AF - 46165SoBJEQ
City of Fridley
�TTMETOPOFTMETWIN$ gUILDING PERMIT
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� ' COMMUNITY DEVELOPMENT DIV.
i ; V���.���'
r � PFOTEGTIVE INSPECTION SEC.
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i--_.�, �'°1�.� CITV HALL FRIDLE� 55d32 NuMBEA a!
i � 612-571-3450 9t0-Ft5
JOB ADDRESS 5778 Hackmann Avenue NE
1 LEGAL LOT NO. BLOCK TRpCT OR RDDITION �
DESCR. 22 4 Parkview �
2 PROPERTYOWNER MAILADDRES$ �
Carl Brudwick 5778 Hacl�ann Avenue NE
3 CONTRACTOR MAILADORESS
Same
d ARCHITECT OR DESIGNER MAIL ADORESS
5 ENGINEER AAAIIADDRE55
8j22i94
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L. L :1 1 O
REC I NO
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pi ♦PVPOVEO BY
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SEEATTACNED
SHEET
571-5446
PMONE LICENSE NO
PHONE UCENSENO.
LICENSE NO.
6 USE OF BVILDING
Residential
7 CLASSOFWORK �
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIH O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House 6 Garage (21 Squares) 2nd Layer; soffit & fascia
9 CNANGEOFUSEFFOM
STIPULATIONS
Roofing can be Che 2nd layer but not the 3rd. Install ventilation to meet
the State Building Code.
TYPE OF CO
SEPARATE PERMITS ARE REQUIRE� FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PEflIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG,
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED 7MIS A7PlICATION 1
AND NNOW THE SAME TO BE TRUE AND CORRECT. ALL PPOVISIONS OF LAWS VALUATION
AND ORDINANCES C�OVERNING THIS TYPE OF WOHK WILL BE COMPLIEO
WITH WHETHER SPEGFIE� HEREIN OR NOT. THE GRANTING OF.A 7ERMIT �I �SO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE
GROVISIONS OF ANV OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �3S.00
Of
STALLS
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ConshuctionAddress:
Legal Description:
Effective t/i/94
CITY OF FRIDLEY
SII3GLE FAMILY AND DUPLEXES R-1 AND R-2 � 3a 3 z-
Building Permit Applira6on
Owner Name & Address: �� �.� i. � u� � c i Tel. �1 .� % 1—�"�I �l 6
Contractor: J e I T MN LICENSE !/
Addtess
Attach to Nsis application, a CertiScate of Survey of the
lot, with thc proposed const�uc�tion drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA:
OTIiL�ik: L�,�
So -�� � � �- -�
Corner Lot (] Inside Lot [] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
w�arn
wiarn
Width
AC � A
Tel. q
xe;gnc sc�. Fc.
Heigt►c sq. Fc.
Hgt/Crround , Sq. Ft.
Side Yatd Sdbacks
Eshni3tsd Cost: S�� o� U�
`�VP2
(Cost on Baak)
Driveway Curh Cbt Width 13ceded: _Ft. + 6 Ft = Ft xj S = S
DATE: �' q APPLICAN'T: A.,� ��� � v c� w ��,� Tel. �` � S" 7— o� 3�
Permit Fee
Fire Surcharge
star� s��t�ge
SAC Charge
License Surcharge
TJriveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
�lYll 1 . _
$ 2S - UU Fee Schectule on Reverse Side
$ /� S�' _001 of Permit Valuation (I/1(kb96)
s • '7s a.soiai,000 va��aop
$ ssoo � sAC u�ic
$ $5.00 (State Liceased Residentiai Conlractors)
$ A1t. "A' or Alt. "8" Above
$ 5450.00 Conservation Pian Review
$ Fee Determined bY EnS�n��B
$ Ageement Necessary [ ] Not Necessary [ ]
$ � � �s
STIPULATIOAiS:
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ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
VALUATION
CITY OF F`RIDLEY
6431 U1vIVERSITY AVENUE NE
FRIDLEY, MN 55432
,/L-SOV4 rna:
: 5778 HACKMANN AVE NE
: 243024230018
: PARKVIEW MANOR
: LOT 22 BLOCK 4
: PLUMBING
: RESIDENTIAL
: ADDITION/ALTERATION
: $ o.00
J 11-1Lb /
PERMTT N .: 200401074
.
DATE ISSUED: 07/12/2004
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL A GAS WATER
HEATER.
# ELEC WATER HEATERS 0 VALUE OF FIXTURF,/APPLIANCE 0
# NEW FIXNRES (EXIST OPENINGS) 0 ik GAS WATER HEATERS 1
# GAS DRYERS
# OF NEW FIXTURES
# WATER TRMT APPLIANCES
APPLICANT
OVERACKER TERRY PLUMBING
1630 CO RD 10
SPRING LAKE PARK, MN SSA32-
(763)572-8880
OWNER
BRUDWICK CARL M& ELLA J
5778 HACKMANN AVE NE
FRIDLEY, MN 55432
0 #GASRANGES
0 VALUE (FOR MINIMUM CALC)
0
AGREEMENT AND SWORN STATEMENT
This permit becomes null a�d 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 goveming this type of wod
will be complied with whether specified herein or not. The
granting of a permit dces not presume to give authoriry to
violate or cancel the provisions of any other state or local ]aw
regul�con�ction or the performance of constructio�.
Bldg
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 7108
SEPARATE PERMITS REQUIIZED FOR WORK OTHER TFIAN DESCRIBED ABOVE.
,J
1000
0.00
0.00
0.00
O.QQ
D.00
35.00
0.00
0.00
0.00
0.50
35.50
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
VALUATION
CITY OF FRIDLEY
6431 UNIVERSII'Y AVENUE NE
FRIDLEY, MN 55432
s�i-3aua r�:
: 5778 HACKMANN AVE NE
: 243024230018
: PARKVIEW MANOR
: LOT 22 BLOCK 4
: ELECTRICAL
: RESIDENTIAL
: ADDITION/ALTERATION
d
s�i-iiai
PERMIT NO.: 2004-01908
DATE ISSUED: 10/18/2004
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. 100 AMP SERVICE
UPGRADE.
l;l
APPLICANT
SUPER ELECTRIC INC
333 COLBORNE ST
ST PAUL, MN 55102
[� ./P' 21 �1:7
BRUDWICK CARL M& ELLA J
5778 HACKMANN AVE 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 tune after work is commenced.
I hereby certify that I have read and examined this
application and lrnow the same to be true and correct. All
provisions of laws and ordinances goveming this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authoriry to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp
ELEC AMP SERVICE FEE
STATE SURCHARGE, ELEC FLAT
TOTAL
PAID WITH CHECK # 6142
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FILL IN COMPLETELY FOR REPLACEMEN7 FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTI�JN AIR VERIFICATION
When realacinsl an existinq furnace, the undersigned hereby ver�es that the
venting has been examined and is free from nast, deterioration, obstructions,
and is Securely supported and firestopped where required. Yes (� No ()
The venting system is plasticlPVC and meets all current codes and manufacturer
specifications induding sizing, length, number of efbows and termination. Yes (� No O
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This doe:s
include AGA-GAMA Category I Central Furnace Venfing Tabfes fior fan
assisted and natural draft appliances.
__ fih� exisHnq cortrbnstiarr air is-stzed atad insta{led.te meei theturrant-r.aleS—
and manufacturer's specifications.
When required to instalt a new com6ustion ai�it will be sized and installed
to meet the current codes and manufacturer's specffications.
Yes ( � No ( )
Yes ( �
Yes � )
When installin4 a new ventina svstem, the undersigned he2by verifi�:s that
it is a listed assembly and meets the current codes and manufacturer's
specificat�ons. This does include AGA-GAMA Category I Central Furnac;�
Venting Tables for fan assisted and natural draft appliancss. Yes (�
Is the common vent and vent connectors s¢ed and i�stalled correctly after
an appliance has been removed from the common vent and veMed
separately as per current codes.
No(� -__
No ( )
No ( )
Yes �) No { )
Appliance Tvae and SizelCommon Vent and Vent C��nnector Information
Appliance #1 Type �.�1��c ��--'� BTU Input y� Fan Assisted or Nat .tia �
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances __�_ Tdal Btu Input �Fe.�
_. — -- - _ _ _ _ ,.. __ _ _
Common Vent Type G'/- .G�' _ Vent Height /AT Diameter 5' inches
, . „
Appliance #1 Vent Connector Height �_ft Length � ft Diameter �_in Type nG G
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
CENTERPOINT ENERGY
HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 _
Signed By: ;i �, � �. - --- Date : _ I o � 7�`6S
�Gii�R' �I SA�,9J.SG Ol J,3'lQ 1 a� �0 l,l 1 � WO?1-i �� : T T b00Z-L2-add �