AF - 46296/�
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City of Fridley, Minn.
BUILDING PERMIT N° 3 4 6'�
nate: .,C. .�" . .` . . ./. ?. . . . .`- ��. . . . . . . . ��`
Owaer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bwtlder ���� ,`����� ,�jj�l.0� v�^'C�,
Addre�s ...................................... Adilress .............................................
LC3CATIQ�V OF BUILDING ,
No. ,.�/��.�.. Street ... .. . ... . �l���
. . . . ......... Part of Lot . .......... ............
.....
. �
Lot .�. � � . . . Biack . . . . . . . . . . . . . . . . . Addititon or Sub-Dfvlsion . . . . . . . . . ���".�..e�f
. �
Corner Lat . :!�. . . . . . . . Inside Lot . . . . . . . . . . . . Setback �.� : . � . . Sideyard . . � .��. •�:� : . �'. �* �. �
DESCRIPTION O� BUILD[NG
To be U :
v o' � �s � °�
7�� . . . . . . . . . . . : . �nt :�`�' : � � � � - v H�t .�'./. � � �. �. �9. �"� �. �. � .!.9�'�
.................... Piont ........ Depth ........ Height ........ Sq. Fk ........ G�. F't. ........
Type oP Construction .��...... 3�st. C.ost���.���. �.... To be Completed ...................
�°; = `' � `'" `�" 1 / �'� _/ Id'T -���%a�"'.�'
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� �-� � In consideration of 1�e is$uance to me oP a permit to construct the building desnbed above, I agree to do
�� � the proposed work in accc�rdanc� with the descrlption above set forth and in compliance witli a11 prov�tsions of
ff' s of the dty of Fridley.
� � �
-
� In consideration of the payment of a fee oP $..�� .. ..�., permit is hereby gran#ed to ... .. .. .. .. .. .... ..
� ........ ....... ....... to construct the building or addition as described skiove. This permit 9s granted upnn
the express condition that the person tn whom it fs granted and hia agents� employees and worl�ea, fn all work
done in, around and upon said building, or any part thereoP, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction� alteration, maintenance, repair and moviug of buildings with-
in the city limits and this pernait may be revoked at any time upon violation of any of the provisfona of said
ordinances.
�S/�" "� � � � • � ; . ..
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NOTICE:
Thla pa�mit does not cover the conatruotion, Installatlon o� al4eratlon fo� wlring, plumbing, gae heatln8r
sewer o� water. Be su�e to sea the Bulldine Inspemkor f�►r separate parmlts for theae itema
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SUi►�.�1� .���.��.� ,,�'��r� Aoar �'�o.� � ,I
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INDUSTRIAL � �lC. E. COULTER ��� f �.� � - - ��
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WfINESB t! � -�:�`� � . . . , . Sj � � ►ARN:VRV�Y� i
CITY LOTB � �� . > ��s LANO SURVEYOR � �'t� � � uxes►wRa
; ...
TOP06RMHIC MA/rINO"�'b- REGISTERED UNDER LAWi OF STATE OF MINNEROTA � � �UDICUL �
� LIC[NBED �Y ORDINANCL OF CITY OF MINN[APOLIi
° 3300 LYNDALE AVE. SQ. MINNEAPOLIS 8, MINN.
� TAYLOR 4-0870
S�R�Er FoR ARV�D E. ����.��.v s��O�Y�n�c ,
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`, I hereby certify that the above is a true and correct plat of a survey o£:
Lots One ( I) and Two ( 2)� Block Nine ( 9),� CARLSON'S SUNIMYT MANOR SOLTTH
� ADDITION, Anoka County, Minnesota. ,,�,�
�,, As survey�d by me this lOth day of October 1958 A. D, � 9�
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City of Fridley, Minn.
BUILDING PERMIT �v� 18 7�
Date: ��___ ��_'"'� ��,,� °
Owner: �,�,� ,,.�;:�;'�° ! :,-.�''�'�,. !'"...�:"��`.� � Builder ..�
Adciresa Addrese —
No.�,��• f-�y� 3tree �
Lot,,� '� � Block
Addition or Sub-Division
Corner Lot _ Instde Lot ' Setback — Sideyard
Sewer IIevation � Foundation IIevation
-��.�*,���
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�- � �� - DESCRIPTION OF BUILDING
To Used ea: �
#� Front Depth -- Height Sq. Ft Cu. Ft '
�
, Front ' Depth ITeight y Sq. F't. Cu. F't
Type of Construction Fs� C'�tr � Y ��"'�'i�o be Completed
In considerai3on oP the issuance to me of a permft to construct the bwllding described above, I agree to do
the proposed work in accordance with the d�scription above set forth and in compliance with all provisions of
ordinancc�s oE the dty oP FrYdley.
�
� ,�
Ea consfderation of the payment oP a fee of $�"��i , permit is hereby graated to
to construct the buflding or addition as described above. Thispe rmit ia granted u�n
the express condition that the peraon to whom ft fs granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildinga
�� dty ]imits and this pern4it may be revoked at any t'�e.,u �n�,olatiidn-o`�`�any oE the provisions of esid
� �'�•� �����--�a;��'*—� 8uila�ns rnapector
NOTICE:
iWs psemh doa net eowr ths coestrncHoe, IestallaHoe }o� rrUtery, phnebtee, oa 6atina, m�nr oe wat�r. B� am To �
th� &rildla8 lespator for aparah p�rmits Por tha� k�s.
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� , APPf.,ICATION FOA BUILDING-PERMIT , � .
. , CITY .OF 1�RIDLEY, MINNESQTA . � , .
. �
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OWNER' S NAML � L�'�v��-� . BUILDER , '�°�l � " �' •
ann�ss , � ' . � ,-,�a�D�ss�P1� -�' . .: ,.. - '
�� `;
�LOGATION OF HUILDING ;:_"s..
��� � � �
No. Stxeet . �� ..,�art �of Loe
. � . . . . -� r � . . . � � ��..�
Lot � � Block ...- _ ,. .Additioa or $ubd�vision .-,. ,
Corner�Lot�Inside Lo `Setback � �3ide-Yard . � �
SEWER ELEVATION FOUNDATION ELE9ATION �
�pplicant ateach to this form Two Certi�f3cates of.Survep of Lot,and.proposed build-
ing��:ocatii.on drawn on these Ce�tificatea. ' . �
� � , �., , . _ ;:
DESCRIPTION OF BUTLDING
To be used as; �
� _ Front ' , , .
• � _ . Depth : , Height,� -
.. Sq. Ft. _ Cu.,Ft•: ..
' "� � Front � � Depth Aeight .
. � . � , , , ; Sq. Ft. � . - Cu. Ft�.� ; -�
, ; �, cx:e
Type"of Construction. � �stimated Cost �-� �.�
To be Completed ' � _. . . , , �
The undersigned'hereby'makes�applicet�Lon �or:,a permit�for ehe work t�erein specified,
a�ree3ng to do all work in strice accordance with the City�of Fridley Ordinances aud
ruliags af Che Department ,p�,;Buil,dia$s, and :hereby. dac�er�� tbat all,,the �acte and
represeatatioas stated in this applicatioa are true aad.correct.
` - . . _��! ,.� "/�'
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�Schedule of Fee Coste can be found on the everse Side).� �
�. � � ,'`� �"1
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BUILDING PEIiMIT FEE SCHEDULE
�
Section 2. The Inspector of Buildinga shall, before issuing any permit for
the erection of any�building or structure, or for any additioa to anq exist-
iag building or strucCure, or for any alterat4ons or rep�ira to 'any existing
building or structure, upon application therefor, require the paymeat by the
applicant for such permit of fees to the.amouat hereia below aet forth and
in the mannex,hereia provided to-wiC: �
2.1. For aay such permit for the erection o.f. any �ire-proof building, other
than.a garage� warehouse, �actory or grain elevator, or for the erectioa of
aay fire-proof addition, for similar occupancy, to anq exiating building
shall be aC the rate of $1.40 for each one thoueand cubic feet, os fraction
thereof, in such cubical contents.
2:2. �For any such permit for the ereetioa of anq fire-proof garage, warehouse,._
factory or grain elevator� or for the erection of anq fire-prcaf addition,
for similar occupancq, to any existing buildiag shall be at the rate of $1.25
for each one thousand cubic feet, clasaified as 11fireproof" by Section 502 af
the Minneapoli� Building Code. -
�. HOUSES
2.3. For �ny such�permit far the erection of any non-fireproof buildiag other
than a garage, warehouse, factory or grain elevator, or any non-firegroof
addition, for s�tmilar occupancy, to aay esiatiag bu9.].ding - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for Che erection of any aon-fireproaf garage, .-
,. warehouse; fa�tory or grain elevator, or for the erection of any aon-fireproof
add9-taLonr-€o�-similar occupancq, to any exiatiag building or for each such
_,�_... -building or addit3oa - ninetq cents ($0.90) for each one thousand cubic feet
or fraetioa thereof, in ehe cubical coneents thereo€ with a minimum of $4.00.-
For Che purpose of computiag fees for building permits, the cub3cal conte�ts
of any bu�lding or.addition to a uni�orm height throughout by muLtipl,ying th.e
grouad area covered from a poinC si� (6) iaches below the floor line oE the
basement or ceilar to the average height of the upper aurface or to tbe
average height of the r�of surface of the main gable of a pitched roof.
2.5. For repairs or alteraCiona to aa existiag structure, the fee ahall be
at the rate of $3.00 per each Five Huadred ]�ollar� ($500.00j or fraction
thereof in the cost of all progoaed work. �
2.6. In no case � ahall the fe�_charged, ,fc,r_-anp-permit� .a� set forth in
Section 2 be less.than $4,D0;
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��_y� .. May 21,
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1979
8431 U�IVERSITY AVENUE
Bigos Properties
P.O. Box 22464
Robbinsdale, MN 55422
�� � � ��� ` � ` �
W.E., RIDLEY, MII�NESOiA 6b432
TELEPHOPdE ( 612)571-3450
Re: Repair & Maintenance of the Rental Property Located at 5].Ol iiorizon
Drive N.E., Fridley, Minneso�a
Dea.r Sirs:
It was confirmed by a routine on-site inspection on May lii, 1979 that the�
above listed rental property was being maintained in violation of Chapter
220, Residential Maintenance Code of the Fridley City Code.
Although the general condition of the propzrty was good, the inspection on
the above date found the following list of deficiencies which must be
corrected. [�ny repairs or improvements must be completed in a worlcmanship
like iaanner. It is the City's hope that sirailar or other deficiencies in
apaxtrnents that were not inspected will be corrected as needed.
EXTE RI OR
1. Provide and maintain a screened enclosure tr,� conceal the re�use
container f'rom view by August 1, 1979._ Tn addition, a hard surface
base should be provided for easier haridling by the hauler.
2. Provide and maintain stripping for the parking lot to indicate
individual parka.ng stalls (10' x 20' ).�-� 7q tt/ �
3. Repair and maintain any broken windows: South side, 2nd floor,
3rd frora west. � ���s7� ��
COMMON ARE�1S
No orders this date.
LAU"iJDRY/FURNACE ROOM
1. Provide and maintain locks on a11 stArage cubicles, even the
unoccupied ones. �=��• %� �/��
2. Provide and r�aintain an approved temperature pressur� relief
valve for the 5tate Courier water heater. �— l�G= � f(� �
APARiMEN`1' #103
Repair and maintain the leaking cold water faucet for the bathtub.�-�7g
�� �/<
�
� Bigos Properties
' May 21, 1979
Re: 5101 Horizon Drive N.E. . Page 2
A reinsPection will be conducted on or about June 18, 1979 to determine
compliance. We are confident in your cooperat�on on these matters and
if any questions or problems arise, please feel free t�o call on us at
571-3450, extension 164.
Failure to aba.te these violations may result in this matter being turned
over to the City Prosecutor for his legal consideration.
Sin ce rely,
�'
S N J. OL O
Environmental Officer
SJO/mh
CC: J. B. Carlson
5290 - 3rd Street N.E., Apt. 204
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CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 r'AX: (763) 571-1Zii7
- �- ��
PERM NO.:2004-00979 �
DATE ISSUED: 06/23/2004
ADDRESS : 5101 HORIZON DR NE
PIN : 263024220099
LEGAL DESC : UNAVAII.,ABLE
: LOT BLOCK
PERMIT TYPE : BUII.,DING
PROPERTY TYPE : MULTI DWELL
CONSTRUCTION TYPE : WINDOW/DOOR REPL
VALUATION : $ 5,000.00
NOTE: SEE NOTATIONS ON PLAN. REPLACE 20 WINDOWS WITHIN EXISTING OPEI�TINGS.
APPLICANT
WINDOWS BY GEORGE
645 FAIRMONT ST NE
FRIDLEY, MN 55432
OWNER
BIGOS BEREK & HELENA
11641 CEDAR PASS
MINNETONKA, MN 55305
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 l�ow the same to be true and correct. All
provisions of laws and ordina,nces goveming this type of wor�
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
regulating con��tuction or��ormance of construction.
� �f
A«..1:.....s� �s�-�M T_�_ �s / Vi_ �'/A
Bldg
BUII.,DING PERMIT FEE
FIRE SURCHARGE
STATESURCHARGE,VALUE
TOTAL
- . • - � - - -
SEPARATE PERMITS REOUIRED FOR WORK (�T'HF.R THAN nF.c�Rr�Fn ARnvF
111.25
5.00
2.50
118.75
�
CITY OF FRIDLEY �,� �7– 1/1/2004
6431 University Ave NE R 3/COMMERCIAL/INDUSTRIAL/PUBLIC/INSTITL7TIONAL
Fridley, MN 55432 BUII.DING PERNIIT APPLICATION �%
(763) 572-3604 FAX (763) 571-1287 b � � � ' `
�o
CONSTRUCTION ADDRESS �J ��� f-fc�� /2r� �1 �� ZI� Zoni ng
Legal
Owner & Address .�i / � o �S ��c `�a- i� � Tel # ( )
CONTRACTOR & ADDRESS l�G� � �,Y ��� Tel# ( )
��f ,� � l�'yu�a-- iT l��- c�� Y '�i fi��—�` y 3 2___
Architect Reg.# Engineer Reg.#
BUILDING CONSTRUCTION
TYPE OF WORK [] New [] Addition �lteration -Describe
� �e �t� 2 fi P� �
OFC. AREA: Length
WHSE AREA: Length
OTHER AREA: Length
Width Height
Width Height
Width Height
Sq. Ft.
Sq. Ft.
Sq. Ft.
APPLICANT �= d�`� �°�� Tel #`��� if? °�2�'° Date ��23 °—c�
,
VALUATION
Sq. Ft. x$ Cost/Sq. Ft. = Valuation S ) �
`� cG'�i
Sq. Ft. x� Cost/Sq. Ft. = Valuation S )_$ �
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE
Building Use Construction Type Occupancy Group
Air Conditioning C7Yes C]No Fire Protection Provided C]Yes C]No
Performance Bond Amount � See Reverse for Schedule Received C]Yes CJNo
PERMIT FEES
Permit Fee
Plan Check
Fire Surcharge
State Surcharge
SAC Charge
Erosion Control
� e1/. �s�
S
g e���
$ �, ��
$
$
Park Fee �
Spec. Assessments $
See Fee Schedule on Reverse Side
65% of Building Permit Fee
.001 x Permit Valuation (1/10th %)
�.50/51,000 Valuation (See Sched. for > �1 Million)
51350 per SAC Unit (Plans to MWCC for determination)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary CJ Not Necessary []
Curb Cut Escrow S feet x /foot
TOTAL � �� v ' �
� � ATTACH STIPULATIONS
3s���� c��
/ � �S . e .�
$1 to $5�
$501 to $2,0�
$2,041 to $25,�4
$25,001 to $50,000
$50,�1 • to $100,000
$100,001 to $500,0�
$500,�1 to $1,000,000
$1,000,�1 and up
BUILDING PERMIT FEE SCHEDULE
$23.50 (Minimum Fee is $23.50 plus surcharge)
$23.50 for lst $500 plus $3.05 for each addn'1 $1� or
fraction, to and including $2,�
$69.25 for 1 st $2,000 plus $14.00 for each addn' 1$1,�0 or
fraction, to and including $25,�
$391.25 for lst $25,0� plus $10.10 for each addn'1$1,0� or
fraction, to and including $50,000
$643.75 for lst $50,� plus $7.� for each addn'1 $1,� or
fraction, to and including $1�,000
$993.75 for lst $100,000 plus $5.60 for each addn'1$1,OQ0 or
fracdon, to and including $5�,�0
$3,233.75 for the lst $5�,� plus $4.75 for each addn'1
$1,� or fraction, to and including $1,0�,000
$5,608.75 for the lst $1,000,�0 plus $3.15 for each addn'1
$1,�0 or fraction
PREPAID PLAN CHECK FEE SCHEDULE
Per Minnesota Building Code - 65 % of building permit fee.
PERFORMANCE BOND POLICIES
When a building permit is issued for a commercial, industrial or a multiple dwelling
residential project which requires outside improvements, a Performance Bond or a Letter of
Credit shall be submitted to the City. The hond will cover all outside improvements, including
but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting,
water & sanitary sewer services, and storm drainage systems.
Calculadon of bond amounts will be determined by the building permit values. The
bond amount will be 3% of the building pemut value up to a 2 million dollar project or a
$60,0� bond. Actual amounts will be rounded to the nearest $100. The City reserves the
right to require greater or lesser bond amounts based on unusual circumstances. Projects with
no outside improvements, generally will not require a bond.
Bonds must remain open until the project is fully completed. Reproducible "as-built"
drawings of all exterior underground utilides must be submitted to the City Engineering Dept
before the project is considered complete and the bond released.� All honds will be held over
one winter and through the next growing season to insure the survival of all landscape
installations. The City will then inspect these properties in August of the year follow'ing the
initial planting. Bonds may then be released in October of that year if all improvements are
satisfactorily completed.
� . _ _
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CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
`_'�
PERMIT O.: 2004-01029
DATE ISSUED: 07/14/2004
(763 572-3604 FAX: (763) 571-1287
ADDRESS : 5101 HORIZON DR NE
PIN : 263024220099
LEGAL DESC : UNAVAII,ABLE
: LOT BLOCK
PERMIT TYPE : BUII,DING
PROPERTY TYPE : MULTI DWELL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 2,800.00
NOTE: INSTALL SOFFIT & FASCIA AND ALUMINUM TRIM. SOFFIT VENTILATION TO MEET TI� STATE BUII.,DING
CODE.
APPLICANT BUILDING PERNIIT FEE 83.25
SELA ROOFING & REMODELING INC (1050 FIRE SURCHARGE 2.80
4100 EXCELSIOR BLVD �'o STATE SURCHARGE, VALUE 1.40
ST LOUIS PARK, NIN 55416-4727 ' TOTAL 87.45
(612)823-8046
OWNER
BIGO5 BEREK & HELENA
11641 CEDAR PASS
MINNETONKA, MN 55305
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 da.ys
at any time after work is commenced.
I hereby certify that I have read and examined this
application and lrnow the same to be true a.nd 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 pemut does not presume to give authority to
violate or cancel the provisions of any other state or local law
regula ' constr crion or the performance of construction.
Applicant Date
Bldg Insp D � �l `1
SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
�
JUL. 2.2004 8�26AM SELA ROOFING SALES
r N� [ l �� ciN oF FRio��r
ADDN [ l ,���� � 6431 Universit�+Ave NE, Fridley, MN 55�432
ALTER [ j.. �� _�� SINGL� FAMILYAND DUPL�XES R-1 AND R-2
BUILDING PERMITAPPLICATION
`��� ,
Construction Ac
Legal Descriptic
Owner Name &
Contractor:
LMNG AREA: l,E
GARAGE AREA:
DECK ARFA:
OTH�R:
Conshuction T
So-�'rfs �
Driveway Curb
DAT�: __ 7' � •
Call (763) 672�604 �
you for card numbe
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharc
Curb CUt Escro�n
Erosion Contro)
Pa�k Fee
Sewer Main Char
TOTAL
� O �v G
N0.329
P.2�2
Effectivve 1 /112004
c
(763) 572�604 Bldg lnsp
(763) S71-1287 Fax
� C��
lddr,p$� ///o �` �,�s�- � �//7s' - ,Bi/� /�u�•ro y�1 � Tel. # �,� - S' 7/ �.� 9Z 3
' �EI�A ROOF'!rT(''� ,�pDE��� �C, • MN LICENSE #
�—��� �CCET„yIOR BLVD. —� Tel. # 6(�g Z 3- �rcx �
S'1'. LOViS P g �6
Att�7����pf�tion, a Certficate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRlpTION OF IMPROVEMENT
� Width� Nei9�� Sq. Ft
Len9�h ,_ Width i„� �Ieight � Sq. Ft,
Len9� _, Width �_ HgyGround `_ Sq. Ft.
�
�
Esfiimated Cost: � Z Od
Wdth Needed; Ft + 6 Ft = Ft x$ = g
' APPLICANT: ��'��L . T�I. �! �! Z • Z
Qo - ��/
�r Permft Fees if mailing in application. Fax to 763y71•1287 if using eredit card a�n��e w;ll catl
CITY USE ONLY -
$ �•°��^Fee Schedule on Reverse Side � �L
���� Z� ,001 of Pemnit Valuatio / � � �
�. ---- n (1 10th /o)
� � � $.50!$9,000 Valuation
$_�� $1350 perSAC Un'rt
$ �5.00 (State Licensed Residential Contractors)
$ Alfi. "A" or Alt. "B" Above
� $450.Op Conservation Plan Review
$ Fee Determined by Engineering
$ /�qreement Necessary [ ] Not Necessary [ ]
$ � / `�^ STlPULATIONS:
�j �
v
�
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
��..
PERNIIT O.: 2 04-�` 0 11''r,
DATE ISSUED: 07/30/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 5101 HORIZON DR NE
PIN : 263024220099
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : BUII.,DING
PROPERTY TYPE : MULTI DWELL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 6,000.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. REMOVE AND REPLACE CONCRETE
FLOORING AND BLOCK.
APPLICANT BUILDING PERMIT FEE 125.25
LIlVIITED PART'NERS THE PLAN CHECK FEE 81.41
4601 EXCELSIOR BLVD STE 301 FIRE SURCHARGE 6.00
ST LOUIS PARK, MN 55416 STATE SURCHARGE, VALUE 3.00
TOTAL 215.66
PAID WITH CHECK # 3094
OWNER
BIGOS BEREK & HELENA
11641 CEDAR PASS
MINNETONKA, MN 55305
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 arid lrnow 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. T'he
granting of a permit does not presume to give authority to
violate or cancel the provisions of any ther state or local law
regulating co ction r the perfo ance o construction.
Applicant ' Date
Bldg Ins D� .
SEPARATE PERMITS Q D FOR WORK OTI�R THAN DESCRIBED ABOVE.
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L
TY OF FRIDLEY
1/1/2004
� u431 University Ave NE R 3/COMIVV�RCIAL/INDUSTRIAL/PUBLIC/INSTITLTTIONAL
Fridley, MN 55432 BLTILDING PERMIT APPLICATION °j �/"���� 1(
(763) 572-3604 FAX (763) 571-1287 �oO `
► ���b�
CONSTRUCTION ADDRESS S�L�� -� �L� Zoning
Legal
Owner
CONTRACTOR & ADDRESS � � � �� Tel# ( )
�' `� �t,� [S �1� �5���
Architect
Reg.# Engineer Reg.#
BUILDING CONSTRUCTION
TYPE OF WORK [J New C7 Addition � Alteration -Describe ��-"� �o�a
OFC. AREA: Length Width Height Sq. Ft.
WHSE AREA: Length Width Height Sq. Ft.
OTHER AREA: Length Width Height Sq. Ft.
APPLICANT �� CJ�L.t �.� �ev��.� Te1 #�l�l-�aa--S39°� Date o
VALUATION�
Sq. Ft. x$ Cost/Sq. Ft. = Valuation S ) ��, �
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ )_°�' �-�
Sq. Ft. x� Cost/Sq. Ft. = Valuation $ ) 'TOTAL VALUE
� V '� Occu ancy Grou ' �
Building e Construction Type p P�
Air Conditioning C7Yes C]No Fire Protection Provided C]Yes C]No �
Performance Bond Amount S See Reverse for Schedule Received C]Yes []No
PERMIT FEES
Permit Fee
Plan Check
Fire Surcharge
State Surcharge
SAC Charge
Erosion Control
$ la��s�
$ �� ��
$ � . 7>�7
$ �, ?��
$
$
Park Fee $
Spec. Assessments $
Curb Cut Escrow �
TOTAL $ �� �S � ��
See Fee Schedule on Reverse Side
65% of Building Permit Fee
.001 x Permit Valuation (1/lOth %)
$.50/$1,000 Valuation (See Sched. for > S1 Million)
$1350 per SAC Unit (Plans to MWCC for determination)
5450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [J Not Necessary C7
feet x /foot
ATTACH STIPULATIONS
$1 to $500
$501 to $2,0�
$2,�1 to $25,�
$25,001 to $50,0�
$50,001 • to $100,000
$100,001 to $500,000
$500,001 to $1,000,�0
$1,0�,001 and up
BUILDING PERMIT FEE SCHEDULE
$23.50 (Minimum Fee is $23.50 plus surcharge)
$23.50 for lst $500 plus $3.05 for each addn'1 $100 or
fraction, to and including $2,�
$69.25 for lst $2,000 plus $14.� for each addn'1 $1,0� or
fracdon, to and including $25,�
$391.25 for lst $25,� plus $10.10 for each addn'1$1,0� or
fraction, to and including $50,000
$643.75 for lst $50,�0 plus $7.00 for each addn'1 $1,�0 or
fraction, to and including $100,�
$993.75 for lst $100,0� plus $5.60 for each addn'1$1,OQ0 or
fracdoa, to and including $500,000
$3,233.75 for the lst $500,0� plus $4.75 for each addn'1
$1,000 or fraction, to and including $1,0�,�
$5,608.75 for the �st $1,000,000 plus $3.15 for each addn'1
$1,000 or fraction
PREPAID PLAN CHECK FEE SCHEDULE
Per Minnesota Building Code - 65 % of building permit fee.
PERFORMANCE BOND POLICIES
OVhen a building permit is issued for a commercial, industrial or a muldple dwelling
residential project which requires outside improvements, a Performance Bond or a Letter of
Credit shall be submitt� to the City. The bond will cover all outside improvements, including
but not limited to landscaping, irrigadon, curbing, blacktopping, screening fences, lighting,
water & sanitary sewer services, and storm drainage systems.
Calculation of bond amounts will be determined by the building permit values. The
bond amount will lx 3% of the building pemut value up to a 2 million dollaz project or a
$60,� bond. Actual amounts will be rounded to the nearest $100. The City reserves the
right to require greater or lesser bond amounts based on unusual circumstances. Projects with
no outside improvements, generally will not require a bond.
Bonds must remain open until the project is fully completed. Repr�ucible "as-built"
drawings of all exterior underground utilities must be submitted to the City Engineering Dept
before the project is considered complete and the bond released.� All bonds will be held over
one winter and through the next growing season to insure the survival of all landscape
installations. The City will then inspect these properties in August of the year follow'ing the
initial planting. Bonds may then be released in October of that year if all improvements are
satisfactorily completed.
Building PLUMBING ���n.it No.• ����- �c��
Inspections R�.+ SII)]E.l�7CIA.�.L .A�PPI.lICA7CI4N Received By:
763-572-3604 CIT`Y 4F FRJ[.DLE�' Da�'�}d� " 20 7
nA� June 21, 2007 YOUR E-MAIL ADARESS wnelsa�lar�anplumbing.com
SrrEnnn�.ss 5105 Nerizen f�rive NE
THIS APPLICAA'T IS: l7 OvJNER �lCONTRACTOR
i
PROPERTY NAME•_ Jnhn Ve�lt1
��� nvvnx�ss: 510a Horizon prive NE crrr Fridley STATE VINZIP rJS�Z >
�N'� rxo�: 7b3/572-9b07
coNrx�►c°roR �; Larson Plumbing, Inc.
;
SUBMI7 A COPY OF STATE LICENSE � 3341 PM �xr Da� 12/31 /2006
YOUR STATE �Dx�ss: 3095 -162nd Lane NW crrv Andover srar�llllN zzr 553�4
Licnvs� wr�r pHONE 763/427-7680 Fax 763/427-9448
Arrz.zcn�orr
PER1YdIT TYP�''s � SINpLE FAMILY O TWO FAM[LY d TOWNi�OUSE
TYPE OF W ORK: o x�w �J tt�Pr nC�r'r
DETATLED DESCRIPTION OF WORK �Nater Heater Replacement
PER MS 168.665 the permit fee is a minimum of $15.Q0 or 5% of the total cQSt up to �500,00, whichever is greater, for the
improvement� installation or replacement of a residential fixia�ue. excluding tJze fnctures. (This should reflect only the cost of labor )
Labor cost under �300 =$15.00. Labor cost between $300 to $500 a cost of tabor x.OS =
FOR PROJECTS WHERE LABOR EXGF.EDS $540, FEES ARE BASED ON $1 U.00 PER FIXTURE, EXCfiPT WHERE NOTED. FIXTURES: (�iDICATE TOTAL
NUMBER OF EAGH BELOW}
BATH SINK/f�AV FLAOR URAINS SHOWER WATER PIPING
BATH7'tJ13 flAS PIPINQ �o cmtrc�rrs� SWIMMINC� POOL � WATER SOFTNER ($35)
CLC}7'HFS WASHE]i �KIiCHEN S1NK WATER CLOSE'f � BACKFLOW PREV. ($15)
DISHWASHER _ LAUNDRX TRAY X WATER HEATER ($35) � FOR IRRIGATION .
WATER MET£R OTHER
'�: •r.. �;;:�3,��,a:w�.:�:��:�'r:�"���'k�''�1'��'�',C'.%. " it:_ "' •-'i:�- '• - -•f�..
:�:: ..t, ..:��SJ�� • `�'i:? > � �:�T3� t•. :..v. y:�- :..� ...�,...�:.�;>cs,:. • '� ,:,�r.=_.. ��'��F"�`�.O�Z;... � 6�7E���1�"ER;$�60 �
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Permii Fea $�_.,QQ Number of fixtures Q$10.00 .. . x�10.00 ffi$
Surchar �e .50 Number of fixtures @�IS.00 x$15.00 a$
TOTAL DUE $�.� Numbar of iYxtures @$35.00 x$35.00 =$
State Surcharge m $ .SO
Tota1= $
THIS tS AN APPLSCATIOPI FOP. A PERAtIT T'OT VALID UNTIL. PP.00FSSED
I hereby apply for a building permit and I acknowledge ti�,at the information above is complete and accwate; rhat the work will be in
conforn►ance with the ordinances and codes of the City of Fridley and wiEh the Minnesota Consfruction Codes; that I understand this is
nat a permit but only an application for a permit and work is nai to start wi�.ovt a permit; that the work will be in accordance with the
approved plan in th , af aIl or t��'ch requ' es review and approval of plans.
SI(31�fATUREOFAPPLI ANT� �RnsrNn� Michael Malonski nAr� 6/21/07
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City of FridIey
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977