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AF - 46334� � City of Fridley, Minn. BUILDING PERMIT N� 415 3 Date: .----__Q .�_..._._1 .1! __ � � _._...___..._..__.. Owner: .............-•-�--------......._..__._._......._............_...-•----.._......_._......_......_.... Bwllder��•'•'��...._.._....... ...._.._.._..�.�= 4/,,.�..�.C''�=� s_._ ..._... Address � Address ....._.......__..._......._.._.._.____._._.._...__.._. •-•---._......_:--------------------- --- -_ _ LOCATIO OF BUILDING /�% r . No. ��-•�":--[_ Street __yG;�.�G.:. _ - •---. . .....��.-�.__.._._. Part o8 Lot ._--- Lot .. -- � ......................_........ Block ._..._............_.......� Addition or Sub-Division ....._............._...... CornerLot ....._ ...................-----.... Inside Lot ...................._............----. Setback ....._............._............._........ Sideyard Sewer Elevation To be "U;�sed as: � 6s;'�..�(��...._`1....._"_""" .............. Po � ��Z� Type of Construction Foundation Elevation DESCRIPTION OF BUILDING % i � P C F ►i a Front °..�.s �. Depth ..°�r._....°?..... _.�Height .-��-�� Sq. F� -�1_�� Cu. Ft. ��°�+� � Front...................._.. Depth ...................._.. Height ....................... Sq. Ft. ...................._.. Cu. Fk � ..................... ............................:... Est. Cost .......1 Q..:�..�...�.P.............._........ To be Completed ..----............._..... � ��otl��+^� i�''�� ` � � �,� " /� `'O C � .�Z� ' '� ,�� r � j � „ � � , � _ _ � . ,., : . � In cottsideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the dty of Fridley. �._ _ � In consideration of the payment of a fee of $_..:.�-.---- •---•--..._.., permit is hereby granted to..------__..-_--__--. -- ._.__�.._.---•----------__..__..----- to construct the building or addition as described above. This permit is the express condition tha.t the b'rented upon person to whom it is gran,ted and his agents, employees and worinnen, in all work done in, around and upon said building, or any part thereof, shall conform in all r�spects to the ordinances of Fridley, Minnesota regarrling location, construction, alteration, maintenance, repair and moviug of bwtldings within the city lim�tts and this permit may be revoked at any time upon violation of an� proviaions of said ordinances. � Building Inspector NOTICE: This permh does not caver the eonstrudion, insfallatfon fo� wirfng, plumbing, eas heatfng, sewer or water. Bs sure fo ses the Building Inspeetor for separate permifs for these itema. � �� / ��'� ;��. ly � � .a�a�.. ..� . +�.� s. vi t "`? _ '_ �_.�. _ .-..r... v_� ..,,,..,;:a� � e �� w � __ .a. . ,.� AT' ��.i S_,�� -��=^ �. � c ____a.�.�� r .: ;T. � ' .,.. ;� � d _ —._.. e . �r 4 ,c�r� � , � :��--°-�-.�••�-�-�^ - .� 1 �'� -� `� ! � � � � � ! � �� _� t� �..:�e �M � � � : ��,, , . � � � � � � ca�'�, � �m� � v� y k - � � 1.�°""°,.�. '� A` �� :, F �, � � . ! � �� •�,� '` ''�. � � � 0 �. q � � �� I �1 � Q i , �7�4 � ` . .. : . -�- � 5.1.�F � � � �°'.: � 71:I �r� ICr: � -� � Ti'Pi, �� ' " P.�c�er �y I�.z?e : . _.�._.............4 �.__.......� ..._..._ .... ... ......... ...... ... �...... .. ..... ....... .. � � �.��' �r"'f,�� -� �� %�°�'``"n',�_ � �� d��,� � � �' �,.s, �.,�'!� �"�,,r..� �'"'y�„„�,�„ . � i 0 � � �• (�. R� �'` _-> �' � ° ' f _�,`.�..� �' � )'�,. -.'_�-'` ,.�'�'�'� / ��.�J,,,A„�. ..a�. �' - � ._ _ `�,('k:•� �_i� � � a tlB �.,. � <' ''�. .. . . .� ,�9:ti ?"x.:... � , � �� Caty of Fridley, Minn.. BUILDING PERMIT .: ,. : •.: pwner; Fxed L. Davis g�� Same A1�dT2Bs4 ��OTIZOYI �1. AddTE88 a.�2*��E. x�c. #41913 1�'0 967'7 �l 9 �� LOCATION OF BUILDING No. �_..�. Street ._.._ Hnv�i �.�n j�; v� ..,., ..�_ Part of Lot Lot ��_ __ Block _�_ Addition or Sub-DivYsion �.'�? R�r �amm� M. or Nor-�h Corner Lot — ]'ns�tde Lot � Setback � Sideyard Sewer IIevation ____� _ Foundation IIevation DESCRIPTION OF BUILDING To i� v� as: �i tchen Add� t� oYlFront ��.!'�� Depth �— Aeight 8z Sq. F't. Cu. F't , Front Depth fTeight � Sq. Ft Cu. F'L Type oY Construction 5ninnd Framc� �t, Cp� ,,,,_�2.,2,�,�-.—..__ To be Completed .Tulv 15. �.9(8 In consideratton of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with tt►e deacription above aet forth compliance with afl proviaions of ordtnancea of the dty of Fi3dley. � � In conafderation of the paqment oP a fee of �1�.. nn , perauit is hereby granted to�e� 7., na.�; a to constcuct the buflding or addition as deacrYbed above. Thia perniit is granted upon the express condition that theperson to whom 3t is granted and hia agents, employees and worlmien, in all work done in, around and u�n said building, or any part thereof, shall conform in all reapects to the ordinancxe of Fridley, Minaesota regarding loc.ation, conatruction, alteration, maiatenance� repair and g oP bufldiugs �� dty limits aad this permit may be revoked at any ti�ne upop viol��ion of ,¢ny of t�e�provisions oE seid // // /r :1 � r.Z.G,.-^.';,;4, NOflCE: � Yhb psmdt does not cevsr t6s co�fn+eHoe, fasHllatiee �er �rtrine, plumbteg, �a 6ealing, sewa er wat�r. B� suro to � flw Buildiee Insp�eto� Por pparaf� parmNs for fhas Nu�. c I XJ ' APFLIGATION FUR`�tJiLDING��1'ERNl�� • �: �: � � � , ;, =�:�CZTY .OF FR7DI,EYf MIP1nT�SUTA �..''�"�. . ,. ,r . . . . � � .. • f7WNE�' S NAME /� + �C�� .�BUZI:DER .. � . _ ,� •-�-- ADDRESS�� ,i/ �,lgL'I.� A O��`...; � ,��iDD�ES3�, � _ ...:_,... _ .�;: _�� .. �..�.. ,��:.- . LOCATI01� (�F �tJ��,D#�dG. � . . . No�.. ..,. .�G� � sTxE�'7r�;_ i� J'Z C�il�� .� l L�� _ �_� . . . .,•. . r,:--� • . . , . ,��_; c�a�/��" LOT �a _BLOCR ADDITTOI+� OR��SIZBD?�VtS"�F�N •- � ..� C� � CORT]E$ LOT INSIDE L4T SE'�BACR�,_SIDEYA�Dl� _ SEWE� ELEVA�.'IOId � ' ''r� � � i �'�+, 'T�P'(3F' �FOOTING ":•+ . . - . . , . .; i .. � ' ,:�� . . . Applicaut attach to Ci�i�$ �fo'rm Z�ro�Certif3c�ites 'of Surv�* of Lot and �p�oposed building loca�tion drawn �oa.'these ` Cert3ficaEes : � ' ' • • - • . . ' ' ` .i . . ' . . . ". Tfl � Be Us � �l � IJ C � s � DESCRIPTION OF BDILDTNG � �9��. . . :� • . . • � � � P, , r ..___� � �i •,a � • , . :, � � . .. �:�`� � liei�ht : - .��:. ��:� .� Square feet � Cubic Feet �• • �ront Depth Height - Squa;e feet Cubic Feet Type of Construction ��/'�&- Estimated Cost ;�GC�� To Be Campleted__�l,�_`L � ��' The uadersigned hereby makes appiication fos a permit for tbe work herei.a specified, agreeiag to do all wark in strict accordance with the City of Fridley Ordinaaces aad rulings of the Department of Buildings, and hereby declares that all the fects and representatioas etaCed in this application are true a d osrect. . DATEi� �� _ „SIt�IATURE 6' G�c�'`� _ .. (Scheciule of Fee Coats caa be found on the Reverse Side). � � � I s� � r��i �. � , d � r � 0 .., _.. .r..�l.•t�. ' �� .. .Lt. � � ... e .. �. _ � . .. . a7': . . .. , .. . . _ , +�_. . � BUII,DING PERMIT FEE SGHEDU:LE SEC�ION 2... The Inspector. af �Buildir�ga sha1�� before� isau�ng petmits for �� the erection of �ny bu�,lding, or struc.tu.�e, or for any.a�LdiCion to anyt e.�s.t�ing. structure'"or ;b��tild�irig, or far � aay alte,ration or �'re'pairs to any exiating building or structure,.upaa1,app,lication therefore.;. �equire the • , th� payment by., tli�`= applican�t for �ueh� permiC of -fees tc 'the� �maunt herein � belaw set forth and in the manner herin ��ovided to-witc .: Uniform �tu�:�t1i�� Qode:' •�' ��ype 1; 2:;`'!�'4- ��75' for �eact� o�ie �thousand� ct�hic, ' feet, or fraetio8 thereof, in sacti� �cubf�gY` contenta :� �ype 3 6 5= $1:90 �f+or each one theusaad cubic teet. . � ��i� � .... . � . . i`.`. F�r the �ur�oee ef cnmputing �fees for�building permits, the�cubical �` contents ef .�ag- bu�.lding or additioa ° t• a uaiform fieight rthroughout by �ltiplyiag the ground area cavered fr#m a poiat six �$) inches belo�r the floc line �f tt��s bas.ement � or ttie� �eiiar te �he average he�ght of the upger surface or to the average height of the roof surface of ths maia gable_of a pitched roof, � � ....,_.. _ . _ . �r,: . . . ..:... .. .. For re�air.s .or alte�ra�ions to an e�istiIIg�s�ructure,�the fee shaZl be at the rate of $3.00 per each ftve hundred dallars ($500.00) or f�a�Gion thereof in . the coeC sf al.l pro�o�ed wo�ck: r'"` '�' �� -- .- � In..no case she�li the fee ch:arged fo�• any� pe�tmit as set fvrth in Section 2 be leas tha� $5.A0. .. � ". ':t�>•. :i. x..:i t.- . ,, � ._. . • . ' NSSSD Cfan��ti'ien -Ciiar es base�d � � ' ' � •• `. ' �; M � " . . � � on locaeien- Area,l�or 3. . � . . . ... . - •�� .. • • . . .. . r. . � .� . . • .. .. :�:: . - .��,� .. .. n ;.- , "..�.i ' . . . . . '.i _' : 4 1 � � i v,o sue�ecT PE T . City of Fridley �j � � � 4 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 ' LL �"'�', r � � PROTECTIVE INSPECTION SEC i � . �� i � � � �'�'1 � CITY HALI FRIDLE� 55432 NUMBER NEV DATE vAGE OF aPVAOVED Br �""� � �'' 612-571-3450 910-F15 3/11/97 � � JOB ADDRESS 5261 Horizon Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. (j 8 Carlson's Summit Manor North SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Rollin/Michelle Brask 5261 Horizon Drive NE 572-2261 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAII ADDRESS Z�P PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION f� ALTERATION O REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Basement alterations 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIFi 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 OR ABANOONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yALUATION SUFTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 9OO .SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @32.00 Fire SC �. JO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. W PLAN CNECK FEE TOTAL FEE $33.40 S �ATUR OFCON'RAC AOAAUTHOA�ZEDAGENT IDATEI WHEN PROPE Y VALIDATED THIS IS YOUR PERM�T P � _•V 5� ATUFE OF OWNEA ��F OWNEA BU�LDEA1 � TE� Bl �NSP � FTE r± rrEw ADDN ALTER [] I] [l �i CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R 2 BUII.DING PERMIT APPLICATION Effective 1/1/97 �� ConstructionAddress: � Z�o � �%u21 ZaJ /✓2/ vIF" � Legal De�cription: Owner Name & Address: u t,t, �.� e' ��j e b�l.l"U''r l�- ` Tei. # S� Z-= 2.2.� / Contractor: �� '1�W,J � fTGh�LL MN.LICENSE # Address: �;; � _-_�� GARAGE AREA: DECB AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the propvsed construction drawn on it to scale. n DESCRIPTION OF IlVIPROVEMIIVT „' � - Length Z, °1 � Width f v� 3'' Height Length Width Height Length Width HgtlGround Tel. � Sq. Ft. Sq. Ft. Sq. Ft. consmi�tion Type: �i✓r?�A fi/�n� Estimatea cost: $ �l �(�\oo " (Fee Sc.hedule on Baek) Driveway C�:rb Cut Width Ne�ded: -, � Ft. + 6 Ft =. - : Ft x$ _$^ DATE: 3 APPLICANr: ` , t�J . T� �� Z'Z� / Pernait Fee Fire Surcharge State Surcharge. SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ ZL � $ ; �1 $ , $ $ $ $ $ $ =- $ � .�d • �� CITY USE ONLY F� 5cheduie on Reverse Side .�1 of Permit Valuation (1/lOth%) $.50/$1,000 Valua.tion $950 per SAC Unit � $5.� (5tate Licensed Residential Contractors) Alt. "A" or Alt. "B ° Above $450.� Conservation Plan Review Fee Determined by Engineering Agreement Necessaty [ ] Not Necessary [ ] � � BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or shucture, or for any addition to any existing building or structute,� or for any alteration or repair to any existing building or structure, upon application therefore, require the paymern by the applicant for such permit of fees`to the amount herein below set forth and in the manner herein provided to-wit: � � TOTAL VALUE,.> . :, _ _ , ,,� ,, ., ., �_ , : :. . _ . ..� , ,, . . $1 to $500 _' , . . _ _ _. � $21 {M�nvmum Fee'is $21 "plus surcharge) � _ $501 to $2,�0 $2,001 to $25,000 $25,001 to $50,� $50,001 to $100,000 $100,001 to $500,000 . � �VSW�WI W $I��W�� . _ . -- $1,000,001 and up $21,for first $5{l0 plus $2.75 for each additional $1� or fraction thereof, to and including $Z,U� $62.25 for first $2,000 plus $12.50 for each additio�l $1,0(l0 or fraction thereof, to and including $25,(�0 $349.75 for first $25,�p plus $9.p0 for each additioffii $1,000 or fraction thereof, to and inciuding $50,� $574.75 for first $50,000 plus $6.25 for each additiomal $1,� or fraction thereof, to and including $1�;� :;. $88'�:25 for;,first $100,(iQ0 plus $5.00 fc .. � . . _ : _ _ _ _. . .._ .. _ _ __ .. $1,i�0 or. fraction,thereof, ro.�a i��iva �� ' �, � 1 ' � ^, (t = � r. a�, �''� :J �` �. '. x# t i � � t .F n, � .�. $2887 25 for the first $��,OOb plus $q. . � --$1�� or fractton..thereof; �to and� includ � � .. . , . . . , _ . __..__ .. . __ _..,__ ._ .�,.�, ___._. _,,.._ _.. _ _. $5012.25 for the first $1,�,�0 plus $1,� or fraction thereof: � � , � :�� DRIVEWAY. DEPRESSION,ESCROW (Concrete (�rb Streets , On1Y) _ - .. , .. .��,1 iF .. , . '�'✓ :, . .. .. each additiom�i < `-. = , �:$s�,� � , r I�� f`` P.�r U Y`. j'�. . .. .' ,-� 4 '•� ° � F - � for ach addrtional - ? d'�1°. AN�,'ki�nn ,;�i1 Z x �. �e�- .. F� -s t r�,�., _� ` •" - . _ _ _ $2:75 for each_ addrtionai �:' �� _ � Alternate "A": Removai and repla,cement of curb and gntter' only = Driveway�:width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and<:gutterand:install'a 3 foot wide � �- - approach with 6 inch depth -_ Driveway,, andth' plus 6 feet times $15.75. _ .,. �_ , . VERIFICATION OF FOUNDATION � �- - Permits for construction will be issued a mmimum� of 24 hours from the time of apphcation to allow for proper review of the proposed structure and of the constciichon site. �"� A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed wiil be required before proceeding with the framing. .. 1� b� � ; � � 'f� �� _._.� 3; � � � f �� i � � � i ,'� _--. � 5 ti `� �� i � i� � � i � �_ � � ( °� \ � � � �3 � � `J � ,� � `� � �� ,�� M .� �' � > �- �D � � � z � � � 4� �J 4 � � � \� C 0 � � � - Q � 4. j � � 3 � � C � �-R1��, , � �} �f� �n�o �s /� r�i�,� � s��) � � v+� �sFn,�— . �I�hS►�r'� �v ��,,,� NG- 1 S /�- .� G w� /��sF�,�-.� 1� �s � W�� T �h.r" �INI Sh�O — �ok c� �c SKC�r l�v°l��r / ,l�� rS c� � �'170� — !S Gun�sT7t,�,1 c�r> ( o,� 7� C/�s�—' �'��, � /1�� - 3�i��9� �0 c�'P1�✓1 r�� n�v'�' (y� (,�11,�t�1 7b /%�/NC� C.viJ G/1t`J?� �(,v �,rG . � r.�� W ITh Tl�vIT ��.� �vv�... �la IUS i� � 1�t �J i i Rt Go /�naCN,oFO �'l•��S h�.�✓G �'Lr� (1J� W li'h �.�5� l,/�P� "�' i� /�LC. /3�H'�U � �o� /J�'G ps � 7b �12�tK�. ,� ��v.r. �� an.t� F�,D d' �1SE' ?ZJ� C��Yi�'2 �il. S7y/�� Tvl�. �1N�s►�� /1vv�. � 11 x Ir ) l�r u, h� � sc�s�"r��'o C�=1�(n� � �^ V�N�� /�, v o,f, 1,�'r-� �- T�� h� � �� ,. P� �S rp�.v�, � �� S 7v /�l�� C S��c� � r h�s c�F� wy�, C c,�,�c„�� f (�2��y��✓�o� � � �� f'�9�1�1 GA�n� 13FC�s�. �e ��E�� s �c��c► �i� /y►��o�,� � �� 1F�IM�,�I, �- jNS ��T1tiG �' C.� 1 c.�.t,, 7Li� %vsr 1S C''�'SF.�7�'uy /►�-�Ma�s � (.�t,= ca�uo- � A� L`L� ca��i G.� �N s r9u. �- r� �t � ��►� � .90o f}u��rra�.et, oc� n,�rs.. ��s�. c�. us t,� ►� 9� �o U,�.� d' � l('.Yl�'U.� � �ir 5 2t, � �'la/�.� 2u� D� vF �� b�, /r� ssy2� S�Z- 2.�� .S�Z- 3�trG t,.� �l�Z-f��3 y w .. � (,�L1�Tie�J..1� �2 S�i6Gl,�l'7� �� /I�,�C. C�lS1� �S �I U?E'c.U�/ R2�2 �N C� RECu/L�1S� � sue�ecT c�ty of Fr�aley � AT THE TOP OF THE TWINS g � I L D I N G P E R M I T „ � � � `L ___��. COMMUNITY DEVELOPMENT OIV. - " r � � PROTECTIVE INSPECTION ,SEC: - 1 . , � � _ /"'1 � CITY MALL FRIDLE� SS432 NUMBER REV DATE PAGE OF �----� � ,•' 612-571-3450 910-Ft5 8/26/97 � � JOB ADDRESS 5261 Horizon Drive NE t LEGAL LOT NO. BLOCK TRACT OI; ADDITION oesca. 6 8 Carlson's Summit Manor North Addition 2 PROPERTY OWNER MAIL ADDRES$ ZIP PNO! P...�"AIT NO. ''25432 -� RECEIPT NO. ��a�� APPROVED 8V SEEATTACMEO SNEET Rollin/Michelle Brask 5261 Horizon Drive NE 572-2261 3 CONTRACTOR MAIL ADDRESS IIP PHONE LICENSE NO New Life Builders Inc 4053 Genie Dr, Andover MN 55304 427-9550 2990 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADDRESS 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION B DESCRIBE WORK Install basement bathroom and laundry room 8 CHAN(3E �F USE FROM STIPULATIONS See notations on plan. ro ZIP PNONE LICENSE NO. ❑ REPAIR O MOVE O REMOVE SEPARATE PERMITS ARE REOUIFED FOR ELECTRICAL, PLUMBING, MEATING. VENTII.ATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NIN(i AUTHOHIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UN I HEREBY CERTIFV THAT 1 HAVE FEAD AND EXAMINED THIS APPLICATION 1 AND KNOW TNE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION ANO OROINANCES GOVEFiNING THIS TYPE OF WORK WILL BE COMPLIED �6, 500 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OFi CANCEL THE pEfiM1T FEE PROVISIONS OF NV OTHER STATE OR LOCAL LAW REGUTATING CON- 124.75 STRUCTIO OR E PERFORMANCE OF CONSTRUCTION. � PLAN CHECK FI ��''�� Licens A UAE O CON'PACTOA OA AUTMOF12ED AGENT IDATEI EN �DATEi OCCUPANCYf3ROUP OCCUPANCVLOAD SO. FT. CU. FT. OFFSTREET PARKING STALLS GARAGES SURTAX $3.25 SAC CMARGE / Fire SC $6.50 $ $139.50 TNIS IS YOUR PERMIJ �, ' � �! / • r�FiE NEW ADDN ALTER �) �� t� CITY OF FRIDLEI' SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: � e�(o ( d��i�o.� p�L� � ti►. � e Effective 1 / 1 /97 ��, �- .� �-�f �� Legal Description: 5�� b1o2.z� K�/�v� ` Owner Name & Address: ��.� N�. M��,,�E� �nA �� Tel. # S?a= ,�� j Contractor: N� �✓ �-� f L �,,.,,,n �� N�,,. MN LICENSE # �.°► M � Address: `1053 tz,.��e s�ry��, �►.��y°�'�-� M�� SS3°� Tel.# �2��-955p Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Li�IIN� AR��: GARAGE AREA: DECK AREA: OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Length Length Length f3lk�r�morvi L va/�{� ��5 � � �, Driveway Ct�rb G�t Width Needed: DATE: � �s�9� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL S'CIPULA"fIONS: Width Width Width _ 1�' �p,a 1 �A�' i _ Height _ Height Hgt/Ground ii ` ,� ' � S o�� , �'f�j��jCJG� � � Sq. Ft. Sq. Ft. Sq. Ft. � Estimated Cost: $ �o ��o°a (Fee Schedule on Back) Ft. + 6 Ft = � Ft x $ � _ $ CITY USE ONLY Tel. # $ f�� - `��- Fee Schedule on Reverse Side $ ,� , �, �� .001 of Permit Valuation (1/lOth%) $ �', �? � $.50/$1,000 Valuation $ $950 per SAC Unit $ �- � " �� $5.00 (State Licensed Residentiai Contractors) $ Alt. "A" or Alt. "B" Above $ � $450.00 Conservation Plan Review $ Fee. Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ ,��.� e t�U[LUIi\'G ['H;RM['C ��E SCHEDL`E.l�; '1'tie Chief Building Official shall, before issuing perniits for the erection c�f any building or struciure, or f��r any addition to any existing building or struciure, or for any alteration or repair io any existing building �:�r structure, upon application therefore, require the payment by the applicant foi• such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to �2�,000 $25,001 to $50,000 $SQ,001 to $100,000 $100!,001 to $Sfl0,000 $500,001 to $1,000,000 .. $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $5� plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 �62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,Q00 $349.75 for first $25,0(}0 plus $9.00 for �ach additional $1,OQ0 or fraction thereof, to and including $�0,000 $574.75 for first $50,000 plus $6.25 for each additional �1,000 or fraction thereof, to and including $1QO,a?0 $887.25 for fust $100,000 plus $S.QO for each addition�.l $1,DOO�or fraction thereof,.to aad including $500,(}00 - $2887.25 for the .first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,OOO,U00 $5012.25 for the first $1,(?00,000 plus $2.75 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROVV (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and .gutter only - Drive�vay widtti plus 6 feet times $13.�0. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with b inch depth - Driveway width plus 6 feet titnes $15.75. VERIFICATION OF FOUNDATION Ycrmits for construction will be issued a minimum of 24 hours from the time of application to ailow for pro��r rcview ot� the proposed stiucture and of the construction site_ r� �:�ercificate or Survey c,f che I�c, sflowin�* the location of the foundation ��nce it has ii lias beLn c�nstruct::.: ��,�i;; t�;, t'c'��t7lrt:ci f�c:f��re J�r��c��din�� u�ith thc framin��. � . i � � � � 1 - �� l0 � �� \ .� �ll�,��c� —�RoArr �� 3�►��- l� w rrK � m�►,� •tvP t�X�'t=�u��G `� l x� cu� �;� K iTC►��,� - si � c�.�,►.c SE� r�r d9 (.� �1/V� G9�3ln/t'75 W1l.�. /3� � i�14 l,t' I� f� Q��. � h$ wA-� v,�-2 � p,� �'21 SI �tG � � -� d1�� T�C�-� � s�" - Z� L�s�� ' i>�0/'�c �'lL�rr� �L=�"s � �� G9� , �P�JITE P'�� t�� FOR � �i+� I�NL� SIGt� _ � 0 �/�v�3 ��r-- �sT�t ��c s�i�� c,�x,sn.�G� sr� e � P • t .` � N i� .• __ � . PLUMBING Break up floor, lay � iine and patch Remove laundry �� Move water line� 4'�?) a�d gas lines fumish stool and Srfower and shower faucets instail stool, shawer and sink (we will fumish sink and faucets) exhaust f�n and venting for dryer install ¢ryer (gas� instalkwasher ener , CARPENTRY Laundry room rough in walls (re-do walt into room) build wali for shower and atso under stairs by stool move window in laundry/wash roam knock aut par� of cement stair well to make entrance into under stair storage floor'? Linoleum ar tiie? Build in Ecitcherr type sirtk boitom, counter top, vartity over sink artd cupboanfs install door for under stair storage Finish walls and ceiting (hung ceiling) ��, � �. � ,� � 1 � '� �. .. .�1 � � , � � I °', • 0 � 1 _i . : e E � NEW LIFE BUILDERS, INC. 4053 Genie Drive Anoka, AiN 55304 Phone: 427-9550 May 30, 1997 Rollin & riichelle Brask 5261 Horizon Drive N.E.. Fridley, MN 55421 Phone: 572-2261 _________________________________________________________________ Estimate to add a bathroom / laundry room area in your basement. _________________________________________________________________ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. il. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. �5. 26. Remove and move pipes as necessary. Install room insulation and furring strips. Break floor up and install a waste line for the toilet. Run vent pipe for fixtures. Run waste lines to the other fixtures. Run water lines to all fixtures and remove water softener. Install electrical, tan with light., one GEI outlet, two light opening's and three switches. Install vapor barrier. Install shower stall and water control valve. Plumbing fixture allowance: $ 945.00 Frame the walls / sheetrock, tape and sand the walls. Install ceiling. Install cabinets, upper and lower. ` Install countertop. Install plumbing fixtures, toilet and sink. Install shower door. Install washer and wall box 1 dryer and dryer vent. Run gas line for dryer. Make access under stair through concrete blocks. Finish off the access w/frame and door. Install bath entrance door. Install sheet vinyl floor covering. Install base mold. Install a glass bl�ock window in place of the existing window. Clean up and remove debris. Plans, permits and fees for construction. Total cost for the work done as specified: Note: Painting to be done by homeowner. . S 11,570.00 s � n O � W �J J O z D � � 2 D r r m m v � O < 0 m 0 -D m � c � (� � m n � � z � 0 A D D z 0 D � r m � I D � z � c � � N m � � � z n 2 m � O � � m m V/ N m � c � � � � m �, � o , n tn V� o � D � � r m r � � O � O � � 2 n N � � � m D T� o � m � � A ,,X.' � N � � � o 0 � � D D v � � � � z m � D r -i m a -� O Z � -� o m � � � � � � w °—° m � Z `< � m m m � � � i � ° � � � p w -. � � a �c � O � O -rt O � 3�� m a,l �� tn m.-x. � * � � � ^�. N � y' � �p � -` � * s � � 7 z� � 3 N_ y� N ' N� � �� t� II. 3� Z m ' w � -° � � � � � � �. j "77 � * n � � .X-► � � 1 � � � m a � m .-, v r c � � Z � "rl X C � m � m � I�IIIIIIIIIIII�O � � js t� �s �y � tn r� tfl E» Fn tfl � � cn o 0 0 � o V V v v w A.i m O O O O O p O O O O O O O � � � � �� D c� v m m C Z a � C � ' � � < m � � � .� c m v 0° m �n m � � °D � c�i � t�► m � � �°�+ �. � m � y o .� � a 7D { -+ a , � � 0 c � s � 7 � � m � � N v � � --I m r Z 0 V'i U',' � � U� U� 'O �, m � � � � z � O � � >n / -� � � � � � > > � s � a a m m � � �. � � _ _"• 3 � � m a � 4 � � m � .7+ �O. m CQ 3 � s � m o m � Q N � � 3 � ` ° m Q. n- � � o .� Qmm3 5 � � � m y 0 _. W p/ ? 7 'a � � � � — � '�. o o n_ c�, m � p1* s w o � o � o � v m o- o 0 � ' � � m a n+ Q' c c�i o m � m °' m 3 � ' m 3 � :. ,� � i � .-. 3 � n ? .+ � � � � m 3 � � � m � � � � � o � � � � � o °t m m _ � m m � � � V � O W D v v � � � �• �� D � � z c 3 � m � 0 "Il TI X � D n n � � D n z n � D n � � a n > � [ n ) ) 7 sue�ecr PfRM��1422.•-.--_____ . c�ty of Fridley �� 8 6 8� AT TME TOP OF THE TWINS B� I L D I N G P E R M I T � r ..572 3�� , � o � RECEIPT NO. � `V �_��_ O MUNITY OEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. 1 . � i-___ A;�"',,� CITY NALL FRIDIE� SS�32 NUMBHi1 REV O�TE PAGE OF AVPROVEO B� L �� 612-571-3450 9�0-Ft5 12/1 98 � � JOB ADDRESS 5261 Horizon Dri e t LEGA� �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED DESCR. 6 8 Carlson's Summit Manor North SHEET 2 PROPERTY OWNEii MAIL AODRES$ ZIP PHONE Rollin Brask 3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO Nutzmann Bros Const 736 lst Ave NW New Bri hton 55 4 ARCHITECT OR OESIGNER MAIL AODRESS 21P PMONE LICENSE NO. 5 ENGINEEFi MAII AOORESS ZIP PMONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW O ADDITION 0 ALTERATION � REPAIR ❑ MOVE O REMOVE B DESCRIBE WORK Reroof house and garage (20 S) Tear-off• Reside house and ara e; Add front canopy 9 CHAN(iE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. See notations on plan. riPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARA7E PERMITS ARE REOUIRED fOR ELECTRICAL, PLUMBING, MEATING, VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NUIL ANO VOID IF WORK OR CONSTqUCTION 20NING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITMIN 80 DAYS. OR IF CONSTfiUCT10N OR WORK IS SUSPENDED OA ABANOONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOpK IS COMMENCED. NO DWIG. UN17S OFFSTREET PARKING 1 MEREBY CERTIFY 7FIAT I HAVE READ ANO EXAMINEO TMIS APPLICA710N STAILS GARAGES ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SUiiTAX ANO ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMPLIED WITM WHETMER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE Ofi CANCEL TME pEqMIT FEE SAC CMARGE PROVISIONS OF ANY 07NER STA7E OR LOCA� lAW REGULATING O STRUCTION OR 7ME PERFO ANCE Of NSTRUCTION LAN CNECK FEE TOTAI FEE , /� / - S�GNATUpE O ON"AACTOp OA AUTMOp�2ED AGENt i0• E W►�EN PROPERL AIID TED THIS IS YOU�i PEpM T i � ' $�GNATUAE O� OWNEA�� OWNEA BU4DEp� �DATE� Bl �NS� OaTt _..�� NEWI ADDN ALTER [l �� [] ConstructionAddress: Legal Description: ��ag�� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 B LDING PERMIT APPLICATION ��/ .�zQ�v � . Owner Name & Address: 0,,,,1, ��Si� Tel. #�%a " aa�6�� Contractor: /��; � �,�.,�,wv %��G�Sv � ws� . MN LICENSE # �a�Y.T %� � Address: `7�'� l S� � t�P r�� Tel. #�a �= �� a`� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the • lot, with the proposed construction drawn on it to scale. Length Length DESCRIPTION OF IMPROVEMENT �� Cfr Width Height Width Height Width H�dGt _ r„�i�i� - Sq. Ft. Sq. Ft. Sq. Ft , .- � , Construction Type P ��'�'� ��s � ��'e-Estimated Cost: $ �� S , (Fee Schedule on Back) Driveway Curb Cut Width Needed: _ Ft. + 6 Ft = Ft x$ _. $ � DATE: // 4� J� � APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � i /�?iy� � (� y �i /S�c� �f� � $ �,/ a �� av ��X�/ ` c �7- % Fee Schedule on Reverse Side $ / f ': � � .001 of Permit Valuation (1 / lOth %) d G �� "'r� $ � . �' � � $.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 v l+ ' $ Agreement Necessary [ ] Not Necessary [ ] �� $ � �'�� l'�� s� ( BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $1Q0,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,Oi}0 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1, 000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereaf, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. . A C \ \ � �� '�� °l � \ 4 � ,� � � ��y. � � � ♦ 0 �V � . \ " V � � � � � � � A � � � � � 0 � c �� -� � � \ � � _ � . i � � \ • ��. �" :��% , _ �'-� :�/�. '�I � �� \. , � � � �� o � � � � ✓� s v' � .� �° � �" y l � � � c �� G � � �. � ,,� _ � r � Rollin and Michelle Brask � 5261 Horizon Drive NE Fridley, MN 55421 June 21, 2002 City of Fridley 6431 University Avenue NE Fridley, MN 55432 Fridley Inspections Department: Our neighbor, Beth Rising, who resides at 5249 Horizon Drive NE, has spoken with us about having a new air conditioning compressor installed between our houses (to replace the existing compressor). We have given our approval for the new unit to be located in the same place the existing unit is located. Please call if you have any questions, G�;�� Ro lin Brask Michelle Brask ADDRESS PIN LEGAL DESC CITY OF FRIDLEY 6431 iTNIVERSITY AVENUE NE FRIDLEY, MN 55432 57Z-36U4 l+'AX: : 5261 HORIZON DR NE : 263024220044 : CARLSONS SUMIVIIT MAN NO ADD : LOT 6 BLOCK 8 PERMIT TYPE : BUII.,DING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION 571-12If7 ->---��-, PERNIIT �.: 2004-01591 f"' DATE ISSUED: 09/14/2004 VALUATION : $ 3,191.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILIT'Y LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF T�-IE DWELLING PER R317 OF TI� 2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCT A 12' X 6' THREE SEASON PORCH WITH A 3' LANDING. APPLICANT BRASK NIICHELLE R& ROLLIN J 5261 HORIZON DR NE FRIDLEY, MN 55421 � ./�� : BRASK MICHELLE R& ROLLIN J 5261 HORIZON DR NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This pemut 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 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 a.ny other state or local law regulating construction or the performance of construction. Bldg BUILDING PERNIIT FEE PLAN CHECK FEE FIRE SURCHARGE STATE SURCHARGE, VALLJE TOTAL 97.25 63.21 3.19 1.60 165.25 N�yy [ j CITY OF FRIDLEY Effeotive 4/1/2004 ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMITAPPLICATION y, �/ � . �,`�` `�. «�� Construction Address: � Z� � I'l U�i 2Ur� /�� s Legal Description: Owner Name & Address: l� L� d- '�J Tel. #�% 3� S� 2� � 2� / Contractor. MN LICENSE # Address: Tel. # LMNG AREA: GARAGE 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 DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: J .S��ooJ �2 • Z � � � • 3 � �� 'i, " � � � (,cq t� c�S � �� -I � � � Construction Type: Estimated Cost: $ ��i / a� Driveway Curb Cut Wdth Needed: F� + 6 Ft = Ft x$ _$ ri �� - DATE: / � �'�i APPLICANT: Te�. # %12-r��- S3 S � Call (763) 572-3604 for Pennit Fees if mailing in application. Fax to 763-571-1287 if using credit 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 $�� $ L�l $ � !' $ �� $ .� $ $ $ $ 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 [ ] TOTAL $ � • �� STIPULATIONS: BUII.DING PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteradon or repair to any existing building or structure, upon applicadon therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $SOO,Ot� $500,001 to $1,000,000 $1,0�,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,� $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each addidonal $1,000 or fraction thereof, to and including $100,000 $993.75 for first $1�,000 plus $5.60 for each additional $1,Q00 or fraction thereof, to and including $500,�0 $3,233.75 for the fust $5�,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,0(�,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,0� or fracdon thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate Perauts for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundadon will be required before proceeding with the framing. New Houses Onlv �� C� I � 4 1 � � N � " .e: °� `'� S1' a ��C �� i � ;i- i rL � F� � � 4 P ��y � � + �� i� .,�— ,�r�' �. er � • �� . .` � � �� n � ` Q � �;� 6 ��y 'P%°�� '� � � � _ ... _.. ,:.. ..__. -�,�., �' : � �'- �G f'� 1 _._._.____ � � � � � �� .� � � � � Y�'� � b' � , � � � `� ''r`J � � � �`4 -�v' � �n �, T � �! � �' �� --�C �Z �� t�' 0 �q• � � °�, � `e's`'F�+� �y `, � �YS��ti� � ��' �:w� �l,��`�3` . �'i, � RO6��_ ''-�, �q� � � F � tr � �. `,.+E.: �� ' �.�;�, � �� ~�.,:� � `°`�;� r� ,. �-..�j� . ,� � �,, �. �:� � ��. � �. � � � D �� t � i M � � � �W v< � x. � � p� ` 6a � .�. �.5 � �� w'U�C+ � � e � s� v s � � � � O � � � a � � � � � �; x 0 .� a�7. V! -�----- - - - - 'V _ o A �'Q lV -�- + � � `,- v X � � 1� � � � � ? � . ,� ._ %,_ � � �- �°'t �� _�:' fy tR v4" '� V -� v �:, ��- � � � �;� �� Y �� ;�, �� _ � :-h,.. � ��.�, �. �E, � `< '`�� :. ,.. t•� ,,,,:� , � �� -�:�, ! d\: e�� < =e� � �S� ' y� �� --.� ! � '-�C. � � � 0 c � � � � � � � � #---��— 't \ 'r �,.� �v � �xn� �� 4 \ � � �� C `�v � ��g _ � � b� �� . � �� . � ��; � � l � � �� x .� Lts �� `\ \� '� � �. `t{ � �f� . � �.� � , �� a. , _�, t f �..� � `k i \ �� tl�. � �' � ��"�,,1 ;F; E^� +;�, a� � � � � � \' s, ��, �: � . F��_ � � 4- �,;� _ � � � �� — � � � d L o� r G �� .� � � s� � til � � � �- �� +� � J � � � � `ra a �9 x � �c f � � � � o L o � �, � � � � L '!-� '� ` O �� .� � �, � � �� w c.r �, �, �' z � � � � ` �—' � ° C3 —� ri �, � �� t � � � �, o � ; �m Q 4 �� "'G -� � 3`— .� � � � � �h � � � �.: � � —�r 4� -F" � a � � — � �• 7 e CITY OF FRIDLEY 6431 iTNIVERSITY AVENUE NE FRIDLEY, NIN 55432 57Z-36U4 l+'AX: ADDRESS : 5261 HORIZON DR NE i PIN : 263024220044 '� LEGAL DESC : CARLSONS SUMNIIT MAN NO ADD : LOT 6 BLOCK 8 571-1"1i37 PERMIT NO.: 2004-01939 DATE ISSUED: 10/20/2004 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL TWO CIRCUITS. # INSPECTIONS 2 APPLICANT BRASK MICHELLE R& ROLLIN J 5261 HORIZON DR NE FRIDLEY, MN 55421 � .']Ty�l � BRASK MICHELLE R& ROLLIN J 5261 HORIZON DR NE FRIDLEY, MN 55421 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 laiow the same to be true and correct. All provisions of laws and ordinances governing this type of worl� 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 sta.te or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date. ELEC PERMIT FEE - MIN (RESn STATE SURCHARGE, ELEC FLAT ELECTRIC FORM FEE TOTAL SEPARATE PERMITS REQUIRED FOR WORK O`1'ti�K "1'tiAN ll��(;Kit3�ll At3UV�. 40.00 0.50 1.00 41.50 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# ��"�1�� Residential Application City of Fridley See Back Side For Required Informa#ion Date a O S Site Address: S�. (e I �0 62. j Zo�n..i � fZ The applicant is: (cirlce one) Owner ontr ct Property Owner: o <.L' � Address: S �rn2 City: State: Zip: Phone: �b3- S�Ia— Cell: Fax: Contractor Information Company Name: R�VB� C�tjl Sh�Bt M��21, �11C. �ri S��pp� Contact Person: 8290 Mal� St N E. S�Ite 39 Address: �j` r1j I�i, MN 55d-�� Y� C' P� Phone: Cel� �� Fax: 7b3-7S4—a�jD� Email: MN Bond# & Ex Date'$OA �1�b5y� So y � � b Type of Work (circle one): New Replacement AlteratioNRemodel Detailed Description of work: Equipment Installed: MFG: CACtlZie � Model: 4 CVpQ'10 Size/BTU: MFG: C�RtL:��2CL Model:3�TkA0a�4 SizeBTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 _New Gas Grill $10.00 �A/C $25.00 Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 �Fumace $35.00 _Pool Heater $35.00 Boiler $35.00 Gas Dryer $10.00 _Ventilator $15.00 Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ ��. 0 0 (Total from above-Minimum fee $35.00) Surcharge � 0.50 Total Due $ ��.sd3 Make check payable to City of Fridley This is an aoolication for a oermit- not valid until processed I hereby apply for a mechanical 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 end with tha Minnesota ConsUuction Codes; that I understand this is not a parmit but only an application for a permit and work is not to start without a permi� that the work will be in a�cordance witli the approved plan in case of all work which requires review and approval of plans. Signature of Applicant: . Date:� d9'OS� Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work o.,.,c....a ai�nr�nn� REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NE�IV HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or F-ropaue/IFGe Chapter 3 with NfN Amendments — 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances 1FGC Cha.pter 5 with MN Amendments b. Fuel other than gas ]MC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Hea.t loss & cooling load per room a. Required. on new construction IMC 1346.0312 5. Ventil.ation a. Per MN Energy Code 7670 or 7672 6. Duct I)esign Per IMC 1346.0603.2 , a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations PLUMBING COMMERCIAL APPLICATION City of Fridley ��a� ' �' Permit Number Received By Date Received DATE �—�� —0 S YOUR E-MAIL ADDRESS SITE ADDRESS �J e�►.Pv 1 ��'ZO n�� TENANT SUITE NO. NAME �0 �` �� C7Z'A S1V PROPERTY OWNER/ ppDRESS SQ'M.C� TENANT CITY STATE ZIP PHONE #�J 6 3" S�I �'' �' ol►oi. �D � NAME �NBi CI�/ SI18et MB�I, Ii1C. LICENSE # ADDRESS � � �' COMTRACTOR C� il 8�/, STATE ZIP PHONE #Cr�� 7�"21� 6�81( (763� 754-29{� PERMIT TYPE ❑ INSTRUTIONAL ❑ MULTI-FAMILY ❑ SWIMMING POOL ❑ TOWNHOUSE ❑ COMMERCIAUINDUSTRIAL �', OTHER TYPE OF WORK p NEyy � REpLACEMENT ❑ ALTJREMODEL DETAILED DESCRIPTION OF WORK Q.�xz\ .c � w�.-to�� 1a�e�olu FIXTURES: (INDICATE TOTAL AIUMBER OF EACH) FEES BASED ON $10 PER FIXTURE, EXCEPT WHERE NOTED URINAL CLOTHES WASH FLOOR DRAINS RPZ VALVE/ ($15j DISHWASHER GAS PIPING BACKFLOW PREV. �WATER HEATER ($3� DRINKING FOUNTAIN GREASE TRAP ROOF DRAINS WATER AAETER FAUCET KITCHEN SINK SHOWER WAT�R PIPING FLAMMABLE WASTE LAUNDRY TRAY SLOP SINK WATER SOFTENER ($35) TANK LAVATORY SWIMMING POOL WATER CLOSET Permit Fee Plan Review Surcharge Total Due $ 3� o0 $ $ .So $ � �. ar O Minimum: $35.00 $.50 on permits less than $1,000 Make Checks Payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT - NOT VALID UNTIL PROCESSED 1 hereby apply for a plumbing permit and I acknowledge that the informatlon above is complete and acxurate; that the work will be in conformancs with the ordinances and c�des of the City of Fridley and with the Minnesota Construcdon Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a perm�; that the work will be in accordance with the approved plan in the case of all wrork which requires review and approval of plans. NAME OF APPUCANT ' DATE �� a�IIO S SIGNATURE OF APPLICANT OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT 6431 UNIVERSITY AVENUE NE, FRIDLEY, MN 55432 (763) 572-3604 N p' N ~ D f ` � G ' ✓- F y Q 7q µ 4,. �i �:*� y m a � �t �+ �� .� � i"` L.* n �..i .+j 8 l� . 1 r• � ZL". �Y ti I� r -� -� � � •��r^�. " 'r � v 'a C .L N a�L .-1 r. •r ,i � .. � N i.� n �, w . � _ � �-. -. .~j H � �� _ i �� .�. I` h � :y : F � t� ` �=+ .�'. ��1. �.. , 'L `z 4: r � - - r 1 T r-. � ^ , �. � � � ti ' � ., :' i .�' � � � • ,- n � ; :� ,. , n ��''th ? i t •- I � O �. �i � . � � � . c v • � �� . � •�'. ��rd AV�. 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