PRE 2010 DOCSCity of Fridley
SUBJECT
1784!5
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
r
',.
RE O.
COMMUNITY DEVELOPMENT DIV.
r�
r PROTECTIVE INSPECTION SEC.
1 i I CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APP OVED BY
612-571-3450
910-F15
1/25/85
JOB ADDRESS 7600 Lakeside Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
17
1
Blomberg Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Garjac Inc. 481 — 206th Avenue N.E., Cedar, MN 55011 434-7096
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X❑
8 DESCRIBE WORK
Construct a 38' x 24' Dwelling and a 221 x 22r Garage Before digging `u cs
TELEPHONE e ELECTRIC-. GAS ELK,
9 CHANGE OF USE FROM TO ,, A\"vyf
STIPULATIONS
Provide City with copy of verifyingNMOMM survey before capping. Provide
sod in the front and side yards, Provide a hard surface driveway,
SEWER LOCATION; (Approx. 10.5' Deep In Street) 144' N. of M.H. (INV. 892.74)
WYE ELEVATION: 893.40 TOP OF FOOTING: 896.40 Minimum
WATER LOCATION: Approx. 10' N. of Sewer Service
DRIVEWAY DEPRESSION: 16+6 = 22 x $13.50 = $297.00
THE CITY OF FRIDLEY DOES NOT GUARANTEE THE SEPARATE PERMITS PEWRED F(0"'
ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS. os. on 1E ��Tyi G, P5.I.�'sASINi
�Y
u
THIS DATA IS FOR INFORMATION PURPOSES ONLY,
AND PERSONS USING THIS INFORMATION SHOULD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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 1 HAVE READ AND EXAMINED THIS APPLICATION
I
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 COMPLIED
$53,450
$26.73
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVIS NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
$295.00
$425.00
STRUC I NOR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
.75
$820.48
SIGNATURE OF ONTRACTOR R` UTHORIZED AGENT (DATE)
WH PROPE LY L HIS IS YOUR PERMIT
..
� S � S�
NSP DATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: 7 4c)c) `-4 t-,- f/<-)- _
Legal Description: o7- /,7 84® c K �' oa w d eler �'s ,-& / eS
owner Name & Address: Tel. #
Contractor: ��9/?T/#C— �N Tel. # 1/3y�'70 ?'5Address: ' 1 .7 /9✓Q
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
Length
DESCRIPTION OF IMPROVEMENT
Width -Z I -
Width 2'2 -
Width '2 -
Width
Height ,
Height
Hgt/Ground
Sq. Ft. 9E16
Sq. Ft. S�'o
Sq. Ft.
Corner Lot [ ] Inside Lot [4 Ft. Yd. Setback 3 Side Yard Setback 12-4
cc
Type of Construction: F��Oyjr' Estimated Cost: $ 7r=�8
Approx. Completion Date: �%¢ % is It (JVv
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ ,0649 $ -
See Back Page for,Explanation
DATE: 1— 2 3 a 0,5'-
Permit
S
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS • Dq. ujs
APPLICANT.
UCS^ Tel. #3
-10-`4
- r
CITY USE ONLY
$ -Zq .aej Fee Schedule on Reverse Side
$.7 25$ of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
$ Fee Determined by Engineering
$
®'UQ Agreement Necessary [ ] Not Necessary [ ]
$
BUMDING 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 Valuation Fees
$1.00 to $500.00 $10.00 (Minimum Fee is $15.00)
$501.00 to $2,000.00
$10.00 for the first $500 plus $1.50 for
each
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00
$32.50 for the first $2,000 plus $6.00 for
each
additional $1,000 or fraction thereof, to
and
including $25,000.
$25,001.00 to $50,000.00
$170.50 for the first $25,000 plus $4.50 for
each
additional $1,000 or fraction thereof, to
and
including $50,000.
$50,001.00 to $100,000.00
$283.00 for the first $50,000 plus $3.00 for
each
additional $1,000 or fraction thereof, to
and
including $100,000.
$100,001.00 and up
$433.00 for the first $100,000 plus $2.50 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 been constructed will be required before proceeding with the framing.
U4 t Y V 38 9% ty Q 35 -& It 5(.3. 68
S70,000. Z83, oa
4 V 3 "to
29 5 .o
. 0
q1dt.
ISO
1
Z
Surveyor's Certificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyets
1446 County Road J, Minneapolis, MN 55432, (612) 784-9346
SURVEY FOR:
B & G Investments
961 Hillwind Road
Fridley, Minnesota 55432
6 ago 01' 0.9" F-
cj
/0'o
LO
'
0 N�4
VA11V
-1011DVAL AN!"r;
AT RIVEWAT
.33'
1-14.1
6 890 01' 09" E — 136.68'
3 3'
DESCRIPTION
Lot 17, Block 1, Blomberg Estates, City of Fridley, Anoka County, Minnesota.
SCALE: 1" = 40
0 Denotes 1/2" diameter iron pipe monument set and capped No. 10832.
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota.
V 1og32 Nov_17, 1980 4278 9
Reg. No. I)ate Job No. Book No.
z: T
Lj
Git
AN'D PERSC'NS
USi';",,G
H,11) UD
VERIFY IT ON
THE SITE.
6 ago 01' 0.9" F-
cj
/0'o
LO
'
0 N�4
VA11V
-1011DVAL AN!"r;
AT RIVEWAT
.33'
1-14.1
6 890 01' 09" E — 136.68'
3 3'
DESCRIPTION
Lot 17, Block 1, Blomberg Estates, City of Fridley, Anoka County, Minnesota.
SCALE: 1" = 40
0 Denotes 1/2" diameter iron pipe monument set and capped No. 10832.
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota.
V 1og32 Nov_17, 1980 4278 9
Reg. No. I)ate Job No. Book No.
(Xlf, /e . . ,��,y L
Y Y
la Fo
5-17�
Y �
g
.� n
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
t� $
N
m
Future Fixtures
e
3.50
u
Old Opening, New Fixture
x
v
$
Water
v
4.00
$
Blow Off Basin
$
5.00
H
i m
a
5.00
$
x ►,
p,
w
a
Hydraulic Valve
Heater
5.00
S
Sump or Receiving Tank
S
s
S
Mater Treating Appliance
$
7.00
$
m
$
5.00
$ 9-60
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or
Appliance
x
u
S .50
m
($15.00)
o
a�1
A
y
�
ow°
w
40.'
u��3
in
u
a
v'�,
1
1
j
let
2nd
3rd
4th
(R) Future Connection Opening
Connected with Sewer
(�) New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
t� $
5.00
$ �;.00)
Future Fixtures
$
3.50
$
Old Opening, New Fixture
S
1.50
$
Beer Dispenser
$
4.00
$
Blow Off Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain Water Leader
$
5.00
$
Hydraulic Valve
$
5.00
S
Sump or Receiving Tank
S
5.00
S
Mater Treating Appliance
$
7.00
$
Hot Water Heater_
$
5.00
$ 9-60
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or
Appliance
$
State Surcharge
S .50
Reinspection Pee $
($15.00)
TOTAL FEE
S_
S 5
Effective Aug. 1, 190L
.5/
Job Address ®® 44r, o
Department of Buildings
City of Fridley
Tel. 0571-3450
The undersigned hereby makes application for --a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
J
Fridley, Mn. 19
OWNER �i fL
KIND OF BUILDINGf, r -
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST /, 0 'o
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP. A,II
Date Q�[�
APPROVAL FOR PERMIT �dV
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
CI YOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450
stay 10, 1985
Mr. Gary D'Aigle
Garjac Construction Co.
481 - 206th Avenue N.E.
Cedar, MN 55011
Re: Final Inspections at 7590. & 7600 Lakeside Road N.E.
Dear Mr. D'Aigle;
Final inspections were made on May 7 & May 3, 19.85 of the above addresses
and the following iters were noted which must be completed before the
structures can be finaled out:
7590 Lakeside Road N.E.
1. Provide sod in the front and side yards by June 15, 1985,
2. Provide a hard surface driveway by June 15, 1985.
3. Provide City with a copy of the verifying survey by June 15, 1985,
4. Post house number on structure by May 20, 1985.
7600 Lakeside Road N.E.
1. Provide a hard surface driveway by June 15, 1985.
2. Provide sod in the front and side yards by June 15, 1985.
3. Provide City with a copy of the verifying survey by June 15, 1985.
We will expect the above items to be completed by the scheduled dates when
reinspections will be made to determine compliance. If you have any
questions on these items, please feel free to contact me at 571-3450.
Sincerely,
(Q) L"U
DARREL G. CLARK
Chief Building Official
DGC/mh
Arm
CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N E.. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
June 18, 1985
Mr. Gary D'Aigle
Garjac, Inc.
481 - 206th Avenue N.E.
Cedar, MN 55011
Re: Final Inspections at 7531 & 7551 Brigadoon and 7600 Lakeside Road
Dear Mr. D'Aigle:
Reinspections were made on June 17, 1985 of the above addresses and the
following items were noted which must be completed before the structures
can be finaled out:
7531 Brigadoon Place N.E. (Unable to gain entrance to structure)
1. Provide sod in the front and side yards.
2. Provide a handrail on the garage steps.
3. Provide insulation in the basement utility rocas.
7551 Brigadoon Place N.E.
1. Provide sod in the front and side yards.
2. Provide City with a copy of the verifying survey.
7600 Brigadoon Place N.E.
Provide City with a copy of the verifying survey.
We will expect the above items to be completed by July 15, 1985 when
reinspections will again be conducted to determine compliance. If you
have any questions on these items, please feel free to contact me at
571-3450.
sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING
PERMIT
IT NO.
18619
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 ; i
,•; CITY HALL FRIDLEY 55432
1 612-571-3450
REC PT NO.
NUMBER
910-F15
REV.
DATE
8/25/86
PAGE OF
APPROVED BY
JOB ADDRESS 7600 Lakeside Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
17
]
Blomberg Estates
SHEET
2 PROPERTY OWNER MAILADDRESS
ZIP PHONE
Donald Dykhoff 7600 Lakeside load N.E.
784-5544
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
l� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 121.x 2W Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
1STALLS 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 COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1/200
$.60
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$20.50
PLAN CHECK FEE
TOTALFEE
$21.10
NTRA O R T DAGENT IDATEI
7 Y
ZTICO
WHEN PROPERLY
`BLDG INSP
ILA LIDATED THIS IS YOUR PERMIT
DATE
SIGNATURE OF 0 d OWNER BU40ERI (DATE)
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address. 76c,Y' Z-"Ike5�j 0 8 1601
Legal Description: K �lv
Owner Name & Address:
®
Tel. # 78 �3 7
Contractor: 5ce Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Q4- Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width __ Hgt/Ground Sq. Ft.
OTHER: '_f ! 2 X �•-v
Corner Lot [ ]
Inside Lot [ ]
Type of Construction:
LIAR C)
Ft. Yd. Setback Side Yard Setback
Estimated Cost: $ / 2 w
Approx. Completion Date: -2- yekl��
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
A
DATE.
2 / `a�APPLICANT :IziTel. 0-y
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Ch.
TOTAL
STIPULATIONS:
CITY USE ONLY
$ (�,� Fee Schedule on Reverse Side
$ 25% of Building Permit Fee
$ -�Q 0 $.50/$1,000 Valuation
$ $475 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Zoo
S6 a -
0)X 1 0
«,. 0(i
10.%"b
ansa
BUILDING 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 Valuation Fees
$1.00 to $500.00 $10.00 (Minimum Fee is $15.00)
$501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
including $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each
additional $1,000 or fraction thereof, to and
including $50,000.
$50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraction thereof, to and
including $100,000.
$100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 been constructed will be required before proceeding with the framing.
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1999
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas**
Gas Range**
NO. RATE TOTAL JOB ADDRESS
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ,�
1.5% of Value of Fixture or Appliance i U
State Surcharge
$ .50
The undersigned hereby makes application for a permit 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 all the facts
and representations stated in this application are true and correct.
I
` , 1999
Owner L\Jnr\(�,
Building Used As _ e
�
Estimated Cost vo PERMIT NO.
PLUMBING COMPANY
? � t
SIGNED BY yC
TEL N0.�?11
A
Approved By / / Rough—In Date Final Date
MINIMUM f -I=L FUK ANY PLUMBINWUA5 PI=Kh
TOTAL FEE PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.
32-
01
SUBJECT
PER
City of Fridley
'0844
AT THE TOP OF THE TWINS
BUILDING PERMIT
r?
R EIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
i
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
j 612-571-3450
910-F15
5/28/91
JOB ADDRESS 7600 Lakeside Road NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
17
1
Blomberg Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Donald Dykhoff 7600 Lakeside Road NE 784-5544
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20.' x 2Qr Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan, Provide frost footings. Treated bottom plates
are required, Provide 40# live load roof system.
WARNING
Before digging call for
all 'utility locations
454.0002
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$80Q0
$4.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$99100
Tire SC $8.0.0
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
P K FEE
TOTAL F E
1.00.
OR MORIZEDAGENT IDATEI
WHEN LY V S YOUR P�ER�MIT
r�
~
�. � I
DATEERBUILDERI
SiGNNaATTUOREWNER0IDATEI
01
NSW [ J Effective 1/1/91
ADDN [J R-1 AND R-2
ALTER [ J Build
ing Permit Application
Constn=tion Add -)&00�_--
Legal Description: 1i / 17 1. J II ,, L,t`�/ c o-1 c r2
Owner Nene & Address: DDIIJ�l o � i�e3,Je RJ Tel. # 7W -S-SW
Contractor: ryv-e Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn an it to scale.
DESCRIB ON OF IIOSOVENM
LIVM AM: length width Height Sq. Ft.
GRrd E AREA: length Width Height Sq. Ft. 4/00
DECK AREA: length Width Hgt/Ground Sq. Ft.
Corner lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ -- BOO
Approx. Completion Date:
Proposed Driveway Width If New Opening Is Desired: Ft.
Width + 6'
DATE: 5= 2 Z - I APPUC ANT:
Permit Fee
2
$ 1 a ®C1
Fire Surcharge
State Surcharge
$ b
SAC Charge
$
Driveway Escrow
$
Park Fee
$
Sewer Main Charge $
$1 10 tco
CITY USE �w7t
See Back Page
Tel. #
Fee Schedule on Reverse Side
.001 x Permit Valuation (1/10th �)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
AaU�x S ys!;-,E w6
gaoo
a,00v- q&no
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T
'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:
$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 $500,000
$15 (Mininn Fee is $15 plus mnvharge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
EMMEMY D[.PRESSICH ESCROW
(Concrete candy Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50.
Alternate "B": Removal and replaoernent of curb arra gutter arra install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
Permits for construction will be issued a minim= of 24 hairs from the time of
application to allow for proper review of the proposed struc4ire 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 fuming.
4
20'
O
SOUTH
36'
HOUSE
+XII 7 y 4h/h�nL+c��
f _ 3-13"
CURRENT GA AGE
1
22'
111
NORTH
C?
_NEW GARAGE
THIS WALL TO BE
REMOVED UPON
COMPLETION OF
20'
7600 LAKESIDE ROAD N.E.
FRIDLEY, MN 55432
Surveyor's Certificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land_ Surveyors
1446 County Road J, Minneapolis, MN 33432, (612) 784-9346
SURVEY FOR:
Gar -Jac Construction
481 206th Avenue NE.
Cedar, Minnesota 55011
33" I
S 89° Ot' 09" F
"Z Z 77
I
10
Ie N
I
I 3 9.co' u.os I O l' 40
W
N, f -T 6 p O •r 1\ X I
.J
n 11.1 G1�.a34 % I
S 891, 01' 09" E ^- 136.88'
.1 4, 3 3'
30
DESCRIPTION
Lot 17, Block 1, Blomberg Estates, City of. Fridley, Anoka County, Minnesota.
SCALE: 1" = 40
O Denotes 1/2" diameter iron pipe monument set and caaped No. 10832.
SET leu PIAT OP BL.OI.�6E�.G M r F'o. 74115 SURVxy.
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota.
inR3q : a�cT. 16, 1485 t�63o qD
Reg. No. Date- Job No. Book No.
CITY OF FRIDLEY INSPECTION DIVISION
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
All Others/Repairs & Alterations (UST ON BACK)
I% of Value of Appliance or Work
Commercial/Industrial
1.25°/ of Value of Appliance or Work
Effective On January 1, 1998
JOB ADDRESS 0 I,-�K., G1 � -
State Surcharge
TOTAL FEE,
$ .50 Burner Trade Name Size No.
MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
BTU HP EDR
BLAINE HTG. AIC ElJ T., INC.
13562 CENWALAVE. N.E.
HEATINMP MN 55304'
Signed ~ Tel No. -75-HP2100
Approved By Rough—In Date Final Date
FILL OUT BACKSIDE FOR.STAC VERIFICATION ON
REPLACEMENT FURNACE
The undersigned hereby makes application for a permit for the work herein
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the facts and
$ 30 00
$ ,
representations stated in this application are true and correct.
.0100
1,0-13 1998
$10.00
$
`
I
OWNER1� X11
n2. 5r OD l�
$10.00
$
G�I?s V1
BUILDING USED AS twl
$10.00
$
G
ESTIMATED COST o l D D. 0 0 PERMIT N0. J 41I
$ 25.00
$
DESCRIPTION OF FURNACE AND OR BURNER
$
No. of Heating Units f Circle One (Steam) (Hot Water) arm r)
Trade Name_F3YU 0U4tZ Size No. 355m&V DLI zDb D
BTU LPO, 000 HP EDR
$
Fuel Mat •&VA4 -80-5 Total Connected Load
State Surcharge
TOTAL FEE,
$ .50 Burner Trade Name Size No.
MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
BTU HP EDR
BLAINE HTG. AIC ElJ T., INC.
13562 CENWALAVE. N.E.
HEATINMP MN 55304'
Signed ~ Tel No. -75-HP2100
Approved By Rough—In Date Final Date
FILL OUT BACKSIDE FOR.STAC VERIFICATION ON
REPLACEMENT FURNACE
CHBINEY AND STACK VERIFICATION
The undersigned, hereby verifies that the existing chimney or stack:
1. Has been ;carefully examined Yes ( No ( )
2. Is free frq_9 rust or deterioration Yes (} No ( )
3. Has no foreign objects lodged within Yes (k No ( )
4. Is securely supported Yes (�) No ( )
5. Meets all current Code requirements for size
and total BTU's connected - Yes 0 No
6 Has total heating BTU's of (2,02 D D
All other BTU's go, D bo
TOTAL BTU's (d o , D D O
7.
Has a liner been provided for water heater
Yes
No ( )
8.
Has combustion air been provided for water heater
Yes
No ( )
Remarks: I r � 1 I � W
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
BLAINE HTQ. &C ELECT., INC.
g��,
AIR HEATING HOUSE HEATING TEST RECORD
DOE
Fy/Q�(j��
AND ELECTRIC.tI C.
i �""" 4
ADDRESS
ad —
APT. _T FLOOR
CITY 41V -1A SUBURB
OCCUPANT
I 4 Ali
OWNER
HEAT LOSS
DATE HTG. INST.
A �a lid+
_/ L
SOLD BY
d, - LCC.
INSTALLED BY r
Electrical Work By L EC
Gas Una By
TYPE OF HEAT
GA FA HW STEAM_ SPACE HTR. _
UNIT HTR._ OTHER
DESIGN
CONVERSION
MAKE
JGAS
r V pct
MAKE OF BURNER
Model
3 •A V O y Z O d
Model
Serial
'35q CA O 3 ?!T ?
Max. BTU Rating
INPUT
9.00 - T'a 0J-7
MAKE OF FURNACE
Model
THERMOSTAT
CONTROLS
�� Haat Plug
Vent Size 7 e-
1
Valve
(t �v S
—fir
KIND OF LINER L
SIZE NONE
Limit
'�f Pis.. _ —
Draft Hood
Regulator . X !�7 _'
Limit Setting
Filters Size x Z S
Number /
Fan Setting
P"
Chimney Location Inside
TSO�.�
Outside
Pilot Type
rir tY
Chimney Construction
Pilot Make
Smoke Bomb
Wtdng
Pilot Model
7
Pilot Timing
�i 6 �.�
Draft
Test Tag —' r
L. W. Cut Off
Door Pressure
Lighting Inst.
Pressure 7j►S
=- . Percent CO, IT v
Date Tested Z
Input CFH
Percent 0 ¢
Company Testing
Stack Temp. /%O Percent CO / �/
Name of Taster
C
Form 235
Building
BUILDING
U.?�.0 FEE SCHEDULE)
Permit No. -,W011 -0a5-1
Inspections
$ 6 b
RESIDENTIAL AP]PLICATION
Plan Review
Received By:
65% of Building Permit Fee
Fire Surcharge
$ f (,
.001 times the total job valuation
Surcharge
763-572-3604
.0005 x Permit Valuation Minimum $.50
CITY OF FRIDLEY
_
$ K , d b
Date R�iHFc(gl
DATE ✓ d Y -MAIL ADDRESS
$
SITE ADDRESS
Curb Cut Escrow
$
THIS APPLICANT IS:
❑ OWNER YCONTRACTOR
$
PROPERTY OWNER/
NAME:
$
TENANT
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
ADDRESS: CITY
STATE P��3
Make checks payable to: City of Fridley Attach Stinulations
PHONE:
CONTRACTOR
NAME:
SUBMIT A COPY OF
STATE LICENSE # EXP DAZE —
YOUR STATE LICENSE
ADDRESS: CITY
TATE P��O`
WITH APPLICATION
�
PHONE �7 FAX INS
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED WINDOWS
❑ BASEMENT FINISH ROOF DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
'
SIZE OF 11V1PROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIOD a
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soft
ADDITIONS.
& PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
WINDOWS/��
2.
Two sets of construction plans
IN EXISTING OPENINGS Yes ❑No LOCATION OF WINDOWS /J U1/
3•
Energy Calculations
OR FOR NEW OPENINGS- ESCRIBE
SIZE OF vim'[
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FF;F:S ARE BAShi) ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USINE 1927
U.?�.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ .,V OCCUPANCY TYPE
Permit Fee
$ 6 b
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ f (,
.001 times the total job valuation
Surcharge
$ 9 Lj
.0005 x Permit Valuation Minimum $.50
License Surcharge
_
$ K , d b
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach Stinulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building 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; that the work will be in accordance with the approved
plan in the case of all work whichn reg ' es r view an approval of plans
SIGNATURE OF APPLICANTSel _ _ IPRINT NAME v b - � - t� (� I � � v5,T I U 'r -015--o
07
Building
$
BUILDING
Permit No.:�
Inspections
$
RESIDENTIAL APPLICATION
Received By:
763-572-3604
$
CITY OF FRIDLEY
lim9cIdIAN ®"06
DATE '- ' d YOUR E-MAIL ADDRESS
$
SITE ADDRESS 7600 Lakeside Rd ne
.0005 x Permit Valuation Minimum $.50
License Surcharge
$_
rj
THIS APPLICANT IS:
O OWNER OCONTRACTOR
$
PROPERTY OWNER/
NAME: Lynne Orrgor
Curb Cut Escrow
ADDRESS: CITY
STATE_ZIP
TENANT
Erosion Control
PHONE:
CONTRACTOR
NAME. Cedar Valley Exteriors
$
STATE LICENSE A 20177285 EXP DATE 3/31/2008
Fee Determined by Engineering
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: 1700 93rd Lane ne CITY 131.1.. STATE mn,Ep155449
WITH APPLICATTON
PHONE 7637552221 FAX 7637555390
$
PROPERTY TYPE
O SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
n BASEMENT FINISH 1090OF ❑ DRAIN TILE
O DECK ESIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: siding and re -roof
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
O HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
_
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
Lst of structural members to be used
List
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDMNS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
O Other
❑ Fascia
and proposed project.
2.
Two sets ofconstruction plaits
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS OYes QNo LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION
Permit Fee
$
2 3-7.
See Back Page for Fee Schedule
.Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
L?a. ( o
001 times the total job valuation
Surcharge
$
/,c 40
.0005 x Permit Valuation Minimum $.50
License Surcharge
$_
rj
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
,j
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = R x $21= $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( }
Total Due
$
f, D. C0
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building 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; that the work will be in accordance with the approved
plan in the case of all work ti es and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME Emily Bernard DATE 9
1 ��