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PRE 2010 DOCSAK V 9 U L. UAt(L6UN U SUN INN. 3200 FRANCE AVE. SO. 3rd. STREET R.E. ' �. I.V. A _ aha. 80.64 75 7.6 if, B5 -e -' vo.a 9100 N : 6 N z.2 '.cp•s- N 505 1A, 8044 �.L '� 212 i N 'jN pR I m N 25 26 4e 74 - 27 _� I 2� ' --90-- —7— -I g ---i�— — O sM h La b _a0 24 40� rj —70— •'s� qo � � 23 22 T -,o ,�4 ?? N Y \p _aam--- 6 o04'^I� LANEI i i� _ 6.2 I 2•e.2 7S v H 50850 6 n4!-� 20 \ s, • 5` 4`• o -e q0 5072 ry�i\�'y9j �1�\. ��' ,\.`: 96{$,• / e .c 15 a, 17 t4 — 7.rz-- i t� ° `y 9+,,6Z i X&�2� —45 i -17/2. -90 Drdina1¢e>° Utitrfies Eat t+n¢ I 1 13 f �- I I —do _ — i L S08 "'I 40.Z v 2 -1 114111-11 hl l_9.j 2.2 5069 508 "' i§D. N 40x ,gl o - ha tP 5017 N ` ( � SO4S N N 5031 $� I CLEARVIEW STREET SUBJECT P City of Fridley 33827 ' AT THE TOP OF THE TWINS BUILDING PERMITf. r NO. v ______ COMMUNITY DEVELOPMENT DIV. 46-�-Wl r PROTECTIVE INSPECTION SEC. NUMBER REV DAVE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F15 8/26/03 JOB ADDRESS 5061 Topper Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 5 1 Carlson's Summit Manor South Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Larry Rozek 5061 Topper Lane NE 763-572-8678 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Topline Construction & Roofing 200 W 98 St, STE 150, Bloomington, MN 55420 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 952-881-2055 20218483 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (17 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $1968 $.98 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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $69.25 F' SC $1.97 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION a PLAN CHECK F TO AFEE Licen S $5 $77.2 0 � / I I N4TUR F CON' C AOA AUTHORIZED AGENT (DATE, 4 IV 6/71 2 41- > EN OP "I/ ' VA IDA lb THIS IS Y UR RMIT I GAVATURE OF OWNER,IF OWNER BUILDER, IDAiEI BLDG/ -NSR - - FIA AUG -18-2003 1222 FROM CITY OF FRIDLEY TO 9528813167 P.01i02 NEW [) CITY OF FRIDLEY Emf Zve 1/Mow ADDN 6431 University Ave NE, Fddiey, MN 55482 (763) 572,4604 E31cig Insp ALTER SINGLE FAMILY AND DUPLEXES R, 1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: _ Legal Description: Owner game & Address: IG0 LEY, Tel. k-7&3 — S %c- -- Ao7 F Contractor. QP U NE NS CP bo\j 4�1 N N uceNsE 0 oda I G E3 Address•_0 lv(�,. s Attach to this application, a Certiflcate of Survey f the lot, with the proposed construction drawn on It to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA. Length ^.�. � Width Height � Sq. Ft. GARAGE AREA: Length Width — Height. Sq. Ft. NECK AREA: Length Width H Ground � _ Sq. Ft, OTHER: 1 k� JSE A -N � 6ftV-A6E Construction Type: �� Robot Estimated Cosi 6 lJ Driveway Curb Cert VVldth Needed: Ft. + 6 Ft = Ft x $ = 6 DATE: G— 03 APPLICANT.- 'Tel. # Call (763) 672-36044or Permit Fees Ef mailing in application. Fax to 763-571-1287 if using credit cant and we wlil call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Ercelon Control Park Fee Sewer Main Charge TOTAL $771.20 CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/1 dth%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt "S" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 YAX: (763) 571-1287 ADDRESS 5061 TOPPER LN NE PIN 263024230099 LEGAL DESC CARLSONS SUMMIT MAN SO ADD LOT 21 BLOCK 5 PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT NO.: 2004-01129 lo DATE ISSUED: 07/19/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL AIR CONDITIONER. # INSPECTIONS 1 APPLICANT HARO ELECTRIC SOLUTIONS 415 DECATUR AVE N GOLDEN VALLEY, MN 55427 C1]"i"RI X1;7 ROZEK LARRY J & MARY G 5061 TOPPER LN NE FRIDLEY, MN 55421 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 1406 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 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp. Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 VAX: (763) 571-1287 ADDRESS : 5061 TOPPER LN NE PIN : 263024230099 LEGAL DESC : CARLSONS SUMMIT MAN SO ADD : LOT 21 BLOCK 5 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT O�20001009 DATE ISSUED: 06/29/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE AND AIR CONDITIONER. # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 APPLICANT DAVES APPLIANCE HEATING & AIR INC 160137 AVE NE COLUMBIA HEIGHTS, MN 55421 (763) 781-6901 OWNER ROZEK LARRY J & MARY G 5061 TOPPER LN NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and 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 the provisions of any other state or local law regulating construction or the performance of construction. Abnlicant ,I Date Bldg HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 60.50 PAID WITH CHECK # 34661 q SRPARNI-E FERM TS KEQU1RP1) FOR WORK OTHERTHAN DESC;RWED ABL)Vh. CITY OF FRIDLEY BUILDING INSPECTION 64431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater 17 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Total $35.00 $ �� U v $10.00 $ $10.00 $ $10.00 $ $25.00 $ FL D Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for CommerciaVIndustrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR JOB ADDRESS 6 0 6 I 1U IPE 0 LAA V Owner Z1A J _P_q Eva Ex' Building Used As ESTIMATED COST PERMIT NO�� / DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel _ Total Connected Load Burner Trade Name BTU HP Size No. EDR 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. $ 0✓P *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE HEATING FAX #�, Date (0 Tel #:z to 3 -7k1-& % 0 ,--D Approved by Rough -in Date Final FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 () 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 () Nox, 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 as per current codes. YeSP4No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input _76,0cxD Fan Assisted or Nat Appliance #2 Type �,xe. BTU Input � T, Fan Assisted or Nat r-3eet Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances I Total Btu Input l t Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height 3 ft Length 3 ft Diameter tr in Type Appliance #2 Vent Connector Height _,3__ft Length ft Diameter ' in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type PLUMBING RESIDENTIAL APPLICATION City of Fridley Pe zzber DATE J-�'" .9 s ®Jg YOUR E-MAIL ADDRESS B� ate R ceived NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE J-�'" .9 s ®Jg YOUR E-MAIL ADDRESS SITE ADDRESS 6 -®Cf THE APPLICANT IS: (CIRCLE ONE) OWNER NAMEP Die PROPERTY OWNERI y-- ADDRESS TENANT CITY STATE PHONE #6% NAME fy) ,1G'L� LICENSE # ADDRESS /� 41 Dk /a 17e7f V -5'0CONTRACTOR CITY STATE-2DZ i ZIP r PHONE # �--�� FAX# PERMIT TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK ❑ NEW REPLACEME/NST DETAILED DESCRIPTION OF WORK ��Gj=Q r f� je& T FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINKILAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER C OET BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY _WATERHTR ($35 FOR IRRIGATION WATER METER OTHER Permit Fee $ MINIMUM: $15.00 or 5% of cost of the improvement -whichever is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ ✓, Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT - NOT VALID UNTIL PROCESSED 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; that the work will be In accordance with the approved plan in the case of all work which requires review and approval ofplans. NAME OF APPLICANT .e2 91-0-40 DATE Please type or print SIGNATURE OF APPLICANT Ai'3�►TE PE�RIf�#'�I}AE R�#��D"'FOR�it�l�'T�s, �LECi�L,�AT�Ii iVIE�E�?CALL•I�` �� s� • r�AS1`ai�(?1'� �� 4qs �� CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT 6431 UNIVESITY AVENUE NE, FRIDLEY, MN 55432 (763)572-3604 10 �7'--1/ Building Permit Fee BUILDING t' See Back Page for Fee Schedule Permit No Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION $ Received By: 763-572-3604 $ { a .0005 x Permit Valuation Minimum $.50 License Surcharge Q4 $5.00 (State Licensed Residential Contractors) SAC Charge CITY OF FRIDLEY $2000 per SAC Unit (Plans to MWCC for determination) D 763-502-4977 FAX ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee EFFECTIVE 1-1-09 Fee Determined by Engineering Sewer Main Charge DATE 7:713X �)01 YOUR E-MAIL ADDRESS tdvtrv[ a ft d pl I� ��I I SLP _C'o n-1 SITE ADDRESS c�� 10 V I J 1. — A E �� THIS APPLICANT IS: ❑ OWNER kCCONTRACTOR PROPERTY OWNER/ NAME: ADDRESS:"70LG CITY-1idk l STATE ZIP6�V�t TENANT PHONE: I &S 2`z ° X67 8 CONTRACTOR NAME: (elf (Am L -P— el E AA STATE LICENSE #I 7 EXP DATE / (� SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: q o S Ii1/ cr P eZ-7 ©CITY STATEU_.ULIP�/ INSURANCE PHONE ® 9 FAX ' PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION 0 GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION WMAINI'ENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: V Q as— ky, A SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, IDING ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS Wes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF � �`l':l L — , OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ID hi NUMBER OF WINDOWS f� ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 14 L41 OCCUPANCY TYPE Permit Fee $ t' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ ,N .001 times the total job valuation Surcharge $ { a .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 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: C!ty of FridLey Attact 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 on site; that the work will be in accordance with the approved plan in the case of all work whicgh, ,requires review and approval of plans. / SIGNATURE OF APPLICANT �%i�t�JUh J r O r/'%� PRIN NAME Gf /i dl ®1 �i t/e/rS�� DATE 7/4®