth, MN 55447
a�Dx�ss: 763/ 745-1400
PxorrE _ License# 20165884
'8� S1TtGLE
❑TWOFA�
QADDITION ❑ GARAGE/SHED
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
❑ SWIMMING POOL
❑ NEW ❑ ADDITION
'H,MAINTEI�ANCE/REPAIl2 ❑ REMODELING
ESCRIBE WORK BEING DONE: � S t��� �'1 ,
ciTY �l�► d �I.V STATE_ZIP 5'SV3�
Od� m �ld,��' on�tS
P5��3w5- LnY?
CITY STATE_ZIP
'E
. ORIES
`9 WINDOWS
❑ DRAiN TILE
❑ OTHER
iZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft.
70FING ❑ HOUSE ONLY
u`MBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
:�RAGES � ATTACHED GARAGE 1. Existing Floor Plan
:OPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan
:OP03ED HEIGHT: 3. List of structural members to be used
DING FOR NEW CONSTRUCTTON INCLUDING DECKS,
Vinyf ❑Soffit ADDITIONS & PORCHES SUBMIT:
Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures
Other O Fascia and proposed project
INDOWS ���� 2. Two sets of construction plans
EXISTING OPENINGS T9Yes ONo LOCATION OF �i�FPiB9WS 3. Energy Calculations
Z FOR NEW OP£I�INGS-DESCRIBE SiZE OF /( V► A e� /`no r�
'�NING CHANGES & 0�ovr
�PE OF WiNDOW TO BE INSTALLED NUMBER OF W�FDOWS �
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
: TOTAL JOS VALUATION S 3 3 �� OCCUPANCY TYPE
nnit Fee
�n Review
rcharge
•e Surcharge
�ense Surcharge
:C Charge
�rb Cut Escrow
�sion Control
rk Fee
wer Main Charge
tai Due
$ �j 1� S See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ 1, G S (.0005) times the total job valuation — Minimum $.50
$ 3. 3 � .001 x Permit Valuation (1l10°/a)
$ 5.� u $5.00 (State Licensed Residential Contractors)
$ $1450 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$20=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ / �"j _� l� Make checks payable to: City of Fridley Attach Sti
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
�°reby apply for a buiIding permit and I aclrnowledge that tl�e information above is complete and accurate; that the work will be in
iformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
-mit but only an application for a permit and wo i not to start without a permit; that the work will be in accordance with the approved
n in the case of all work which requires review a proval of plans.
NATURE OF APPLICANT PRINT NAME / 1!" 1 �L /��� lC DATE J /� b 7