AF - 47985sue�ecr MIT .
City of Fridley 19610
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � RE O.
� `L _____ COMMUNITY DEVEIOPMENT DIV.
r � •� PROTECTIVE INSPECTION SHC. ���j y�
� ` �
� /�"1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE - PAGE OF APPROVED BY
�.---� • •�� 612-571-3450 910-F15 7/27/88
� �
JOB ADDRESS 1('�2 j�].Stlri CO11T't N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 1 Heather ��CS SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Ron/Ka.thy Barrows
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Brickner Builders Inc. 6240 Highway #65 N.E,, #208
4 ARCHITECT OR DESIGNER MAIL ADDRESS rl ey, . ziP PMONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDIN(3 •
Residential
7 CLASS OF WORK
C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Constxuct a 47'; x 38' Dwelling a�d a, 22:r'. x 34� Gara,ge; ma�onry fi,re�lace.
SEPARA�E PERMI
8 CHANOEpFUSEFROM I�ING, HEATING, PLUMBING AND SIG(V
STIPULATIONS See notations on plan. Provide City with copy of verifying survey
before framing/cappirig. Provide sod in the front and side yards. Provide a
hard surface driveway. Maximum projection fr�n back of house for deck is
12 feet. Paid Park Fee of $1,500.00. Paid 5torm Sewer Fee of $800.00.
SEWER IACATI�T; "Y" 112' East of Manhole "Y" ELEV: 956.63
M1."'NIMUM TOP OF FOOTING: 959.63 Elevation
WATER LOCATION: In same trench as sewer WARNING
TWE CITY OF FRIDLEY DOES NOT GUARANT�E TI-1E BefOfe dlgg111g C�Ij IOGa� Ut���S
�qCCURACY OF UTtLITY LUCATIONS A:':� ELEVA'fIONS. TE��pHONE'•�CECTRIC-GA� �}��
�'WIS DATA IS FOR INFORMATION PURPOSES ONLY, REQUiREb ��' �,,�+��4
�1ND PERSONS USING THIS INFORMATION SHOUL�
�l$RI�'1! (T flN THE StTE. ,
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATINp, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $728,650 $64.33
DOES NOT PRESU GIVE AUTHORITY TO VtOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS O NY OTHER STATE OR LOCAL LAW REGULATING CON- y�"741.00 $550.00
STRUCTIO H PERFORMANCE OF CONSTRU TION.
PLAN CHECK FEE TOTAL FEE
� y�� 2, ' N/A $1,355, 33 + PF & SS
Si REOFC N�RACTOROR IZEDAGENT IDATEI !� WHEN PROPERL VALIDATED THIS IS YOUF PERMIT
� a ��
SiGNATURE OF OWNER tIF OWNER BUILDERi IDATE� BLOG �NSP �a E
�°� � City of F�ridley EEfec:tive 5/L88
f�1IDd�1 I� 7 R-1 AI�ID R-2
ALZER [ ]
Buildinq Peaait P�pplication
tbnstruc.tian Aaaress: l� 7 a K�r �` b T� �, ��, �� ,�-t-
r�;� Descriptim: �c��t" 3 � d` I I /� e oz �, e�- �a. c �
Owr�er Nane � Address : R o h�- k�.� � v � at. v V c:� �� , c Tel. #
Cbntrac�or :� 1r i c.k�, ,� lb a��1 -e V s � fv , Tel. #
AcY7ress: �2 �/ O N-t.�v �� # a O�
Attac� to this appl ication, a Certif 3cate o� Sluvey of the
lat, with the prop�sced oonstructian dra�m on it to scale.
�I�i � I1�RWH�
�Yi��BF�:. Iength Width � 3� Eeic,�t '
c�ic� �: Lei,gth a a wic3t.r: � eeic�t
St�. Ft.
s�. Ft. ;
DEQC ARFA: Length width Hgt/Gro�a St� Ft.
.
�� �—...r-�.���.
Q�rryer Lot [] Inside Lvt [] Ft. Yd Setback Side Yard Set�acks
�ipe af Gbnstructian: ��,� w� , o 0
V r Fstimatec] Cost . S
Aj�IOX. aD1I1�lE't1011 I$�: CJ"c 1 �,� a��.C2� .
Alt. A Alt. B
Proposed Drive�vay Width If New Opening Is Desired: S S
Width + 6'� See Back Page
� !
11ATE : � APPLI(�NP : �/ c �!�/ c k' h E�
�tt F�ee s °a I _ t�
Stat+e S'urc�arge S �n � ���
SAC marge �_ �`C�
Driveway Escrcw S �'�
�ar 4 �.� s e��oc��
� � � � � � � ���o�
1�0►�iL S � �����
CI.TY OSE GZiE.Y
T�.. � �7 �/ —� ���
Ppe Schedule on Reverse Sicle
5.50/51,000 Valuation
$550 per SAC Unit
Al� •A� Or Alt. •B' Ab�Ve
I�e Determired by Ehgi�ering
Agree� t�ecessary [] l�bt iJecessary I]
��oi�il�IQ�LS:
/�1A�1 P��'SR��� �� �� °�
��1 � �� ��t�r� �S I Z ���GTi ,
d -
I��. !�s c��
ce� �, � �— G �50 5�
��� 3m� te� �.��
1� r � �
:_1)1 • �. ' �+;w Y �a� `M:���. 1
Zl�e Q�ief Building Official shall, before 3ssuing permits for the erection of any
building or structure, or for any aclditi� to any existing building or etructure, 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 manr�er herein provided to-wit:
'lOr!'AL VALUE
_0
Sl to 5500 S1S Q�iinimua F�ee is S15 plus surcharge )
5501 to 52,000 S15 for first 5500 plus S2 for each additiona]. �100 or fraction
thereof, to ar�d including S2, 000
52,001 to 525, 000 S45 for f irst S2, 000 plus S9 for each additional S1, 000 or
fractian thereof, to and including 525,000
525, 001 to 550, 000 5252 for f irst 525, 000 plus S6. 50 for each additicna7. S1, 000 or
fraction thereo�, to and incl�ing 550,000
S50,001 to 5100,000 $414.50 for first 550,000 plus 54.50 for each additional 51,000
or fraction thereof, to and including 5100,000
5100, 001 to 5500, 000 5639.50 for first �100, 000 plus 53.50 for each additional Sl, 000
or fraction thereof, to and incluc3ing 5500,000
;�:,�J,001 to 51,000,000 SZ039.50 for the first �500,000 plus �3 for each additional
81,000 or fractiaal thereof, to and including 51,000,000
51,000,001 a�d up 53539.50 for the first 51,000,000 plus S2 for each additional
51,000 or fraction thereof
��V�v n�tzF��n� �al�rw
(Concrete (�rb Streets Only)
Alternate "A": Renoval and replaoement o� curb and gutter anly - Driveway wiclth plus 6
feet times 513.50.
Alternate "B°s Renaval anc] replaoement a� curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet tinies 515.75.
J�+; rl : N ��� �." ��.U� � : ►1 �;�
Permits for construction will be issued a minimuan of 24 hours f rom the time of
applicatian to allaw for proper review a� the proposed structure and of the oonstruction
site.
A Certificate of Sluvey of the lot, showing the location of tt►e frnuidation once it has
been wnstructed will be required before prooeeding with tlze fr�ning.
. A
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lohn Bradle �
� � � s architectuno►I consuitants inc.�
_?,_sooe s�at s.E. osscc.��. sa�9 �. Is�Ms:s-�ns._ __ _�_. t
I�/an'�J °��-�8 Date�/� ���
Owner �
Contractor� �--�1����
Site Address
1)TOTAL EXPOSED WALL AREA °%��' sq. ft i�U"��=
2) TOTAL EXPOSED ROOF/�EILING AREA �� � 2 sq. it. xil"'�_.u�
VYALL AREA CALCULATIONS�
TOTAL WINDOW AREA
GLA2ED
TOTAL DOOR AREA
?OTAL GLASS DOOR AREA
_. GLAZED
TOTAL fIREPLACE WALL AREA
70TAL WALL FRAMING AREA
NET INSULATED WALL AREA
?OTAL RIM JOIST AREA
TOTAL FOUNDATION AREA (EXPOSE�)
TOTAL FOUNDATION WINDOW AREA
F�
Ic�J sa.rt.x'u".�� �.._. �=
s q- sq:ft.x'u" �;�� = 3— �=
_� � � sq.fLx�U���=�! `�
�� aq.fRx�U"�3� = I �'_ . � .
� Z 3 F� �.ft.x'�"�= ` .
1"7 �) sq.ft.x'U" � v 4= I- �e
Z�4 sq.h.x U" �° 4= �� 9�
( 2g- sq.tt.x'ti" �.. � �" = h-- ��
1 � sq.ft.x�U'� �S =
3) TOTAL �''��1
!t ilem 3!s ihe some os,o� less lhan llem l, you have met ihe Intent of
2 MCAR 1.160QB A ond D.
ROOF/CElLINO CALCULATIONS-
TOTAL SKYLIGHT AREA
70TAL ROOF��ILING FRAMING AREA
NET INSULATED ROOF CEILING AREA
�Q.t�x�U°�=
f C.v 2. n n� OL�o �
sq.�.x u - 4=
. ( 4-t..� O sq.fi.x�Uu�v?'Z = 3Z`
, � 4) TOTAL . ��3
.. If Ifem 4 is the sorrie os,a less thon ltem 2, you hove met fhe Infent of
2 MCAR 1.16008 A a�d O.
ALTERNATE BUILDING ENVELOPE DESION
. To utilize fhe tofal envelope system method, the sum of Items ! ond 2 ahall
be Qreater fhan the sum of ltems 3 ond 4.
�
_ tI +2)_=
- 3) +41 =
� 1 hereby cerNfy lhct the buildlnp here descrfbed meets or exceeds the Sfate of M'rro,esoto
Enerpy Conservotion Act.
������,..�
�� � w I �,�, ��.�...� �ONSTRUCTION
FRAMING SECTION
� inferior otr film 0.68
Z �' SHL,P.�.� .4S
3 S2lnches of soft wood �,g1
g Zsl sc 4�.u..��+E z o�
� s�o�.-� , b I
g exterior ofr fllm 0.1T
. TOTAL R � � � °
U = 11R �-
SECTION (INSULATED)
� interlor air film 0.6
2 ~ z-4+-• �� �4S
3 Se '' i��.�.•� �.�. 19, o
4 �� �'��� L,oL
5 s���.� .b 1
g exterlor a1r film p 17
-� TOTALR� .�
U = VR �_
�IST SECT�ON �
� interior air fllm 0.68
2 Sz� ��►1� i.-�• 19, o
$ �'1 � <s.f�...�o�v �� o�l
4 L �+Y E-wJ��FFN-E t o,4,,
5 si,����y �8t
g exferlor aTr film p,��
- - TOTAL R � � �
U = I/R .°4�
ATION SECTION
� interlor olr fllm 0.68
2 lu�-r� n��. �.
3 w��c�.,� o�,�� � ,2a
q exferlor a1r ftlm
5 0.17
- - TOTAL R �S
�U = 1/R�_
,,
*-
��
VENTED
CONSTRUCTION � `•
CEILING SECTION (INSULATEDi
( � aiMerior oir fil m O 61
( 2 5/q dw��Qoc � .5�
t3 • a..�� ..+�� ��
(q exterior oir lilm (sN�( 0.61
TOTAL R �.]r- $
U = 1/R • OZZ
CEILING FRAMING SECTION -
( � j,nte►Jor olr film � 0.61
(2 Ei'g 5�+�,�,a�o�c,c .Sto
� $ •�: = ..•►..� I..+st.r�. - �
(4 inferior olr f11m 0.61_
(5 3K inc.�s of soft wood 4.35
' TOTAL R 3q.13
U = I/R .DZto
CEILiNG SECTION � INSULATED�
( � inferior air film 0.61
_ (2 5/v Qoc � • ��
�3 � �a$ p P Ti �%—
(q exterior atr flim (stfil� • 0.61
TOTAL R z+ �
U = 1 /R .{.C?��
CEILING FRAMING SECTION _
( �,f�ntertor air film 0.61
. �e 9A r� � . � l�
. (3 �? c� op�� 3L�.c�O
(4 interlor air film 0.61
�g �'2inches of soft wo�d 5�(f
��- ��s� .TOTAL R 4 5,34�
.!I = 1 /R •OZZ
EXPOSED BEAM CEILING SECTION
(.� L ferior air film 0.61
�2
(3
�4 0.17
(5 exfericr oir tilm
TOTAL R
�, . . _
L = 1/R
f
RONALD F,. NIFYER
. ' LAND SIIRVEYOR
• • LANO 9URV6YING `3UBOIVIBION DE910N
TBLEPMON6 771-4866
968 J69f16 ST. 9T. PAUL, MINN. Sf'�101
I hereby certify that this survey was prepared by me and that I am a duly
Registered Land � eyor under the laws of the State of Minnesota. �
� Reg. No. 9051 Date : / ��'���
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Saalet 1" = 40'
0 7.ndicates iron monument
Lot 3. B1ock 1. HEATHER OAKS. Anoka Gounty. Minnesota.
Contains 10�239 sq.,ft..
. . . .. , e� •
_ RONALD F. 1�'IEYER
- LAND SURYEYOR
LAND SURVEYINCi SUBDIVISION DE81GN
TELEPHONE 771-4586
985 JESSIE ST. ST. PAUL, MINN. 55101
I hereby certify that this survey was prepared by me and that I am a duly
Registered Land � eyor under the laws of the State of Minnesota.
• Reg. No. 9051 Date:
� 8 23-BB
flo. � iror,
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Scale: 1" = 40'
o Indicates iron monument
Lot 3. B1p�k 1� HEAT� OAKS� Anolea County� A�i.nnesota.
Contains 10,239 sq, ft..
CIiY OF
F[ZIDLEY
FR[DLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55-�3� •(61?) 571-3450 • FAX (612) 571-1287
May 23, 1997
Ronald Barrows, _
�672 Kristin CowGt
Fridley MN 55432
Subject: Heather Oaks Subdivision - Drainage Easement
Dear Mr. Barrows:
PW97-089
It has come to our attention that there has been a significant amount of landscaping done to the rear yards
of a number of the homes along the north boundary of the Heather Oaks Subdivision. This letter is being
sent to all residents along this line.
There is a 10-foot-wide drainage easement centered on this line to allow storm water runoff to drain to the
east and west into holding ponds. This area is intended to be swaled to channel this runoff. Landscaping
which raises the yard and changes this swale impacts the way storm water drains. City Code states that
changes on one property must not affect the neighboring properties. If we receive complaints that one
properiy has changed the drainage pattern so that water runs onto an adjacent properiy in a manner contrary
to its original design, we must investigate and possibly initiate Code Violation proceedings. �
In order to avoid future conflicts, we request that you discuss any significant projects with your neighbors
so that concerns on these projects can be resolved before a problem is created. If you have questions and
would like to review haw your future or past projects impa.ct others, please call me at 572-3551. Thank you.
Sincerely,
v---
Jon H. Haukaas
Assistant Director of Public Works
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COMMON VENT VENT CONNEC40R AND COMBUSTION AIR 1/�RIFICATION
When �eplacins� an existinsi fura�ce, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obs#ructions, Yes No
and is securely suppor4ed and firestopped where required. (� �)
The venting system is plasticlPVC and meets aA current codes and manufact�rer
specifications inc�uding sizing, tength, nur�ber of eibows and terminatio�. Yes (� No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacture�s specifications. '6his does
include AGA-GAMA Category l Centra! Furnace Venting Tabtes for fan Yes �No ()
assisted and natural draft appliances.
The existin� combustion air is sized and instalted to meet the current codes
and manufacture�'s specifications.
VVhen cequired to insta4l a new combust6on ai�it wil! be sized �nd insgalted
to meet the cu�rent codes and mar�ui�cture�'s specifications. .
Yes � No ( }
Yes (�o t )
When installing a new v�ntin� s�steen, the undersigned hereby verifies tY�at
it is a iisted assembly and meets 4he c�rrer�t codes and manufacturer's
specifscations. This does inciude AGA-GAN1A Category I Central Fumace Yes (,�No ()
Venting Tables for fan assisted and natural ciraft appliances.
9s the common vent and vent connec4ors sized and installed correctly after
ar�, applianc� has been r�moved from the coraimor+ vent and ven#ed y�s (�No ()
separately as per cuRent codes.
A lianca T e and Siz�lGommon Vent �nd i/ent Connector Information
Appliance #1 Type a A Vl �'ili Input ` Fan Assisted or Nat , _
Appliance #2 Type �TU Input Fan Assisted or Nat �._._
Appiiance #3 Type �TU Input _ Far� Assis4ed or Nat
Total Appliances Total Btu tnput
Cammen Vent Type Vent Height Diametee � inches
A�apliar�ce #1 i/ent Connector Fleight f� Le�gt�a ft Diameter _ in '�ype ,�„�,.
Appliance #2 Veni Connector Height fi Length it �iamefer _____in 'Typ� �
Appliance #3 Vent Connector HeigE�t ft Length �t Diameter _____ �� TYRe ...�-_--
ALTERATIONS: Desc�ib�
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THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPUANCES OR THE
�4PPUCATION WILL BE RETURNED
CC3ti"IL�OI�! �/EI�T� l/Ff`T nl�!f� GTnR AI�D .(�MB 1STI(�N AIR VF_RIFICATInN
VI/hen nrp� IacinQ an eYictin� f�rance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
a�tl is securely supported and firestopped where required. Yes () No ()
�he venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The pY��no �eme��en a�r is sized and installed to meet the current codes
and manufacturer's specifications.
Whel1 fequlred to �n�tall a new cem6�ctien airi it will be sized and installed
to rr�eet the c�rrent codes and manufacturers specifications.
When �'��n�a ne ventin0, c�, the undersigned hereby verifies that
it is a listed assembly and meets the cuRent codes and manufacturers
speciflcations. This does inGude AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes.
Yes( ) No( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes( )No( )
�.. .. .- ... .����.. -� ... -. ...- . . ..��. .�
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
ap���ance :t� Typ� --- ---- - . BTI,J lnn�t Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
� : � r•► .- ..-
HEATING CO:
Signed By: Date :
���
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMII�Y E1N'D DUPLEXES R-1 AND R-2
BUII.DING PERNIIT APPLICATION
Construction Address: �
G1,� �
�
i��o�
>�,�, � ��G �y�
Legal Description: �
Owner Name & Address: �-�q1f1�P � � �2 l a. �. Tel. �(� r5'1�� - ��'�
Con�ractor: 1'1� 1, Ct, � - MN LICENSE # ` ��� �ct � � . �;
Address: � o�� �% ��Cv ��7� '� � lk'J? U1, L Tel. #� �oZ' �0%' (��S �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R: i-es�r 0�
Attach to this applicadon, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.. .
DESCRIPTION OF IlVIPROVLll�SENT
L,ength Width Height Sq. Ft.
Length Rlidth Height Sq. Ft.
Length Width . .Hgt/Ground Sq. Ft.
_ � _ ., /' _ , n '\ � o� r. o _ , . _n
Construction Type: Esrimated Cost: $_ �%� � 3•�'
Driveway C�rb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$ � �
DATE: APPLICANT: Tel. #
Permit Fee
Fire Surcharge
Sta�� Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
ParY Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ��. �
$ ���
$ `��-
$
$ �—j e G��
$
$
$
$
1� �
6� ,� ° �� ��"
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuadon (1/lOth%)
$.SOi$1, 'Q� v al'uaiiG�7
$1050 per SAC Unit
$5.00 (Staie Licensed Residential Contr2ctors) �
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ � Not Necessary [ J
I°
i��/—_i �
nnn�
nnn�
The
Kordiak
COrnpany
�,�`+d �e �5 � lP
3948 Central Avenue N.E., Minneapolis, MN 55421
763-788-9651 763-572-2287
Fax 763-788-4420
n Real Estate
October 24, 2005
n Property Management,
Jon Haukaas
Public Works Director
Fridley City Hall
6431 University Ave NE
Fridley, MN 55421
Dear Jon,
n Income Tax Service
I am writing regarding the yellow "Caution Children" sign in front of my
house at 1672 Kristin Court. The neighbors requested and paid for a
portion of it. They are permitted for a period of five years. October now
represents the end of the five years.
I desire that the sign be removed. t find it unappealing and difficult to work
around. I would accept respohsibility for its removal. It serves no purpose
on a short cul de sac street and I believe that we neighbors on the block
would look out for our children without the benefit of a sign. Should any
neighbor desire I will be happy to help pay for it and would argue that it
should then be located in their yard.
I recognize that this item is not one of your top priorities but would
appreciate it if you can find a way to remove it. If you desire to talk to me
about this please call.
incerely,
�
Jim Kordiak
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE�"L(!ITlI L
SITE ADDRESS �
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
BUILDIl�T�
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-08
YOUR E-MAIL ADDRESS
❑ OWNER �CONTRACTOR
CONTRACTOR ADnRESS:� �' !
SUBMIT A COPY OF pHONE �
YOUR STATE LICENSE
STATE LiCENSE #
PROPERTY TYPE I❑ SMGLE FAMILY/NEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
PERMI'F TYPE
TYPE OF WORK:
DESCRIBE WORK BEING
ROOFING
NUMBER OF SQUARES _
GARAGES
PROFOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
O Aluminum
❑ Other
Permit N
Received By:
Date Re(��;'n ��YI9°�at� 2i �
ITY 6TIGl l`C'l l STATE 6'
c��Coon d a��i S STA
_ FAX
EXP DATE
SiZE
STORIES �
0 ADDITION ❑ GARAGE/SHED u wiNUUw�
O BASEMENT FINISH ❑ ROOF � DRAIN TILE
❑ DECK O SIDMG �OTHER
❑ SWIMMING P�L
❑ NEW HOME CONSTRUCTION ❑ ADDTI'ION
� MAMTENANCE/REPAIR ❑ REMODELING
^----.�.. ..._-� ._. r� ,__.,,�., r.......,. • ---,�,nwAA/ .
WINDOWS
IN EXISTING OPENINGS ❑Y� �No
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
O HOUSE ONLY
❑ HOUSE & GARAGE
0 ATTACHED GARAGE
❑ DETACHED GARAGE
HEIGHT
zrn '�
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
�Soffit ADDITIONS. & PORCHES SUBMI'f:
� Trim 1. Site Plan/Survey showing the exis6ng structures
❑ Fascia and proposed project
2. Two sets of construction plans
3. Energy Calculations
LOCATION OF WINDOWS
NUMBER OF
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�j (USING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $'•�Q' Li �— OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
$ /
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21 =$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary (
$ _ A� Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
Attach
I hereby apply for a buil " rmit 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 an with e 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 in accor ' the r plan in the case of all work which req�s rqview an�oval of plans.
SIGNATURE OF APPLIC NT ' PRINT NAME C,���� %Q(G� � 14 f`Yl �j8 h!i DATE � $ Q
APPROVED BY rd� � c �,LL_���L— DAT
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before. issuing pernuts 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:
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432 �
� 763-572-3604
Faz: 763-502-4977
�
�
t
�_
�xP��B ���� �Pp�t
11711 9thAvenue NW Coon Rapids MN 55433
c�� c��g • ��r �
Animal Removal • Caps and Screens
(763) 427-5288 (218) 828-9570 Licensed • Bonded • Ful1y Insured
S�v�tg Csaater Metio c� B,ar�d LakesAna 28 Y�an Fxprriente • No Mt�s
PROPOSAL TO REPAIR OR INSTALL
To repair damaged crown on chimney and replace spalling clay tile on dwnmy flue.
Customer: Jim Kordiak
Site Address: 1672 Kristin Court
City/State/Zip: Fridley, MN 55432
a+�� ��4'
,♦ �
; ���
� ��
Date: March 3rd, 2008
P�one: (763) 572-2287
File #: 9708c
1.
2.
3.
4.
5.
JOB DESCRIPTION
Obtain permits as necessazy.
Provide house and roof protection; set up ground and roof scaffolding as needed.
Remove existing chimney crown. Note: A Level 3 Inspection will be performed at this time.
Hidden damages revealed by opening the chimney will be bid out at this time and are not included
in this proposal.
Install a new 12 x 12 inch clay flue tile and cement crown using steel re-bar; metal lath; cement
consisting of portland cement, sand, bonding agent, fiber mesh; closed-cell foam expansion joint(s),
and silicone sealant. The crown will have a drip ledge to protect the chimney made with form
boards which will be removed once the cement has set (3 to 5 days). The pernut will be signed off
by a city inspector upon this return trip.
Remove all debris and scaffolding.
6. Tax on materials $ 4.70.
Tile size 12 x 12
Number of tiles 1
T'his work (including a11 materials, tax, and labor) as outlined above will he completed for the price of
$ 797.00 (price valid 30 da.ys from Proposal date) Mazch 3rfl, 2008
Terms are 50% down at acceptance of Proposal and remainder of 6alance due upon completion axid
satisfaction. (Brent's Cleaxi Sweep)
I do hereby accept the terms and conditions of this Proposal:
Date: Customer Signature:
` a �� �ren#';� �le�n ��ue��r
11711 9th Avenue NW Coon Rapids MN 55433
(763) 427-52sa (21a) s2s-957o
Serving Gnaur M�rro d Brainerd Lakes Area
� �
CONDITION � U U
C
� .
c�o �' a
REPORT y � Q
� � Z
CHIMNEY (�U � •---
1. Height Cj Roof Pitch �
3�f
2. Chimney Cap/Spark Arrestor ___ ►iatwr
3. Crown / Wash
4. Brickwork / Mortar
5. Flashing
6. Flue Liner / I.D. ��!
7. Glazed Creasote
sMO�
FlREPLACE
8. Smoke Chamber
9. Damper
10. Firebox / Grate
11. Condition of Face Brick
12. Spark Screen / Qoors
13. Hearth Protection
14. Animals / Birds in Chimney
15. Misc.
l INTFI
ASH
WDODSTOVE OR FIREPLACE INSERT
16. Stove Pipe Condition (woodstove)
17. NFPA Approved Flue Connection (insertJ
18. Installation / Thimble / Ctearances
OTHER SAFETY CONSIDERATIONS
19. Fire Extinguisher / Smoke Detectors
_ �
- �
R S��tVTi Oi�
( :himncy ( :I��anin�; • ( :himnc•y Ilrpair tW�1�d s,
Animal Ilcmcrval • (:aps and tirrc�•ns �� �����
I.iccnsrd • li<mdr.J � Fully InsunJ " S��p
Z7 Years Experience • llfo Mcss
Customer � �� ii .
Addcess �
City . -C State
��_ /a. 2 -ri �7'�-- r7� �✓�
20. Gas Furnace Flue Liner
21. Fire Escape Plan
ype of Home: ❑ Rambler ❑ Split I� 2-Story ❑ Other
ear Built: Home Chim�ey
�onstruction of Roof:
,� Asphalt C7 Cedar Shakes ❑ Tiles ;=I Other �
ype of Fireplace: �7 Pre-fab �Masonry � Modular
o. of Fireplace:�� 2 3 4
Joodstove: ❑ Insert � Free Standing ❑ Pellet
lain Heat Source: � Oil � Gas ❑ Other ;�
dould you like an estimate on repair: �Yes O No r��`��
ast Cleaned: Year(s) Ago ❑ Never
low did you hear about us? O�Referral � Yellow Pages
❑ Media - N, Newspaper O Direct Mail f� .Other
�e: This sheet is the result ol a visual inspeclion done at the lime ot cleaning. It is intanded
e convenience to our customer.. not as CertHicetion ot lire worthiness or salety. Since
Date 7�c� -s �V % Time � � .
�
r
� r_ �`°' - �
Fireplace end chiinney should be ins
Sweep's or Mason's Signa �
RECEIPT / INV0ICE d
DESCRIPTION
� DATE CpMPL�T'ED �
CUSTOME�i ��RIFICi
I have read this torm and now
tor
TQTAL
�—��;
�,
����
- l _ � ��
, /
� C
�Zx � z � r�
�
/
I PRICE
�
rtry wohd6urin�systam e�pear
3uilding
-nspections
?63-572-3604
:TE ADDRESS [
�i�ki'PLI�AId'�IS: --
'RO�t ERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
�OUR STATE LICENSE
VJITH APPLICATION
PROPERTY TYPJ�
PERMIT TYPE
�o
Gi
BIJILDING
RE�IDENTIA.L APPLICATIOI�T
CITY OF FRIDLEY
Permit No.:
Received By:
� :�;�� �r�.
YOUR E-MAIL ADD SS �( o d � s� � �� � r�or� � s. �o �
„ n.. ,. ��
B-@Vl'i�iER----�e62�-3'�1�T@
�D�ss:_ l 4��- Kr � 7�� �(' 7`
PxorrE:_ 7 � a�_ 5-t d. - a7 � 4 �
Pella Windows & Doors
NAME:
sTa.� Lic 15300- 25th Avenue N.- Suite 100
���S: Plymouth, MN 55447
PHONE �63/745-1400
��G� License# 20165884
❑ TWO FA �
Q ADDTfION
❑ BASEMENT FINISH
� DECK
�E oF woxx: o
�ESCRIBE WORK BE]NG
IZE OF IMPROVEMENT
[JIvIBER OF SQUARES
.4RAGES
�OPOSED SIZE:
:OPOSED HEIGHT:
❑ ROOF
❑ SIDING
❑ SWAAMING POOL
��.� ❑
Wrl1(�cw i'
❑ HOUSE ONLY
D HOUSE & GARAGE
❑ ATTACF�D GARAGE
❑ DEfACHED GARAGE
f�
. . ,��
���34s • Gok�
SSY3�
CITY STATE ZTP
❑ DRAIN TII.E
� OTI�R
HEIGHT
n,
BASEMENT REMODELING SUBMIT•
1. Existing F1oor Plan
2. Proposed floor plan
3. List of str�chiral members to be used
:DING FOR I�IEW CONSTRUCTTON INCLUDING DECKS,
Vinyl �Soffit ,ADDITIONS. & PORCHES SUBivIIT•
`��n� � T� 1. Site P1adSurvey showing the e�dsting structures
Other ❑ Fascia and proposed project
INDOWS 2. Two seis of constiuction plans
RXTCTING OPENII�TGS�7Yes ONo LOCATIQN OF WINDOWS 3. Energy Calculations
t FOR NEW OP£NINGS-DESCRIBE SIZE OF p 1�
'ENING CHANGES &
PE OF WINDOW TO BE 1NSTALLED�O� ���r�� •�rt���gg� OF 9JII�DOWS �
ALL FEES ARE BASED UN VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS;
(USING THE 1997 U.B.0 FEE SCHEDULE)
. TOTAL JOB VALUATION $ �{ d o 0 pC�p��, �E
rmit Fee
�.n Review
rcharge
-e Surcharge
;ense Surcharge
.0 Chazge
rb Cut Escrow
�sion Control
-k Fee
.�ver Main Charge
tal Due
$ � �1:.�
$
$ '�,1� -b c�
$ y,a-o
$ S.�u
$
$
$
$
$
C�7
�ee Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) iimes the total job valuation — Minunum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridlev Attach
THIS IS AN APPLICAT70N FOR A PERMTP-NOT VALID UNTIL PROCESSED
�reby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in
formance with the ordinances and codes of the City of Fridley and with the Minnesota. Construcrion Codes; that I understand this is not a
rnit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
z in the case of all work which requCes vi andapproval ofplans.
VATURE OF APPLIC '��' pRINT NAME l r I� S L I1 /(� � DATE l L� ��
Page 2- Builda.ng Residential Application
, BLTILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
-
structure, or for any addition to a.ny existing bualding or structure, or for �ry a1t-eration or repair
—-- to any existing building or structure, upon application therefore, require fhe paym.ent 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 FEES
$1 to $500 $23.50 (Minimum Fee is $23.5.0 plus surchazgej-
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each addirional $� 00 or firaction, to and
includi.ng $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional$1,000 or fraction, to and
including $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000 $643.75 for 1� $SO,OQO plus $7 for each additional $1,000 or fi-acizon to and
� � including $100,000
$100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to
and 'mcluding $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each ad.ditional$1,000 or
fraction to and including $ I,OOO,OOU
$1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each addiiional$1,000 or
fraciz�n
VERII+�CATION OF FOUNDATION
Permits for constru.ciion will be issued a min;mum of 24 hours from the time of application to
allow for proper review of proposed siructure and of the construction site.
A Certificate of Survey of the lot, showin.g the location of the existing foun.dation will be
required before proceeding with the fram.ing. New Houses Onlv
City of Frid.ley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977