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PRE 2010 DOCS&a&--23 City of Fridley, Blinn. 11611 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: _ August -22,19 72 Owner: _Landyest Development GQrporation Builder Laudvest Construction Company -_ Address _2828 -m 5th Avenue South 1Kpls Address Same LOCATION OF BUILDING No. __1.3.09______. StreetTT�r be-r.-Ri ,� Part of Lot 7�lie N. 824.7 feet of the W of the N of the NF of Section 13 t Block __ ------ _ ____ Addition or Sub- ivWon Comer Lot _.___ _ ___ Inside Lot _ _ Setback Sideyard Sewer Elevation _ _____ _ — Foundation Elevation __...._ 419yyj DESCRIPTION OF BUILDING To be Used as: Townh o„ s e 11h i t — Front 49-1 Depth . 29'74;! " Height 20' _ Sq. Ft. x.918 Cu. Ft. 1$sb 48 Front . _ _ Depth Height .— Sq. Ft. Cu. Ft. Type of Construction Wood Frame Est. Cost 22 101 To be Completed 3 months Stipulation: Owner agrees to negotiate an agreement whereby he will be able to connect to existing sanitary sewer, water and storm sewer now in place along the east side of the project or if an agreement is not possible, the owner understands that he will have to connect to the City sanitary sewer and water in 69th Avenue and provide his own approved storm sewer outfall to Rice Creek. All utility plans must be approved and proper performance bonds filed prior to there construction. Owner agrees to install a City approved curb along 69th Avenue or allow the City to install said curb in 1973 and assess the cost against the property. In consideration of the issuance to me of a permit to construgi Abe building described above X to do the proposed work in accordance with the description aboveset and in compliance with all pro ons. of Ordinances of the city of Fridley. 11.50 State SurcharRe In consideration of the payment of a fee of $ , permit is hereby granted to T.andvPst- (:nns _ Co, to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agenis, employees and workmen, in all Work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings vyithin the city limits and this permit may be revoked a t upon violatio f of the provisions of said ordinances. Building inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. f APPLICATION FOR RESIDENTIAL, ALTERATION' OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA BUILDER OWNBRIS NAME: LA�� (��S'-- f�c,/, �U/��• : C' ADDRESS: ADDRESS • NO• /��°' STREET : or • 4,17'r D F ADDITION:_ �T BLOCK: SIDEYARD s.,,,, --..— CORNER LOT: INSIDE LOT: SETBACK: f Surve of Lot and Proposed APPlicant iocationto this dram on tho Certificates e Certificates. building DESCRIPTION OF BUILDING To Be Used AS: � r/ � Height: rout: �? C� �1� ° Depth: Square Feet : 2/ Cubic Feet: • Height: Front: Depth: Cubic Feet: Square Feet; Estimated Type of Construction: Ea Coat• $ To Be Completed: ed hereby makes apP licativn for a Permit for the work, he -veto The undersign s and hereby agreeing to do all work in sttac�A�°o f Building ith t',iie City � specified, g of the Dep application FFidle7 Ordinances and rulings declax es that all the facts and representations stated in this are true and correct. sIGNATURE: PAs: (See Reverse Side For Additional Information.) City of Fridley Application for Plumbing and Cas Ruing Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number. Kind and Location of Fixtures eY RATE TOTAL Number Fixtures ...................... aNO. 1 x re.� $ 1 Ra Z § w S �j < 3 �U' °d (�9 §(�4 ? O • F • N WATER HTR. GAS ELEC. Base x 3.25 $ Water Heater (Up to y` ,pooBTU) 1 ...... x siog $— 3, a a New Ground Run Old Bldg . ............ x 3.25 $ 1st ` I • 0 0 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $—a—n)- Additional Additional Fixtures .................... x s& 2nd /99;eoo Al I I I Gas Range to 00@wW8 BTU .............. x ' $ 3rd 4th • Future Connection Openings e New Fixture, Old Openings I Connected with Sewer Cesspool � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: RATE TOTAL Number Fixtures ...................... aNO. 1 x $*6e $ 1 -1-do Future Fixture Opening ................ x hft $ /• S� New Fixture Old Opening .............. x t;ft $ / • Sd Catch Basin .... ..................... x 3.25 $ Water Heater (Up to y` ,pooBTU) 1 ...... x siog $— 3, a a New Ground Run Old Bldg . ............ x 3.25 $ ,�Q't' i Zl/e 7&V /Juctu— . • 0 0 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $—a—n)- Additional Additional Fixtures .................... x s& $ /99;eoo Gas Range to 00@wW8 BTU .............. x ' $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ �3. 5 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all, work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. C--\ Fridley, Minn- ` 1 —1 G - 19� Owner Kind of Building Used as To be completed about Estimated Cost, $ Old ew Building Permit ROUGH 1,� FINAL [l i V Applicatia� for Pourer Proofs and Hsa ft Cooling. Yentilo lon. Re -U and Air Conditioning Syderns and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ................ .. $10.00 $ Replacement of Furnace .... .. ..... 6.00 $ Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3.00 $— MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ........ ..$10.00 $ / each add. 60,000 BTU .................... .. 3.W i Replacement of Furnace . .. .... 6.00 $ Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $- Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam R.nnEach add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ _ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 189,000 BTU) 5.04 over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ zoo $ Additional Fixtures x .75 $ Gas Range to 199,400 :$ 5.00 $ AIR CONDITIONING U l) FAN HEATING SYSTEM Sae FM Schedule YENYILATING SYSTEM I $ ALTERATIONS & REPAIRS TOTAL PEE ROUaH (SURCHARGE Dept. of Bldgs. Phone 860-3450 City of Fridley: v The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and carreaL Yidley, Minn_ „ Z.) 2 Owner Kind of Building Used as�L—�-�� To be completed about _� l -3 Estimated Cost, $---1-2 _ Permit No. Permit No. - '..�y DATION OF WORK HEATING or PO team, Hot Water, �IIyLNo_ Trade Name Size Nb --1�� u Capacity U Sq. Ft. E.D.R BTU gp. Total Connected Load Kind of Fue BURNER — Trade Na* Size No Capaci3q. FL E.D R BTU Bw. 3 7BY Business Phone (REMARKS -OVER) SUBJECT PERMIT NO. City of Fridley �40 AT THE TOP OF THE TWINS BUILDING PERMIT i � R�toq COMMUNITY DEVELOPMENT DIV. r L PROTECTIVE INSPECTION SEC. i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/6/90 JOB ADDRESS 150.9 North Ti'mb,er Ridge N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED N. 824.7 h of Wk of of NES of SectionJ3 SHEET DESCR. 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Four Season Construction Co. P.O. Box 32033, Fridley, MN 55432 786--4039 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Townhouse 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION LR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Repair front steps/deck (A' x 6" 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 60 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. I 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 $250 $150 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- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VAI1aATED THIS IS YOUR PERMIT SiGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSP FIAT NEW [ ] Effective 1/1/90 ADCN [ ] R-1 AND R-2 ALTER I 50Y Building Permit Application Construction(" Address : Legal Description: 5 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESQtIPrION OF MWYEMENr LIVMG AREA: length Width. Height Sq. Ft. GARAGE AREA: length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. oma:Pr �a 1'0 Corner lot [ ] Inside Tot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ 5tp °m Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: 9.O APPLICANT': Tel. # Permit Fee $ O U State Surcharge $ d SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ STIPUTATIONS: CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT of Fridley 877 06 AT THE TOP OF THE TWINS BUILDING PERMIT (f.2 rpCity `FtECEPT NO. 1 • COMMUNITY DEVELOPMENT DIV. __ r V ------ PROTECTIVE INSPECTION SEC. NUMBER REv OATS PAGE OF APPROVED BY OIL�'•'1 CITY HALL fRIOLEY 55432 �"" �'' 612-571-3450 910 -FIS 12/3/98 JOB ADDRESS 1501,1505 1509 1513,1517 1521 1525 1529 North Timber Ride N.E. 1 LEGAL LOT NO.-OftTRACTOR ADDITION SEE ATTACHED DESCR. Part, of Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO A-1 Roofing & Const. 3020 -5919 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 1 8 USE Of BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION x@ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof town homes 114 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 r WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $9769 S4.88 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS Of A Y OTHER STATE OR LOCAL LAW REGULATING CON- 9.77 STRUCTION OR TH PERFORMANCE OF CONSTRUCTION 162.25 Fire SC PLAN CHECK FEE TOTAL FEE 2 - , `9 176.90 SIGNATURE OF CONTRACTORORAUTWORIZEDAGENT IDATEI WHEN PROPERLY LIDAT D THIS ISYOU PERMIT 3/y/yaJ/ S.GNATURE OF OWNERJF OWNER BUILOERI IDATEI Bl INSP TIi TE NEW [ j Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 D Oq �� BUILDING PERMIT APPLICATION _ �` 0 kc5o ConstructionAddress: :-AL Q ' i 01 Q_ Vo`j r 76 +`Ic,� l SZA , t S Z`::� , Legal Description: Owner Name &Address: Contractor: Address: ; n, LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # MN LICENSE # / Q Tel. # 5Q 6�- S� I Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height I,ength Width Hgt/Ground I ILA I Sq. Ft. Sq. Ft. Sq. Ft. cp Construction Type: p , �` Estimated Cost: $ q11 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: t'Z - 3 -qI APPLICANT: Tel. # z;q 6, Permit Fee Fire Surcharge State Surcharge SAC Charge., License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main' Charge TOTAL . STIPULATIONS: CITY USE ONLY $ g.2, ?S' Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ a $.50/$1,000 Valuation $ $1000 per SAC Unit $ `— $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review a l'7�.9d Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 nA l 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO RE INSTAL I Fn ON FACH FI nnR Effective On Jan 1, 2000 /50� /V Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE SIGNED BY Approved By(/ \ Rough -In Date ............ - ��1 ��1I111-II•l�J• TEL NO. - L Final Date kff :RM1T IS 20.00 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE iF • PLUMBING FIXTURE RATES: NO. F � .F F •' The undersigned hereby makes application for a permit for the work herein ® F Lam® specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the P,uilding Division, and hereby declares that all the facts Blow Off Basin $ 7.00 .and representations stated in this application are true and correct. Catch Basin $ 7.00 PETTERSEN, COLLEN Rain Water Leader $ 7.00 1509 TIMBER RIDGE NORTH 20 Sump/Receiving Tank $ 7.00 FRIDLEY, MN 55432 — (763) 780-0320 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 Water Heater - Gases" _� $10.00 Building Used As �;E-61 DIE�AU Cet_, Gas Range"" Gas Dryer" $10.00 $10.00 o,_ C� Estimated Cost PERMIT NO. C� Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY ©1Z�L�j�/Z„tJ1' ?1Wj C� Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE SIGNED BY Approved By(/ \ Rough -In Date ............ - ��1 ��1I111-II•l�J• TEL NO. - L Final Date kff :RM1T IS 20.00 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE ���9 rU PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS '54NI- I -s dta OI✓ 1'2_.. New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the P,uilding Division, and hereby declares that all the facts Blow Off Basin $ 7.00 .and representations stated in this application are true and correct. Catch Basin $ 7.00 PETTERSEN, COLLEN Rain Water Leader $ 7.00 1509 TIMBER RIDGE NORTH 20 Sump/Receiving Tank $ 7.00 FRIDLEY, MN 55432 — (763) 780-0320 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 Water Heater - Gases" _� $10.00 Building Used As �;E-61 DIE�AU Cet_, Gas Range"" Gas Dryer" $10.00 $10.00 o,_ C� Estimated Cost PERMIT NO. C� Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY ©1Z�L�j�/Z„tJ1' ?1Wj C� Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE SIGNED BY Approved By(/ \ Rough -In Date ............ - ��1 ��1I111-II•l�J• TEL NO. - L Final Date kff :RM1T IS 20.00 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( ).No( ) The venting:,system is. plastic/PVC and meets all current codes and manufacturer specifications .including sizing, length, number of elbows and termination. Yes O No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance,has been. -removed from the common vent and vented separately asper current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat' Appliance#2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : GiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 14, 2003 Mr. Collen Pettersen 1509 North Timber Ridge NE Fridley, MN 55432 Re: Final Inspection at 1509 North Timber Ridge NE Contractor: Norblom Plumbing Co Dear Mr. Pettersen: A plumbing permit was issued on July 24, 2002 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1509 N TIMBER RIDGE NE PIN : 133024110097 LEGAL DESC UNAVAILABLE LOT BLOCK PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE DECK PERM NO.: 2004-0113 DATE ISSUED: 07/22/2004 VALUATION : $ 2,335.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. REPLACE A 24'X 7'6" DECK. STATE LICENSED CONTRACTOR 1 APPLICANT GASSEN COMPANY INC 7275 BUSH LAKE RD EDINA, MN 55439- (952)522-5575 BLOOM COLLEEN R 1409 OSBORNE RD NE SPRING LAKE PARK, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel t provisions of any other state or local law regul mg co ction t eriormance of cons ctio7. Annlican _ Date V'73/ BUILDING PERMIT FEE 83.25 FIRE SURCHARGE 2.34 STATE SURCHARGE, VALUE 1.17 LICENSE SURCHARGE 5.00 TOTAL 91.76 PAID WITH CHECK # 24678 SEPARATE PERMITS REbUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY eq1'? Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 5543P (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION ✓J,: Construction Address: _ r Legal Description:'e� Owner Name & Address: Tel. # A` Contractor. 7A �- MN LICENSE# �A�a.�ti� � Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT �.. ngth Width_ Height Sq. Ft 96 GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: / � e Construction Type: / --k f Estimated Cost: $ Driveway Curb Cut Width Needed: 6 Ft = Ft x $ _ $ DATE: U / 3 '-A APPLIC Tel.# Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review E15 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ TOTAL $ /' STIPULATIONS: Building BUILDING Permit No.: - 02.1 Inspections RESIDENTIAL APPLICATION Receiv 763-572-3604 • CITY OF FRIDLEY Date RJR . DATE C3 D7 YOUR E-MAIL ADDRESS /7GeYGt r✓t'-�< SITE ADDRESS SO , 5�) .001 times the total job valuation THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: tip u G Del ADDRESS: /,moi' / iTZ CTTY-�/ STATE ZIP SiZ TENANT SAC Charge PHONE: CONTRACTOR NAME: 57ir-,,�r6e", STATE LICENSE # a 2 417V EXPDATE 3�3 /l!U e ft + 6 ft = ft x $21= $ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: —'c�? �$ ,O6-tsh Lu. IOORd CITY-&diria STATfi/ •3� I APPLICATION PHONE FAX ?57,R - ZZ -.Roo q PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE Sewer Main Charge ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERNUT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS $ ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK ❑ SIDING ❑ OTHER THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED ❑ SWIMMING POOL TYPE OF WORK: ❑ NEw ❑ ADDMON ❑ MAINTENANCEMEPAIR ❑ REMODELING DESCRIBE WORK BEING DONELikel(C C/OSq. SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of stnwtinal members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and propos pmjec 2. Two sets of construction plans WINDOWSnergy 3 IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENING&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 N ERIALS: (USING THE 1997 V B.0 FEE SCHEDULE) 5) TOTAL JOB VALUATION $ � OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ — 65% of Building Permit Fee Fire Surcharge $ , 5�) .001 times the total job valuation Surcharge $ ,,M .0005 x Permit Valuation Minimum $.50 License Surcharge $ , T, 610 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ 3,R -�s Make checks pUable to: C of Fridley AttachSti ulations 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 whi�S,sview and approval of plans. , SIGNATURE OF APPLICANT jj:::, 00%