AF - 47438•
City of Fridley, Minn.
BUILDING PERMIT
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Owner.......................................
Addr�s ......................................
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N° 3539
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Builder � ... . . ..............
Address... i!� .................................
L4�CATIO�V OF BU[LDING
No. .Gll.�l.�.. Street . ... .. ....... ...��...... Part of Lot ........... ............
Lot . � . . . . . . Biock . . � . . . . . . Addition or Sub-Dfvision . . . ��lLl�e� . . .
,
Corner Lot . .. .. . . .. . . . Inside Lot !� . . .. .. .. . Setback c��"�. .�. Sideyard .�U .—`. Z� �. .. . . . ., . .. . . . .
DESCRIPT[ON O�' BU[LDING
To be Used as: �
� t
� �(/ / / �/
�,.kvC��e�i�... Front J.� � Depth 4��� y Height 1..�..a Sq. Ft. �lQs,7. Cu. Ft. ���!
.................... Front ........ Depth ..... Height/ Sq. Ft. ........ G�. Ft. .......
Type of Construction ................... 's� Co�t.��X�/.�P. r...�.�...-. To be Completed ...................
In consideration of t'he iss�ance to me of a permit to
the proposed work in accordance with the descrIption ab
ordinances of the city of Fridley.
desribed above, I agree to do
ampliance wfth all provisions of
...............................
/�O
In consideration of the payment of a fee of $?�1. . . : � : . , pertnit is hereby granted to . . . . . . . . . . . . . . . . . . .
. . . .. .. .. .. .. . . .. . . . . . . .. to construct the building or addition as described above. This permit is granted upon
the express condition that the person to wham it is �ranted and his agents, employees and worlmzen, in all wark
done in, around and upon said building, or any part thereof, shall conform in all respects to Yhe ordinsnces of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
vin the city limits and this pezmit may be revoked at any time upon violation of any of the provisions of said
ordinances.
.'�1....... Building Iriapector
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NOTICE:
This permit does not cover the construction, inatallation o� alteration for wiring, plumbinp, pas heatin�,
sewer or water. Se sure to see the Building inspector for aeparate permits for these itema
Date:
Owner
City of Fridley, Minn• _._._.._---,
.
BUILDING PERMIT N° 5 2 3 5
_�'`....w.._...�,�� _..�.:� .._...._.._.._.__.�..._
• Builder
. _.: . .._._. __ _.. _... ..:: ..---__.._...._......._..---..._..�...___
Address
Address
•- LO ATION OF fl G
No. .�. ...��.. Street ....._... .. ��tl�"�'. .... ...._� .• ..t. Part t •-----....
----.._------�--.__._..... ._..._...._.�.
Lot ._ .._.._......._...._. Block ....._._.._._. ....___...._._...... . Addition or Sub- 'vision •_- : ---- - .. ... . .w._
_____.
_.. �, . .. '""'
Corner Lot _.__----.--__.._.... Inside Lot ..... �--•-.---•.-- ---••.�,,;�.-----...:. Sideyard ..._.._�--�--._.._._...._.._.....�..._._.__....
SewerElevation _._--•...._.__.-•----.._.._.._...._.._.._..____..._...._----.._.--•---•--.. Fo dation Elevation ..--•---...._........_......----_......_....__..___.._._..._.._.
DESCRIPTION OF BUILDlNG
To :
_. .. .... Front ...,�.. Depth ...:�" .:_ Height •--,�� .. Sq. F� ._. _.. Cu. FL ..'��� �
..... _' �. Fro t�_i�.✓.....__ Depth _..� 'ght _.,�� Scl. Ft.�/.
. _.. Cu. F� � � �
Type o# nstru n..� ....._.:.__.. Est. Cost���i..�. ��..----------_.... To be Completed •------__--...__..._____�....�..
In consideratfon of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance wlth the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
�_�._.__w..__...�._
In consideration of the payment of a fee of $. ._.�....._:.._.._.., permit is hereby granted to._._..—.r.
_.__.__........_....._..._.._.._...._..._.._._.___ to construct the building or addition as deseribed above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon sa,id 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 buildings
within the city limits and this permit may be revoked a t any time upon violaticuz-efyany of the provisions of said
ordinances. � . „/'� J
Bttildin8 Inapecto�
NOTICE:
Tbis p�rmil doss not eove� ths aonstwetion, installatfon fo� wirfnp. plumbFng. 9as h�ating, sawsr or water. B� suw b sN
th� Bui{ding inspector fo� ssparare p�rmits for fhess iMms.
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APPLICATSON FOR HUIi�ING PER�II'r
CITY OF FRIDIEY, MIIJNESOTA
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Owner s Name � �� t � Builder
Address • � � Address,,,�J� .S� � ��� „�,_,
IACATION OF BUILDING
�
No.� C? Street �-1�-c-1���1C---c_.- --- Part oi Lot .
Lot �� Block ��"� Addition or Subdivisi
Corner Lot � side Lot Setback Side-Yard
SEWER ELEVATION FOUNDATION ELE1iATI0N
�pplicant attach to thia form Certificate of Survey of Lot and propo�ed buildiug
location.
DFSCAIPTION OF BIIILDING
To be used as:
� � Front�Depth � Height____�,�_ �
Sq. Ft. �„� O Cu. Ft. _����
i�s.P, <�_..,�.� T+�nr►t ��i Denth �� HeiaChll �d' � --
�. �. ,i sa �. �. .L� �
Type of
To be Completed � � �.� �
ted cost �� 1�,� -��
The undersigned hereby �akes appl�cation for a permit for the work herein specified,
agreeing to do all work in atrict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declaxes that a11 the facts and represeatations
stated in this apglication are true and correct. -
DATT („ :,� �" � C � SIGNATtkiE
(A Schedule of Fee Coste can be found on the Reeerse Side.)
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City of Fridley, Minn.
BUILDING PERMIT
nat�: , � �� 19� �
�\��"� ` � � �.7 �
N°
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Owner: (!h�stQr `�tmb�'-'�. _.._....... Builder MpTk �.t�eTS __....___.._.._...__..._.._..._..__
_.._.__._.
Address E2�SKL:.sT�.�.4.�1,�:�..�r,__�� $�..�......__...____.._._ Address �? �1� AV6. N..�_._.._.______��.______
LOCATtON OF BUILDING
No. _ 6704 _. street .._.. Jackson .St.�N. F._---._.._.._...__.._.._._. Part of Lot __ ..r
Lot _.�--.w_....___ Block _._.._._._...�......._.._._..__. Addition or Sub-Division .__B?b��.81i T8TT8C8
Corner I.at _____._..__.._ Inside Lot _._.._.._.._..�.._._ Setback _..____.__..__.._...__._ Sideyard
Sewer IIevatiaa _.._.._�._..._._.___.._..._.._.._._._._�.._._..___..__ Founda.tion IIevation __._—
To be Used as:
�oat
Front
Type of Construction
DESCRIPTION OF BUILDING
Depth _ .._ Height _.—__.� Sq. F'�
Depth r._.�._._ Fieight _._..._____ Sq. F� .�__._
__.. Es� Cost __.�:.� ��.._..___ To be Coa►Pleted
Cu. Ft
Cu. Ft
xepair Stor� Damage
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
th� propoeed work in accwrdance with the description above set forth and in mpliance with all pro�viaions oi
ordinanoes o! the city of Fridley.
In co�sideratfa� o! the payment of a fee of �_..�,(�..(X'a.__._.._.., permit is hereby granted to_ �1'g ��-d�l'S
to construct the building or addition as described above. This pexlnit is granted upon
the express Condition that the person to whom it is granted and his agents, employees and workmen, in all wark
done in, around and upon said building, or any part thereof, shall oonform in all respects to the ordfnauces o�
Fridley, Minnesota regarding lceation, construction, altera.tion, maintenance, repair and moving of buildings
within the dty ]imits and this permit may be revoked at a►�y time upon violation of ar�y of the provisions of said
ordinances.
ii�":!"_ ,�
NOTICE:
'Ihis pumit dws net eowe 1h� wns�euetioa, instatlNion fer wGLro. Phnnbino. Ya h�a1H�o, sMw�r or wN�r. M swr h aM
Nn 6uiWio� Is�elor for aparaN p�eaiits fer fh�� If�se.
.� , �
APPLICATION FOR BUiLDING PERMIT
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, < _ CITY` OF FRI�B7C`, 1�lINNB'SOTA . . _. � . .
: ;.. . . . , , _. . _ .
. .. , ��j� .
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' OWNER' S NAMS ', '� ' BttILDLR - 1�` lQ`�t
ADDRESS, ADDRESS� '�� �, � � � ' U.u-c` � 0 .
. -. ,., . : • .. �,'.
. .' �OCA�.'IqN QF BUII.D�N� . - .., . _��� �
_ . . , . . . . . - _ � -
� �„ �.. , - , � , �-
No. �%00 �, ��� St���eC . . . . ��at� o'f Ld�� .:;
, . . , �' . , r • . s . �""'��'�
. ... . : , .
LOT�� $LOCK .J ADDZTION OR . SUBDTVISION%�,�G�V /� lal�� Ri4 G�
._ . , . . .
Corneir Ldt =�.. � Ir�sfde ' yt�T � ` ' S�iCback ' ; ' - ' S�.d�-�ta�rd� ' . : �'. -, -
--'.,,,,,-- —�--.....
. . _. , , . . � .. _. _
3EWER ELBVATION • . `'''FdUN���2t'7fi�'ELEVAZ`IbIQ ` . �
.. :� �• . . . . ,
Applican� �tCacH to this fo�m Two Certificates of Sui:'vey of Lot and propoeed
building locatiiori dra�tn on these Ceztiiicates. '�-
To be used as:
aBSCI�ii�T�Olt 'b�'�`�'tii�Di�tG ' :,:. . . . :
. . . __._.. , . . �- .. . ; - ,. .. ,.
_. � A . , ; .. �
. . . .. � ;!(i' n ." . _
Front Dept � eight
Sq. Ft. Cu.,Ft.
. grcmt , . , - Deptii , -� :�g���, ,r. .
.��
: � " Sq. FC. �. - . Cu. Ft; : r., � . .-�
Tqpe of Cqa�etruction ^� Estimated Coet � oZ� ,�o. �,_„
To be `cdmpi�ted � . _ . , �
The undersigned hereby aiakies applicat�oin for a permit- 'for the work' hereit� �p�cified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances
and rulings of the Departaaent of Buildings, and hereby di�clare� that gi1=��the facts
and representatians stated 'in'this�'applicatic>n are true gnd �correct. ��
�DATE
(Schedule of
� . , SI�NATUR� v� l��.G� -
.,
CoaCs can be found on the Reverse Side).
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COMMERCIAL - RESIDENTIAL
202T Uaity Aveaue North, Minneapolis, Minnesotu SS422 a a Telaphone 588-3988
��,y i�, �.���
�h�sC�r �hur�b�r�
b'�d� Jaakaor� N.E.
8op�ir of +�t�rm Qamsg� �►t �lae eb�ra addr►ee�r to oc►n�r��r� a�'
th�► tollc��►�ags
Hs-bui�.d t�+a aar att��ahed gar�go ��2' x��' }+�od bresss� .
H�.g rvcf aa g+�regs (�' ov�rh�r�,. �h�ks axtdrior� ta matc��
h�w�e. i�mur �l�atrio 0psr�iog+� plr�a txa► s�vivol��srt� in ga�eg�r,
lb � g�r�g� door.
�.2� �c 2�� bre+�sceor�y, B�olve�e�d p�rt af breegew�y �.2� x� l+�t.
���tty p�ad o�a g�r�gs w�11, ��ad ha�se w�al7:. D�Veo �rtr�lbr�
�� ��rc� �ld�►� �►t' brs��e�►ay. Tw�a► �3+�N'a��a ,�e�lvusle flaarr� oa�
br+eo�ex�q. 1�r�r��L�r pins pan�ili�t�; aq �eril�.ag of b�r�a.wa�r.
C�qe t�mili�a� 2igk�t �ad ope sxit�h, ��s u�tsi8a l�gh�i ��d. sxl.to�t
1� �a��ee�s�rey.
�p�+q• t�o3a b�aard o� ree�� �!' i�o�ss. H��,�i���► t�ras �►i.�a•►
�c��r�r ran re►sr of house. 8�p+��,� �nd replaa� ah'tlaes en re�r.
Camplete� �t�►x ��f. ��p7.+�as eh�lce� o� b�dPaom aids, �I�o,
f'�o3,� b�rard. 8�pa1r b�ria�c mold �aa �t�atia�re. ��r tac�i� ta+pe�d
_ on frnni of hcau�e. Ata�x �h+�kos �nd r�rd�c�ofl or� ea�irs i'ront.
Be-�"inist� f9.�re kitoh�a aabin+�t lleac+r�. 8sp�ir or��►i�r 3,�a iti�-
ah+e�. He.»�epr�y k�te�heb cee�.ling �nd r��sca�r�te k�,t�hea. 8�-
plac+� tvro w�+nd�ws .• �tarma a�ad a+�raoQS ip ki�chera. 8�pe�;r
re�ar d�ror jamb. �r�o thra�hoid �� ae�r rmar dvc►r. 8em�v�
a�ai�t�qg sa�th w�ll of kitahsa aod rs�u��,d. �i�►w Ar�troq�
�:al��d llt�caleum �n kitah+�n.
8,pair bathroom �ar�rr�.
�ID�i�"0Q! �13 .,
Hede►4cra�te re�r b�,dr4c+m.
Bedro�►m �� s
i%�r �l���etrc�ok e�� cpi �11 af be�aroam end redeoor�►t�.
f�.�iah t�ro doar+�.
�dr+�n� ��;
Bmf'l.r�l�ah thr�� d�€,re. ��r-g�+��e� wi�ad��. 8�sdeeorete.
8l�-
B��e►msat t
�eraave e+�t �.re �sllia� t 31s a rs� i l� � �c 16' � a�4 r�px:a��.
�►�sr�e�e�h�rd �her�pane �►iadox �.n ].�ving roam i� r�vt fl.gutred
�.� thit� bid.
H1t�ve �r�y exist3.mg debri�r t`x�ti� �rermis�a xi�e� job �� tia�plttud.
Total pri�� - IaDor �c m�at�rial �8,�4�'i.OA
� �u�ts+�li �va�k � .. •
��...�..��- ���,�/
Ct'tY OF FRtDLEY INSPECikON DIV, . � Effective On January 1, 1993
6431 Universiry Ave NE
F�idley, MN 55432 APPLfCAT10N F�R POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS ANp OEVICES .
i � i_ i
Residential
Fumace Sheli and Duct Work, Burner -
Aiso Rep{acement Furnace
Gas Riping (Needed with new furnace)
Gas Range
Gas Dryer
Rate TOTAL
$ 20.00 $ o • U�
$ 10.00 �
$ 10.00
$ 10.00
*Air Conditioning -- Atl Sizes S 10.00
$R4�1� �4�n��.o��} . �
All Others/Repairs 8� Aiterations (LIST ON BACt�
1% of Vafue of Appliance or Work
Commerciall�ndust�ial
t96 of Value of Appliance or Work
State Surcharge
TOTAL FEE
J�B ADDRESS (� 7Q p Q �,�-yV ,��h/ p�'
The undersigned hereby makes appiication for a permit for the work herein
specified agreeing to do ail work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the iacts and
representatioris stated in this application are true and co ct.
� a� ,1993
$ � � V .
BUtLDING USEQ AS � �i
� _
ESTIMATED COST � 9D�, /�'U PERMtT NO. , I� �C '"
� /D • !J�
DESCRIPitON OF FURNACE AND OR BURNER
$ No, of Heating U its � Circle One (Steam} {Hot Water) 1�1i ��
Trade Name �ie�ftNT Size No. ��t$AAV 03Co ��p
BTU ia(D, tl?I"D HP EDR
$ Fuelf� O,y�.� Total Connected Load /, 0?lZ�
� �
'�o.SD
MINIMUM FEE FOR ANY HEATING/COOLlNG 1,[_/ENTILATION
REFRfGERATIONlAIR CONDlTtONING PERMIT IS �15.00
PLUS THE 5.50 STATE SURCHARGE
REI4�SPECitON FEE $30.00
*Air Condldoners can not be placed in a side yard v�ithout
wrftten pe�mission from adjotning pro{�erty ov�mer.
r � �
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:�
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANY
Signed
BLAINE HTQ. A/C 8� ELECT. IN�:
13562 CENTRAL AVL=. N.E.
--._._- ----
Tel No. 7$ 7-��, �
Approved By �� Rough-in Date ' Final Date _�p -1 q-93
FiLL OUT BACK SIDE FOR STACK VERfFiCATION ON
REPLACEMEN7 FURNACE �
� �
a�
��
�.Q-r rn �` � �� � l 3 �i cp
6��,�� -HEATING HOUSE HEATING TEST RECORD
AIR CONDf710NING
ANp ELEC7RIC, WC.
1�
ADDRESS � G � r APT. FLOOR CITY SUBUqB
OCCl1PANT Y t�' OWNER
HEAT LOSS DATE HTG. INST. �� r4' 3
SOLD BY INSTAILED BY
Electrical Work By -1_ Gas Line By
TYPE OF HEAT GA FA � HW STEAM_ SPACE HTR._ UNIT HTR.� OTHER
GAS DESIGN CONV6RSION
MAKE MAKE OF BURNER
Model f.� Model
Serial - � Max. BTU Rating
INPUT MAKE OF FURNACE
Model
THERMOSTAT
Valve _�
Liroit �
Limit Setting _
Fan Setting _
Pflot Type _
Pilot Make _
Vent Sizo � � �
KIND OF LINER UG SIZE NONE
Draft Hood Regulator
Filters Size ,�c��"��' G,U!✓d Number �
Chimney Location r Inside � �" Outside
Chimney Construction
Pilot Model Smoke Bomb wtd�g _
Pilot Timtng � f•�eG Draft Test Tag
L. W. Cut Off '"" Door Pressure Lighting
Pressure , Percant CO, Date Tested
input CFH d Percent O= %.� � � Company Testing �
Stack Temp. ,�,_ Percent CO � Name of Tester r�_
Form 235
sue�ecr IT N O.
City of Fridley �;���,��, -� 9
AT THE TOP OF THE TWINS g U 1 L D I N G P E R M I T �
f
� �
, ` IPT NO.
� COMMUNITY OEVELOPMENT DIV. `Z�
� �L_�
r � � PROTECTIVE INSPECTION SEC. �
� �
� �
, � /'��1 � CITY HALL FRIDLE� SS43Z NUMBER� REV DATE PAGE OF qVPROVED 8�
�"""�� ��� 612-571-3450 910-F15 8/7/96 � �
JOB ADORESS 6700 Jackson Street NE
t l EGAI LOT NO. BIOCK TRACT OR ADDITION SEE ATTAGHED
DESCF;. 3 5 Brookview Terrace SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Jerry Krummel 6700 Jackson Street NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Al1 American Roofing 4112 �7 Ln NE, Blaine MN 55014 786-6676 5160
4 AFICHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING \ ,
_._.
Residential `�• � � �
7 CLASS OF WORK
❑ NEW ❑ ADOITION CJ ALTERATION �1 REPAIR ❑ MOVE O REMOVE
8 DESCRBE WORK
Reroof House & Garage (28 Sq) Tear-off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
?YPE OF CONST. OCCUpANCY GROUP OCCUPANCV LOAD
SEPAFATE PERMITS ARE REUUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR Alq CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION
OR WQRK IS SUSPENDED OR ABANDONED FOR A PERIOD Of 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFiEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIEO @ @
WITH WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT `P91O y�.SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEAMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING cor,- �34. %S Fire SC �. 91
S CTION OR THE PERF F CONSTRUCTION.
� �� PLAN CHECK FEE TOTAL FEE
License SC $5.00 $41.16
OF CON"AAC70A OR AUTHORIZED AGENT IDATE� HEN PfiQPER�Y V IDATED THIS IS YOUR PERMIT
�� �
S�GNATURE OF OWNEA i�F O�NNEA BUILDEAi �DATE� /BLDG � P q�7E
NEW
ADDN
ALTER
I�
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 3/1/96
ConstructionAddress: _(,, `� O CJ �,.� � K s Gtiu S'--�-
Legal Description:
Owner Name & Address: ,•e r r y `� �v i,v� � Q� Tel. #
Contractor: {� LL � t�1 F_te l�{A 1'� �.c�-�� �I (� MN LICENSE #���
Address: �C��� �/(�����-'�i�'(�.�, �//,� 97 �� /�� Tel. #
Attach to this application, a�"e�f'i�cate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LNING AREA: Length Width Height Sq. Ft.
GA.RAGE AREA: �n�n w�ar� Height Sq. Ft.
DECK AREA: �n�n � w�ar� HgtJGround Sq. Ft.
OTHER: �erpv� �vv� �- ��ruc�� 2� s� I tae -OFF
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yaxd Setbacks
U
Tyge of Construction: Estimated Cost: $ CQ
Approx. Completion Date:
(Cost on Back) �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �- 5 - Q � APPLiCA�tT: J � Me s �. �r s � a. k Tel. # ? �G - � � 7 �
Permit Fee
Fire Surcharge
State Surcharge
SAC Cha.rge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� ��.�,�
$ . �/
$ <SD
$
$ .�.C�
$
$
$
$
� `�/.l�
CITY USE ONLY
Fee Sch�lule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuarion
$900 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.OQ Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
,��-
City of Fridley
AT THE TOP OF THE TWINS
r
� �
� •
COMMUNITY DEVELOPMENT OIV.
' � b -���� ,
r � � PaOTECTwE iNSPECTiON SEC.
� .
� � �"'1 � CITY MALL FRIOLE� 55�32
�.---�': �.' 612--571--3450
SuBJECT
�U ILDING PERMIT
NUMBER pEV DATE PAGE OF
910•F15 8/18/00 / /
108 ADDRESS 6700 Jackson St NE
t IEGA� lOT NO. BLOCK TRACT OR ADD1710N
oESCR. 3 5 Brookview Terrace
2 PFOPERTY OWNER MAIL ADDFESS
31323
IPT NO.
�V ��
vnOVEO Br
SEE ATTACHEO
SNEET
Laurie Krummel 6700 Jackson St NE 572-9208
3 CON7RACTOR MAIL ADORESS ZIP PNONE IICENSE NO
Alpine Des. F� Bldrs. 6760 Shingle Creek Pkwy., Brooklyn Center, I�II�1 55430
l ARCHITECT OR OESIGNER MAII AOORESS ZtP PMONE LICENSE NO.
(612)585-8965 20069780
5 ENGINEEii MAII ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUIIDING
Residential
7 CIASS OF WOFK
❑ NEW O AODITION � ALTERATION Ci� REPAIR ❑ MOVE O REMOVE
8 �ESCRIBE WORK
Remodel existing lower level bath,
9 CHANGE OF USE FROM
STIPULATIONS
For stipulations, see at�Cached plans.
TO
SEPARATE PERMITS
REQUIRED FOR:
PLUMB NGG ANDnSIG�IS
TYPEOfCONST OCCUPANCY
SEPARATE PEAMITS AqE REOUIRED FpR ELEC7RICA�, PLUMBING, NEATING.
VENTILATING OR AIR CONOITIONING
1NIS PERMIT BECOMES NULL AND VOIO IF WORK OF CONSTRUCTION ZONING SO. FT
AUTHOR12E0 IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOp A PERIOD OF 120 pAYS AT
ANV TIME AFTER WOFK IS COMMENCED. NO. DWLG. UNITS
I MEREBY CERTIFY THAT 1 HAVE REAO AND EXAMiNEO TNIS APPLICATION 1 STALLS
ANO KNOW THE SAME TO BE TRUE ANO CORRECT ALL PROVISIONS Of LAWS VALUATION
ANO ORDINANCES GOVERNING THIS TYPE OF WOFK WILL 9E COMP�IED
WITM WHETHER SPEGFIED MEREIN OR NOT TME GRANTING OF A PERMIT �S�OUO.00
OOES NOT PRESUME TO G�VE AUTHORITV TO VIOIATE OR CANCEI THE pERMIT FEE
PfiOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
TRUCTION R THE PERFORMANCE OF CONSTRUCTION �. ��.ZS.ZS
PIAN CNECK f
�/8" Oo Licens S $5. 0
-' $iGNeiUAFO CON'AACIOQOA�UTH �ZEO�GENt iDATE� c OOnec v�ie��nw�
a
�o.re�
)UP OCCUPANCV
CU fT
�FSTREET PARNiNG
GnRAGES
JRTAI(
$2.50
Fire SC $5.00
iOiA FEE
137.75
THIS Ij�,QUQ P Mli ��
'�.`�/�
r�c�E
s
NEVV [ ]
ADDN []
ALTER [ ]
Construction Address: _
Legal Description:
Owner Name & Address:
Contractor: l r
Address ID� ��� ;�
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
Effective 1 /1 /2000
(763) 572-3604 Bldg {nsp
7��� �(�
✓� � � �C�
i ) I ,�j�
� Te�. # 5 ZZ �"� 2� g
MN LICENSE # l�v� 1� ��Z�
Tel. # Gy�:�ti 1����j�
,� � ! �.� J`� S�%� Q
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LNING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Wdth Hgt/Ground Sq. Ft
OTHER: ��'
Construction Type: Estimated Cost: $ ��
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � 2'"� —�� APPLICANT: ,k�;��� �J11 1 `� ��l• � � _ . Tel. # �I�Z � Z Z.r'J �� p� Z
,-
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Catl (763) 572-3604 for Permit Fees if mailing in application
$%�J�.o�� Fee Schedule on Reverse Side
$ ,� •� .001 of Permit Valuation (1/10th%)
$ a � s� $.50/$1,000 Valuation .
$ $1100 per SAC Unit
$ �.(� $5.00 (State Licensed Residential Contra�tors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ �,�j /. �j
,
Laurie Krummel
6700 Jackson Street North East
Fridley, Minnesota
55
Job#
Date: 7/1/00
Rev :
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SCOPE OF PROJECT:
Remodel existing lower level bath.
Remove existing plumbing fixtures, save stool and haul away remaining.
Remove existing cabinets and countertops and haul away.
Remove e�sting wa11 and ceiling finish to framing and haul away.
Remove existing wa11s and door as indicated by shading on existing/demo plan
and haul away.
Remove existing concrete floor as required for plumbing relocations and patch.
Remove existing electrical as required per plan.
Wrap cold water pipes with foam insulation per contract.
1. Remove e�sting window(throw) and install new glass block per contract.
* Glass block style: . (Vented)
* Mortar: Cleaz silicone or mortar (to be determined by manufacturer)
* Sill: Oak 1 x_ with #310 shoe trim top & bottom.
2. Shower:
* Style: Cultured marble.
* Cultured marble wa11s:
* Shelf color: White.
* Floor tile: ($4.00 per square foot allowance)
�'* Faucet: DELTA #623. Color: Chrome.
* Shower door: Hammered glass with brushed chrome frame.
3. Existing stool to be re-used. (NOTE: NO warranty on stool.)
4. 2'4"x6'6" 6 Panel firlhemlock prehung door (((NOTE DOOR HEIGHT)))
* Rough opening: 2'6"x6'8 112".
* Jamb size: 4 9/16" due to new 2x4 stud walls.
* Door swing per plan. (if swing changes adjust electric)
* Hardwaze: privacy lockset.
* Trim: Oak princeton casing, stained by owner.
Page 1 of 4
5. Vanity cabinet: ($600.00 Allowance)
* Manufacturer: Custom.
* Style: Oak square raised panel
* Exterior finish:
* Interior finish: White melamine.
* Hardware:
* Accessories per plan.
Countertops:
* Style: Cultured marble.
* Backsplash: 4" Integral.
* Sidesplash: None included.
* Edge style: Bult nose.
* Color:
* Sink: Standard oval, integral.
* Faucet: DELTA #522mpu. Color: Chrome.
6. Mirror:
* Edge style: Pencil.
* Size: 55"+- x 36".
[) Ceramic tile:
* Floor: . ($4 sq.ft. allowance)
* Base: . ($2.SO lf. allowance)
* Threshold: . ($15 allowance)
* Accessories, towel bars, holders, etc... ($48 allowance)
General Notes
[J Remove (3) exisring basement windows and replace with vented glass block windows
per contract.
* Glass block style: . (Vented)
* Mortar: Clear silicone or mortar (to be determined by manufacturer)
[J Any yazd damage REPAIR including trees, shrubs
and all landseaping by OWNER.
[] AlI painting, staining and decorating by OWNER.
{) Floor covering by OWNER. (unless noted otherwise)
[] Dumpster is for ALPIlVE use only.
[] Heating per contract.
[) Plumbing per contract.
Page 2 of 4
[] Electric per contract:
* ALL FIXTURES furnished by owner and installed by ALPINE, if
on job at electrical finish. (includes exterior flood lights)
* Switch and outlets to be "NORY / WHITE" color.
CABLE TV rough-ins are by owner. ALPINE will
advise owner when to ca11 for installation.
Any SECURITY SYSTEM repairs or addirions by OWNER.
No DOOR BELL BUTTON relocation is included in this contract
(door chime for basement jobs)
* Note you have been chazged in this contract for:
1 - ground fault interrupter "GFI" receptacle
1 - recessed light openings (includes HALO H7-ICT w/shower trim)(or equal)
1 - standard light openings (no fixture included)
3 - standard switches
1 - broan 70 cfin exhaust fan (or eyual)
4 - battery operated smoke detectors
Any changes to the above quantiries will be charged or credited
accordingly.
Indicate any special receptacles needed for computers,
enterta.inment centers, etc. and any special heights wanted.
[) OWNER DIRECT "Do it yourself' TTEMS:
(OWNER is responsible for a11 contractual obligarions:
selections, schedule, cost liabilities, and callbacks
ALPINE to assist in schedule coordination).
[] CAUTION:
DO NOT remove, teaz down, or dig up anything before building
permit is on job site.
[) OWNER to protectlmove all personal properiy from, in, or around
construction azea, both interior and exterior. Please review
azea before construction start-up and remove neccesary items.
Room Finish Schedule
Room Ceiling Wails Finish Underlay- Base Casing
Floor ment
Batliroom 5/8" sheetrock 1/2" sheetrook Ceramia tile N/A Ceramio tile Oak prinoeton
"Textured" ready for paint
Closet Existing Exiating E�tisting N/A F�detin8 Fao�nB
Mxh�ical F�riating Faosting Exiating N/A E�rinating Faristmg
Room
Page3of4
IMPORTANT HEALTH NOTICE.
Some of the building materials used in this home (or these building materials) emit
formaldehyde. Eye, nose, and throat imtation, headache, nausea and a variety of
asthma-like symptoms, including shortness of breath, have been reported as a result
of fortnaldehyde exposure. Elderly persons and young children as well as anyone
with a history of asthma, allergies, or lung problems, may be at greater risk.
Research is continuing on the possible long term effects of exposure to formaldehyde.
Reduced ventilation may allow formaldehyde and other contaminants to accumulate in
the indoor air. High indoor temperatures & humidity raise formaldehyde levels. When a
home is to be located in areas subject to extreme summer temperatures, an air
conditioning system can be used to control indoor temperature levels. Other means of
Controlled mechanical ventilation can be used to reduce levels of formaldehyde and
other indoor air contaminant.
If you have any questions regarding the health effects of formaldehyde. Consult your
doctor or local health department.
x a
Homeowner Date Homeowner Date
x a
Project Manager Date Designer Date
Page 4 of 4
�
CITY OF FRIDLEY INSPECTION DIV. �� ` �
6431 University Ave NE �/ �-�� V •
Fridley, MN 55432 ��.b � APPLICATION FOR PLUMBING AND GAS FIITING PERMIT
572- 3604
MARK NUMBER OF FIXTURESTO BE INSTALLED ON EACH FLOOR
1N�t!�r :: Bath :;> Wash Orink Floor !CatGM = Auto. Qas '
Stories Clos�..< Urinal Tub :::; Shower Sm;k. ;; Tray Fount ...:; Drain Basin ::. Washet 1�ppl. >'
Floor 1
Flo 2
or
Fo 3
I or
Flo 4
or
.
�x �S� � a��u-t�m �''� � A S¢,
PLUMBING FIXTURE RATES: NO. RATE TOTAL
��— �
Old Opening, New Fixture
Dis enser
Blow Off Basin
Catch Basin
Rain Water Le�Qer�-,
Sump/FM1eceiving TankS' � - , " - -
Water`�Treating Appliance�
Water Heater -Electric
Water Heater - Gas**
Gas Range**
Gas Dryer**
Back Fiow Preventer Required OYes O No
Type
$ �.o0 2l � !� 6
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$� O,s00}
$ 7.00 °•- r" �
$10.00
$10.00
$10.00 r',
$15.00 .
Reinspection �ee $42.00iHr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.596 of Value of Fixture or Appliance
: State Surcharge
$ .50
�
Effedive On January 1, 1999
Gas
Water Neater
Gas Elec
,��'" �r'r r�5 t�`�j l�O'u�' Gt - t ot y � C1 Co d°�
JOB ADDRESS { C� 7 D D �;�} C��C S U t•� �-� r l� .�✓
The undersigned hereby makes application for a perm it for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that ali the facts
and representations stated in this application are true and correct.
2po0
�' 2" , �ee9
�`
Owner �� 1'' U, �/Y� W�, 2 �•-.
�
Building Used As � Viti � ,
Estimated Cost _ I� G!%�v � PERMIT NO. �O2�+f �
*��'P�1MBING COMPANY � 1�, P�C�� � � � � {'1 L <
.� ' �� �
SIGNED BY TEL N0. (p I'- Y 7
Approved �Aac�gh-ln Date Final Date f���✓��
.�
�� �
TOTALFEE $!� �� PLUS THE $.50 STATE SURCHAf�E
�
>
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTIOfV 504(A) AND TABLE 6-A. MINIMUM SIZE 9 St�J�iCHES.
i
;
F _5
Building PLUMBING
Inspections RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTIVE 7-1-2010
DATE �— ��' � YOURE-MAILADDRESS �� � CCvL�Z✓
SITE ADDRESS 7� J� C� S 4�^ S"�
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE, BOND AND
CERTIFICATE OF
INSURANCE
PERMIT TYPE
TYPE OF WORK:
❑ OWNER �ONTRACTOR
Na�: Lc��r�e
ADDRESS: % 7 G G ��t C� G h $ d�
PHONE: %� 3 ' Z �
NAME: C cv�d�r Uic-trj , P/LW' !�
Permit No.:�� � � �
Received By: �
Date Rec'd•.`r�
: nd- c,r� �� � Cd�'1
CITY I,���J f{/ STATE�`WZIP
STATE LICENSE # G 7%��% 3 �'- ` EXP DATE IZ^ 3/— / U
STATE BOND #���� 3 S � Z 2' � EXP DATE % Z—�—� V
ADDRESS: �D lZ G� wC��v�tr�`^ { 5'��w�" CITY �I/t �r�{� STATE � ZIP r.1�3�!
PHONE 7(o3`.S^iiri-�/Z�'s '' FAX 76) _ ycf�_ 2a� — -
�SINGLE FAMILY
❑ NEW
DETAILED DESCRIPTION OF WORK
❑ TWO FAMILY
', �-REPLACEMENT
❑ TOWNHOUSE
�vl -� f t f' V �. lvt
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELAW). MINIMUM FEE
$35.50.
BATH SINK/LAV FLOOR DRAINS ' SHOWER
BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL
CLOTHES WASHER KITCHEN SINK ', WATER CLOSET
_ DISHWASHER _ LAUNDRY TRAY ', WATER HEATER ($35)
�! WATER METER r�aclVt�
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID iTNTIL PROCESSED
WATER PIPING
� WATER SOFTNER (S35)
BACKFLOW PREV. ($15}
FOR IRRIGATION
, OTHER
I hereby apply for a plumbing 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 application for a permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in the c e of all w rk which requires review and approval of plans. � O�{ ��� �_(G
SIGNATURE OF APPLICANT �� PRINT NAME ����) DATE
APPROVAL INSPECTORS SIGNA URE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977